ORCID Profile
0000-0001-9222-7736
Current Organisation
Uppsala University Hospital
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Publisher: Wiley
Date: 20-05-2023
DOI: 10.1111/JAN.15697
Abstract: To develop and test a questionnaire using the Fundamentals of Care framework to measure person‐centred pain management. Cross‐sectional exploratory descriptive design. Development in three phases: (a) literature search for questionnaires measuring person‐centred pain management, (b) seven‐step process developing items using thematic analysis, (c) initial feasibility and validity testing. Theoretical and empirical evidence was used, including the ‘Strategic and Clinical Quality Indicators in Postoperative Pain management’ questionnaire, the Fundamentals of Care framework and person‐centredness principles. Theoretical experts ( n = 2) reviewed the questionnaire, further evaluated by providers ( n = 5) and patients ( n = 5) using a think‐aloud process, and by additional questions in the questionnaire answered by n = 100 patients. The questionnaire was tested February to March 2021, at four surgical wards in a university hospital. The evaluation showed initial support for feasibility and validity, and the questionnaire was found to represent and be sensitive to capture the patients' experiences of person‐centred pain management and being easy to answer. The 100 patients with acute abdominal pain who answered the questionnaire (aged 18–89 years, 46 women and 54 men), identified missing elements of fundamental care in their pain management, indicating that the questionnaire is sensitive to capture specific areas for improvement. This first attempt at transforming the essential components of person‐centred pain management into measurable items in a questionnaire was found promising. The questionnaire is suggested to be further tested for psychometric properties and patient benefit to provide clinical guidance in acute surgical care to meet the patient care need of pain management. The developed questionnaire addresses the need of nurses and nursing leaders to evaluate the delivery of person‐centred pain management in acute surgical care, to relieve the patient from pain. Patients and providers were involved in testing the questionnaire.
Publisher: Wiley
Date: 27-05-2023
DOI: 10.1111/JOCN.16770
Abstract: To test a model for person‐centred pain management using qualitative evidence in the literature and refine it based on the results. A qualitative systematic review with thematic synthesis using the Fundamentals of Care framework. A literature search in February 2021 in six scientific databases: CINAHL, PsycInfo, Pubmed, Scopus, Social Science Premium Collection and Web of Science, reported using ENTREQ and PRISMA. Quality assessment was performed for the in idual studies. Thematic analysis and the GRADE‐CERQual approach were used in the synthesis including the assessment of confidence in the evidence. The model was tested against the evidence in 15 studies appraised with moderate or high quality and found represented in the literature but needed to be expanded. A refined model with a moderate/high confidence level of evidence presents elements to be used in a holistic care process The nurse is guided to establish a trusting relationship with the patient and enable communication to identify and meet pain management needs using pharmacological and non‐pharmacological management. Nurse leaders are guided to support this process by providing the right contextual conditions. The strengths of the confidence level in the refined model, and that it is represented from the nurse and patient perspectives in nursing research across countries and cultures, support our recommendation for empirical evaluation. The model links the knowledge of pain management elements from in idual studies together into actions to be performed in clinical practice. It also outlines the organizational support needed to make this happen. Nurses and nursing leaders are suggested to test the model to implement person‐centred pain management in clinical practice. No patient or public contribution. What Problem Did the Study Address? There is a need to transfer available evidence of person‐centred pain management into practice to relieve the patient from pain. What Were the Main Findings? Person‐centred pain management is of high priority for patients and nurses around the world and can be performed in a holistic care process including patient–nurse trust and communication, supported by contextual conditions to deliver timely pharmacological and non‐pharmacological pain management addressing the patient's physical, psychosocial and relational care needs. Where and on Whom will the Research Have an Impact? The model is to be tested and evaluated in clinical practice to guide the providers to relieve the patient from pain. Relevant EQUATOR guidelines were used to report the study: The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Statement.
Publisher: Wiley
Date: 27-07-2018
DOI: 10.1111/JAN.13739
Abstract: To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contributes to or detract from successful pain management for the patient with acute abdominal pain (AAP) across the acute care pathway. Although pain management is a recognized human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and in idual practitioners' performance. Focused ethnography, applying the Developmental Research Sequence and the Fundamentals of Care framework. Participant observation and informal interviews (92 hr) were performed at one emergency department (ED) and two surgical wards at a University Hospital during April-November 2015. Data include 261 interactions between patients, aged ≥18 years seeking care for AAP at the ED and admitted to a surgical ward (N = 31 aged 20-90 years 14 men, 17 women 9 with communicative disabilities) and healthcare practitioners (N = 198). The observations revealed an organizational culture with considerable impact on how well pain was managed. Well-managed pain presupposed the patient and practitioners to connect in a holistic pain management including a trustful relationship, communication to share knowledge and in idualized analgesics. Person-centred pain management requires an organization where patients and practitioners share their knowledge of pain and pain management as true partners. Leaders and practitioners should make small behavioural changes to enable the crucial positive experience of pain management.
No related grants have been discovered for Therese Avallin.