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School of Nursing and Midwifery College of Health Sciences University of Ghana Legon University of Ghana http://ugspace.ug.edu.gh Running Head: PAIN MANAGEMENT OF ROAD TRAFFIC ACCIDENT CASUALTIES SCHOOL OF NURSING AND MIDWIFERY COLLEGE OF HEALTH SCIENCES UNIVERSITY OF GHANA LEGON EXPLORING PAIN MANAGEMENT BY NURSES AMONG ROAD TRAFFIC ACCIDENT CASUALTIES AT A MILITARY HOSPITAL IN GHANA BY THOMAS KWAME TATA 10089068 THIS THESIS IS SUBMITTED TO THE UNIVERSITY OF GHANA, LEGON IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF MPHIL NURSING DEGREE JULY 2019 University of Ghana http://ugspace.ug.edu.gh PAIN MANAGEMENT OF ROAD TRAFFIC ACCIDENT CASUALTIES DECLARATION This is to attest that this thesis is the result of research conducted by Thomas Kwame Tata for the Award of Master of Philosophy Degree in Nursing at the School of Nursing and Midwifery of the University of Ghana. This thesis has not been presented either in whole or part to any university for award of any degree or certificate. Authors and publishers whose work have been cited in this study have been duly acknowledged in the text and the reference list. ……………………………… ……………………… THOMAS KWAME TATA DATE (STUDENT) ……………………………….. ……………………… PROF LYDIA AZIATO DATE (SUPERVISOR) ………………………………. …………………….. DR LILLIAN AKORFA OHENE DATE (CO-SUPERVISOR) i University of Ghana http://ugspace.ug.edu.gh PAIN MANAGEMENT OF ROAD TRAFFIC ACCIDENT CASUALTIES ABSTRACT The quest for pain relief has been the reason why casualties visit the emergency department to seek appropriate intervention. The aim of the study was to explore pain management by nurses among Road Traffic Accident casualties at the 37 Military Hospital. A qualitative descriptive design guided by the caregiver aspect of the Social Communication Model of Pain (Craig, 2009) was used in the study. Purposive sampling technique was employed to recruit thirteen nurses from the trauma surgical emergency unit of the 37 Military Hospital. Interviews were conducted using a semi-structured interview guide. All the interviews were recorded and transcribed verbatim. Data was manually analysed and four themes were generated using thematic content approach. These were; nurses’ pain assessment of casualties, nurses’ pain management of casualties, nurses’ personal pain experiences and institutional factors influencing casualties’ pain assessment and management. The study identified the importance of application of adequate knowledge of pain assessment and management in the intervention of RTA casualties’ pain. Personal pain experiences of nurses turn to influence their pain management. The study also identified inadequate staff and logistics, lack of training and protocols and limited working space to adversely affect pain management of road traffic accident casualties. The study concluded with the recommendation that nurses at the emergency units to be adequately knowledgeable in pain management and have access to an environment that can meet the pain relief expectations of casualties. ii University of Ghana http://ugspace.ug.edu.gh PAIN MANAGEMENT OF ROAD TRAFFIC ACCIDENT CASUALTIES DEDICATION I dedicate this work to my wife and children (Agnes, Amenuveve, Edem and Makafui) and all my siblings for their encouragement and support. iii University of Ghana http://ugspace.ug.edu.gh PAIN MANAGEMENT OF ROAD TRAFFIC ACCIDENT CASUALTIES ACKNOWLEDGEMENT I give thanks to God Almighty for His immeasurable mercies upon me throughout this study. I wish to express my appreciation and gratitude to all the participants of the study. I am forever indebted to my supervisors Prof Lydia Aziato and Dr Lillian Akorfa Ohene for their guidance, support and encouragement to complete this work. I am also thankful to all lecturers and non-teaching staff of School of Nursing and Midwifery at the University of Ghana for their assistance during this work. My special thanks go to my wife Agnes Esi Ledi who took care of the home during my absence and supported me in this work. I am grateful for the diverse contributions from my colleagues and all others towards the completion of this work. I wish to express my gratitude to the Administration of the 37 Military Hospital for permitting me to conduct the research in their facility and the staff of the Trauma Surgical Emergency Unit who were participants of this study. I am also thankful to all authors that I used in this work. iv University of Ghana http://ugspace.ug.edu.gh PAIN MANAGEMENT OF ROAD TRAFFIC ACCIDENT CASUALTIES v University of Ghana http://ugspace.ug.edu.gh PAIN MANAGEMENT OF ROAD TRAFFIC ACCIDENT CASUALTIES TABLE OF CONTENTS CONTENT PAGE DECLARATION .................................................................................................................. i ABSTRACT ......................................................................................................................... ii DEDICATION .................................................................................................................... iii ACKNOWLEDGEMENT ................................................................................................. iv TABLE OF CONTENTS ................................................................................................... vi LIST OF TABLE(S) ........................................................................................................... ix LIST OF FIGURES ............................................................................................................ x LIST OF ABBREVIATIONS ........................................................................................... xi CHAPTER ONE ................................................................................................................. 1 INTRODUCTION ............................................................................................................... 1 1.1 Background to the Study ............................................................................................. 1 1.2 Problem Statement ...................................................................................................... 4 1.3 Purpose of the Study .................................................................................................... 5 1.4 Objectives of the Study ............................................................................................... 5 1.5 Research Questions ..................................................................................................... 5 1.6 Significance of the Study ............................................................................................ 6 1.7 Operational Definitions ............................................................................................... 7 1.8 Structure and Organisation of the Study ..................................................................... 7 CHAPTER TWO ................................................................................................................ 9 LITERATURE REVIEW ................................................................................................... 9 2.1 Conceptual Framework ............................................................................................... 9 2.2 Review of Related Literature..................................................................................... 12 2.2.1 Nurses Knowledge in Assessment and Management of Pain ............................. 12 2.2.2 Personal Pain Experiences .................................................................................. 17 2.2.3 Institutional Factors Influencing Pain Assessment and Management ................ 20 CHAPTER THREE .......................................................................................................... 22 METHODOLOGY ............................................................................................................ 22 3.1 Study Design ............................................................................................................. 22 3.2 Research setting ......................................................................................................... 23 3.3 Target population ...................................................................................................... 24 3.3.1 Inclusion Criteria ................................................................................................ 24 3.3.2 Exclusion Criteria ............................................................................................... 24 vi University of Ghana http://ugspace.ug.edu.gh PAIN MANAGEMENT OF ROAD TRAFFIC ACCIDENT CASUALTIES 3.4 Sampling Method ...................................................................................................... 25 3.5 Sample Size. .............................................................................................................. 25 3.6 Data Collection .......................................................................................................... 26 3.7 Piloting of the Instrument .......................................................................................... 26 3.8 Data Management ...................................................................................................... 27 3.9 Analysis of Data ........................................................................................................ 27 3.10 Methodological Rigour ............................................................................................ 28 3.11 Ethical Considerations ............................................................................................
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