How do Thai patients receiving haemodialysis cope with pain?

Background
Pain affects peoples' well-being and quality of life and is one of the most common symptoms experienced by people receiving haemodialysis (HD).

Objectives
To explore how Thai people receiving HD perceive pain, the effect of pain on their lives, and how they cope with and manage pain.

Methods
Purposive sampling was used to recruit participants from two Thai outpatient haemodialysis facilities in Songkhla province. Face-to-face, in-depth individual interviews using open-ended questions were conducted during January and February 2012. The interviews were audio-recorded and transcribed verbatim. Data were analysed using Ritchie and Spencer's Framework method.

Findings
Twenty people receiving HD participated in the study: age range 23–77 years; 10 were females. Three main types of pain emerged: physical pain, which occurred when needles were inserted during HD treatment and vascular access operations; psychological pain due to unfulfilled hopes and dreams and changes in family roles; and social pain. Perception of pain was influenced by the general populations' perceptions of chronic kidney disease. Participants used two main coping styles to manage pain: health-adjustment and health-behaviour styles. These two coping styles encompassed four specific coping strategies: religion, spirituality, accepting pain associated with HD treatment, and social support. Coping styles and strategies were influenced by Thai culture.

Conclusion
The study elicited information that could help nursing staff understand how Thai people manage pain and the importance of cultural beliefs to their pain experience and coping strategies, which in turn can help nurses plan appropriate pain management.