Pain knowledge and attitudes of nursing students: a literature review

Nursing students' knowledge of and attitudes towards pain management: An integrative review

OBJECTIVES

The objectives of this review were to appraise the available literature regarding nursing students' knowledge of and attitudes towards pain management; and secondly, to examine the instruments currently used to measure students' knowledge of and attitudes towards pain management.

DESIGN

This review was conducted using Whittemore and Knafl's five-stage framework for integrative reviews.

DATA SOURCES

A comprehensive search to retrieve relevant studies published in English between 1978 and 2022 was conducted using the databases: CINAHL, MEDLINE, Embase and Scopus databases. An updated search of the same databases was performed to identify studies published in 2023-2024.

REVIEW METHODS

The initial search located 558 articles. One more relevant article was identified from an updated search test. Total of 244 duplicated records were removed. The remaining 315 studies were eligible for screening. After screening and checking for eligibility, 29 included articles were critically appraised using the Joanna Briggs Institute critical appraisal tools.

RESULTS

Synthesis of the findings of the 29 included studies indicated that, internationally, nursing students have limited knowledge and often hold negative attitudes towards pain. Various instruments have been used to measure students' knowledge and attitudes towards pain. Most studies used true/false or multiple-choice questions and Likert-type scales. The validity and reliability of most of the tools were reported to be acceptable. The most commonly used instrument was the Knowledge and Attitudes Survey Regarding Pain.

CONCLUSION

The findings from this review suggest the need for refinement of pain education programs to improve nursing students' knowledge of and attitudes towards pain management. Future research should focus on understanding the personal and environmental factors that impact students' level of knowledge and attitudes so as to inform curriculum development and ultimately the quality of the care graduates provide.

Nursing students' pain management self-efficacy and attitude towards patients with chronic pain: What can be done better in education? A cross-sectional study

AIM

This study has been conducted to determine nursing students' pain management self-efficacy and attitudes towards patients with chronic pain.

BACKGROUND

Pain is a significant phenomenon that often leads individuals to seek medical attention, influenced by various factors and commonly encountered by healthcare professionals. Adequate knowledge and positive attitudes among nurses play a crucial role in the thorough assessment and effective management of pain, resulting in favorable outcomes for hospitalized individuals.

DESIGN

This study used a descriptive cross-sectional design.

METHODS

The research was conducted with 322 undergraduate students who were continuing their education in the autumn semester of the 2023-2024 academic year at Aksaray University, Faculty of Health Sciences, Department of Nursing. Data have been collected by using Student Information Form, Pain Management Self-Efficacy Questionnaire (PMSEQ) and the Attitude of Healthcare Professionals towards Patients with Chronic Pain Scale. Mann-Whitney U, Kruskal-Wallis significance test and Spearman Correlation analysis have been used to evaluate the data.

RESULTS

The mean total score of the PMSEQ was 62.91 (SD 15.58) and the mean total score of the Attitude of Healthcare Professionals Towards Patients with Chronic Pain Scale was 3.94 (SD.52). Those students who willingly opted for the nursing profession, perceived themselves as proficient in managing chronic pain, administered care to patients experiencing pain during clinical placements, believed they received sufficient education in pain management throughout their studies and rated their overall health status as "very poor" demonstrated higher levels of self-efficacy in pain management (p<0.05). As a result of the analysis performed according to the mean scores of the Attitude of Healthcare Professionals Towards Chronic Pain Patients Scale and its sub-dimensions of the students participating in the study, a statistically significant difference has been found according to their gender, academic year and self-sufficiency in pain management (p<0.05). It has been determined that there is a weak positive correlation between the total mean scores of the participants' PMSEQ and the Attitude of Healthcare Professionals Towards Patients with Chronic Pain scale (r=.260; p<0.01).

CONCLUSIONS

In this study, as nursing students' self-confidence in pain management self-efficacy increased, their attitudes towards patients with pain also increased positively. In the nursing curriculum, there is a necessity for integrating pain management education and fostering awareness to adequately equip nursing students in addressing the pain requirements of patients.

Nursing Students' Perceptions on a Pain Management E- Learning Module: An Exploratory Quantitative Study

BACKGROUND

Nursing students are graduating ill-prepared to assess and manage pain in older adults. To address this gap, we developed an e-learning module on the topic.

AIM

To examine nursing students' perceptions on a pain management e-learning module focused on older adults.

METHODS

Utilizing an exploratory quantitative design, we assessed nursing students' perceptions of the e-learning module. We used a feedback survey (four 5-point, Likert-type items) and one open-ended question to assess students' perceptions. Descriptive statistics were used to summarize students' perceptions and demographic characteristics. Responses to the open-ended question were content analyzed.

RESULTS

A total of 181 of 249 students completed the module, of whom two-thirds were female. Students perceived that the module enhanced their knowledge, confidence, and perception in working with older people. Students also found the method of instruction interactive and enjoyable.

CONCLUSIONS

The e-learning module on pain management was viewed by nursing students to be helpful and its interactive method of learning improved their knowledge, confidence, and perceptions of working with older adults in pain.

A framework for capacity enhancement of Rwandan nurse educators and preceptors facilitating nursing students to learn pediatric pain management

INTRODUCTION

In low- and middle- income countries like Rwanda, children are most likely to suffer from painful and life-limiting conditions due to various factors predominant in these settings. Adequate pre-licensure pain management training can improve pain relief nursing practices. Educators and nurses in practice have a responsibility to teach the soon-to- be nurses for holistic competent nursing care of children, emphasizing the importance of and addressing child's suffering, yet inconsistencies were reported in what was taught regarding pediatric pain management from a theoretical perspective by nurse educators as compared to their counterparts in clinical settings in Rwanda.

DESIGN

This study applied a qualitative approach using group discussions based on nominal group technique (NGT) to develop and validate a conceptual framework supporting the capacity enhancement of nurse educators and preceptors facilitating students' learning about pediatric pain management in Rwanda.

METHODS

NGT meetings were conducted with academic nurses (n = 8), nurse clinicians (n = 4), and nursing students (n = 2) during a 2-day workshop to identify strategies, discuss the relevance of each strategy and to agree on key concepts of a framework for improving the ability of nurse educators and preceptors to teach PPM to nursing students. After four weeks another round of NGT meetings were done with nursing faculty (n = 6), academic nurse leaders (n = 3), nurse preceptors (n = 2), clinical nurse leaders (n = 2), a nurse leader from a regulatory body (n = 1), and nursing student (n = 1) to validate the developed framework.

FINDINGS

Four main strategies corresponding to the key concepts were mapped in a framework. Participants had a consensual agreement on the importance of the developed framework, they confirmed its completeness and practicality. In addition, participants found that the developed framework is logical, and confirmed that it is applicable for its purpose.

CONCLUSION

The developed framework presents an opportunity to respond to the gaps in nursing pain education in the context of limited resources settings such as Rwanda. It can also be applied in nursing practice and nursing research, aligning with the need of improving the quality of care of suffering children. Furthermore, the framework can be adapted and utilized to meet the needs of healthcare professionals other than nurses.

CLINICAL RELEVANCE

Strategies are suggested to improve the ability of nurse educators and preceptors in clinical settings to facilitate the acquisition of pediatric pain management competencies by the next generation of nurses. Future Rwandan nurses could then use the competencies acquired to provide optimal health care to children with pain in the best way possible during their practices.

A review of chronic pain education for UK undergraduate nurses

Chronic pain is a common complaint within health care and staff can face difficulties in caring for affected patients. It has been recommended that training in chronic pain should be within health professionals' educational curriculum. However, despite this recommendation and a free pain curriculum being available, undergraduate nursing courses still have a low number of hours dedicated to pain education. Factors that affect undergraduate nurses are: disparity about whether pain should be taught by theoretical content in the university or by health professionals in clinical placements, the movement towards interprofessional learning in an already crowded curriculum, and the lack of clarity about how to assess students on their knowledge. This review recommends that chronic pain needs to be specifically defined as a learning outcome with a recognised assessment on a generic undergraduate nursing module to ensure all students are exposed to it.

Development and Implementation of an Online Pain Management Continuing Education Program

BACKGROUND

Multiple studies indicate a lack of pain management training across a range of healthcare specialties. The online Joint Pain Education Program (OJPEP) was created to provide content covering various topics that range from general pain science to integrative care to pain management. The present study evaluates the feasibility of an interdisciplinary, self-guided, online pain management continuing education program, the OJPEP.

PARTICIPANTS/SUBJECTS

A total of 228 learners participted in this study. Of the 228 learners, 58 learners identified as registered nurses and 12 learners identified as nurse practitioners.

DESIGN

Prospective single-arm education feasibility study.

METHODS

Potential learners were provided invitations to participate via emails from clinic leadership and postings to hospital intranet websites. Learners registered online and could select up to eight modules, based on the materials developed from a Department of Defense/Veterans Administration project. Learners evaluated their satisfaction with module quality and applicability.

RESULTS

A variety of providers, predominately non-prescribers, across many health care specialties, registered for modules. Across all modules except one, less than half of participants who registered completed the selected module. Time stamps indicated many learners skipped module content. Of those who completed the continuing education evaluation to obtain certificates, the majority indicated the content was of high-quality, appropriate, and evidence-based. One-third to approximately one-half of learners indicated that they would apply content in their clinical practice. Completion of the intended 3-month follow-up survey was poor.

CONCLUSIONS

Though modules were acceptable per learner responses, future work is needed to: develop modules that are more engaging (e.g., interactive) and applicable to learners; and improve implementation methods to include dissemination and evaluation metrics.

Popcorn in the pain clinic: A content analysis of the depiction of patients with chronic pain and their management in motion pictures

The watching of films is popular and accessible to broad segments of the population. The depiction of medical conditions in films has the potential to affect the public's perception of them and contribute to stereotypes and stigma. We investigated how patients with chronic pain and their management are depicted in feature films. Films that contained characters with or references to chronic pain were searched for using databases such as the International Movie Database. Themes that emerged from the content analysis revolved around the films' depictions of characters with pain, their health care providers, and therapies for pain management. Patients with chronic pain were depicted in various ways, including in manners that could elicit empathy from audiences or that might contribute to the development of negative stereotypes about them. The attitudes of health care professionals toward patients with chronic pain ranged from compassionate to dispassionate. Pain management was typically depicted as lacking in breadth or using multidisciplinary approaches with a focus on pharmacological management. The variety of topics related to chronic pain depicted in feature films lends to their use in medical education strategies to better inform health care professions trainees about chronic pain management.

Teaching pain management to health professional students: A systematic review and meta-analysis

Background

Satisfactory pain management can have a significant impact on clients' activities of daily living. We questioned what types of pain management education might improve health professional students' knowledge, skills and perceptions?

Method

From inception until 30th July 2020, we searched MEDLINE, EBM Reviews, CINAHL Plus, ERIC, EMBASE, Cochrane database and Monash University library. Inclusion criteria were controlled trials of health professional students' pain education compared to alternative education, usual curriculum or no intervention. Studies were limited to English. Data were synthesised using meta-analysis.

Results

Fourteen articles were included in this review. For continuous data, meta-analysis demonstrated a clear effect favouring the intervention for knowledge SMD 1.47 [95% CI 1.18, 1.77], skills 0.93 [0.58, 1.28] or perceptions 0.69 [0.31, 1.08]. For dichotomous data, results showed no effect for knowledge 4.21 [0.65, 27.41], skills 2.26 [0.47, 11.01] or perceptions 1.96 [0.66, 5.76]. However, the overall result showed an effect 2.82 [1.20, 6.59] favouring the intervention.

Conclusions

In summary, short theoretical interventions are sufficient to change students' knowledge and perceptions. Longer interventions incorporating interactivity improve skills. Further research is required to indicate the best method, outcome measure, length of intervention and follow-up in delivering these pain courses and assessing the cost and long-term retention of information.

The Impact of Nurses' Beliefs, Attitudes, and Cultural Sensitivity on the Management of Patient Pain

INTRODUCTION

Nurses' attitudes and beliefs may impact pain management. This study investigated nurses' perceptions regarding their own and patients' pain experiences by examining relationships between pain cautiousness and stoicism, cultural sensitivity, and personal pain attitudes.

METHODOLOGY

A correlational methodology examined nursing staff in a Midwestern private hospital. The sample included 102 primarily female (95.1%), Caucasian (97%), and married (66%) nursing staff. Measures included the Intercultural Sensitivity Scale, Pain Attitudes Questionnaire to Assess Stoicism and Cautiousness, and the Pain Management: Nurses' Knowledge and Attitude Survey.

RESULTS

Cultural sensitivity was a significant predictor of pain knowledge and attitudes total score (R² = .081, β = .244, p = .040), while pain stoicism and pain cautiousness were not predictive.

DISCUSSION

Findings highlight the importance of nurses being aware of personal attitudes, beliefs, and cultural sensitivity in pain management. Results also demonstrate a gap between the knowledge and utilization of nonpharmacologic pain management interventions among nursing staff.

Evaluating the relationship between empathy, pain knowledge and attitudes among nursing students

BACKGROUND

It is essential for nurses to manage pain effectively. Nurses start to learn about pain while still students. Pain assessment is more effective with knowledge of pain, positive attitude, and empathy. Nurse educators should evaluate nursing students' knowledge and attitudes toward pain management and their relationship with empathy and should revise the curriculum accordingly. No published studies have been found to date where the relationship between nursing students' knowledge and attitudes toward pain and empathy has been investigated.

OBJECTIVES

This aim of this study was to determine the factors affecting pain knowledge and attitudes of nursing students, and to evaluate the relationship between students level of empathy and pain knowledge and attitudes.

DESIGN

This study was a quantitative, descriptive-correlation design.

SETTINGS AND PARTICIPANTS

The study population was 150 students who were studying in the third and senior grades a nursing department in North Cyprus. The sample included 133 nursing students.

METHODS

Data were collected with the 'Student Descriptive Information Form', 'Knowledge and Attitude about Pain' questionnaire, and the "Basic Empathy Scale" (BES). The data were evaluated with descriptive analysis, nonparametric tests, and correlation analysis by using SPSS 20.0 program.

RESULTS

Mean affective and cognitive empathy scores were 30.16 (SD = 4.42) and 29.29 (SD = 2.65), respectively, and the mean score obtained from the Nurses' Knowledge and Attitudes Survey Regarding Pain was 13.50 (SD = 3.22). Furthermore, 91% of the participants stated that the patient is the most accurate judge of the intensity of pain, but only 1.5% of them responded correctly to questions on pharmacological methods of pain therapy. A weakly positive correlation was found between cognitive (r = 0.100, p = 0.252) and affective (r = 0.013, p = 0.881) empathy levels and pain knowledge and attitudes; nevertheless, this was not statistically significant (p > 0.05).

CONCLUSIONS

The study results indicate that curricula regarding pain management should improve the knowledge and attitudes of nursing students toward pain management. Seminars and practical training about how to use empathy in pain management should be planned and clinical practice should be scheduled more frequently.

Student nurses' pain knowledge and attitudes towards pain management over the last 20 years: A systematic review

OBJECTIVE

To discover if nursing students have improved their level of pain knowledge and their attitudes towards pain management over the last 20 years.

DESIGN

Systematic review utilising the Kable, Pich, and Maslin-Prothero 12 step approach to document a search strategy.

DATA SOURCES

A search was conducted from 2000 to 2020 using CINAHL, PubMed, Embase and ProQuest.

REVIEW METHODS

Studies exploring the level of pain management knowledge and attitudes of nursing students were included. The Critical Review Form - Quantitative Studies provided the appraisal framework (Law et al., 1998). A narrative synthesis of eligible studies was undertaken.

RESULTS

Six studies with a total of 1454 participants were included. The studies demonstrated that nursing students have not improved their level of pain knowledge and attitudes towards pain management in the last 20 years. Whilst many nursing students thought they possessed adequate pain knowledge, the studies all demonstrated that their pain knowledge is lacking and that they do not have appropriate attitudes towards pain. Students did not recognise the patient who was not grimacing as being in pain despite the patient report of pain.

CONCLUSIONS

These findings support the notion that nursing education does not include sufficient focus on pain identification and management. Alignment of nursing pain education with the curriculum developed in 1993 by the International Association for the Study of Pain is needed to ensure nurses have appropriate knowledge so that patients can receive effective pain management.

Exploration of Hospital Inpatients' Use of the Verbal Rating Scale of Pain

Background: Assessment of pain largely relies on self-report. Hospitals routinely use pain scales, such as the Verbal Rating Scale (VRS), to record patients' pain, but such scales are unidimensional, concatenating pain intensity and other dimensions of pain with significant loss of clinical information. This study explored how inpatients understand and use the VRS in a hospital setting.

Methods: Forty five participants were interviewed, with data analysed by thematic analysis, and completed a task concerned with the VRS and communication of other dimensions of pain.

Results: Participants anchored their pain experience in the physical properties of pain, its tolerability, and its impact on functioning. Their relationship to analgesic medication, personal coping styles, and experiences of staff all influenced how they used the VRS to communicate their pain.

Conclusion: Participants grounded and explained their pain in semantically similar but idiosyncratic ways. The VRS was used to combine pain intensity with multiple other elements of pain and often as a way to request analgesic medication. Pain scores need to be explored and elaborated by patient and staff, content of which will imply access to non-pharmacological resources to manage pain.

The effects of pain management education on knowledge, attitudes, and beliefs in nursing students in Turkey: A quasi-experimental study

PURPOSE

The aim of this study is to examine the effects of pain management education on nursing students' knowledge, attitudes, and beliefs concerning pain management in Turkey.

DESIGN AND METHODS

A quasi-experimental design with pretest/posttest measures was used. The study sample included 79 students.

FINDINGS

The nursing students were found to have enhanced knowledge, attitudes following the initial education, and at the 3-month evaluation, compared to their knowledge and attitudes about pain before the education. However, education had no influence on their organic and psychological beliefs as they did not change across time.

PRACTICE IMPLICATIONS

Pain management education improved the knowledge and attitudes of nursing students. Nurse educators could revise their teaching methods and adopt interactive education methods.

Recognising and assessing acute pain

This article considers two areas of practice that are fundamental to the provision of high-quality nursing care for people experiencing acute pain: the initial recognition of pain, and the formal assessment of pain. The initial recognition of a patient's pain is a subject that is frequently overlooked in the literature. However, if nurses are unable to identify that a patient is experiencing pain, then a formal pain assessment may not take place, which in turn negatively affects the quality of any subsequent pain management. This article explores some of the barriers to the initial recognition of pain and examines how a formal pain assessment can support optimal patient care.

A Cross-Sectional Survey Exploring Nursing Students' Knowledge and Attitudes Regarding Opioids and the Opioid Epidemic

BACKGROUND

The opioid epidemic continues to be a serious public health crisis in the United States. One way to address this issue is to effectively educate future healthcare providers, especially nurses, who play a key role in managing pain and improving opioid-related outcomes.

METHODS

A 34-item electronic survey was administered to traditional baccalaureate student nurses at a large, public University School of Nursing. The survey was used to assess participant demographics, general knowledge, and attitudes regarding opioids and the opioid epidemic, and relevant personal and professional experiences. Quantitative responses were analyzed using descriptive statistics, ANOVAs, and logistic regression; free-text responses were categorized by frequency of keywords.

RESULTS

In all, 134 students (response rate 42.3%) completed the survey. Increases in student opioid knowledge and confidence scores over the 4 years were statistically significant (p< .001). General opioid attitudes were primarily negative (n = 70; 52.5%) or neutral (n = 54; 40.3%), and few students (n = 12; 9.0%) reported positive experiences caring for patients with substance use disorders. Free-text responses revealed that nursing students are eager to contribute to the conversation regarding how to address this critical public health issue and recognize they have a key role to play in safely supporting patients coping with pain.

CONCLUSIONS

Although opioid knowledge and confidence scores were higher for 4th year compared with 1st year nursing students, there is room for continued improvement. Curricula and clinical experiences must thoughtfully integrate opioid and pain management content longitudinally across all years of a nursing program to optimize care for both patients in pain and those coping with substance use disorders.

The Experience of New Graduate Registered Nurses as Managers of Pain

BACKGROUND

Beginning their post-licensure clinical practice can be a challenging time for new registered nurses. Pain management is considered an essential responsibility for nurses, requiring pain management that is prompt, safe and effective. Research is needed to examine the experiences of new registered nurses as they adjust to their new role using what they have already learned about pain and pain management.

PURPOSE

To examine the lived experiences of new registered nurses, who have been in the role less than a year, as they transition into their registered nurse role as a manager of pain utilizing what they have learned about pain and pain management in the undergraduate program and/or continuing professional development.

DESIGN

This research was a phenomenological study in which interviews were audio-recorded and transcribed verbatim.

PARTICIPANTS/SETTING

Eight new graduate registered nurses employed less than a year at a 415-bed regional hospital were interviewed.

METHODS

Content analysis guidelines were used for the analyses of texts.

RESULTS

Themes of navigating relationships, the practice of pain management and disconnect between school and real life were developed from the analyses of texts.

CONCLUSIONS

Knowledge generated from this study can be used to better understand the experience of new graduate registered nurses regarding pain management and enhance pain management curricula in undergraduate nursing education and continuing professional development.

Pain Prevalence, Pain Management, and the Need for Pain Education in Healthcare Undergraduates

BACKGROUND

Pain is a common health problem in undergraduate students. Pain prevalence, pain management strategies and knowledge among healthcare groups has not been revealed yet.

AIM

This study explored pain prevalence, intensity, pain management strategies, knowledge, and education in undergraduate students specializing in healthcare science. The findings will highlight the necessity for increasing pain management education in the university setting.

DESIGN

A questionnaire-based, cross-sectional study was conducted.

SETTINGS/ PARTICIPANTS

Data was collected from 1,490 university students in Tokyo between December 2015 and April 2016. A χ square test was performed to examine differences in pain status and management strategies according to gender. We compared medical knowledge scores among disciplines using one-way analysis of variance.

RESULTS

In total, 511 (79.2%) students had experienced bodily pain during the preceding 6 months. Pain prevalence differed by gender. More nursing students had used both pharmacological and nonpharmacological methods for pain management than had students from other disciplines (p = .011). Pain medication knowledge of students in other disciplines was low to moderate, with greater knowledge observed in medical students (p < .05).

CONCLUSIONS

Education regarding pain management should be developed that considers differences among disciplines. Additionally, poor pain management knowledge could affect the quality of care students provide to patients after graduation. Enhancing pain management knowledge by providing suitable pain management education in universities may contribute to better pain management for students, and this may translate to their work in clinical settings.

Knowledge and Attitude of Ethiopian Oncology Nurses About Cancer Pain Management: National Survey

BACKGROUND

Cancer is becoming a leading cause of death worldwide. Pain is a common and devastating symptom of cancer patients that can significantly affect the patient's quality of life. Optimal cancer pain control requires adequate knowledge and positive attitudes of nurses. Little is known about the knowledge and attitudes of oncology nurses towards cancer pain management in Ethiopia. The current study aimed to assess the knowledge and attitude of nurses and determinants of cancer pain management in all oncology centers in Ethiopia.

METHODS

A nationwide cross-sectional survey was conducted on 138 nurses in all oncology centers in Ethiopia. Self-completed survey questionnaires were distributed using the 'Knowledge and Attitudes Survey Regarding Pain (KASRP)' tool. Both bivariable and multivariable logistic regression analyses were used. Both crude odds ratio and adjusted odds ratio with the corresponding 95% CI were calculated to show the strength of association. Variables with a p-value of <0.05 were considered as statistically significant.

RESULTS

Only 7.2% (95% CI: 2.9, 11.6) of oncology nurses had good knowledge and attitude about cancer pain management. Among 41 items, the mean number of correctly answered questions was 20.4 (SD = 5.13). Nurses who had a master's degree in nursing were positively associated with good knowledge and attitude about cancer pain management.

CONCLUSION

In this nationwide study, the overall knowledge and attitude level of oncology nurses towards cancer pain management were poor. Nurses who had a master's degree in nursing were significantly associated with good knowledge and attitude towards cancer pain management. Regular training and revision of the contents of pain management education in the academic curriculum of nursing education are recommended.

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.

Comparison of the effectiveness of teaching strategies for a pediatric pain management program for undergraduate nursing students: A quantitative evaluation using an objective structured clinical examination

Pain is a common experience for hospitalized children; however, nursing students are often not adequately trained in pediatric pain management. Innovative teaching strategies, such as e-learning, have been employed for instructing students, however success of these platforms has not been quantitatively measured. This study compared students' knowledge and skill performance following a researcher-designed pain management program administered with three teaching strategies: traditional face-to-face, e-learning, or blended learning. Undergraduate nursing students in Taiwan (N = 296) randomly assigned to one of the teaching strategies participated. Knowledge of pain management, and pain management skills were quantified. A subjective assessment of attitudes towards learning found no significant difference between groups. Knowledge of pediatric pain management did not differ significantly between groups (p = 0.36). A 15-item objective structured clinical examination (OSCE) measured the competency of pain management skills; scores were not significantly different, regardless of teaching strategy (p = 0.70). Traditional face-to-face teaching was as effective as both innovative strategies. Evaluating students' skills following a pain management program with an OSCE provided a quantitative assessment of competency. Innovative strategies for teaching pediatric pain management could be a cost-effective way to provide flexible learning opportunities for nursing students who are distant from educational institutions.

Associated factors with the knowledge of nurses of a high complexity oncology centre in Brazil, on the management of cancer pain

Pain is one of the most prevalent symptoms in cancer patients and may be directly related to cancer or to the procedures needed for its diagnosis and treatment. It is estimated that about 40% of cancer patients receive inadequate treatment for painful conditions. Among the barriers to adequate pain management are inadequate knowledge and the dysfunctional beliefs of healthcare professionals. Therefore, the present study aims to assess the knowledge of oncology nurses on the management of pain, as well as the factors associated with it. It is a cross-sectional study with 126 nurses working at a High Complexity Oncology Centre in Brazil. Knowledge about the management of cancer pain was evaluated through the instrument ‘Nurses’ Knowledge on Cancer Pain Management—World Health Organization—developed by Ramos (1994). In the analysis of the association between knowledge about pain management and the independent variables, Poisson regression was used with robust variance, and values of p ≤ 0.05 were considered statistically significant. Adequate knowledge prevalence was 54.1% confidence intervals (CI 5.40%–62.80%). These nurses differed in relation to those with inadequate knowledge regarding the source of knowledge about pain, the ethical aspects in the treatment of the patient with oncologic pain, and non-pharmacological methods (coeliac plexus neuroleptic block) for pain control. Also, the factors associated with adequate knowledge were longer professional experience time ([10–19 years (ratio prevalence (RP) = 1.72, 95% CI: 1.05–2.81), 20–29 years (RP = 2.56, 95% CI: 1.63–4.02), 30–39 years (RP = 3.45, 95% CI: 2.25–5.29]), and not believing that the use of opioids causes harm to patients corresponded with a greater chance prevalence ratio (PR = 1.20, 95% CI: 1.12–1.20) of having adequate knowledge. The findings of the study point to the need for continuing education, updated education, and reflection, especially for nurses with less professional experience.

The importance of chronic pain education and awareness amongst occupational safety and health professionals

Purpose: Occupational safety and health (OSH) professionals are often the point of contact for health and safety policies derived in the workplace, and the handling of incidents in their aftermath. As chronic pain affects 20% of people, many pain-awareness campaigns and educational activities target healthcare professionals. However, initiatives directed toward OSH professionals are also important to aid in prevention and rehabilitation efforts. The objective of this study was to describe knowledge and attitudes of OSH students with regard to chronic pain. Methods: A web-based cross-sectional study was conducted amongst a convenience sample of 88 students enrolled in the distance learning OSH undergraduate certificate program at the Université du Québec en Abitibi-Témiscamingue (Quebec, Canada). Results: Although 30% of students were already employed within OSH or human resources and 40% reported intervening in cases involving chronic pain in their line of work, 56% of respondents had received no training on chronic pain and its treatment in the past five years. Only 14% chose to take the optional 45 hr course dedicated to pain within the program. OSH students also exhibited poorer knowledge and more negative attitudes toward people suffering from chronic pain when compared to other groups assessed in the province of Quebec, including healthcare professionals, chronic pain patients, and people not suffering from chronic pain (p≤0.0002). Half of the respondents (51.9%) were not aware that chronic pain affects 1 in 5 adults. Conclusion: Our study demonstrates a need for pain education within OSH training programs and through continuing education.

An Analysis of Italian Nurses' Approach to Patients' Pain: A Nationwide Online Survey

Healthcare providers play a fundamental role in evaluating pain. Several issues about how nurses are educated remain unsolved. The aim of our study was to address how Italian nurses manage patients suffering from pain in daily practice. A cross-sectional survey was administered among Italian registered nurses. Data were collected using a 34-item questionnaire that had been previously validated during a pilot study. The lowest level of participation/education/information events was observed in the South (p=0.0001). A significant difference among the four areas was found in the department affiliation of responders (p=0.0001). Pain assessment at patients' admission was most frequent in the Northeast (32.9%), whereas the lowest frequency was found in the South (15.1%) (p=0.0001). The prevalence of nurses' knowledge of pain scales and their distribution in usual applications was similar in the Northwest and -east, and Central Italy, but lower in the South (p=0.0001). This study underlines the need for change in the clinical approach to pain treatment in healthcare. Pain assessment is a fundamental step for preparing individualized therapeutic plans, and nurses play a crucial role in improving the quality of life of suffering patients.

Knowledge, Attitudes, and Practices of Postoperative Pain Management by Nurses in Selected District Hospitals in Ghana

INTRODUCTION

There is documented evidence pointing to the fact that there are numerous challenges with postoperative pain (POP) management globally. However, these challenges with POP management are more profound in developing countries.

PURPOSE

The purpose of this study is to examine the knowledge, attitude, and practices of nurses concerning POP management in four selected district hospitals in Ghana.

METHODOLOGY

A descriptive, cross-sectional survey was employed to evaluate nurse's knowledge, attitude, and practices pertaining to POP management. Multistaged sampling was used to draw the respondents. An adapted version of the Nurses Knowledge and Attitudes Survey Regarding Pain instrument was used to test the knowledge, attitude, and practices of nurses and midwives. Descriptive statistics were used to analyze the data in order to present quantitative descriptions of variables in this study.

RESULTS

This study showed that nurses in the four district hospitals had knowledge deficits regarding POP management. Eighty-one representing 48% of nurses had low knowledge on POP management. An overwhelming majority of nurses (97.6%) relied on routinely rendered basic nursing skills to relieve POP and a few used pharmacological interventions. However, nurses had good attitudes toward POP management.

CONCLUSIONS

POP is ineffectively managed by nurses in district hospitals in Ghana. Nurses and midwives in Ghana need to adhere to best practices in POP management by increasing their theoretical and practical knowledge, so that there will be tangible positive change in POP management in Ghana.

RECOMMENDATIONS

Nurses must be empowered through continuous development programs to keep abreast with changing trends that pertain to POP management.

Pain: A content review of undergraduate pre-registration nurse education in the United Kingdom

BACKGROUND

Pain is a global health issue with poor assessment and management of pain associated with serious disability and detrimental socio economic consequences. Pain is also a closely associated symptom of the three major causes of death in the developed world; Coronary Heart Disease, Stroke and Cancer. There is a significant body of work which indicates that current nursing practice has failed to address pain as a priority, resulting in poor practice and unnecessary patient suffering. Additionally nurse education appears to lack focus or emphasis on the importance of pain assessment and its management.

DESIGN

A three step online search process was carried out across 71 Higher Education Institutes (HEIs) in the United Kingdom (UK) which deliver approved undergraduate nurse education programmes. Step one to find detailed programme documentation, step 2 to find reference to pain in the detailed documents and step 3 to find reference to pain in nursing curricula across all UK HEI websites, using Google and each HEIs site specific search tool.

RESULTS

The word pain featured minimally in programme documents with 9 (13%) documents making reference to it, this includes 3 occurrences which were not relevant to the programme content. The word pain also featured minimally in the content of programmes/modules on the website search, with no references at all to pain in undergraduate pre-registration nursing programmes. Those references found during the website search were for continuing professional development (CPD) or Masters level programmes.

CONCLUSION

In spite of the global importance of pain as a major health issue both in its own right, and as a significant symptom of leading causes of death and illness, pain appears to be a neglected area within the undergraduate nursing curriculum. Evidence suggests that improving nurse education in this area can have positive impacts on clinical practice, however without educational input the current levels of poor practice are unlikely to improve and unnecessary patient suffering will continue. Undergraduate nurse education in the UK needs to review its current approach to content and ensure that pain is appropriately and prominently featured within pre-registration nurse education.

Assessing knowledge, perceptions and attitudes to pain management among medical and nursing students: a review of the literature

INTRODUCTION

Chronic pain results in significant personal, societal and economic burden. Doctors and nurses have a pivotal role in patient pain management. In order to determine the effectiveness of current pain education on knowledge, attitudes and perceptions of medical and nursing students, there needs to be a valid measure to assess and quantify these domains. We reviewed the literature to identify approaches for assessing knowledge, perceptions and attitudes to pain management among nursing and medical students.

METHODS

Databases of peer-reviewed literature including CINAHL, EMBASE, ERIC, PsycInfo, Medline and PubMed were searched for articles published between 1993 and December 2014 using the following search terms: student, graduate, intern, junior, pain, pain management, analgesia, analgesic, pharmacology, pharmacological, knowledge, competence, attitude, preparedness, practice, nursing, medical, doctor, nurse.

RESULTS

The search revealed over 3500 articles, and on application of the inclusion criteria, 26 articles were included in the review. A total of 14 instruments were used in these studies with the Knowledge and Attitudes Survey Regarding Pain (KASRP) as the main instrument in 9 out of the 26 articles. The various instruments used different question formats such as multiple-choice questions (MCQs), true/false statements and Likert scales that went from 3 points to 7 points. Clinical skills examinations were also used in four studies to assess pain management.

CONCLUSION

There is no gold standard instrument currently used to assess knowledge, perceptions and attitudes to pain management. The results of this review showed, despite the diversity of standardised instruments that have been used to assess knowledge, perceptions and attitude to pain management, the literature has consistently reported that knowledge about pain management among nursing and medical students was generally poor among both groups.