Nurses Knowledge and Attitude Regarding Pain Management of Persistence of Undertreated

In 2002 the research conducted by McCaffery and Robinson shown that the nurses have score higher marks who have advanced degrees and the experience of above 15 years regarding pain knowledge and attitudes surveys. The purpose behind the activity was to offer the individuals a tool for self-assessment of knowledge about pain management which will and provide teachers with the data which will help them setting education priorities. In January 2002 an online survey was published in under the name nursing 2002 in which nurses were invited for the participation in survey. 3282 individuals participated in the survey. The average age of the participants was female of 41 years old having a decade of experience of working as medical or surgical nurse in remote areas.to pass the survey the participants were required to correctly complete 80% of the survey. Only 3.9% of the participants passed the survey with 100% marks. The average score was 11 corrected answers out of 15 questions. More than half of the individuals were not able to score passing marks. Participants with masters degrees and have practiced in hospice and oncology settings were assessed to answer the questions with higher accuracy. On the basis of the survey conducted it is concluded that there is a biggest need of educational program for the nurses working in surgical and medical hospitals having less than five years. It is assessed that pain assessment and management are essential elements of nursing care. In 2011 a research was conducted by Al-Shaer et al using sample of 129 registered nurses from 10 different nursing units in hospital located in US. Modern version of Knowledge and Attitudes Survey Regarding Pain (KASRP) was used for the study. The nurses were concluded to have insufffient knowledge regarding the assessment and management of pain. Stats remained the same with respect to experience and other categories. In 2007 a study was conducted using two convenience samples to find out whether registered nurses working in orthopedic area, whose knowledge in pain management area is improved after the completion of knowledge and competency training and showed better results. The no of registered nurses participated in the survey was 113. 65 registered nurses from orthopedic area are included in group in I and 48 nurses from different clinical backgrounds were included in group II. The average score of accurate answers was 73.8%. Average score of group I was 75% and group II was 72.6%. Passing criteria set by McCAFFERY & Robinson was 80%. The results of the study were similar to results of the related studies regarding nurses’ knowledge in clinical practice regarding pain managemen

In 2011 Lewthwaite and colleagues conducted a research in urban tertiary care hospital on mid-western Canada. Modified version of Ferrell and McCaughey’s KASRP was used in the study. Out of 761 surveys the response rate was 43%. 93% of participants were female with average age of 42 years. 58% were diploma holders, 42% had bachelors or master’s degree. The majority was working in the area of surgery. Average score of the study was 79%. By using the Mann-Whitney U test it is assessed that the nurses with bachelors and master’s degree scored relatively higher marks as compared to diploma holder nurses. It was concluded that pain management is still a problem in health care system and nurses are needed to be educated on pain. The studies also reveal that nurses needs adequate knowledge in pharmacology but mere acceptance of problem will not solve the problem.

     A descriptive research was conducted in paranesthesia areas for the assessment of knowledge and attitudes of healthcare service providers. In 2008 Knowledge and Attitudes Regarding Pain Management Survey made by McCaffery’s and Ferrell was handed over to a population of 138 in which 72 of them responded which makes the response rate 52%. The aggregate average score was 72.25% which was considerably low, identifying the need of research and development in pain management area.  And par-anesthesia practice.

Another study conducted by McMillan, Tittle, Hagan, and small in 2005 for the purpose of determining the changes in attitudes and knowledge of pain resources nurses (PRNS) as a result of intensive pain management course. 18 nurses were examined before and after the participation in 32 hours intensive pain management and were selected from various units at a veterans administrations Hospitals in the southeast of United States. The test was conducted on pain management principles knowledge and the nurses attitude survey. The knowledge testing before the test was quite close to passing ratio but scores were improved drastically after going through the intense pain management course by elevating to 80%. In department of attitude toward pain the scores were low with the percentage of 66.6% and the slight improvement was seen in after test results with 69.3%. The improvement in results authenticated the effectiveness of the intense pain management course and the similar courses were recommended to be offered in other settings for the encouragement of practicing nurses for the provision of better health care facilities to the patients. It is proposed that nursing attitude and beliefs can impact the aggregated results of patient care in intensive care setups.

     Another study conducted by Layman Young, Horton, and Davidhizar in 2006 to find out attitude of nurses towards pain assessment is implemented and the relation of the attitudes to experience and education. Young along with his partners established an open ended questionnaire which was based on expectancy-value model developed by Fishbein and Ajzan. A sample of 52 nurses from intense care unit ward was asked regarding their believe about pain assessment, use of pain assessment tools, usage of pain assessment tools for the improvement of patients condition. After that each of the participants graded their attitudes regarding their feeling about each belief. Their attitude regard to pain assessment ranged between very positive to negative however in general they were very positive about the use of pain management tools for the betterment of patient results. Using the Fishbein and Ajzen’s formula for the calculations of attitudes, the average score turned out to be 8.3 positive with scoring range between -6 to 28. Stats from study indicated that increase in years of experience was not the motive for positive outcome on the usage of pain assessment tool and their advantage for patients’ outcome. It was concluded that the Fishbein and Ajzen model turned out to be quite beneficial way of extracting information on the attitude of the nurses for the usage of pain assessment tools. For further improvement in the studies the research should be done with open ended questionnaire bigger amount of sample size under different settings.