The Lived Experience of Iraqi Nurses about Pain Management after Cardiac Surgery: A Phenomenological study
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Objective: To explore Iraqi intensive care nurses’ lived experiences of postoperative pain management after cardiac surgery and to identify perceived barriers and improvement strategies.
Methods and Materials: A qualitative descriptive phenomenological design was conducted in five governmental cardiac centers in Iraq. A purposive sample of 25 ICU nurses with at least two years of postoperative cardiac care experience participated. Data were collected through semi-structured face-to-face interviews in Arabic, audio-recorded, transcribed verbatim, translated into English, and analyzed using inductive qualitative content analysis. Trustworthiness was strengthened through procedures addressing credibility, dependability, confirmability, authenticity, and transferability.
Findings: Three themes emerged: (1) nurses’ personal experiences of pain management; (2) factors influencing pain management; and (3) suggestions to improve pain management. Nurses emphasized a multimodal approach, routinely combining physician-ordered analgesics with non-pharmacological measures such as positioning, deep-breathing/coughing exercises, reassurance, and maintaining a calm environment. Systematic pain assessment using pain scales and patient reports, supported by observation of changes in vital signs, was considered essential for timely intervention. Major barriers included the absence of formal pain-management training, heavy workload and staffing shortages, intermittent availability of analgesics, and variability in patients’ cooperation and psychological status. Participants recommended context-appropriate protocols, continuing education, improved resource provision, and stronger interprofessional communication to enhance patient comfort and satisfaction.
Conclusion: Iraqi ICU nurses perceive post-cardiac surgery pain control as an assessment-driven, multimodal process constrained by training and system-level barriers. Institutional protocols and ongoing training, alongside resource support, may improve the consistency and quality of postoperative pain management.
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