Factors Influencing Patients’ Experiences of Pain Management in the Emergency Department

Shoqirat, Noordeen; Mahasneh, Deema; Khresheh, Reham; Singh, Charleen; Al-Momani, Muwafaq; Mahmoud, Abeer A.

doi:10.1177/0844562119851332

Cited by 4 publications

(13 citation statements)

References 27 publications

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“…Yet, there was also some evidence of discussion, suggesting patient involvement and partnership in their ED care. Patient experiences were optimised when care providers delivered the right amount of information in an understandable way, [35-37, 47, 50-55, 57, 58, 60-62, 65, 67, 69, 70, 75-78] when they communicated with empathy and compassion, [47,49,56,68,69,79] when patients were informed about care processes and treatment options, [46,49,52,56,62,65,68,69,72,80] updated throughout their ED journey, [39,66,69] were able to discuss matters that were important to them, [35-37, 47, 52, 54, 67, 68] and were encouraged to talk and ask questions. [50,65,69] Generally, patients who felt informed by their care providers, reported better experiences characterised by feeling reassured, safe and confident.…”

Section: Communicating With Patients To Keep Them Informedmentioning

confidence: 99%

“…Patients valued emotional aspects of care as it made them feel important and understood by their care providers,[40,48,49,65,81] such as when empathy and genuine concern was demonstrated. [38-40, 43, 45, 47, 49, 56, 60, 65, 81, 82, 86] This occurred when care providers used reassuring words, touch and body language,[40,41,47,49,68,79] when they informed patients' family or friends that they were in the ED,[48,49,61,68,75,82] and by ensuring patients did not feel lonely [37,40,48,49,64,68,[80][81][82]. Receiving an inadequate level of emotional support[40, 43,44,49,65,72,73] or follow-up responsibility for and control of patients' care,[39,41,49,61,88] were efficient and responsive,[37,40,41,45,48,49,56,66,…”

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confidence: 99%

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A systematic mixed studies review of patient experiences in the ED

et al. 2021

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BackgroundUnderstanding patient experiences is crucial to evaluating care quality in EDs. However, while previous reviews describe the determinants of ED patient experiences (ie, factors that influence patient experiences), few have described actual patient experiences. The aim of this systematic mixed studies review was to describe patient experiences in the ED from the patient’s perspective.MethodsEmbase, Medline, ProQuest Nursing and Allied Health, the Cumulative Index to Nursing and Allied Health Literature and the Cochrane Library electronic databases were searched, with publication dates limited between 1 January 2001 and 16 September 2019. Studies describing adult patient experiences in the ED were included. Studies describing patient satisfaction, proxy-reported experiences or child/adolescent experiences were excluded. The quality of included studies was appraised using the Mixed Methods Appraisal Tool (2018 version). An inductive, convergent qualitative synthesis of the extracted data was undertaken following Thomas and Harden’s (2008) methods.ResultsFifty-four studies were included and of those, only five (9%) studies included a standardised definition of patient experience. Two inter-related themes emerged: Relationships between ED patients and care providers; and Spending time in the ED environment. The first theme included four subthemes regarding respect, communication, caring behaviours and optimising patient confidence. A key finding related to the potential for power imbalances between patients and their care providers. The second theme included two subthemes regarding physical aspects of the ED environment and patients’ waiting experience. Patients attributed more importance to the waiting experience itself rather than the duration they had to wait.ConclusionsPatients in the ED have unique and complex experiences. Greater research is needed to understand the relational and environmental factors that contribute to power imbalances between patients and care providers, how to support more positive waiting experiences, and developing a standardised definition of patient experience in the ED.PROSPERO registration numberCRD42020150154.

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Section: Communicating With Patients To Keep Them Informedmentioning

confidence: 99%

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confidence: 99%

A systematic mixed studies review of patient experiences in the ED

et al. 2021

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“…The evidence from the literature confirmed that the trusting relationship was essential for pain management, highlighted as a crucial component in the model for PCPM. This relationship was described as based on mutual understanding within the care team, that is providers, patient and relatives, regarding the cause, experience and management of pain (Aziato & Adejumo, 2015;Brown & McCormack, 2006;Dihle et al, 2006;Idvall et al, 2008;Lauzon Clabo, 2008;Rejeh et al, 2008;Shoqirat, 2014Shoqirat, , 2015Shoqirat et al, 2019Shoqirat et al, , 2020Smith et al, 2006). This was achieved when the nurses truly listened to the patient and trusted the experience (Dihle et al, 2006;Idvall et al, 2008;Rejeh et al, 2008;Shoqirat, 2014).…”

Section: Establish and Maintain A Trusting Relationship Including The...mentioning

confidence: 99%

“…'I was in pain, but her (the nurse) assuring body language made me feel less stressed' (Shoqirat et al, 2020). This was also underlined by a nurse in a study from Iran: 'I try to have a good relationship with them (patient) about pain and suffer, listen to them carefully, and do TA B L E 1 Example from the coding scheme for the individual studies included in the systematic review.…”

Section: Establish and Maintain A Trusting Relationship Including The...mentioning

confidence: 99%

Testing a model for person‐centred pain management: A systematic review and synthesis guided by the Fundamentals of Care framework

Avallin

Athlin

Kitson

et al. 2023

Journal of Clinical Nursing

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AimsTo test a model for person‐centred pain management using qualitative evidence in the literature and refine it based on the results.DesignA qualitative systematic review with thematic synthesis using the Fundamentals of Care framework.Methods and Data SourcesA 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 individual studies. Thematic analysis and the GRADE‐CERQual approach were used in the synthesis including the assessment of confidence in the evidence.ResultsThe 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.ConclusionsThe 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.Implications for the Profession and/or Patient CareThe model links the knowledge of pain management elements from individual 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.Patient or Public ContributionNo patient or public contribution.ImpactWhat 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.Reporting MethodRelevant EQUATOR guidelines were used to report the study: The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Statement.

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“…Some studies reveal that satisfaction with postoperative pain treatment is less associated with patients’ actual pain experience, but rather with appropriateness of care and involvement in pain management [ 6 ]. The review of abroad literatures reported that conflicting arguments regarding patient satisfaction with pain management in contradict ways [ [7] , [8] , [9] ]. In spite of such studies, there is still limited clinical information available on the association of patient characteristics, patient perception of pain experience, and patient satisfaction with postoperative pain management [ 10 ].…”

Section: Introductionmentioning

confidence: 99%