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Developing the practice context to enable more effective pain management with older people: An action research approach

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McCormack, Brendan and Brown, Donna N (2011) Developing the practice context to enable more effective pain management with older people: An action research approach. Implementation Science, 6 (9). [Journal article]

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URL: http://www.implementationscience.com/content/6/1/9

DOI: 10.1186/1748-5908-6-9

Abstract

BackgroundThis paper, which draws upon an Emancipatory Action Research (EAR) approach, unearths how the complexities of context influence the realities of nursing practice. While the intention of the project was to identify and change factors in the practice context that inhibit effective person-centred pain management practices with older people (65 years or older), reflective critical engagement with the findings identified that enhancing pain management practices with older people was dependent on cultural change in the unit as a whole. MethodsAn EAR approach was utilised. The project was undertaken in a surgical unit that conducted complex abdominal surgery. Eighty-five percent (n = 48) of nursing staff participated in the two-year project (05/NIR02/107). Data were obtained through the use of facilitated critical reflection with nursing staff. ResultsThree key themes (psychological safety, leadership, oppression) and four subthemes (power, horizontal violence, distorted perceptions, autonomy) were found to influence the way in which effective nursing practice was realised.. Within the theme of 'context,' effective leadership and the creation of a psychologically safe environment were key elements in the enhancement of all aspects of nursing practice. ConclusionsWhilst other research has identified the importance of 'practice context' and models and frameworks are emerging to address this issue, the theme of 'psychological safety' has been given little attention in the knowledge translation/implementation literature. Within the principles of EAR, facilitated reflective sessions were found to create 'psychologically safe spaces' that supported practitioners to develop effective person-centred nursing practices in complex clinical environments.

Item Type:Journal article
Faculties and Schools:Faculty of Life and Health Sciences
Faculty of Life and Health Sciences > School of Nursing
Research Institutes and Groups:Institute of Nursing and Health Research
Institute of Nursing and Health Research > Person-centred Practice
ID Code:17037
Deposited By:Mrs Julie Cummins
Deposited On:17 Feb 2011 15:24
Last Modified:17 Feb 2011 15:24

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