Abstract
Background: Nurses are the first to encounter a patient in pain. A nurse’s knowledge of pain management in patients receiving hemodialysis allows them to provide optimal pain management. Objective: The aim of this qualitative study is to explore the experiences, perceptions, and beliefs of nurses in the hemodialysis unit regarding pain management practices and identify nurses’ educational needs to improve nurses’ pain management in practice. Methods: A purposive sample of 16 nurses working in four out-patient hemodialysis units in Amman, Jordan, was recruited. The data was collected through semi-structured interviews. The interviews were audio-recorded and transcribed manually for the following content analysis scheme. Results: The five themes and fifteen sub-categories were extracted from the nurses' experiences regarding nurses’ knowledge of pain management. The five categories that emerged from the analysis were (1) nurses’ knowledge of pain management, (2) nurses’ self-learning pain management strategy, (3) nurses’ approach to pain management, (4) patients continue to suffer unrelieved pain, (5) nurses’ educational needs. Relevance to Clinical Practice: This data will prove to be useful for evaluating pain management practices for patients on maintenance hemodialysis, developing educational programs for nurses working in hemodialysis units with a focus on improving pain management, and providing knowledge regarding these issues. More research is recommended among nurses for understanding pain knowledge in patients on maintenance hemodialysis. Conclusion: This qualitative analysis indicated that nurses are not fully aware of various strategies for pain management. Nurses’ perception of pain and pain management was found to be limited to pain assessment and some non-pharmacological management strategies. It has been revealed that nurses require educational interventions regarding pain management in practice.
Highlights
Patients with End-Stage Renal Disease (ESRD) who tend to undergo Maintenance Hemodialysis (MHD) routinely report pain [1]
Relevance to Clinical Practice: This data will prove to be useful for evaluating pain management practices for patients on maintenance hemodialysis, developing educational programs for nurses working in hemodialysis units with a focus on improving pain management, and providing knowledge regarding these issues
More research is recommended among nurses for understanding pain knowledge in patients on maintenance hemodialysis
Summary
Patients with End-Stage Renal Disease (ESRD) who tend to undergo Maintenance Hemodialysis (MHD) routinely report pain [1]. 75% of the patients on dialysis perceived their pain management plans to be inadequate; evidence-based guidelines that provide a framework for the prescription of pharmacological therapies and the evaluation of ESRD patients are lacking. The pain experienced by chronic kidney disease patients is multidimensional. The etiology of pain diagnosed in patients with chronic kidney disease can be either simple or difficult. Pain may be a consequence of kidney failure, be associated with systemic and comorbid underlying disease, or be a direct consequence of actual hemodialysis or peritoneal dialysis [8]. Understanding the etiology of pain in patients with ESRD is vital to the formulation of effective pain management plans [9]. Various causes of pain among ESRD, including musculoskeletal, dialysis-related pain, peripheral neuropathy and vascular diseases, have been found to be the leading causes of discomfort [10]. A nurse’s knowledge of pain management in patients receiving hemodialysis allows them to provide optimal pain management
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