Zhu, Ningning, Peipei Xu, Jie Ma, Yajing Liang, Xiaoyue Xu, & Jinzhi Li (2019, September). Patients, caregivers and nurses’ attitudes toward patients’ participation in knee and hip joint replacement pain management: A Q-methodology study. Contemporary Nurse: AJournal for the Australian Nursing Profession, 55(6), 507-521. (doi: 10.1080/10376178.2019.1666019) (Link: https://doi.org/10.1080/10376178.2019.1666019)

Abstract: Background: It is important for patients to participate in pain self-management to assist with pain relief. However, research indicates patients are often not actively involved in their acute pain management. Objectives: To understand the attitudes of patients, family caregivers and nurses to patient participation in pain management after their knee or hip joint replacement. Design: Q-methodological design. Methods: 45 participants were recruited from a public acute-care hospital. This included 15 patients, 15 caregivers and 15 nurses. Forty-nine statements were rank-ordered in a Q-sort table, PQMethod 2.35 was used for data analysis. Results: Four factors which explained 65% of the variance were identified from factor analysis. Factor one named “Endurers” represented negative attitudes and knowledge deficit in pain and pain management. “Supporters” represented a positive faith, and emphasized the key role of physicians in promoting patient involvement. “Worriers” represented those who had some concerns and advocated non-drug pain relief strategies, and “Wabblers” were those who held a skeptical attitude and were easily influenced by past experiences. Conclusion: Each group of participants have significant knowledge deficit in pain management. Patients and caregivers were more likely to have a passive attitude and false cognition towards pain and analgesic drugs. Nurses often play a role as a supporter, however it is hard for them to understand their important role in facilitating patient involvement in their pain management. Impact statements: This is vital to develop education programs for nurses, caregivers and patients to help facilitate the role of the patient to actively engage and participate in pain management strategies.

Xiaoyue Xu <xiaoyue.xu@uts.edu.au> is in the Faculty of Health, University of Technology, Sydney, Australia. Jinzhi Li <2639917769@qq.com> is in the School of Nursing, Bengbu Medical College, Bengbu, China.

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