Knowledge, Attitude, And Practices Toward Pain Management Among Nurses Of Gombe General Hospital – Butambala District.

Abstract

Introduction: On a global scale, numerous nurses working in general practice exhibit a lack of knowledge regarding fundamental principles of pain management. This knowledge gap extends to the attitudes that nurses hold towards pain and its evaluation. This attracted the researcher to carry out a study on specific objectives that included; assessing knowledge, attitude & practices toward pain management among Nurses of Gombe General Hospital Methodology: A descriptive cross-sectional study design with qualitative methods of data collection and analysis was used. A sample size of 133 respondents who were nurses selected by simple random sampling was used. Data was collected using questionnaires. Results: Nurses’ knowledge towards pain management; majority agreed that; 126 (95%) had any formal training on pain assessment and management, 80 (60%) had informal, 93 (70%) received palliative care training, morphine has a dose ceiling (86; 65%), give opioid analgesics in case the cause of pain isn’t known (110, 83%), an optimum pain relief isn’t achieved with a single dose of an anticonvulsant (96; 72%), morphine administered intravenously had a time peak effect of 10-15 minutes and effect duration of 2-4 hours (80; 60%). Morphine administered orally had a time peak effect of 3 hours and an effect duration of 12-18 hours (54 (41%). Abrupt withdrawal of opioid analgesics has fatal effects, chronic pain has effects such as decreased appetite, and sleep disturbances (89; 67%). Thought assessing pain is very important before management 117 (88%), manage pain on a fixed schedule 109 (82%) and 94 (71%) give opioid analgesics intravenously to patients in deep pain. Nurses’ attitude that the majority; 106 (80%) never agreed with patients’ self-report of pain all the time, 91 (68%) using a pain assessment tool is extremely important, 102 (77%) encouraged patients to withstand pain as much as possible, 117 (88%) nurses depend on caregivers to assess the pain of children. Also, 112 (84%) patients’ spiritual beliefs determine their response to pain, 80 (60%) narcotic (tranquilizer) and opioid addiction lead to impaired control over drug use, compulsive use, continued use despite harm, and craving, 55 (41%) pain is best judged by patients themselves, 47 (35%) much pain would attract patient to ask for more pain medication and 53 (40%) believed every patient should be assessed independently based on cultural influences. However some nurses never believed; 89 (67%) that if a patient’s thoughts are distracted from pain, they usually do not suffer from severe pain, 110 (83%) that patients who have a history of substance abuse shouldn’t be given opioids and 109 (82%) old patients were unable to put up with opioids analgesics for pain relief. Nurses’ practice towards pain management were; majority 74 (56%) used pain assessment tools to evaluate patients’ pain where 33 (45%) occasionally used a pain assessment tool, 84 (63%) documented pain outcomes whereas 48 (36%) did it once every shift (two hours) and 90 (68%) never discussed pain during nurse’s report, 77 (58%) adjusted the first dose of opioid, according to specific patient’s response, 102 (77%) administered water for injection as a test for pain intensity, 96 (72%) intravenously gave opioid analgesics to patients with severe pain of abrupt onset and 113 (85%) gave 30mg of IV Morphine administered for 4 hours. Conclusion: Nurses had good knowledge and practices on pain management among nurses but had negative attitudes towards pain management. Recommendations: There is a need for intensive continuous on-the-job training and reminders for pain management in work areas, and the hospital administration should provide adequate resource materials.