Family members' perceptions of pain behaviors and pain management of adult patients unable to self-report in the intensive care unit: A qualitative descriptive study

Background: Current guidelines suggest that family members be consulted in the pain assessment process of patients unable to self-report. However, little is known regarding family members' perceptions of their loved one's pain behaviors and pain management. Aims: This qualitative descriptive study aimed to describe family members' perceptions of pain behaviors and pain management in critically ill hospitalized patients admitted to an intensive care unit and unable to self-report. Methods: A qualitative descriptive design was used. This study was conducted in a medical-surgical intensive care unit in Canada. Family members of nonverbal adult patients participated in a semistructured interview regarding their perceptions of pain behaviors and pain management in the intensive care unit. Results: Ten family members with a nonverbal loved one admitted to the intensive care unit participated. Family members agreed on the presence of pain in the intensive care unit and reported being proactive and applying nonpharmacological interventions to help palliate pain of their loved one. Although family members identified behavioral indicators such as grimace, limb movement, and verbal complaints to assess pain in their loved one, the majority were unsure of their ability to detect pain. Conclusions: Family members have intimate knowledge of their loved one and could be invited to share their perceptions of their loved one's pain when they feel confident to do so.