Cancer-Related Pain Assessment Practices among Nurses: A Focused Ethnography in a county Referral Hospital in Kenya

Abstract

Introduction: Up to 80% of cancer patients in Kenya continue to experience untreated moderate to severe pain. A key step for nurses in the management of cancer pain is conducting a comprehensive assessment. This study explored cancer-related pain assessment practices among nurses in Kenya.

Methods: A focused ethnographic approach, twenty-five (n=25) participants were recruited using purposive, snowballing sampling strategy from an oncology and private ward in a large teaching and referral hospital. Semi- structured interviews and observations were used to collect data. Content analysis was used to analyze the data.

Findings: Cancer-related pain assessments were not a routine practice in both wards. Assessments were triggered by patients’ behavior, patient’s verbal reports of pain, and during evaluation of the outcome of an intervention. Based on observations the ward culture influenced how nurses intervened. For instance, nurses in the oncology ward took patients verbal reports of pain into account unlike the nurses in the private ward who believed their observations were superior to patient’s verbal reports.

Conclusion: To an extent pain assessment practices were influenced by the ward culture, patient’s perspectives were not prominent. Tailored interventions taking into consideration the ward culture are needed to enhance pain assessment practices among nurses.