Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Developing the practice context to enable more effective pain management with older people: an action research approach | Brown and McCormack Implementation Science 2011 6 9 http content 6 1 9 IMPLEMENTATION SCIENCE Implementation Science RESEARCH ARTICLE Open Access Developing the practice context to enable more effective pain management with older people an action research approach Donna Brown1 Brendan G McCormack2 Abstract Background This paper which draws upon an Emancipatory Action Research EAR approach unearths how the complexities of context influence the realities of nursing practice. While the intention of the project was to identify and change factors in the practice context that inhibit effective person-centred pain management practices with older people 65 years or older reflective critical engagement with the findings identified that enhancing pain management practices with older people was dependent on cultural change in the unit as a whole. Methods An EAR approach was utilised. The project was undertaken in a surgical unit that conducted complex abdominal surgery. Eighty-five percent n 48 of nursing staff participated in the two-year project 05 NIR02 107 . Data were obtained through the use of facilitated critical reflection with nursing staff. Results Three key themes psychological safety leadership oppression and four subthemes power horizontal violence distorted perceptions autonomy were found to influence the way in which effective nursing practice was realised. Within the theme of context effective leadership and the creation of a psychologically safe environment were key elements in the enhancement of all aspects of nursing practice. Conclusions Whilst other research has identified the importance of practice context and models and frameworks are emerging to address this issue the theme of psychological safety has been given little attention in the knowledge translation implementation literature. Within the principles of EAR facilitated reflective sessions were found to create psychologically safe spaces that supported practitioners to
