|Appears in Collections:||Faculty of Health Sciences and Sport Journal Articles|
|Peer Review Status:||Refereed|
|Title:||Routines and rituals: a grounded theory of the pain management of drug users in acute care settings|
acute care settings
|Citation:||McCreaddie M, Lyons I, Watt D, Ewing E, Croft J, Smith M & Tocher J (2010) Routines and rituals: a grounded theory of the pain management of drug users in acute care settings, Journal of Clinical Nursing, 19 (19 - 20), pp. 2730-2740.|
|Abstract:||Aim. This study reviewed the perceptions and strategies of drug users and nurses with regard to pain management in acute care settings. Background. Drug users present unique challenges in acute care settings with pain management noted to be at best suboptimal, at worst non-existent. Little is known about why and specifically how therapeutic effectiveness is compromised. 4 Design. Method. A constructivist grounded theory approach incorporating a constant comparative method of data collection and analysis was applied. The data corpus comprised interviews with drug users (n = 11) and five focus groups (n = 22) of nurses and recovering drug users. Results. Moral relativism as the core category both represents the phenomenon and explains the basic social process. Nurses and drug users struggle with moral relativism when addressing the issue of pain management in the acute care setting. Drug users lay claim to expectations of compassionate care and moralise via narration. Paradoxically, nurses report that the caring ideal and mutuality of caring are diminished. Drug users’ individual sensitivities, anxieties and felt stigma in conjunction with opioid-induced hyperalgesia complicate the processes. Nurses’ and hospitals’ organisational routines challenge drug user rituals and vice versa leading both protagonists to become disaffected. Consequently, key clinical issues such as preventing withdrawal and managing pain are left unaddressed and therapeutic effectiveness is compromised. Conclusion. This study provides a robust account of nurses’ and drug users’ struggle with pain management in the acute care setting. Quick technological fixes such as urine screens, checklists or the transient effects of (cognitive-based) education (or training) are not the answer. This study highlights the need for nurses to meaningfully engage with this perceptibly ‘difficult’ group of patients. Relevance to clinical practice. The key aspects likely to contribute to problematic interactions with this patient cohort are outlined so that they can be prevented and, or addressed.|
|Rights:||The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author; you can only request a copy if you wish to use this work for your own research or private study.|
|Affiliation:||HS Research - Stirling|
University College Dublin (UCD)
Western General Hospital
St John's Hospital, Livingston
Royal Infirmary of Edinburgh
University of Edinburgh
University of Edinburgh
|McCreaddie et al 2010.pdf||111.98 kB||Adobe PDF||Under Embargo until 31/12/2999 Request a copy|
|jocn_3284.pdf||470.1 kB||Adobe PDF||Under Embargo until 31/12/2999 Request a copy|
Note: If any of the files in this item are currently embargoed, you can request a copy directly from the author by clicking the padlock icon above. However, this facility is dependant on the depositor still being contactable at their original email address.
This item is protected by original copyright
Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.
If you believe that any material held in STORRE infringes copyright, please contact email@example.com providing details and we will remove the Work from public display in STORRE and investigate your claim.