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      Knowledge and Attitude Towards Non-Pharmacological Pain Management and Associated Factors Among Nurses Working in Benishangul Gumuz Regional State Hospitals in Western Ethiopia, 2018

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          Abstract

          Background

          Millions of people worldwide are suffering from pain. Non-pharmacological therapy has an important role in the treatment of pain and is recognized as a valuable, simple help to lower the dosage of analgesic drugs needed, decreasing the side effects, reducing drug dependency and reducing health care costs; however, knowledge and attitude of nurses greatly affect the use of non-pharmacological pain management methods.

          Objective

          The study aimed to assess knowledge and attitude towards non-pharmacological pain management and associated factors among nurses working in Benishangul Gumuz Regional State Hospitals, western Ethiopia, 2018.

          Methods

          Institution-based cross-sectional study was conducted from April 1st to May 1st, 2017. Two hundred sixteen nurses were selected by using simple random sampling. Data were collected by using a pretested self-administered structured questionnaire. Collected data were checked, coded and entered to Epi-Info version 7 and exported to SPSS version 20 for further analysis. Bivariable and multivariable logistic regression was used.

          Results

          A total of 209 professional nurses participated in the study, a 96.7% response rate. This study shows that 51.2% (95% CI: 51.1–51.3) of nurses had adequate knowledge and 47% (95% CI: 46.9–47.06) of nurses had a favorable attitude towards non-pharmacological pain management. The findings reveal that level of qualification (AOR=12.2 (3.05, 48.4)), taking educational courses (AOR=7.5 (2.7, 21.24)), nurse to patient ratio (AOR=4.9 (1.64, 14.55)) and work experience were factors significantly associated with knowledge. Findings also show that nurse to patient ratio (AOR=10.36 (2.8, 38.4)), training (AOR=4.6 (1.4, 15.4)) and knowledge of non-pharmacological pain management (AOR=4.3 (1.74, 10.56)) were significantly associated with nurses' attitude to non-pharmacological pain management.

          Conclusion and Recommendations

          Nurses in Benishangul Gumuz regional state hospitals have unfavorable attitude, but they have relatively adequate knowledge about non-pharmacological pain management. Work experience, level of education, nurse to patient ratio and taking educational courses were associated with nurses’ knowledge, and nurse to patient ratio, training, and knowledge of non-pharmacological pain management were associated with nurses’ attitude. Therefore, efforts should focus on innovative educational strategies for nurses, training and achieving a 1:6 nurse to patient ratio.

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          Most cited references 33

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          Sex differences in pain: a brief review of clinical and experimental findings.

          Recent years have witnessed substantially increased research regarding sex differences in pain. The expansive body of literature in this area clearly suggests that men and women differ in their responses to pain, with increased pain sensitivity and risk for clinical pain commonly being observed among women. Also, differences in responsivity to pharmacological and non-pharmacological pain interventions have been observed; however, these effects are not always consistent and appear dependent on treatment type and characteristics of both the pain and the provider. Although the specific aetiological basis underlying these sex differences is unknown, it seems inevitable that multiple biological and psychosocial processes are contributing factors. For instance, emerging evidence suggests that genotype and endogenous opioid functioning play a causal role in these disparities, and considerable literature implicates sex hormones as factors influencing pain sensitivity. However, the specific modulatory effect of sex hormones on pain among men and women requires further exploration. Psychosocial processes such as pain coping and early-life exposure to stress may also explain sex differences in pain, in addition to stereotypical gender roles that may contribute to differences in pain expression. Therefore, this review will provide a brief overview of the extant literature examining sex-related differences in clinical and experimental pain, and highlights several biopsychosocial mechanisms implicated in these male-female differences. The future directions of this field of research are discussed with an emphasis aimed towards further elucidation of mechanisms which may inform future efforts to develop sex-specific treatments.
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            Pain as a global public health priority

            Background Pain is an enormous problem globally. Estimates suggest that 20% of adults suffer from pain globally and 10% are newly diagnosed with chronic pain each year. Nevertheless, the problem of pain has primarily been regarded as a medical problem, and has been little addressed by the field of public health. Discussion Despite the ubiquity of pain, whether acute, chronic or intermittent, public health scholars and practitioners have not addressed this issue as a public health problem. The importance of viewing pain through a public health lens allows one to understand pain as a multifaceted, interdisciplinary problem for which many of the causes are the social determinants of health. Addressing pain as a global public health issue will also aid in priority setting and formulating public health policy to address this problem, which, like most other chronic non-communicable diseases, is growing both in absolute numbers and in its inequitable distribution across the globe. Summary The prevalence, incidence, and vast social and health consequences of global pain requires that the public health community give due attention to this issue. Doing so will mean that health care providers and public health professionals will have a more comprehensive understanding of pain and the appropriate public health and social policy responses to this problem.
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              Knowledge and attitudes regarding pain management among nurses in Hong Kong medical units.

              To investigate knowledge levels and attitudes regarding pain management among nurses working in medical units in Hong Kong and factors that might influence their knowledge and attitudes. Pain, a common symptom for patients in medical units, can be relieved by effective pain management. Nurses have a vital role in implementing pain management effectively and must, therefore, have a solid foundation of knowledge and a positive attitude towards pain management. Cross-sectional study. A self-administered survey including demographics and the nurses' knowledge and attitudes survey regarding pain-Chinese version (NKASRP-C) was completed by 143 nurses working at medical units in a public hospital. Descriptive statistics and stepwise regression were used in the data analysis. A deficit in knowledge and attitudes related to pain management was prominent (percentage of total score = 47.72, range = 20-76%). Although nurses had developed appropriate attitudes towards pain management, discrepancies between practice and attitudes existed. Those with a higher percentage of correct scores in NKASRP-C had longer clinical working experience and applied knowledge of pain to their daily work. The findings of this study, identifying problems of inadequate knowledge and inappropriate attitudes regarding pain management, are of concern. A better understanding of the factors that affect such knowledge and attitudes and of the discrepancy between attitudes and practice, can provide useful information to be included in education programmes for nurses and to inform policy on the provision of pain management.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                jpr
                jpainres
                Journal of Pain Research
                Dove
                1178-7090
                16 November 2020
                2020
                : 13
                : 2917-2927
                Affiliations
                [1 ]Department of Nursing, Pawie Health Science College , Pawie, Ethiopia
                [2 ]Department of Pediatrics and Child Health, Nursing, College of Medicine and Health Sciences, Bahir Dar University , Bahir–Dar, Ethiopia
                Author notes
                Correspondence: Lemessa Jira Pawie Health Science College , PO Box: 50, Pawie, Ethiopia Email lemessa21@gmail.com
                Article
                265544
                10.2147/JPR.S265544
                7678465
                © 2020 Jira et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 0, Tables: 11, References: 39, Pages: 11
                Funding
                Funded by: No funding;
                No funding was obtained to carry out the present study.
                Categories
                Original Research

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