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Title: Acute pain management in children : an ethnographic approach
Author: Williams, Anna M.
Awarding Body: University of London
Current Institution: University of London
Date of Award: 2012
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This ethnographic study explores how children's pain is managed in the context of a general paediatric ward. Fieldwork was conducted on one ward over a period of 11 months. Data were collected using observations and informal interviews. Children (n=5) aged 8-16 years, their mothers (n=4) and nurses (n=5) participated in in-depth interviews exploring understandings and experiences of pain and pain management. A symbolic interactionist stance was taken, using the key concepts of pain work and the ceremonial order of the ward. In the context of the ward, pain is a eo-constructed phenomenon, incorporating the perspectives, interpretations and interactions of those involved. Nurses drew on expected and unexpected trajectories and their interactions with children to construct pain as a working or 'clinical' entity. They conceptualised pain in three main ways; routine/normal pain, fear as pain and complex pain. Children's accounts of pain revealed how pain was interpreted using temporal and causal dimensions with their mothers being central to their experiences of pain management. Mothers also drew on causal and temporal dimensions to interpret pain, contextualising this in their knowledge of their child. Nurses carried out various forms of work which served to sustain the ceremonial order ofthe ward. This included pain work, identity work, and emotion work. Pain work was also negotiated by nurses within the wider social context of the ward, showing how the division of labour, spatio-ternporal features, and the social organisation of the ward shaped pain management practices. The key findings taken together reveal multiple conceptualisations of pain at work, and multiple dynamics of interaction, in which nurses play a pivotal role. This thesis therefore develops new understandings of children's pain and pain management in using an ethnographic approach, and by applying sociological concepts to develop an integrated and theorised analysis of acute pain management on a paediatric ward.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available