Nurses' perceptions on pain behaviours among burn patients : a qualitative inquiry in a Ghanaian tertiary hospital

Background Pain sustained from burns is usually quite severe and has been linked to extreme distress, preventing patients from contributing to their care. Nurses have legal and professional obligations to promptly assess burns pain by using pain assessment tools and by relying on the patient’s behaviour and expressions. Objectives To explore nurses' perceptions on pain behaviours among burn patients in a Ghanaian tertiary hospital. Methods A qualitative descriptive design was used. A total of 11 nurses were recruited through a purposive sampling technique from a burns unit of a tertiary facility in Ghana. Semi-structured face-to-face interviews were conducted. Analysis was done using thematic content analysis, from which two major themes and nine subthemes were identified. Findings Patients express their pain by adopting both verbal and non-verbal communication means. However, due to the subjective nature of pain, nurses’ perceptions of pain were not sufficient to effectively assess the degree of pain. Verbal indicators that nurses perceived to be pain behaviours of burn patients were screaming, crying, praying and groaning, while frowning, reduced sense of humour, and body language were some non-verbal indicators nurses used to confirm the existence of burns pain. Nurses in Ghana must adopt the use of objective pain assessment tools, in conjunction with perceived pain behaviours, for optimal pain management outcomes. Conclusions Patients with burns experience intense pain from both the burns and the procedures that are done for them to aid in their healing. A systematic pain assessment by nurses, as part of the health care team, is a vital guide to pain management. To ensure consistency in the assessment of pain, there is a need to design protocols and policies to guide all nurses in the assessment of burns pain in the burns unit