Date of Award

2007

Degree Type

Thesis

Degree Name

Bachelor of Nursing Honours

School

School of Nursing, Midwifery

Faculty

Faculty of Computing, Health and Science

First Advisor

Dr Ruth McCingley

Abstract

Pain is a complex phenomenon that can be challenging for staff working in residential aged care facilities (RACFs) (Fisher et al., 2002; Twycross, 2002). A high prevalence of pain reported by older individuals has been reported and suggests that further study in this area is warranted (Higgins, Madjar & Walton, 2004). Research suggests that a significant barrier to effective pain management in the elderly is the provision of primary care by care staff who have little or no education about pain, pain assessment or pain management (Allcock, McGarry & Elkan, 2002). Studies have identified personal carers as being in a unique position to improve pain management, because of their working relationship with residents (Ferrell, 1996; Horgas & Dunn, 2001). However, there is a lack of literature which specifically examines personal carers' perspectives of providing care to residents in pain on a daily basis. This thesis presents a study of personal carers working in RACFs in regional Western Australia. A descriptive and explorative qualitative approach has been applied to examine the experience personal carers' have had with older residents in pain. A purposive, convenience sampling method allowed access to six personal carers currently employed in regional Western Australia. Data was generated by in-depth interviews focusing on the personal carers' experiences of caring for older people in pain. Interviews were audiotape recorded, transcribed and coded to ensure confidentiality and anonymity of participants. The findings of this study provide an understanding of the complex care needs of older residents in pain and illuminate the role of personal carers in the pain management process. A constant comparison method of analysis was used to develop a central theme and a sub-theme with associated categories. The central theme, Perfect Positioning, emerged from the data to encompass all aspects of the position personal carers have in the pain management process. Five associated categories, Frontline, Knowing the Residents, Emotional Attachment, Teamwork and Rewards for Getting It Right, provide explanation of the pivotal role of personal carers in RACFs in pain management. A sub-theme, Extended Roles, describes the additional responsibilities associated with pain management that are inherent in the personal carers' role. Two related categories, Clinical Judgements and Nagging were identified and highlight the responsibility of personal carers in the pain management process. This study contributes an understanding of the issues related to the experience of caring for older residents in pain. The research findings and recommendations established from this study have implications for clinical practice, education, administration and for future research in the aged care setting.

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