Decision Making between Patients with Chronic Kidney Disease and Nurses about Managing Pain

2.50
Hdl Handle:
http://hdl.handle.net/10755/148728
Type:
Presentation
Title:
Decision Making between Patients with Chronic Kidney Disease and Nurses about Managing Pain
Abstract:
Decision Making between Patients with Chronic Kidney Disease and Nurses about Managing Pain
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Manias, Elizabeth, RN, MPharm, PhD
P.I. Institution Name:The University of Melbourne
Title:Associate Professor
Co-Authors:Allison Williams, BNurs, PhD
[Clinical session research presentation] OBJECTIVES: To examine how decisions were made between patients with chronic kidney disease and nurses about managing pain, and how these decisions affected the types of analgesic and adjuvant therapies administered. METHODS: A naturalistic, observational design was used in all five adult renal units in Victoria, Australia. Observations of 2-4 hours were undertaken at random times on a nurse-patient dyad. Individual interviews were completed after each observation to obtain further information about pain decision-making. All observations and interviews were audio-taped and transcribed verbatim. Three decision styles of passive, collaborative and active decision styles comprised the overarching thematic framework. Transcripts were subjected to thematic analysis and descriptive statistical analysis was undertaken in relation to analgesic and adjuvant medications administered during observations. RESULTS: Data collection was carried out with 14 nurses and 53 patients, and 103 pain activities occurred during observations. Of the 103 pain activities observed, 78 involved a passive decision style between the nurse and patient, 19 involved a collaborative decision style, and 6 comprised an active decision style. Passive decision-making occurred because of language barriers, alterations of patient affect, physical isolation of patients, and patients' desire not to be involved. The majority of routine analgesic and adjuvant medications administered involved the use of a passive decision style. There were more situations that led to administration of a pro re nata opioid medication using a collaborative or active decision style compared to when a passive style was used. Most notably, 10.5% of passive style decisions observed resulted in no administration of an analgesic or adjuvant medication. All collaborative and active decision styles observed resulted in administration of some form of analgesic or adjuvant. CONCLUSIONS: Patients with chronic kidney disease should be encouraged to participate in pain management decisions to optimise their chances of receiving appropriate and adequate analgesic relief.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDecision Making between Patients with Chronic Kidney Disease and Nurses about Managing Painen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148728-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Decision Making between Patients with Chronic Kidney Disease and Nurses about Managing Pain</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Manias, Elizabeth, RN, MPharm, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The University of Melbourne</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">emanias@unimelb.edu.au</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Allison Williams, BNurs, PhD</td></tr><tr><td colspan="2" class="item-abstract">[Clinical session research presentation] OBJECTIVES: To examine how decisions were made between patients with chronic kidney disease and nurses about managing pain, and how these decisions affected the types of analgesic and adjuvant therapies administered. METHODS: A naturalistic, observational design was used in all five adult renal units in Victoria, Australia. Observations of 2-4 hours were undertaken at random times on a nurse-patient dyad. Individual interviews were completed after each observation to obtain further information about pain decision-making. All observations and interviews were audio-taped and transcribed verbatim. Three decision styles of passive, collaborative and active decision styles comprised the overarching thematic framework. Transcripts were subjected to thematic analysis and descriptive statistical analysis was undertaken in relation to analgesic and adjuvant medications administered during observations. RESULTS: Data collection was carried out with 14 nurses and 53 patients, and 103 pain activities occurred during observations. Of the 103 pain activities observed, 78 involved a passive decision style between the nurse and patient, 19 involved a collaborative decision style, and 6 comprised an active decision style. Passive decision-making occurred because of language barriers, alterations of patient affect, physical isolation of patients, and patients' desire not to be involved. The majority of routine analgesic and adjuvant medications administered involved the use of a passive decision style. There were more situations that led to administration of a pro re nata opioid medication using a collaborative or active decision style compared to when a passive style was used. Most notably, 10.5% of passive style decisions observed resulted in no administration of an analgesic or adjuvant medication. All collaborative and active decision styles observed resulted in administration of some form of analgesic or adjuvant. CONCLUSIONS: Patients with chronic kidney disease should be encouraged to participate in pain management decisions to optimise their chances of receiving appropriate and adequate analgesic relief.</td></tr></table>en_GB
dc.date.available2011-10-26T09:49:41Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:49:41Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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