Kasrp Kuisioner

Preprint not peer rev
International Journal of Caring Sciences May-August 2020 Volume 13 | Issue 2| Page 1
Original Article
Knowledge and Attitudes of Nurses towards Postoperative Pain Management

in Southern Ethiopia
Wegene Jemebere
School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
Gezahegn Bekele
School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
Berhan Tsegaye
Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
Zemenu Yohannis
Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
Correspondence: Wegene Jemebere, School of Nursing, College of Medicine and Health Sciences, Hawassa
University, Hawassa, Ethiopia E-mail: jemebere@gmail.com
Abstract
Introduction: Effective management of postoperative pain can lead to comfort, better mobility, improved recovery
and a short stay in the hospital while untreated pain has harmful impacts on the patients as hopelessness, hinder their
response to treatment, and negatively affect their quality of life. Inadequate knowledge and undesirable attitudes
toward postoperative pain management were reported as one of the major difficulties to implement effective pain
management among nurses.
Objective: The main purpose of this study was to assess the knowledge and attitudes of nurses towards
postoperative pain management working at Hawassa University comprehensive specialized hospital.
Methods: Institution based cross-sectional study was conducted among two hundred three nurses working at the
surgical, gynecology, obstetric wards, ophthalmic unit and operation theater from April 1-30, 2019. Data were
collected through standardized worldwide accepted “Knowledge and Attitudes Survey Regarding Pain” (KASRP)
tool it contains 37 items questionnaire of two domains: knowledge and attitude towards pain management. The
collected data was analyzed using SPSS version 20. A chi-square test was done and significantly associated factors
were identified.
Result: One hundred and eighty-seven questionnaires were returned giving a response rate (92.1%). The mean score
of correct answers was (22.5%) with a minimum and maximum score of (18.2%) and (75.4%) respectively. After
categorizing the level of knowledge and attitude, (82.2 %) of nurses possessed very low knowledge and negative
attitude towards postoperative pain management. Prior training on pain management (X 2 = 14.935, P=0.001) and
reading of medical books or journals about pain (X 2 = 5.019, P=0.025) were significantly associated with knowledge
and attitude of nurses towards post-operative pain management.
Conclusion: Nurses had a very low level of knowledge and a negative attitude towards post-operative pain
management. The hospital provides in-service training and avail reading medical books to improve nurse’s
knowledge and attitude towards post-operative pain management. The federal ministry of Health of Ethiopia
enriches the pain content of the nursing curriculum.
Keywords: Nurse, knowledge and attitude, post-operative, pain management, Ethiopia.
www.internationaljournalofcaringsciences.org
This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3693030
Introduction investigation tools are not applied on a consistent

Post-operative pain is defined as a complex basis in acute care situations and this also pays to
response to tissue trauma during surgery and it is under-treatment of pain (McCaffery 2000).
an expected and annoying yet controllable problem Although studies have shown that pain education
(Kehlet H 2006). An earlier study stated that ill- programs increase nurses’ knowledge and improve
managed post-operative pain may have lengthier attitudes towards pain management, the
stays in hospitals, higher readmission rates, late management of postoperative pain by nurses still
healing of wounds, more recurrent outpatient remains a problem and also insufficient education
visits, and altered immune tasks. Such unwell and training for nurses were amongst the issues
treated pain has deep long-lasting concerns and it reported as poor postoperative pain management
rises emotional and behavioral replies during (Goodrich 2006). Even if Ethiopia developed a
future painful occasions (Smart 2005). national pain management guideline in 2007
Effective postoperative pain management has (Health 2007), many studies demonstrated that
numerous benefits include reducing the patient’s pain was untreated adequately due to various
pain, faster postoperative recovery, improved reasons among which nurses' inadequate
sleep, increased mobility, increased patient knowledge and inappropriate attitude were the
satisfaction, and leads to shorter hospital stays leaders (Eyob, Mulatu et al. 2013) and
(Smart 2005).Ineffective pain management is quite (Woldehaimanot, Saketa et al. 2014). Until now,
a common phenomenon across the globe there is no enough proof to understand the real gap
(Dunwoody CJ 2008) and remains to be a in Ethiopia. Thus, this study was planned to define
grievance of hospitalized patients despite the nurses’ knowledge and attitude towards post-
weight laid on the patient’s right to proper pain operative pain management. The finding delivers
treatment and the augmented alertness of the well-timed and baseline information related to
unfavorable properties of pain that is inadequately nurses’ knowledge and attitudes towards post-
treated and managed (Idvall 2002). For the operative pain management at HUCSH. These
effective management of pain in post-operative results may be used as a basis for comparisons in
patients, strong clinical knowledge, attitudes, and upcoming research and interventional studies could
skills in the assessment of pain are essential for be planned on pain management. This is the first
nurses. They must also perform well in the control study done in HUCSH and the Southern part of
of and effective administration of pain medication. Ethiopia in general.
However, several obstacles to this have been
Method and Materials
identified, knowledge deficit on the use of
appropriate pain measures and negative attitudes Study design, period and study area
are the major problems (Smart 2005). A health institution based cross-sectional study
One of the most crucial and immensely provides was conducted on April 1-30, 2019. The study was
aspects of a patent’s pain management is the role conducted in Hawassa University comprehensive
of nurses. Having such an important and specialized hospital. The hospital was established
unavoidable role; nurses must have an adequate in 2004 by a collaboration of the federal ministry
level of knowledge and a positive attitude in the of health, regional government health bureau and
delivery of post-operative pain management based Hawassa town community. The hospital is found in
on effective training (Al Qadire M 2014). Even if the south-western part of Hawassa town and is
pain management has been an integral part of bordered to the east by Hawassa town, to the north
nursing practice for many years, yet there are still by Tabor Mountain, to the west by Hawassa Lake
too many who lack the basic knowledge necessary and to the south by private local residents.
to manage pain appropriately (McCaffery 2000). It delivers a variety of both outpatient and inpatient
Numerous nurses are still trusted their private view services for about 20 million people from all over
about patient’s pain, rather than using their southern regional states (SNNPR) and neighboring
documented assessment to support them and to Oromia region. Currently, it has 400 beds and
select suitable opioid doses. Proper pain provides patient care in a broad range of services
to over 90, 200 outpatients, 18,116 hospitalized Stearns 2000). The content validity of KASRP was
patients, and 1,092 emergency cases annually. It established by a panel of pain experts.
offers services at general and specialty levels. The
hospital is also center for different initiated The KASRP content was based on the pain
projects and the vision is to make the hospital a management guidelines of the American Pain
center of training and research for tropical diseases Society, WHO, and the Agency for Health Care
in addition to curative services. Policy and Research. The KASRP Cronbach alpha
is 0.70 and test-retest reliability > 0.80 (Howell
Sample size and sampling procedure and Stearns 2000).
No specific sampling strategy was employed in The KASRP was revised in 2012 and used by
this study, all nurses working surgical, obstetrics, worldwide researches to assesses the Knowledge
gynecology wards, ophthalmology unit and and Attitudes of health professionals regarding
operation theater during the data collection period pain management (Hope 2012). According to the
were involved in the study. These wards were KASRP tool, the high score indicates a higher
purposefully selected because nurses have level of knowledge and a positive attitude while
exposure to patients with post-operative pain the low score indicates a lower level of knowledge
therefore, adequate knowledge and positive and a negative attitude.
attitude are needed from nurses to manage post-
operative pain. The questionnaire was administered in English
because Ethiopian nurses are capable to understand
Exclusion criteria and answer questions in the original language of
- Nurses in maternity, annual and sick leave the KASRP (all nursing education, curricula, and
during the data collection period. examination in Ethiopian nursing institutions are
conducted in English).
- Nurses who are not willing to participate.
Data collection procedures
Data collection instruments
Data were collected through a self-administered
To collect the data, two questionnaires were used: questionnaire. Questionnaires were distributed to
(I) Form of nurse information and (II) Knowledge each nurse and they were asked to tick the best
and Attitudes Survey of Nurses Regarding Pain. answer. Adequate time was given to read and
Form of Nurse information understand the questions and then submit their
responses.
This form was prepared by investigators and
comprised of questions on the nurses' sex, age, The data collectors stayed with the participants
current unit of employment, level of nursing until they filled the questionnaire. Trained diploma
educational, year of experience in caring patients, nurses with previous data collection experience
reading experience of any books or journals about have collected the data. An average time spent to
pain, Experience of pain management training and complete one questionnaire per nurse was 30-40
personal experience of pain which required anti- minutes.
pain medication. Data quality control measures
Knowledge and Attitudes Survey Regarding Data collectors and supervisors were trained on
Pain (KASRP) was used as an instrument. data collection processes and procedures for half a
The KASRP is a 39-item questionnaire developed day. Filled questionnaires were checked on a daily
by Ferrell, McGuire, and Donovan (Ferrell 1993) basis for completeness, clarity, and accuracy. Data
to assess nurses’ knowledge and attitudes toward cleaning was undertaken before entry and analysis.
pain management. It consists of 21 true/false Data analysis
questions, 14 multiple-choice and 2 case studies.
Data were coded and entered into Epi data version
Howell acknowledged that KASRP is the only 3.1 and exported to SPSS version 20 statistical
available instrument to measure nurses’ knowledge software for analysis.
and attitudes about pain management (Howell and
Descriptive statistics was made using frequency reading any books or journals about pain but only
tables, mean, standard deviation, graphs, pie (26.7 %) participated in pain management training.
charts, and other narrative explanations. A chi- Furthermore, (77.0 %) of nurses reported the
square test was applied for finding an association personal experience of pain. Table 1.
among the variables.
Nurses’ Knowledge and Attitudes regarding
Operational definitions:
postoperative pain management
The researcher categorized the level of knowledge
and attitude into 5 levels using McDonald's percent The mean score of nurses’ knowledge and attitude
correct score of cutoff points. towards postoperative pain management was
(22.5%) with a minimum and maximum score of
Composite percent Level of knowledge and (18.2%) and (75.4%) respectively. Item analysis
score attitude was made to determine which items answered
90 – 100 % Very high correctly by more nurses and which items
80 – 89.9 % High answered correctly by fewer nurses. Table 2.
70 – 79.9 % Moderate The five items that the highest number of nurses
answered correctly on KASRP in ascending order
60 – 69.9 % Low
were (I) The efficiency of Aspirin and other
< 60 % Very low nonsteroidal anti-inflammatory agents (75.4%);
Ethical consideration (II) the effect of patients’ spiritual beliefs on pain
control (70.6%); (III) definition of Narcotic/opioid
A written ethical clearance was obtained from the addiction (70.1%); (IV) the efficiency of
Institutional Review Board of Hawassa University,
combining analgesics (65.8%) and (V) the
Hawassa, Ethiopia. A formal letter of cooperation
was written to the Hawassa university preferred route administration of opioid analgesics
comprehensive specialized hospitals. After the during severe pain (65.8%) Table 2.
provision of sufficient information about the The result also found five items that the lowest
purpose of the study, verbal and written consent
number of nurses answered correctly on KASRP in
was obtained from all study participants.
ascending order were (I) the right time of morphine
Participants were also informed that participation administration to moderate pain (18.2%); (II) the
was on a voluntary basis and they can withdraw correct pain score of talking and joking patient
from the study at any time if they are not (19.7%); (III) risk of respiratory depression with
comfortable with the questionnaire. To ensure the
opioid analgesics (20.3%); (IV) the correct pain
confidentiality of respondents, their names were
score of quietly lying patient with grimaces (20.8
not written on the questionnaire.
%) and (V) the accurate clinical manifestation of
Results opioid physical dependence (21.9%) Table 2.
Nurses socio-demographic characteristics The
Level of Knowledge and Attitude
response rate of this study was (92.1 %) meaning
187 respondents completed and returned the Further item analysis was computed after
questionnaire while 16 respondents (7.9%) did not, categorization of the level of knowledge and
despite they were given the questionnaire. More attitude according to operationally stated. A great
than half (52.9%) were male nurses and (40.1 %)
proportion of nurses (82.1%) were found with a
in the age range of 25-29 years. Nurses working in
Operation theatre were (31.6 %) and most (68.4) of very low level of knowledge and negative attitude
participants were Bachelor degree holders. followed by low (10.2%) and no single nurses
identified with high or very high levels of
The professional experience of (58.8%) knowledge and positive attitude. Graph 1.
participants in caring patients was between 1 to 5
years. In addition, (75.9 %) of nurses experienced
Factors associated with Nurses’ Knowledge and towards post-operative pain management. The chi-
Attitudes square test revealed that prior training on pain
In order to make a better understanding of the management (X2 = 14.935, P=0.001) and reading
variables, the researchers conducted additional data of medical books or journals about pain (X 2 =
analysis to determine which factors may contribute 5.019, P=0.025) significantly associated with
to the knowledge and attitude level of nurses nurses' level of knowledge and attitude towards
post-operative management Table 3.
Table 1: Nurses' socio-demographic characteristics, Hawassa University comprehensive specialized,

southern Ethiopia, 2019 (N=187).
Socio-demographic characteristics N %
Sex
Male 99 52.9
Female 88 47.1
Age (years)
20-24 68 36.4
25-29 75 40.1
30-34 35 18.7
>35 9 4.8
Current working unit
Surgical ward 37 19.8
Gynecology ward 22 11.8
Labor and maternity ward 48 25.7
Ophthalmologic unit 21 11.2
Operation theatre (all) 59 31.6
Level of nursing education
Diploma 59 31.6
Bachelor degree 128 68.4
Years of experience in caring for patients
1-5 years 110 58.8
6-11 years 64 34.2
11 and above years 13 7.0
Reading any books or journals about pain
Yes 142 75.9
No 45 24.1
Experience of pain management training
Yes 50 26.7
No 137 73.3
Personal experience of pain
Yes 144 77.0
No 43 33.0
Table 2: Frequency and percentage of correctly answered questions by nurses, Hawassa University
comprehensive specialized hospital, southern Ethiopia, 2019 (N=187).
Item Item content Correct response

number
True or false questions
N %
1 Vital signs are always reliable indicators of the intensity of a patient’s pain 78 41.7
(False)
2 Because their nervous system is underdeveloped, children under two years of 71 37.9
age have decreased pain sensitivity and limited memory of painful experiences
(False)
3 Patients who can be distracted from pain usually do not have severe pain 88 47.1
(False)
4 Patients may sleep in spite of severe pain (True) 50 26.7
5 Aspirin and other nonsteroidal anti-inflammatory agents are NOT effective
141 75.4
analgesics for painful bone metastases (False)
6 Respiratory depression rarely occurs in patients who have been receiving stable
109 58.3
doses of opioids over a period of months (True)
7 Combining analgesics that work by different mechanisms (e.g., combining an
NSAID with 123 65.8
an opioid) may result in better pain control with fewer side effects than using a
single analgesic agent (True)
8 The usual duration of analgesia of 1-2 mg morphine IV is 4-5 hours (False) 82 43.9
9 Research shows that promethazine (Phenergan) and hydroxyzine (Vistaril) are
65 34.8
reliable potentiators of opioid analgesics (False)
10 Opioids should not be used in patients with a history of substance abuse (False) 91 48.7
11 Elderly patients cannot tolerate opioids for pain relief (False) 78 41.7
12 Patients should be encouraged to endure as much pain as possible before using
90 48.1
an opioid (False)
13 Children less than 11 years old cannot reliably report pain so clinicians
86 46.0
should rely solely on the parent’s assessment of the child’s pain
intensity (False)
14 Patients’ spiritual beliefs may lead them to think pain and suffering are
131 70.6
necessary (True)
15 After an initial dose of an opioid analgesic is given, subsequent doses
116 62.0
should be adjusted in accordance with the individual patient’s response
(True)
16 Giving patients sterile water by injection (placebo) is a useful test to
109 58.3
determine if the pain is real (False)
17 Vicodin (hydrocodone 5 mg + acetaminophen 500 mg) PO is
approximately equal to 5-10 mg of morphine PO (True) 66 35.3
18 If the source of the patient’s pain is unknown, opioids should not be

used during the pain evaluation period, as this could mask the ability to 102 54.5
correctly diagnose the cause of pain (False)

19 Anticonvulsant drugs such as gabapentin (Neurontin) produce optimal 100 53.5
pain relief after a single dose (False)
20 Benzodiazepines are not effective pain relievers unless the pain is due to 118 63.1
muscle spasm (True)
21 Narcotic/opioid addiction is defined as a chronic neurobiological 131 70.1
disease, characterized by behaviors that include one or more of the
following: impaired control over drug use, compulsive use, continued
use despite harm, and craving (True)
Multiple-choice questions
22 The recommended route of administration of opioid analgesics for 81 43.3
patients with persistent cancer-related pain is (oral)
23 The recommended route administration of opioid analgesics for patients 123 65.8
with brief, severe pain of sudden onsets such as trauma or postoperative
pain is (IV)
24 Which of the following analgesic medications is considered the drug of 85 45.5
choice for the treatment of prolonged moderate to severe pain for cancer
patients? (Morphine)
25 Which of the following IV doses of morphine administered over a 4- 46 24.5
hour period would be equivalent to 30 mg of oral morphine given q 4
hours? (Morphine 10 mg IV)
26 Analgesics for postoperative pain should initially be given (Around the 85 45.5
clock on a fixed schedule)
27 A patient with persistent cancer pain has been receiving daily opioid 38 20.3
analgesics for 2 months. Yesterday the patient was receiving morphine
200 mg/hour intravenously. Today he has been receiving 250 mg/hour
intravenously. The likelihood of the patient developing clinically
significant respiratory depression in the absence of new comorbidity is
(less than 1%)
28 The most likely reason a patient with pain would request increased 97 51.9
doses of pain medication is (The patient is experiencing increased
pain)
29 Which of the following is useful for the treatment of cancer pain? (All 95 50.8
of the above)
30 The most accurate judge of the intensity of the patient’s pain is (The 110 58.8
patient)
31 Which of the following describes the best approach for cultural 101 54.0
considerations in caring for patients in pain: (Patients should be
individually assessed to determine cultural influences)
32 How likely is it that patients who develop pain already have an alcohol 84 44.9
and/or drug abuse problem? (5 – 15%)
33 The time to peak effect for morphine given IV is (15 min) 84 44.9
34 The time to peak effect for morphine given orally is (1 – 2 hours) 65 34.8
35 Following abrupt discontinuation of an opioid, physical dependence is
41 21.9
manifested by the following: (Sweating, yawning, diarrhea and
agitation with patients when the opioid is abruptly discontinued)
Case Studies
36A Patient A: Andrew is 25 years old and this is his first day following
37 19.7
abdominal surgery. As you enter his room, he smiles at you and
continues talking and joking with his visitor. Your assessment reveals
the following information: BP = 120/80; HR = 80; R = 18; on a scale of
0 to 10 (0 = no pain/discomfort, 10 = worst pain/discomfort) he rates his
pain as 8.
A. On the patient’s record, you must mark his pain on the scale below.
Circle the number that represents your assessment of Andrew’s pain (8)
36B B. Your assessment, above, is made two hours after he received
morphine 2 mg IV. Half hourly pain ratings following the injection 34 18.2
ranged from 6 to 8 and he had no clinically significant respiratory
depression, sedation, or other untoward side effects. He has identified
2/10 as an acceptable level of pain relief. His physician’s order for
analgesia is “morphine IV 1-3
mg q1h PRN pain relief.” Check the action you will take at this time
(Administer morphine 3 mg IV now)
37A Patient B: Robert is 25 years old and this is his first day following
abdominal surgery. As you enter his room, he is lying quietly in bed and 39 20.8
grimaces as he turns in bed. Your assessment reveals the following
information: BP = 120/80; HR = 80; R = 18; on a scale of 0 to 10 (0 =
no pain/discomfort, 10 = worst pain/discomfort) he rates his pain as 8.
On the patient’s record, you must mark his pain on the scale below.
Circle the number that represents your assessment of Robert’s pain: (8)
37B B. Your assessment, above, is made two hours after he received
morphine 2 mg IV. Half hourly pain ratings following the injection 36 19.2
ranged from 6 to 8 and he had no clinically significant respiratory
depression, sedation, or other untoward side effects. He has identified
2/10 as an acceptable level of pain relief. His physician’s order for
analgesia is “morphine IV 1-3 mg q1h PRN pain relief.” Check the
action you will take at this time: (Administer morphine 3 mg IV now)
o
Figure 1: Catagory of nurses' level of knowledge and attitude, Hawassa University comprehensive
specialized hospital, Southern Ethiopia, 2019 (N=187).
Table 3: Factors associated with the Nurse's level of knowledge and attitude towards post-operative
pain management, Hawassa University comprehensive specialized hospital, Southern Ethiopia,
2019 (N=187).
Knowledge and attitude level

Variables Moderate Very low-low X2 test P-value
Prior training on pain Yes (n=50) 13(26%) 37(74%) 14.935 0.001*

management
No (n=137) 8 (5.8%) 129 (94.2%)
Reading of medical books or Yes (n=141) 20 (14.2%) 121(85.8%) 5.019 0.025*
journals about pain
No (n=46) 1 (2.1%) 45 (98.9%)
Discussion implicated in the nurses’ inadequate management

Post-operative pain is upsetting to patients of patients in pain (Dalton and Greer 2001).
experiencing surgical events. Nurses with adequate This study showed that the mean correct answer
knowledge and positive attitude play a key role in score was (22.5%) meaning nurses were able to
alleviating post-operative pain. The contribution of correctly answer only (22.5%) the questions on
inadequate knowledge and nurse’s negative average. The result was much lower than study
attitudes towards the pain experience has been conducted in other parts of the world for example
it was (65.64%) on Pakistan nurses (Zeb 2019), Al Qadire and Al Khalaileh 2014, Manwere,
(59.05%) on Bangladesh nurses (Basak 2010), Chipfuwa et al. 2015, Woldehaimanot, Saketa et
(64.5%) on Indian nurses (Manwere, Chipfuwa et al. 2014). Therefore, these areas may add more
al. 2015) and (47.72%) on Hong Kong nurses (Lui barriers to pain management and prevent patients
2008). Among several factors contributing to this from receiving adequate pain management.
finding, lack of in-depth pain contents in
undergraduate nursing education and inadequate This study clearly pointed to the fact that nurses’
in-service training on pain topics in Ethiopia seem knowledge and attitudes of postoperative pain
to play an important role. Also, the other likely management are associated with certain factors.
explanation may be nurses from these countries Thus, prior training on pain management and
possess a higher level of knowledge about pain reading of medical books or journals about pain is
management incomparable to the Ethiopian very important to nurses for improving their
context. knowledge and attitude in providing care for post-
operative pain. This result was consistent with
This study also identified that (82.2%) nurses had a results reported by earlier studies (Al Qadire and
very low level of knowledge and positive attitudes Al Khalaileh 2014).
regarding postoperative pain management. This
inadequate knowledge contributes to the possibility Conclusion and Recommendation
of under-treatment of patients’ post-operative pain. This study concluded that nurses retained a very
This finding was surprisingly low even if it was low level of knowledge far from an optimal and
supported by different studies throughout the negative attitude towards post-operative pain
world. For example, the researcher found that the management than previously reported findings
level of low knowledge among Indonesian nurses worldwide. Finally, this study provided significant
was (50%) (Tarjuman 2006). Only (7.7 %) of evidence of the knowledge deficit of nurses
nurses had a moderate level of knowledge and concerning pain management in Ethiopia.
positive attitudes. This also low as compared to
(69%) Malaysia nurses scored a moderate level of It is critical that the hospital must arrange training
knowledge towards post-operative pain workshops on post-operative pain management for
management (Ho, Choy et al. 2009). staff nurses to close the gap. The federal ministry
of Health of Ethiopia should enrich the pain
Several factors might contribute to the very low content of the nursing curriculum.
level of knowledge and negative attitudes among
nurses in this study. Firstly, only (26.7 %) The results of this study also provided a framework
participants had received pain management for the policymakers, government, and non-
training and it is given for a small proportion of government organizations to develop and
nurses in the Ethiopian context because of the implement continuing education programs and in-
budget issue. Secondly, it seems likely that pain service training for nursing staff on pain
management content is not given in-depth on the management, which can enhance the quality of
nursing curriculum in the Ethiopian context. patient care.
According to the result, the five ranking orders of Therefore, it is imperative that pain management
the least correctly answered items (lower than should be considered in detail as the fifth
21.9%) were identified and indicated that nurses fundamental vital signs to reduce patients’
had very low knowledge and negative attitudes in suffering from pain.
some parts of pain management. These included Limitation of the study
appropriate pain score assessment, fear of
addiction, right dose and the right time of Participants who completed the survey were from
pharmacologic pain medications (Table 2). These one setting and might not entirely reflect the
results were amusingly very low and inconsistent knowledge and attitudes of nurses in broad. This
even if earlier studies reported relative low would reduce the possibility of generalizing the
findings in these important areas of pain implications of the study. Therefore, a larger-scale
management (Lui 2008, Yava, Cicek et al. 2013, survey that includes a larger number of nurses and
settings would be highly recommended.
List of abbreviations Goodrich, C. (2006). "Students’ and Faculty

WHO: World Health Organization; KASRP: members’ knowledge and attitudes regarding
Knowledge Attitude Survey Regarding Pain; UK: pain management: A descriptive Survey. ."
United Kingdom; USA: United States of America; Journal of Nursing Education 45(3): 140-142.
IRB: Institutional review board of Hawassa Health, M. o. (2007). National Pain Management
University; SNNPRS: Southern Nations Guideline. Ethiopia, Bole Printing.
Nationalities and Peoples Region; Ho, S., et al. (2009). "Survey of nurses’ knowledge
and attitude regarding post operative pain
Acknowledgment
management at a teaching hospital in
We would like to thank Hawassa University Malaysia." 4(1): 47-52.
comprehensive specialized hospital and school of Hope, C. o. (2012). “Knowledge and Attitudes
nursing for material support. Survey Regarding Pain” developed by Betty
Ferrell, RN, PhD, FAAN and Margo
The authors are also grateful to supervisors and
McCaffery, RN, MS, FAAN, revised 2012.
data collectors who showed the greatest effort in
Howell, D., Butler, L., Vincent, L., Watt-Watson,
acquiring appropriate information.
J., & and N. Stearns (2000). "Influencing
Finally, we would like to extend heartfelt thanks to nurses’ knowledge, attitudes, and practice in
the study subjects who have kindly cooperated in cancer pain management." Cancer Nursing
providing the required information. 23(1): 55–63.
Idvall, E., Hamrin, E., Sjostrm, B. & Unossom, M.
References
(2002). "Patient and nurse management of
Al Qadire M, A. K. M. (2014). "Jordanian nurse’s quality of care in postoperative pain
knowledge and attitude regarding pain management." British Medical Journal 11(40):
management." Pain Manag Nurs 15: 220-228. 327-334.
Al Qadire, M. and M. Al Khalaileh (2014). Kehlet H, J. T., Woolf CJ (2006). "Persistent
"Jordanian nurses knowledge and attitude postsurgical pain: risk factors and preventon."
regarding pain management." Pain Management Lancet 36(7): 1618-1625.
Nursing 15(1): 220-228. Lui, L. Y. Y., So, W. K. W., & Fong, D. Y. T.
Basak, S. (2010). Knowledge and attitudes of (2008). "Knowledge and attitudes regarding
nurses and their practices regarding post- pain management among nurses in Hong Kong
operative pain management in Bangladesh, medical units." Journal of Clinical Nursing 17:
Prince of Songkla University. 2014-2021.
Dalton, J. A., Carlson, J., Blau, W., Lindley, C., Manwere, A., Chipfuwa T, Mukwamba M.M,
and S. M. Y. Greer, R. (2001). "Documentation Chironda G. (2015). "Knowledge and attitudes
of pain assessment and treatment: How are we of registered nurses towards pain management
doing?" Pain Management Nursing 2(2): 54-64. of adult medical patients: a case of Bindura
Dunwoody CJ, K. D., Pasero C, Rathmell JP, hospital." Health Science Jouranl, 9(4): 1.
Polomano RC (2008). "Assessment, McCaffery, M., Rolling-Ferrell, B. & Pasero, C.
physiological monitoring, and consequences of (2000). "Nurses’ personal opinions about
inadequately treated acute pain." J Perianesth patients’ pain and their effect on recorded
Nurs 23: S15-S27. assessments and titration of opioid doses." Pain
Eyob, T., Mulatu A and Abrha H (2013). Management Nursing 1(3): 79-87.
"Knowledge and attitude towards pain Smart, S. (2005). "Post-operative pain management
management among medical and paramedical knowledge and attitudes of pediatric nurses: A
students of an Ethiopian University." 3(127): New Zealand regional view. Unpublished
2167-0846.1000127. master’s thesis. Victoria University of
Ferrell, B., McGuire, D., & Donovan, M. ( 1993). Willington.".
"Knowledge and beliefs regarding pain in a Tarjuman ( 2006). "Nursing management of pain in
sample of nursing faculty." Journal of postoperative patient in Indonesia. Unpublished
Professional Nursing 9(2): 79. master‟s thesis, Burapha University, Chonburi,
Thailand.".
Woldehaimanot, T. E., Saketa, Y. J. Zeleke, A. Zeb, A. (2019). "Nurses’ Knowledge Regarding

M, Gesesew, H. A, Woldeyohanes. T. R. Post-operatve Pain Management." Journal of
(2014). "Pain knowledge and attitude: a survey Healthcare Communications 4(1).
among nurses in 23 health institutions in
Western Ethiopia." Gaziantep Medical Journal,
20(3): 254-260.
Yava, A., Çicek, H, Tosun, N, Ozcan C, Yildiz,
D, Dizer, B. (2013). "Knowledge and Attitudes
of Nurses about Pain Management in Turkey."
International Journal of Caring Sciences
6(3).494-505

Kasrp Kuisioner

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Kasrp Kuisioner

Uploaded by

Copyright:

Available Formats

Preprint not peer rev

International Journal of Caring Sciences May-August 2020 Volume 13 | Issue 2| Page 1

Knowledge and Attitudes of Nurses towards Postoperative Pain Management

Introduction investigation tools are not applied on a consistent

Table 1: Nurses' socio-demographic characteristics, Hawassa University comprehensive specialized,

Item Item content Correct response

18 If the source of the patient’s pain is unknown, opioids should not be

correctly diagnose the cause of pain (False)

Knowledge and attitude level

Prior training on pain Yes (n=50) 13(26%) 37(74%) 14.935 0.001*

Discussion implicated in the nurses’ inadequate management

List of abbreviations Goodrich, C. (2006). "Students’ and Faculty

Woldehaimanot, T. E., Saketa, Y. J. Zeleke, A. Zeb, A. (2019). "Nurses’ Knowledge Regarding

You might also like