The views of patients, healthcare professionals and hospital officials on barriers to and facilitators of quality pain management in Ethiopian hospitals: A qualitative study

被引:22
作者
Eshete, Million Tesfaye [1 ,2 ]
Baeumler, Petra I. [3 ]
Siebeck, Matthias [2 ,4 ]
Tesfaye, Markos [5 ]
Wonde, Dereje [6 ]
Haileamlak, Abraham [7 ]
Michael, Girma G. [1 ]
Ayele, Yemane [1 ]
Irnich, Dominik [3 ]
机构
[1] Jimma Univ, Inst Hlth, Dept Anesthesiol, Fac Med, Jimma, Ethiopia
[2] Ludwig Maximilians Univ Munchen, Ctr Int Hlth, Munich, Germany
[3] Ludwig Maximilians Univ Munchen, Univ Hosp, Dept Anaesthesiol, Multidisciplinary Pain Ctr, Munich, Germany
[4] Hosp Univ Munich LMU, Dept Gen Visceral Vasc & Transplantat Surg, Munich, Germany
[5] St Pauls Hosp, Millennium Med Coll, Dept Psychiat, Addis Ababa, Ethiopia
[6] Jimma Univ, Dept Sociol, Coll Social Sci & Humanity, Jimma, Ethiopia
[7] Jimma Univ, Inst Hlth, Dept Pediat & Child Hlth, Fac Med, Jimma, Ethiopia
关键词
ACUTE POSTOPERATIVE PAIN; DEVELOPING-COUNTRIES; SURGERY; ANESTHESIA; PERCEPTIONS; EXPERIENCES; ANALGESIA; INTENSITY; ATTITUDES; RELIEF;
D O I
10.1371/journal.pone.0213644
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Postoperative pain remains a challenge in the developed world, but the consequences of inadequately treated postoperative pain are particularly severe in low-and middle-income countries' Since 2011, reports have drawn attention to the poor quality of postoperative pain management in Ethiopia; however, our multicenter qualitative study was the first to attempt to understand the factors that are barriers to and facilitators of quality pain managment in the country. To this aim, the study explored the perspectives of patients, healthcare professionals, and hospital officials. We expected that the results of this study would inform strategies to improve the provision of quality pain management in Ethiopia and perhaps even in other low-and middle-income countries. Methods This study used a qualitative, descriptive approach in which nine healthcare professionals, nine patients, and six hospital officials (i.e. executives in a managerial or leadership position in administration, nursing, or education) participated in face-to-face, semi-structured interviews. Thematic data analysis was conducted, and patterns were explained with the help of a theoretical framework. Findings The barriers identified ranged from healthcare professionals' lack of empathy to a positive social appraisal of patients' ability to cope with pain. They also included a lack of emphasis on pain and its management during early medical education, together with the absence of available resources. Enhancing the ability of healthcare professionals to create favorable rapport with patients and increasing the cultural competence of professionals are essential ingredients of future pain education interventions. Conclusions Barriers to and facilitators of postoperative pain management do not exist independently but are reciprocally linked. This finding calls for holistic and inclusive interventions targeting healthcare professionals, patients, and hospital officials. The current situation is unlikely to improve if only healthcare professionals are educated about pain physiology, pharmacology, and management. Patients should also be educated, and the hospital environment should be modified to provide high-quality postoperative pain management.
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页数:20
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