La gestione del dolore in Pronto Soccorso: una indagine fenomenologica sul vissuto degli infermieri

Introduction: pain is a subjective and complex phenomenon, representing the first cause of access to Emergency Departments. Early management of pain through nurse-led analgesia protocols improves outcomes and patient satisfaction. Aim: this study aims to analyse the experiences of triage nurses regarding the pain of adult patients admitted to the Emergency Department, highlighting the main barriers to an objective pain assessment and the strategies adopted to manage it, to improve proper pain management. Materials and Methods: this qualitative study has an interpretative phenomenological design; data is collected through semi-structured interviews. The study is reported according to the COREQ-32 checklist. Results: twenty nurses in the Veneto region (Italy) Emergency Departments were interviewed. Seven themes were identified: nurse-led analgesia protocols, pain management in children, non-pharmacological interventions, differences between acute and chronic pain, the role of caregivers of elderly/cognitively impaired patients, nurses’ personal experience of pain, and objectivity of nurses’ pain assessment. Conclusions: the interviews revealed a series of factors hindering optimal pain management related to the setting, such as Emergency Department overcrowding, or categories of difficult patients, such as children or elderly people with cognitive impairments. Positive experiences have also emerged, such as the usefulness of non-pharmacological techniques and the participatory role of family members and caregivers, during pain assessment of cognitively impaired patients.