Nurses’ knowledge, Attitudes and Barriers to Effective Pain Management in Intensive Care Units Governmental Hospitals in West Bank, Palestine

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Hariri, Bassam
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جامعة النجاح الوطنية
Background: Pain is a momentous affliction suffered by patients admitted to the Intensive Care Units (ICUs) that may lead to chronic pain disorders, and can negatively affect the physiological and psychological outcomes for patients and their families. Aim and objectives: This study aims at assessing nurses’ knowledge and attitudes toward pain management of ICU patients, and to identify barriers that affect the optimal pain management among ICU nurses of the Governmental hospitals in the West Bank, Palestine. Furthermore, to detect the relationship between the levels of knowledge/attitude and any other factors affecting nurses. Method: A cross-sectional survey was conducted about the ICU nurses. The study was carried out in twelve (12) governmental hospitals in Palestine, between August and November 2020. Nurses who work in the (ICUs) were invited to participate in this study. One hundred twenty-three (123) nurses who responded to participate out of (164) nurses with a (75%) response rate. Nurses who have been working in hospitals for at least six months were included in this study. The tool was a questionnaire derived from the nurses’ knowledge and attitudes survey regarding pain (NKASRP) section, and was used to gather data about pain management with a minimal test value = 0.80. Furthermore, analyses were executed employing (SPSS). Results: Despite the fact that only 37 (30.1%) of the nurses caring for ICU patients had prior education regarding pain management in the last (2) two years, more than half of nurses 71 (57.7%) testified they had an effective role in pain management. However, precise response rate of NKASRP grade was 47.8%, while the mean number of correct answers to all questions was (19.61±13.51) with a range of 24% to 80%. A statistically significant difference was found regarding years of practice in intensive care units, as well as previous pain education in the last 2 years in favor of those who had pain education (0.5048) vs. (0.4166), with the total mean scores of knowledge and attitudes (p<0.05). There was a highly associated positive correlation between knowledge and attitudes. The study revealed that the (5) least correctly answered questions were related to the case study items about the route of administration of opioid analgesics, and physical dependence. The total barrier score was 2.399 out of 3. No statistically significant differences were found between the demographic features of the nurses and the perceived barriers. However, the highest perceived nurse-related barriers to effectual pain management were insufficient staff knowledge of pain management evenly with nurses' indifference 90 (73.2%). Conclusions: Findings of this study verified that the surveyed nurses had poor knowledge of pain management and less than optimum, and was associated with poor attitudes, as well as a high barrier score signifying a gap toward effective pain management. A significant positive correlation was found between knowledge and attitudes. Recommendations: Nurses have to be well-prepared and knowledgeable on pain management modus operandi. It is recommended that ICU nurses should be provided with in-service training and ongoing pain management courses. Fitting and convenient strategies to minimize potential barriers can be renovated to better empower nurses to employ practice guidelines to yield effective pain management to ICU patients. Expectantly, this study is to be espoused and aptly integrated by MoH and vigorously to be considered legally mandatory upon all health bodies and educational organizations in Palestine.
Pain, Pain management, Attitudes, Education, Knowledge, Nurses, Barriers.