Development and psychometric appraisal of the Pain Management Self-Efficacy Questionnaire

This study examined the impact of evidence concerning the presence of 1) a biomedical basis for pain and 2) psychosocial influences on practitioner appraisals of patient pain experiences. Furthermore, the potential moderating role of patient pain behavior was examined. In an online study, 52 general practitioners and 46 physiotherapists viewed video sequences of 4 patients manifesting pain, with accompanying vignettes describing presence or absence of medical evidence and psychosocial influences. Participants estimated pain intensity, daily interference, sympathy felt, effectiveness of pain medication, self-efficacy, their likability, and suspicions of deception. Primary findings indicated lower perceived pain and daily interference, less sympathy, lower expectations of medication impact, and less self-efficacy when medical evidence was absent. The same results were found when psychosocial influences were present, but only when the patient displayed higher levels of pain behavior. Furthermore, absence of medical evidence was related to less positive evaluations of the patients and to higher beliefs in deception in both professions. The presence of psychosocial influences was related to less positive evaluations and higher beliefs in deception in both professions. In sum, a range of contextual factors influence health care practitioner responses to patient pain. Implications for caregiving behavior are discussed.

Physicians report they feel ill-prepared to manage chronic noncancer pain (CNCP), in part because of inadequate training. Published studies and clinical observation demonstrate that trainees lack confidence and reflect negative attitudes about CNCP. Overall, there is minimal published guidance on specific specialty roles and responsibilities in CNCP management.

The presence of pain is one of the main reasons why people seek health care, yet pain is often undertreated. Inadequate treatment has been linked to health care workers' failure to assess pain and to intervene appropriately. It may also result from the limited attention given to pain management in nursing curricula. This descriptive study explored nursing students' knowledge and attitudes about pain management. The Nurses' Knowledge and Attitude Survey Regarding Pain was used to collect data from clinical nursing students. The sample (n = 313) was obtained from approximately one fourth of the baccalaureate of science in nursing and associate degree in nursing programs in Louisiana. Data analysis revealed misconceptions about analgesic administration and duration, along with an exaggerated fear about the incidence of addiction among patients. Knowledge of pharmacology items was lower than that of nonpharmacology items. When faced with a clinical scenario that required an initial assessment of a patient's pain, most students responded appropriately. However, when the situation required reassessment based on the patient's response to the student's chosen intervention, a majority of them responded incorrectly. Overall, students in the baccalaureate degree programs scored significantly higher (65% correct) than students in the associate degree in nursing programs (60.8% correct) (t [311] = -3.321, p = .001). However, the combined mean score for both groups was 64%, indicating inadequate knowledge of pain management. Despite major initiatives by accrediting agencies, statewide Pain Initiatives, and professional organizations, knowledge of pain management is still inadequate. Nursing faculty need to critically review their curricula to determine whether students are being taught in-depth and up-to-date pain management information that incorporates evidence-based research and current standards of care.