A Survey of the Knowledge and Attitudes of Oncology Nurses toward Pain in United Arab Emirates Oncology Settings

Knowledge and practical skills for cancer pain management among nurses on remote islands in Japan and related factors nationwide

OBJECTIVE

To clarify the knowledge and practical skills needed for cancer pain management among nurses on remote islands in Japan and related factors nationwide.

SETTING

Due to geographical factors, nurses working on remote islands in Japan have few opportunities to attend training programs, which makes it difficult to acquire the knowledge and practical skills needed to provide pain management for patients with cancer.

METHODS

We conducted a self-administered questionnaire survey regarding knowledge and practical skills in pain management for patients with cancer.

DESIGN

Cross-sectional study.

PARTICIPANTS

Nurses working in cancer pain care in medical facilities and home care on remote islands throughout Japan.

RESULTS

We analysed 128 responses. Regarding knowledge, the average accuracy level was 49.1%. Items with a low accuracy rate included selecting medicine according to the type of pain and the patient's condition. Regarding practice, the items with low scores included analgesics appropriate for the type of pain and relating physical pain to mental, social and spiritual aspects. The most common significant factor in both knowledge and practice was related to postgraduate training.

CONCLUSIONS

These findings suggest that to improve the knowledge and practical skills for cancer pain management among nurses on remote islands in Japan, it is necessary to incorporate clinical reasoning into basic education and establish remote education systems and consultation systems with other facilities.

Validity and reliability study in undergraduate healthcare students towards the solution of a neglected problem in working life: Attitude scale towards patients with chronic pain

BACKGROUND

Chronic pain is the type of pain that healthcare professionals frequently encounter. Health care students' attitudes towards pain management are not sufficient and this negatively affects their chronic pain management. When students cannot manage the chronic pain they will experience professional burnout, depersonalization, and a decrease in compassion and empathy in patient care. Therefore, the first step in improving health care students' attitudes towards patients with chronic pain is to determine their attitudes.

OBJECTIVE

This study aims to test the validity and reliability of the Scale for Healthcare Professionals' Attitudes towards Patients with Chronic Pain (HCPAPCP Scale) in healthcare students.

METHOD

This quantitative study was conducted with 205 health care students in January-February 2022. Data were collected online with Personal Information Form and the HCPAPCP Scale. To determine the reliability of the scale, internal consistency and test-retest, and for construct validity, exploratory factor analysis and confirmatory factor analysis were performed.

RESULTS

The results of the exploratory factor analysis showed that the two-factor scale consisting of 18 items, the factor structure, and the distribution of factors in items were the same as the findings of the original scale. The Cronbach's Alpha coefficient was 0.88 for the first factor and 0.74 for the second factor. Test-retest reliability was 0.60. In confirmatory factor analysis, the model had a good and acceptable fit.

CONCLUSION

We found that the HCPAPCP Scale was valid and reliable in healthcare students.

Exploring health professionals' knowledge of cancer-related pain: a scoping review

BACKGROUND

Cancer-related pain is a complex multidimensional experience that affects all aspects of life. To support those impacted by cancer-related pain it is essential that health professionals have adequate knowledge in its assessment and management.

AIMS

To explore the knowledge of health professionals regarding cancer-related pain.

METHODS

A scoping review methodology was used to systematically search the literature published between 2010 and 2020. Databases CINAHL, Medline and PsycINFO were searched using terms 'cancer pain', 'healthcare professional', 'knowledge', 'attitudes' and 'barriers'.

FINDINGS

The search identified 38 articles. They focused on nursing knowledge with minimal involvement of allied health professionals. Knowledge levels were variable with the majority demonstrating poor knowledge. Common knowledge gaps included around fear of addiction, principles of cancer-related pain assessment and management, and interventional techniques.

CONCLUSION

Knowledge of cancer-related pain is variable with several knowledge gaps. More work is needed to ensure health professionals have adequate knowledge regarding the complexity of cancer-related pain.

Rehabilitation Nurses' Knowledge About Pain in Older Adults in Malta

PURPOSE

Rehabilitation nurses require adequate knowledge about pain to improve patient experience and quality of care. We explored nurses' knowledge and attitudes towards pain in older adults in a large rehabilitation hospital in Malta.

DESIGN

A cross-sectional study.

METHODS

In total, 130 nurses received a short survey, which gathered sociodemographic data, information regarding usual pain management, and prior education on pain. A modified version of the Knowledge and Attitudes Survey Regarding Pain (KASRP) with 18 questions was used, alongside the 24-item Pain in the Older Adults' Knowledge Survey (POAKS). Non-parametric tests identified factors associated with KASRP and POAKS scores.

RESULTS

Overall, 89 nurses completed the survey (response rate 68%). The median modified KASRP score was 50% (IQR 3.00), with only two nurses achieving the proposed "adequate" score of >80%. The median POAKS score was 79% (IQR 4.00). The only determinant of performance was nationality, with Maltese nurses performing better in POAKS than non-Maltese nurses (median 20.00 (3.00) vs. 16.50 (5.00); p = .003), indicating a possible language-related performance issue. Nurses scored poorly in some questions relating to analgesia administration, particularly opioids, as well as pain indicators and pain assessment.

CONCLUSIONS

Rehabilitation nurses have fair knowledge of pain management in older people but require further education, particularly in opioid indications for pain management, pain expression, and assessment.

Dosage of Physical Activity to Avoid Impairment of Activities Due to Pain: Analysis of Population-based Conditional Processes

BACKGROUND

Physical activity's established health benefits include pain control, yet there is no consensus on the required dosage according to the literature.

AIM

To test the influence of exercise on perceived health in patients whose daily activities are limited due to pain. Besides, analyze the possible moderating effect of age and find a formula for exercise dosage based on the perceived level of health.

METHODS

Cross-sectional study based on the 2017 Spanish National Health Survey with 4,123 participants reporting activity limitations in their daily activities due to pain. The International Physical Activity Questionnaire (short version) was used to calculate energy expenditure. Data included age, sex, leisure-time physical activity, sitting time, pain-related impairments, pain medication, and perceived health. Mediation regression analysis was conducted using the SPSS PROCESS 4.0 macro.

RESULTS

Results indicate a decline in perceived health with age. The relationship between exercise (energy expenditure) and perceived health was highly significant (d=-0.224, p<0.001). Age moderated the association between pain and energy expenditure up to 75.61 years (0.1568, p=0.05) and between energy expenditure and perceived health up to 75.74 years (-0.289, p=0.05), but this effect diminished afterwards. A formula was developed to estimate energy expenditure based on the desired level of health.

CONCLUSIONS

The perception of health in people who are limited in their daily activities due to pain (moderate to very much) is mediated by the amount of physical activity they perform. Besides, this perception is moderated by age, up to 76 years.

Evaluating the Quality of Pain Management Satisfaction Among Oncology Patients in a Hospital Setting: Psychometric Properties of the Arabic Version of Pain Care Quality Survey

PURPOSE

The purpose of this mixed-methods psychometric study was to translate and adapt the Arabic Pain Care Quality (APainCQ) Survey to Arabic and to measure the quality of pain care provided to Arab patients.

PATIENTS AND METHODS

This study used an iterative, mixed-methods approach that employed cognitive interviews, expert content analysis, and factor analysis to develop the APainCQ Survey. The study was conducted at Dubai Hospital, Dubai Health Authority, United Arab Emirates. Arabic-speaking patients admitted to the oncology/hematology inpatient units with a minimum 24-hour stay were eligible for the study.

RESULTS

The sample consisted of 155 patients. The iterative exploratory factor analysis process resulted in the sequential removal of three items. The results of the significant Bartlett test (P < .001) of sphericity and Kaiser-Meyer-Olkin test of 0.93 for both the health care team scale and the nurse scale. The total variance explained was 76.17% for the health care team scale and 60.91% for the nurse scale, which explained 56.51% for factor 1 with 14 items and 4.40% for factor 2. Regarding internal consistency reliability, Cronbach's alpha and McDonald's omega for the health care team scale and nurse scale were high; both values were .95. Internal consistency reliability of pain assessment and pain management subscales of nurse scales were also high, with values of 0.96 and 0.79, respectively. Moreover, there was a moderate correlation (r = 0.66; P < .001) between the two subscales in the nurse scale.

CONCLUSION

This study provides evidence that the APainCQ is a reliable and valid measure of pain dimensions, including pain management and monitoring. This APainCQ scale can potentially expand research and clinical assessment in the Arab world.

Nurses' knowledge and attitudes regarding pain management: Cross-sectional survey in the Eastern Province of Saudi Arabia

AIM

This study aims to investigate the nursing staff's knowledge and attitudes regarding pain management in the Eastern Province of Saudi Arabia.

DESIGN

A quantitative descriptive cross-sectional survey.

METHODS

Between January and March of 2020, 183 registered nurses from two hospitals in the Eastern Province of Saudi Arabia participated in the Nurses' Knowledge and Attitude Survey regarding Pain. We determined the average mean score for both the individual and the aggregate scores and the t-test.

RESULTS

The nurses had an inadequate level of knowledge and attitude regarding pain based on the average mean score for this factor. There was a statistically significant correlation between length of time spent working as a registered nurse and the nurses' reported scores on tests measuring their knowledge and attitude towards pain.

Knowledge about Pain in Spanish Nursing Students

BACKGROUND

All nurses should receive training and education regarding pain as part of their pre-graduate stage, as its assessment and appropriate management when treating patients largely depends on them. With the right knowledge it is possible to reduce its high prevalence, as well as the serious consequences it can lead to.

AIM

To determine the level of knowledge and attitudes towards pain of final-year nursing students in Spain.

METHODS

Descriptive cross-sectional study using a convenience sample of five Spanish universities during the academic year 2020-2021. The Spanish version of the Knowledge and Attitudes Survey Regarding Pain (KASRP) was used. In addition, socio-demographic variables such as age, sex, relationship status, employment status, and the number of dependants were collected. The specific palliative or oncology subjects of each university was also assessed.

RESULTS

A total of 224 questionnaires were collected. One of the nursing universities obtained the best score in the KASRP (59.75%) which was significant (p = .001). This university was the only one that offers specific subjects in palliative or oncologic care. A training deficit in aspects related to pain assessment and pharmacologic concepts was detected. We found no relationship between the KASRP and the different sociodemographic variables.

CONCLUSIONS

Specific training in palliative care improves the students' knowledge regarding pain, although the results did not reach an acceptable minimum. The universities' training programs for Spanish students need to be adapted in order to achieve better results.

Psychometric Evaluation of the Nurses' Cancer Pain Management Competency Scale

BACKGROUND

There is lack of instruments for assessing nurses' comprehensive pain management competency.

AIM

This study aimed to assess the psychometric properties of the Nurses' Cancer Pain Management Competency Scale and to conduct a cursory survey of the pain management educational needs/resources of nurses caring for patients with cancer pain.

METHOD

A convenience sample of 230 Korean nurses who met the eligibility criteria completed the researcher developed the Nurses' Cancer Pain Management Competency Scale and a pain management educational needs/resources survey. The Nurses' Cancer Pain Management Competency Scale was based on the pain management core competencies identified by Fishman et al (2013). Internal consistency was assessed using Cronbach's alpha, and construct validity was examined using exploratory factor analysis with varimax rotation.

RESULTS

Cronbach's alpha of the scale was 0.89. Nurse cancer pain management competency includes four factors, which accounted for 68.44% of the variance: the context of pain management, pain assessment and measurement, management of pain, and multidimensional nature of pain. Approximately 42% of nurses had no available protocols related to cancer pain management. Nurses preferred multi-component educational modalities, including simulation-based learning.

CONCLUSIONS

Findings support internal consistency reliability and content and construct validity of the Nurses' Cancer Pain Management Competency Scale that can help examine pain management competency of nurses. Adopting an evidence-based clinical cancer pain management-related protocol and multi-component training programs are needed to achieve optimal cancer pain management competency in nurses.

Health care Professionals' Attitudes Toward Patients with Chronic Pain: Scale Development Study

BACKGROUND

One of the obstacles in chronic pain management is the attitude of healthcare professionals. Although literature reports that the negative attitudes of healthcare professionals such as stigmatizing their patients with chronic pain and applying inadequate treatment cause failure in chronic pain management, there is no scale to measure the attitudes of healthcare professionals towards patients with chronic pain.

PURPOSE

This study aimed to develop a scale for identifying healthcare professionals' attitudes towards patients with chronic pain.

METHOD

We prepared a draft scale in the form of five-point Likert. We applied the draft scale to 379 voluntary healthcare professionals working in two hospitals in 2019. Internal consistency and testretest methods were employed to determine the reliability of the scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used for construct validity.

FINDINGS

According to the EFA, the scale had two factors explaining 45.68 of the total variant. We labelled the first factor "sensitivity orientation" and the second factor was labelled "misconception orientation". Cronbach Alpha coefficients were 0.88 and 0.75 for the first and second factors respectively. Test-retest method reliability was r = 0.83 in the first factor and r = 0.75 in the second factor. The CFA showed that they were within the limits of acceptable fit values.

CONCLUSIONS

Our study found that the scale for healthcare professionals' attitudes towards patients with chronic pain is a valid and reliable tool.

Broad Needs Assessment of Pain Education in Graduate Medical Education

This article describes a survey-based study of graduate medical residents and fellows in an integrated health system. The study explores pain curricula, learner perspectives about pain education, and learner knowledge, attitudes, and confidence. Results indicate that pain education in the graduate medical setting is inadequate to meet learner needs.

A Survey of Knowledge and Barriers of Healthcare Professionals toward Opioid Analgesics in Cancer Pain Management

PURPOSE

Pain is among the most frequent and troubling symptoms in cancer patients. Despite the availability of updated treatment guidelines and effective pharmacological therapies, undertreatment of cancer pain remains a global problem. Opioids are the mainstay analgesics to treat moderate-to-severe cancer pain. The goal of this study was to assess the knowledge and barriers towards opioid analgesics for cancer pain management among healthcare professionals in Oncology Units in Jordan.

METHODS

A structured questionnaire was administered to healthcare professionals (consultant doctors, resident doctors, pharmacists, and nurses) at three Oncology Units in a cross-sectional study design.

RESULTS

A total of 201 healthcare professionals completed the questionnaire. The average age was 34.8 ± 8.1 years (range 23-58) and 49.3% of respondents were nurses. The mean score for the knowledge of opioids was 12.5 ± 3.2 out of 24 points (range 2-20). An acceptable level of knowledge was observed in 50.7% of participants, while 49.3% had poor knowledge. Knowledge items mostly answered incorrectly were related to opioid administration, pharmacology, dosing, adverse events, rotation, and toxicity. Knowledge scores were significantly higher for consultant doctors compared to pharmacists and nurses (p=0.016 and p < 0.001, respectively). Healthcare professionals who handled opioid analgesics had significantly higher mean knowledge scores than those who did not (p=0.012). Linear regression analysis revealed that being a consultant physician has an independent, statistically significant association with higher knowledge scores. Among perceived barriers to using opioids, fear of addiction by patients was the most frequently reported barrier by respondents (79.6%). Other highly recognized barriers were fear of adverse effects by patients (67.2%) and lack of training programs on opioid dosing and monitoring (63.7%).

CONCLUSIONS

This study revealed major gaps in the knowledge of opioids and pain management among healthcare professionals. There is an urgent need for developing innovative interventions to improve the knowledge of opioid analgesics and the understanding of pain management guidelines among healthcare professionals in Jordan.

Predictors of nurses' attitudes and knowledge towards pain management in Italy. A cross-sectional study in the hospital settings

INTRODUCTION

Pain is multidimensional, and as such it is the chief reason patients require urgent health care services. If inadequately assessed and untreated, pain may negatively impact on the quality of life of the patient. Pain management is an essential part of Nursing. The aim to this study is to examine the level of knowledge and attitudes with regard to pain among Italian nurses who work in clinical settings.

METHODS

The Ferrell and McCaffery's Knowledge and Attitudes Survey Regarding Pain was distributed to 266 nurses employed in one specialized hospital in Rome, Italy. The staff in the survey work in three different settings: the intensive care unit, the sub-intensive care unit, and an ordinary ward. Descriptive statistics were employed and a logistic regression model was performed to evaluate the factors that may influence the attitude and knowledge of care providers.

RESULTS

49.6% of the sample correctly answered items about attitudes, 47.4% about knowledge, and 36.5% about assessment. The results show that the odds ratio of developing positive attitudes towards pain was 1.76 times higher in nurses employed in the sub-intensive care unit than in other settings. There are no statistically significant associations of knowledge between setting, sex or education.

CONCLUSIONS

Our survey revealed a limited overall level of knowledge and attitudes with regards to pain management among nurses. Implementing specific training for health professionals, starting with academic education, is therefore a priority. Further research is needed on a larger sample of Italian nurses.

A Nonrandomized Pretest Posttest Study on the Impact of an Educational Pain Management Program on Nurses' Knowledge and Attitudes Regarding Pain in a Middle Eastern Country

BACKGROUND

Although nurse's knowledge and attitudes regarding pain management has been sufficiently studied worldwide, the impact of an educational intervention program in improving such attitudes and knowledge has not been likewise researched, especially in Middle Eastern countries.

AIMS

To examine nurses' knowledge and attitudes regarding pain at a university hospital in Lebanon before and after the introduction of a pain management educational program. And to assess the relationship between the characteristic of nurses and their pain knowledge.

METHODS

Design; A nonrandomized pretest posttest study design was used. Setting; A university hospital in Lebanon. Participants; Included 183 nurses using the Nurses' Knowledge and Attitudes Survey Regarding Pain questionnaire. The pain educational intervention was based on the principles of Ajzen's theory of planned behavior.

RESULTS

A significant difference between the pre and post test scores was noted (p = .016). Questions answered correctly by 80% of participants were related to questions about pain, pain assessment and management, and questions related to medications, such as correct dosages and opioid side effects were not answered correctly by the majority of nurses. There were significant associations between test scores and the nurses' educational level, their age, and their years of experience. Nurses who worked in critical care units, the emergency department and oncology had higher scores than nurses who worked on general units.

CONCLUSIONS

Despite the intensive pain education provided at our institution, the pain knowledge of nurses remains below that recommended level which indicates a dire need for more intensive and continuous education in order to provide a pain free environment.

Knowledge and attitudes regarding cancer pain management among oncology nurses in China

Objective

There are limited studies examining knowledge and attitudes among Chinese oncology nurses regarding cancer pain management.

Methods

We conducted a cross-sectional survey among oncology nurses from 26 hospitals in China. The nurses completed the Knowledge and Attitudes Survey Regarding Pain (KASRP) questionnaire. Multivariate models were used to identify factors associated with nurses’ KASRP score.

Results

A total of 982 nurses completed the KASRP (mean score = 21.56 ± 4.00), and 8 (0.81%) nurses had a passing score. The results of multivariate regression indicated that clinical rank and experience in cancer pain management were associated with good knowledge and attitudes regarding cancer pain management.

Conclusion

The Chinese nurses in our study did not have adequate knowledge of or positive attitudes related to cancer pain management. Clinical rank and experience caring for patients with cancer could be used to help identify nurses with inadequate knowledge and attitudes regarding treating cancer pain.

Knowledge and Attitudes of Home Care Nurses in Cyprus in the Management of Cancer Pain

Pain is a common symptom for cancer patients. It is a problem for themselves and their relatives. Nurses are confronted with the treatment of cancer pain in their everyday clinical practice. Efficient management requires accurate and appropriate knowledge, positive attitudes, and competent evaluation skills. The aim is to explore the knowledge and attitudes of Cypriot home care nurses in pain management of cancer patients. Regarding methodology, a quantitative descriptive design was used and the data were collected with the Greek version of the McCaffery and Ferrell Nurses’ Knowledge and Attitudes Survey Regarding Pain questionnaire along with a demographic questionnaire. The sample of the study consisted of home care nurses working in non-profit organizations in Cyprus ( n = 31). For the analysis of data, the SPSSv.21. was used and the statistical significance was set to the p = .05. Results revealed of the total of 35 questions only 13 were answered correctly by the 80% of the participants. Limited knowledge was reported mainly on the duration of action, the effect and dosage of Pethidine, the risk of addiction and the use of non-medication interventions. Significant differences were found to the level of knowledge as regards the age and the experience of nurses. In the case study exercise, it was found that false assessment of pain was related to wrong decisions. Nurses’ attitudes seemed to be positive. In conclusion, the study revealed the knowledge deficits and need for continuous education of home care nurses on the assessment and management of pain for patients with cancer. Empowering nurses with better skills to deal with pain, a most distressing symptom of cancer, will result in a better quality of life for patients. However, the integration of pain management within the national cancer strategies is also very important.

Determinants of Knowledge of Pain among Nurses in a Tertiary Hospital in Spain

BACKGROUND

Poorly controlled pain in patients is related to several complications, such as increased nosocomial infections and mortality, where nurses play a crucial role.

AIMS

To analyze determinants of pain as well as nurses' knowledge and attitudes towards pain in the inpatient services of a tertiary center in the Spanish public health network.

METHODS

The Knowledge and Attitudes Survey Regarding Pain questionnaire was administered to all nurses in the center from January to March 2019. Additional sociodemographic variables, such as gender, age, employment status, work experience, professional group, and academic degree, were collected and analyzed. Item Response Theory was used for discriminant analysis of each question and its relationship with the final score.

RESULTS

A total of 282 questionnaires were collected from those distributed among nurses working in medical, surgical, oncological, and intensive care services. The average score obtained on pain-related knowledge and attitudes was 58.89%. We found significant differences (p < .001) between the KASRP score and the professional group score. There were no differences in final score based on academic level or age. Questions related to pharmacology resulted in low scores and did not discriminate between levels of knowledge, being considered difficult. We did not find items that allowed discriminating between levels of knowledge.

CONCLUSIONS

A knowledge gap exists regarding nurses' pharmacological and assessment concepts, and there are differences in knowledge depending on professional group. The KASRP allows for a good discrimination of low levels of knowledge.

Factors Related to Nurses' Knowledge and Attitudes Toward Pain in Hospitals in Low-Income Areas

BACKGROUND

Effective pain management is closely related to nurses' knowledge and attitudes toward pain. Limited studies have been performed related to nurses' knowledge and attitudes toward pain in hospitals in low-income areas.

AIMS

This study surveyed the knowledge and attitudes of nurses toward pain management in county hospitals from low-income areas in Hunan Province, China.

SETTING AND PARTICIPANTS

The study included 4,668 registered nurses working in 48 county hospitals in low-income areas in China.

METHODS

A cross-sectional study examined the knowledge and attitudes of nurses with regard to pain using the Chinese version of the Knowledge and Attitude Survey Regarding Pain (KASRP) via the WeChat application.

RESULTS

The 4,668 registered nurses completed the survey; of these, 43.6% indicated they had never received continuing education for pain. The mean percentage score for KASRP was (40.3 ± 7.95), and none of the respondents achieved a percentage score of >80%. Further, of the 40 items, only two had a correct rate of >80%. Continuing pain education did not significantly affect KASRP. Multiple stepwise linear regression showed that education level, ethnicity, professional title, position, and department were independent influencing factors for KASRP scores.

CONCLUSION

Almost all nurses in county hospitals of low-income areas had deficiencies in various aspects of pain management knowledge. Better educated nurses with higher professional title or management position, those from the Han ethnicity, and those from the oncology department had higher mean KASRP scores. Current continuing education programs for pain did not improve the pain management capability of the nurse. High-quality and standardized pain educational programs should be implemented to improve pain management.

Impact of a pain management program on nurses' knowledge and attitude toward pain in United Arab Emirates: Experimental-four Solomon group design

BACKGROUND

Lack of knowledge about pain is a common barrier to effective pain management. Educational pain management programs directed to health care professionals can improve knowledge and attitudes about pain. However, changing practice is more challenging, but can be achieved with more targeted educational interventions within the clinical setting.

OBJECTIVES

The main objective of this study was to examine which of four separate pain management educational designs improved nurses' knowledge and attitudes toward pain over time. Secondary objectives were to compare and contrast nurse's knowledge and attitudes toward pain before and after the educational intervention.

DESIGN

This randomized controlled trial using a four Solomon group design.

SETTING

This study took place in Dubai Hospital, Dubai Health Authority, in United Arab Emirates between January 2019-April 2019.

PARTICIPANTS

The sample consisted of 200 registered nurses who were randomly selected and assigned into four separate educational groups. Participants had at least one year of experience in Dubai hospital prior to data collection.

RESULTS

paired t-test has shown the experimental group scored significantly higher than the control group (p < 0.01). One-way ANOVA revealed significant post-test score differences between groups p < 0.001. A repeated measures ANOVA with a Greenhouse-Geisser correction determined that mean scores over three months was not statistically significant. Indicating that the level of knowledge did not change over time within any of the groups.

CONCLUSION AND RECOMMENDATIONS

The most important findings were the relatively low pre-test knowledge scores among staff nurses, and the significant improvement in knowledge for most test items following the educational intervention. Moreover, the level of knowledge and attitudes were maintained over three months. The pain management program proved to be effective in improving nurses' pain knowledge, attitudes, and assessment practices. Nurses in the experimental group increased their pain score significantly after the pain management program. Registration number: NETUBR.