Development of Theory-based Interventions
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nternational Journal for Human Caring
abstract
Inadequate attention is paid to the role of theory in guiding practice. three main factors
affect the use of theory to guide clinical practice: insufficient theory knowledge, insufficient
administrative support to encourage the development of theory-based interventions, and
the busy task-oriented climate of many nursing settings. Pain management is a vexing
problem confronting clients and healthcare professionals. the primary purpose of this
paper is to introduce scholars and clinicians to the basic tenets of Dossey’s (2008) theory of
integral nursing to aid nurses in designing client-centered pain management interventions
grounded in the theory’s main constructs of holism and healing.
272012, Vol. 16, No. 1
as the primary authority on the pain
experience, thereby prompting clinicians
to pay closer attention to clients’ description
of their lived experience of pain rather than
relying on a standardized definition of pain.
From a holistic perspective, all elements that
comprise the pain experience are equally
important and frame clients’ perception of
pain, the behaviors clients use to manifest
the impact of the pain experience, and
clients’ responses to varied methods used
to treat pain. Being knowledgeable about
pain management practice is an expected
competency of every registered nurse, yet
many nurses continue to describe barriers
that impede the management of clients’ pain
(Rejeh, Almadi, Mohammadi, Kazemnejad,
& Anoosheh, 2009). The literature supports
the notion that nurses’ knowledge and
attitudes about pain management is linked
to their ability to help clients successfully
manage pain; updating knowledge about
methods for relieving pain is key to improving
practice (Duignan & Dunn, 2008; Lui, So,
& Fong, 2008; Matthews & Malcolm, 2007;
Xue, Schulman-Green, Czaplinski, Harris,
& McCorkle, 2007).
Many strategies have been developed
to help bridge the gap between what nurses
know and what they actually do in practice
to help manage clients’ pain (Dihle,
Bjølseth, & Helseth, 2006). The problem
of under-treated pain persists and is likely
complicated by the lack of application of
theory to guide pain management practice.
When coupled with nurses’ uncertainty
about how to autonomously treat clients
in pain, pain relief outcomes are often
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