Respecting Autonomy while Nudging: A Phenomenological Study of TENS Use in Post-anesthesia Care

Area of Science:

• Nursing
• Healthcare Management
• Pain Management

Background:

• Post-anesthesia care often involves managing postoperative pain.
• Opioid-sparing strategies are crucial for patient safety and recovery.
• Transcutaneous electrical nerve stimulation (TENS) is an alternative pain management modality.

Purpose of the Study:

• To explore healthcare professionals' lived experiences with nudging to use TENS in post-anesthesia care.
• To understand the factors influencing the adoption of TENS through nudging strategies.

Main Methods:

• A 12-week transparent, passive, and asynchronous nudging strategy using posters.
• Descriptive phenomenological study analyzing semi-structured interviews with 13 peri-anesthesia professionals.
• Data analysis using Giorgi's descriptive phenomenological method.

Main Results:

• Nudging reawakened awareness of TENS when aligned with professional values and clinical relevance.
• Resistance to nudging occurred when perceived as excessive or intrusive.
• Relational interactions and peer modeling enhanced nudging effectiveness, while professional autonomy remained paramount.
• Nudging prompted reflection and reconsideration, even without immediate practice change.

Conclusions:

• Nudging is an ethically acceptable, non-intrusive prompt for opioid-sparing strategies like TENS in post-anesthesia care.
• Transparent and autonomy-respecting nudging supports ethical practice by balancing influence with professional judgment.
• Effective nudging contributes to safer and more sustainable postoperative pain management.