- Title
- The uptake of guidelines for cancer pain management and its impact on nurisng practice in South Korea: a critical ethnography
- Creator
- Kim, Miran
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2019
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Given cancer causes pain and suffering impacting the quality of life of patients the use of evidence-based guidelines (EBGs) for pain management is essential for improving patient experiences. The Cancer Pain Management Guideline (CPMG) in South Korea was introduced in 2004 following many concerns of healthcare professionals, including nurses, about the suffering of patients with cancer due to pain. South Korean healthcare professionals believed that the introduction of the CPMG would influence the care and treatment of patients with cancer pain. This study aims to critically explore the impact of the introduction of the CPMG on clinical practice of the nurses in cancer care facilities. Further, the study aimed to uncover the roles and functions of nurses and the factors that influenced or hindered the adoption/spread/uptake of the CPMG. To answer the research question ‘What is the impact of the introduction of the Cancer Pain Management Guidelines on nursing practice in South Korea healthcare context?’ Critical Ethnography was deemed the most appropriate methodology, because it allowed the researcher to observe the practice, examine documents, explore reports on experiences and critically examine the emergent themes from the storylines provided by the 10 nurse participants working in acute cancer care units in South Korea. A total of 13 themes were classified into three superordinate themes and some themes contained further subordinate themes, which included themes relating to the uptake of the CPMG, nurses’ usual practices and the nurses’ experiences of managing pain. There was little evidence of the impact of the introduction of the CPMG on nursing practice. The findings also revealed that nurses’ usual practice was observed as ‘transactional’ and not always demonstrating an advanced level of decision-making informing practice to serve the patients’ true needs based on evidence. Nurses themselves were not evaluating their own practice and embracing a comprehensive set of roles and functions related to pain management. Nursing practice was influenced by various issues in terms of nurses’ decision-making. These included: 1) the medically driven nature of the development processes for a set of guidelines suitable for use as EBGs; 2) an absence of evidence of the organisation’s role in support of EBGs and subsequent support for quality care and a supportive work culture; 3) the valuing of the nursing contribution, and an apparent undermining of the nurses’ role by all involved; and 4) lack of patient-family centred care aligned with the concept of a therapeutic partnership and mutual respect. Recommendations include the need for an integrated approach at four levels: Policy informing the national guidelines; organisational support for implementation of EBGs; involvement of nurses in the EBP through the use of EBGs; and recognition of patients and families’ involvement in education and decision-making about their care.
- Subject
- nursing; cancer pain management; evidence-based guidelines; South Korea; acute care
- Identifier
- http://hdl.handle.net/1959.13/1397938
- Identifier
- uon:34370
- Rights
- Copyright 2019 Miran Kim
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 3 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 111 KB | Adobe Acrobat PDF | View Details Download |