Nurses' Knowledge, Attitudes, and Barriers Toward Pain Management Among Postoperative Patients in Jordan

Pain Experiences and Coping Methods of Living Liver Donors Experiencing Chronic Pain After Surgery: Qualitative Study

BACKGROUND

Living liver donors are known to experience many physical symptoms such as pain in the postoperative period.

AIM

This qualitative study was conducted to examine pain experiences and coping methods of living liver donors experiencing postoperative chronic pain.

METHODS

The study sample consisted of 16 living liver donors. Data were collected using a personal information form and a semi-structured questionnaire. Quantitative data were analyzed as number, mean, standard deviation, and percentage. Qualitative data were analyzed within the framework of thematic and content analysis methods.

RESULTS

The mean postoperative chronic pain rate of living liver donors was 4.5. Eight of these people reported experiencing sudden, pinprick-like pain after liver transplantation. Living liver donors stated that the greatest factor that increased their pain was exertion/spontaneous movement. Half of them stated that the pain they experienced after transplantation had no impact on their daily life activities. Most of the living liver donors stated that the pain they experienced had no impact on their social lives; however, it caused sadness and psychological deterioration. The most preferred method to cope with pain was the use of medication.

CONCLUSIONS

Living liver donors experienced moderate postoperative chronic pain, and a significant proportion of them reported psychological symptoms related to the pain they experienced. A multidisciplinary pain team can help with pain management by providing training conducted in transplant centers.

Iranian Nurses' Knowledge, Attitude, and Practice of Complementary Therapies for Pain Management

INTRODUCTION

Complementary therapies (CTs) are being increasingly used by people with health issues and recommended by their health care providers. Although there are numerous studies available that address nurses' knowledge and attitudes regarding pain management, there are few that include the use of CTs by nurses in Iran. Therefore, this study was conducted in selected areas of Iran to assess nurses' knowledge, attitudes, and current practice regarding the use of CTs.

METHODS

A cross-sectional study was conducted on a random sample of 850 nurses from various regions of Iran between 2020 and 2022. A questionnaire was used that consisted of seven items addressing demographic characteristics, 15 items to assess knowledge, 25 items to address attitude and 22 items to address the practice of CTs in the area of pain relief. Descriptive and inferential statistics were used to analyze the data.

RESULTS

The participants' mean age was 33.26 ± 7.24 years. Most nurses (89.9%) had not received formal education on CTs. However, 78.6% of nurses reported personal use of CTs, and 62.3% reported using or recommending it to their patients at least once. Regarding the knowledge of CTs, nurses scored 5.81 on a 15 points scale indicating a considerable gap in their knowledge of CTs. Regarding attitudes toward the specific therapies, nurses believed that massage is highly (46.4%) or moderately (31.6%) effective in pain relief. Regarding effectiveness, nurses ranked the following as the top four CTs: music therapy, humor, hydrotherapy, and use of cold / heat.

CONCLUSION

The nurses in this study scored low on knowledge of CTs, meaning that they knew little about CTs. However, they showed a favorable attitude toward CTs and a majority of them had a history of personal use, and recommending some types of CTs to their patients for pain relief. Therefore, it is crucial for nurse managers to provide opportunities to acquire knowledge of CTs. Moreover, nurse educators should advocate for updating nursing curricula to include CTs as an essential component of pain management education.

Surgical Patients' Evaluation of Pain Management Quality and Surgical Nurses' Pain-Related Knowledge and Attitudes

PURPOSE

The present study was aimed at investigating the quality of pain management evaluated by inpatients in surgical clinics, and pain-related knowledge and attitudes of nurses working in surgical clinics, surgical units, or emergency services.

METHODS

The study was conducted as a descriptive and cross-sectional study. The study data were collected from inpatients in surgical clinics (N = 306), and from nurses working in surgical clinics, surgical units, or emergency services (N = 57) between January 2020 and September 2020. The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) and Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP) were the tools used for data collection.

RESULTS

The mean scores the participants obtained from the severity of worst pain, pain relief, and satisfaction with pain treatment components of the APS-POQ-R were 6.14 ± 2.59, 59.28 ± 22.26, and 8.99 ± 1.62, respectively. There were significant differences between many components of the APS-POQ-R in terms of such variables as age, sex, undergoing previous surgery, presence of pain before surgery, surgery performed, and type of anesthesia (p < .05). The mean score the participants obtained from the NKASRP was 15.35 ± 3.87.

CONCLUSIONS

It was concluded that the patients' pain was relieved moderately, that they were very highly satisfied with pain treatment, and that the nurses' pain-related knowledge and attitude levels were below the moderate level.

CLINICAL IMPLICATIONS

Nurses should support patients whose in-bed activities were prevented due to pain, involve them in pain treatment decisions, advise them about pain treatment options, and encourage them to use nonpharmacological methods.

Bibliometric Analysis on Cholecystectomy Surgery in the Nursing Field

PURPOSE

This study aimed to bibliometrically examine nursing publications regarding cholecystectomy surgery.

DESIGN

The study is a bibliometric analysis.

METHODS

The study was conducted in the Web of Science database. The keywords "cholecystectomy AND nursing" were used during the scanning. The data were evaluated in quantitative aspects.

FINDINGS

In the study, 481 publications were identified, publications were made between 1987 and 2023, the average number of years since the release of the publication was 10.2, and the annual increase rate was 8.19%. The most active country was the United States, and the journal most often published in was the "Journal of Perianesthesia Nursing." In the last 3 years, the themes of "meta-analysis, complication, pain, anxiety, quality of life" have been trending, the most working and continuing to develop our "laparoscopic cholecystectomy" and "pain" themes, and the leading theme in the field was "anxiety".

CONCLUSIONS

This study is the first bibliometric study examining nursing studies on cholecystectomy and provides a comprehensive overview of cholecystectomy and nursing issues over 36 years. In quantitative data, it was concluded that although studies in this field have a long history, the number of publications is low, and the annual growth rate is low. According to the quantitative evaluation results, it was found that the most studied topic in this field was laparoscopic cholecystectomy and pain, minimally invasive intervention and perioperative period topics remained isolated, and computerized tomography and gallbladder themes were among the newly emerging themes.

Nurses' Knowledge, Attitudes, and Barriers Toward Pain Assessment and Management in Assir Region, Saudi Arabia

Purpose:This study aims to assess nurses' knowledge and attitude towards pain assessment and management as an essential component of holistic nursing and patient care. Study Design: A cross-sectional descriptive design. Methods: A convenient sample of 282 nurses working in four health care institutions in the South region of Saudi Arabia was enrolled. The Knowledge and Attitudes Survey Regarding Pain tool was used to collect data from April-July 2021 through a web-based survey. Findings: The knowledge level and attitude of the nurses toward pain assessment and management was inadequate. The participants' correct mean score was (2.98). Forty percent achieved a passing score of 70%. Female nurses, postgraduate, working in medical-surgical units, had 5 to 10 years of work experience had higher knowledge and attitude levels. The barriers were categorized as patients, nurses, physicians, and system-related barriers. The most perceived barriers were nurses' shortage (76.2%); restricted opioids regulations (66.7%); and unavailable comfort measures as alternatives (59.9%). Conclusions: Inadequate nurses' knowledge and negative attitudes toward pain assessment and management is an alarming global concern. Healthcare administrators have to improve nurses' competencies through continuous education and training programs, adopt updated guidelines and eliminate barriers to achieve holistic patients' care including optimal pain control.

Unmet Supportive Care Needs of Jordanian Patients with Colorectal Cancer: A Cross-Sectional Survey

Objective:

Colorectal cancer (CRC) is ranked the second most common cancer diagnosed in both men and women in Jordan. This paper aims to explore the unmet supportive care needs (USCNs), and their predictors among Jordanian survivors with CRC.

Methods:

A cross-sectional descriptive correlational research design with a convenience sample of 180 patients with CRC was conducted. Participants completed the Supportive Care Needs Survey-Short Form 34.

Results:

Jordanian patients with CRC reported their highest perceived level of need in the information and psychological domains. Multiple linear regression revealed that income and the number of chemotherapy sessions were significant predictors in the physical and daily living domains. Age, type of surgical treatment, and type of clinical setting were significant predictors of USCN in the psychological, patient care and support, and the health system and information domains.

Conclusions:

The health-care systems should work to meet all the supportive care needs for patients with CRC, particularly the informational and psychological needs domains where patients express unmet needs. Special care should be given according to age, type of surgery, and the doses of chemotherapy received. This study further confirms a disparity in the care and support provided to Jordanian cancer patients with different health-care settings in the country.

Intrathecal Morphine Versus Ketamine in Postoperative Pain After Hysterectomy: Double-Blinded, Randomized Clinical Trial

PURPOSE

Abdominal hysterectomy is one of the most commonly performed gynecologic surgical procedures and is frequently associated with moderate to severe pain. The present study compared the effects of morphine and ketamine on postoperative analgesia, hemodynamic stability, and postoperative adverse effects in patients who underwent abdominal hysterectomy.

DESIGN

This randomized controlled trial compares the effects of morphine plus adjuvants to those of ketamine plus adjuvants, administered as spinal anesthetic agents in patients who underwent abdominal hysterectomy.

METHODS

Eighty patients were randomly assigned to two different groups: group M (morphine, 40 mcg) and group K (ketamine, 20 mg); the anesthetic agents were combined with equal quantities of other adjuvants. Postoperative analgesia was evaluated by means of a numeric pain rating scale; adverse effects (pruritus, nausea and vomiting, urinary retention, respiratory depression, and changes in bowel habits) at specific postoperative time intervals of T1 (4 hours), T2 (12 hours), and T3 (24 hours) were documented and compared. Hemodynamic stability was assessed intraoperatively.

FINDINGS

Both groups displayed similar patient characteristics, comorbidities, paravertebral block level, and intraoperative hemodynamics. The present study observed a significant difference in postoperative analgesia between the two groups, 12 hours after the surgery, with group M exhibiting better results, compared with group K (P = .004). The pain scores obtained from group K were consistent with the amount of rescue medication (tramadol) administered to the subjects in the group, which showed a concomitant higher consumption of tramadol, compared with group M (42.5 and 71.8 mg in group M and group K, respectively, P = .011). Group M showed a higher incidence of pruritus, changes in bowel habits, and constipation compared with group K.

CONCLUSIONS

Compared with ketamine, intrathecal morphine obtained better postoperative analgesia up to 12 hours after surgery, with a higher incidence of pruritus without any significant change in other variables.

The effect of pain management training in workshop on the knowledge, attitude and self-efficacy of pediatric nurses

Background and Aims

Pain is the fifth vital sign, and pediatric nurses plays a key role in the process of pediatric pain management. The present study aimed to determine the effect of pain management training on the knowledge, attitude and self-efficacy of pediatric nurses.

Methods

This is a quasi-experimental study including two groups of test and control. The experimental group received a workshop method with a content including (ethical aspect, physiology, assessment tools, and pharmaceutical and non-pharmacological pain management) and was not given in the control group. The PNKAS self-efficacy questionnaires was completed by the participants before and one month after the beginning of the study. The data were analyzed using descriptive statistics and independent T-test, Fisher exact, and Chi-square tests using SPSS version 20 software.

Results

The mean pre-test scores of knowledge and attitude in the control and experimental groups was 50.79-47.14, and after one month was 47.46-53.09, respectively, showed that, training was significantly effective in the knowledge and attitude of the experimental group (P value = 0.01). The mean pre-test score of self-efficacy in the control and experimental groups was (17.01-18.06), and one month later was 20.36-21.03 respectively. Although the self-efficacy score increased in both groups, training significantly increased the self-efficacy of pediatric nurses in the experimental group (P value <0.001).

Conclusion

Pain management training is required due to the poor knowledge of pediatric nurses and the importance of pain management in improving the quality of nursing care and the satisfaction of patients with the In addition, feeling high self-efficacy without sufficient knowledge of pain management can disrupt pediatric pain management.

Knowledge and Attitudes of Ethiopian Nursing Staff Regarding Post-Operative Pain Management: A Cross-Sectional Multicenter Study

BACKGROUND

Pain management is one part of management in the postoperative period. The prevalence of moderate to severe postoperative pain and its functional interference is high in Ethiopian patients. In this study we aimed (1) to assess nurses' knowledge and attitudes regarding post-operative pain management; (2) to identify the factors of nurses' knowledge and attitudes.

METHOD

A cross-sectional multicenter study was conducted. All nurses working in Amhara region referral hospitals were involved in the study. The Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP) was used to measure the nurses' pain management knowledge and attitudes. Bivariable and multivariable logistic regression was used to identify factors associated with knowledge and attitude.

RESULTS

A total of 433 nurses were included. Of the total respondents, 90.6% of them had a bachelor's degree with work experience of between 1 to 5 years (58.5%). Only 76 (19.2%) participants got access to read journals and 66 (16.7%) had taken training regarding postoperative pain management. The results showed that 56.5% [95% CI= (51.6-61.3)] respondents had adequate knowledge and 8.9% [95% CI= (6.1-11.6)] of them had positive attitudes towards POP management. Higher level of education [AOR=8.2; CI= (2.51-26.83)], getting access to read journals [AOR =1.83; CI= (1.01-3.30)], and taking POP management training [AOR=8.63; CI= (3.67-20.28)] were statistically associated with adequate knowledge. Similarly, positive attitude towards postoperative pain management was associated with taking POP management training, available of pain management course in the curriculum, and getting access to read.

CONCLUSION

Although more than half of nurses in the study area had adequate knowledge towards POP management, only a small number had a positive attitude. Taking POP management training and getting access to read journals were significantly associated with good knowledge and attitude towards POP management; therefore, regular in-service training and getting accessing reading materials (such as journals or articles) are recommended to enhance quality service to patients.