Patients' attitudes to analgesics and expectations of emergency care : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand

Abstract

Alleviating pain and suffering has long been a goal of health professionals. Pain has been shown to be one of the leading reasons that patients present to emergency departments (ED) throughout the world and the use of analgesics in ED's has been extensively explored. What has been less extensively researched is why some patients in pain choose not to use analgesics and what it is that they expect from emergency health care. The present work is an exploratory study looking at the attitudes of patients in pain, presenting to an urban ED and declining analgesics. It asks why patients decline analgesics and what they expect from emergency care. Seven participants were recruited over a two month period and volunteered to participate in semi-structured interviews while waiting to see a health professional. Four women and three men participated. Thematic analysis led to several themes being reported. People did not like taking analgesics because their injury was "not that painful"; they used "pain as a reference point"; and they had an "aversion to taking medications". Reasons for accessing emergency services included a "need to know what's wrong" and a belief that "diagnostic tests" were required. A surprising theme to emerge was the use of dental pain as a reference point for pain tolerance and pain behaviours. It was concluded that health professionals should accept that some patients in pain do not desire analgesics. Patients have non-pharmacological means of coping with pain. They access emergency care for diagnosis, active treatment, and have an underlying need to understand the cause of their pain. It is suggested that future study might include interviews with health professionals to compare and contrast their subjective perceptions with objective observations and to investigate the use of dental pain as a reference point.