Nursing research methodology: transcending Cartesianism

Pressure Ulcer Pain

OBJECTIVE

To describe and interpret the complexities of the pain experienced by persons with painful pressure ulcers.

DESIGN

Heideggerian hermeneutic phenomenology.

SETTING AND SUBJECTS

Ten participants with pressure ulcers hospitalized in an acute-care community hospital were interviewed.

METHODS

Multiple taped interviews, transcripts, and field notes were collected over an 8-month period. Data analysis occurred over a 16-month period and included an initial process of naming the text, identifying themes, and writing the interpretations of each participant's story. Secondary analysis comprised reading across the texts for commonalities and shared meanings. These data were related to other literature sources, shared with a team of researchers familiar with the Heideggerian hermeneutic phenomenology process, and with wound, ostomy, and continence nurses.

RESULTS

A total of 22 themes and 1 constitutive pattern were identified. Participants with varying stages of pressure ulcers shared poignant stories about their pain. Many related their accounts and instances of actions by health personnel and the treatment interventions that were painful. Some related their accounts of communication failures that contributed to stress, tension, and anxiety.

CONCLUSIONS

The findings of this study clearly indicate the need for increased attention to pain assessment and pain management in nursing education, nursing practice, and nursing research. The findings also suggest that the commonly used definition of pain is insufficient and needs revision.

Older men in contemporary discourses on ageing: absent bodies and invisible lives

Contemporary discourses on ageing are essentially 'feminized', and as such report little on the experiences of older men. Living into late old age has become, and will continue to be, a normal phenomenon in our social worlds for both men and women. As a disadvantaged group, older women have attracted more attention than their older male counterparts. Yet this 'advantaged' older man may well be shackled by his gender role, and male gender socialization does impact upon men in later life. Older single men often have poorly developed social and family networks leaving them at a disadvantage. However, the masculinities of older men are conspicuously absent from most male gender studies. Rather than omitted, it is more that the dominant discourses of younger and middle-aged men are preserved. In turn, disability and disease do accompany old age yet disability has remained in the background and is, consequently, underdeveloped. This is not to say that disability represents the whole experience of health for older people, but it is clearly not an ageist fantasy. The phenomena of ageing, gender (including masculinity), and disability can be connected and consequently interpreted and understood by studying embodiment in old age.