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Respecting Autonomy while Nudging: A Phenomenological Study of TENS Use in Post-anesthesia Care
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden; Institute of Health Sciences at Lund University, Lund, Sweden.
Department of Anaesthesiology and Intensive Care/Pain Centre, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden; Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden; Faculty of Health Sciences, Department of Nursing and Health Promotion Acute and Critical Illness, Oslo Metropolitan University, Oslo, Norway.
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2026 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: To describe healthcare professionals lived experiences of being nudged to use transcutaneous electrical nerve stimulation (TENS) in post-anesthesia care.

DESIGN: Descriptive phenomenological study.

METHODS: A 12-week transparent, passive and asynchronous nudge strategy was implemented in a 15-bed surgical recovery ward where healthcare professionals were exposed to rotating posters to encourage TENS use. Thirteen professionals with varied peri-anesthesia roles participated in semi-structured video-recorded interviews. Data were analyzed using Giorgi's descriptive phenomenological method.

FINDINGS: Nudging was experienced as a contextual and relational influence. It reawakened awareness of TENS and supported reflection when aligned with professional values, ethical transparency, and clinical relevance. Resistance occurred when nudges were perceived as excessive, misplaced, or intrusive. Relational interactions, such as peer modeling, strengthened the effect, while professional autonomy remained central. Nudging often prompted inner dialogue and reconsideration even without immediate behavioral or practice change.

CONCLUSIONS: Nudging can serve as an ethically acceptable, non-intrusive prompt in post-anesthesia care to re-engage clinicians with opioid-sparing strategies such as TENS. When transparent and respectful of autonomy, nudging supports ethical peri-anesthesia healthcare professionals' practices by balancing influence with professional judgment, thereby contributing to safer and more sustainable postoperative pain management.

Place, publisher, year, edition, pages
Elsevier, 2026.
Keywords [en]
descriptive phenomenology, healthcare professionals, non-pharmacological pain treatment, nudging, postoperative care, transcutaneous electrical nerve stimulation (TENS)
National Category
Nursing Palliative Medicine and Palliative Care
Identifiers
URN: urn:nbn:se:oru:diva-129689DOI: 10.1016/j.jopan.2026.05.016PubMedID: 42322341OAI: oai:DiVA.org:oru-129689DiVA, id: diva2:2082211
Funder
Swedish Research Council, 2021–01166University of Gothenburg
Note

Funding Agencies:

This study was funded by the Swedish Research Council (project 2021–01166) and the University of Gothenburg Centre for Person-centred Care (GPCC), Sweden. GPCC is funded by the Swedish Government’s Strategic Research Areas grant (Care Sciences) and the University of Gothenburg, Sweden.

Available from: 2026-06-30 Created: 2026-06-30 Last updated: 2026-06-30Bibliographically approved

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