A qualitative exploration of the language and expression of pain in a Cape Town emergency centre
Date
2020-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY : Background: Oligoanalgesia is increasingly being identified as an issue affecting emergency centres universally, especially in low- and middle-income countries where a lack of culturally specific pain scales compound the issue. Despite successful translation of pain scales into different languages, differing cultures and dialects often lead to the pain experience being inappropriately categorised and communicated. This study aimed to explore the language and the expression of pain in adult patients who required tube thoracostomies for penetrating chest trauma, at a district level hospital.
Methods: The study was conducted at a district level hospital in Cape Town. An explorative qualitative study design was used, using a single stage semi-structured English language interview. All adults who had a thoracostomy tube inserted for penetrating chest trauma were eligible for inclusion. Audio recordings were transcribed, and thematic content analysis of interview data was performed. 22 participants were interviewed (All male, ages 18-45). All participants could speak English at least as a second language.
Results: Participants had difficulty expressing pain using language and often used non-verbal means; expressing a limitation of functioning and a need for additional analgesia were common mechanisms to express severity of pain; expression of intensity pain was often conveyed by categorising pain as tolerable or intolerable with the latter associated with hopelessness and defeat. The actual language used was simple, and commonly used colloquialisms unique to the setting. Barriers to communication between patient and doctor related to use and interpretation of pain scales and the poor relationship between doctor and patient.
Conclusion: This study emphasises the inadequacy of currently accepted pain assessment methods in this setting in terms of use and interpretation. It highlights the need for culturally appropriate tools and training of doctors in communication related to pain.
AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.
Description
Thesis (MFamMed)--Stellenbosch University, 2020.
Keywords
Oligoanalgesia, Pain -- Treatment -- Cape Town (South Africa), Pain -- Psychological aspects, Trauma centers -- Cape Town (South Africa), Expression, UCTD