Nurses' knowledge and attitudes regarding pain

Abstract

Background: Nurses have a crucial role in the assessment and management of pain in the care of the postoperative patient. However, international research has shown significant numbers of nurses surveyed had knowledge and attitudes regarding pain which failed to meet the expected standard. There appears to have been a lack of current evidence on this topic in the New Zealand context. Therefore, this study surveyed the knowledge and attitudes regarding pain, of nurses involved in adult postoperative care. Aim: The aim of this study was to explore the knowledge and attitudes of registered nurses (RN’s) regarding pain across five District Health Boards (DHB’s) of the North Island of New Zealand (NZ). The purpose was to establish baseline information in the New Zealand context on RN’s knowledge and attitudes regarding pain, which may inform future strategies to develop pain knowledge and attitudes in this cohort. Methods: A cross-sectional descriptive non-experimental design was used to collect data from RN’s involved in adult postoperative care using a modified version of the Knowledge and Attitudes Survey Regarding Pain (KASRP) tool (Ferrell & McCaffery, 2014). Study data were collected via the online KASRP survey, and managed using the Research Electronic Data Capture (REDcap) tool. Demographic data were collected, specifically: Age, gender, years as RN, and years of surgical experience, hours worked per week, DHB employed by, highest nursing qualification, ethnicity, and country of original nurse training. Data were analysed using the Statistical Package for the Social Sciences (SPSS). Findings: One hundred and twenty-eight RN’s participated; a response rate of 27.95%. Of these 84 were completed surveys, and 44 incomplete. The averages of nurses’ KASRP scores were 73.1%, with only 41.7% achieving a score over the recommended score of 80%. The key areas associated with poor RN performance were pharmacological knowledge of opioids, and addiction and abuse. With no correlation found between age, years as an RN, years of surgical experience, hours worked per week, country of original nurse training and scores on the KASRP. RN’s self-evaluation of knowledge and attitudes to pain management demonstrated some nurses underestimated their abilities, while others overestimated. Conclusion: To this authors’ knowledge, the present study was the first to evaluate knowledge and attitudes of surgical RNs’ regarding pain in New Zealand. This study showed KASRP scores achieved by the participants in the study were consistent with those published over the preceding 20 years of KASRP tool use. Large surveys investigating nurses’ knowledge and attitudes regarding pain have commonly resulted in mean scores below the stated standard. Consequently methods of modifying knowledge and attitudes regarding pain need to change. Regular ongoing education is required for pre-graduate and postgraduate nurses to deter fears and increase knowledge and attitudes of opioids. Also, an area of deficit is the biopsychosocial approach to pain in the postoperative patient, and therefore could be a beginning point for learning activities.