Normalizing suffering: A meta-synthesis of experiences of and perspectives on pain and pain management in nursing homes

Older people who live in nursing homes commonly suffer from pain. Therefore, relieving suffering among older people thatstems from pain demands knowledge improvement through an integration of international knowledge. This study aimed tointegrate current international findings and strengthen the understanding of older people’s experiences of and perspectiveson pain and pain management in nursing homes. A meta-synthesis study using Noblit and Hare’s interpretative metaethnographyapproach was conducted. Empirical research papers from journals were collected from various databases. Thesearch process and appraisal determined six articles for inclusion. Two studies were conducted in the US and one each inIceland, Norway, the UK, and Australia. The older people’s experiences of pain as well as perspectives on pain managementfrom all involved (older people, their family members, and healthcare staff) were integrated into a theoretical model usingthree themes of ‘‘identity of pain,’’ ‘‘recognition of pain,’’ and ‘‘response to pain.’’ The metaphor of ‘‘normalizing suffering’’was devised to illustrate the meaning of pain experiences and pain management in nursing homes. Society’s commonattitude that pain is unavoidable and therefore acceptable in old age in society*among older people themselves as well asthose who are responsible for reporting, acknowledging, and relieving pain*must change. The article emphasizes that painas a primary source of suffering can be relieved, provided that older people are encouraged to report their pain. In addition,healthcare staff require sufficient training to take a person-centered approach towards assessment and management of painthat considers all elements of pain

Balancing preterm infants’ developmental needs with parents’ readiness for skin-to-skin care: A phenomenological study

The aim of this article is to articulate the essence and constituents of neonatal intensive care unit (NICU) nurses’ experiences in enacting skin-to-skin care (SSC) for preterm newborns and their parents. SSC is commonly employed in high-tech NICUs, which entails a movement from maternal–infant separation. Parents’ opportunities for performing the practice have been addressed to NICU staff, with attitude and environment having crucial influence. The study was carried out with a reflective lifeworld research approach. Data were collected in Denmark, Sweden, and Norway by open-dialogue interviews with a purposive sample of 18 NICU nurses to achieve the essence of and variation within the phenomenon. NICU nurses experience balancing what they consider preterm newborns’ current and developmental needs, with readiness in both parents for SSC. They share an experience of a change in the history of NICU care to increased focus on the meaning of proximity and touch for the infants’ development. The phenomenon of enacting SSC is characterized by a double focus with steady attention to signals from both parents and newborns. Thereby, a challenge emerges from the threshold of getting started as the catalyst to SSC