Doing the right thing: using hermeneutic phenomenology to understand management of wound pain

Despite the availability of assessment tools, analgesic medications, and technologically advanced dressings, achieving adequate pain control in wound care continues to present challenges for healthcare practitioners, patients, and their families. Pain in general has been the subject of much clinical and scientific investigation, but most has focused on the biological aspects of pain management. The psychological aspects of pain management and factors stemming from the relationship between caregivers and care recipients have received less attention. Relational issues are particularly relevant when dealing with medical procedures that involve a caregiver actively touching a care recipient. This paper explores pain management in chronic wound care, particularly at dressing change, with an emphasis on the relational aspects of care. Work from a recently completed hermeneutic phenomenological study of 18 registered nurses performing wound care in long-term, acute, and community care suggests strengthening the therapeutic relationship between patient and nurse may have a positive impact on healthcare providers' pain management practices and patient quality of life. Although nursing was the focus of the study, the observations provided are relevant for any clinician providing hands-on, compassionate wound care.