Wether education has a positive impact on nurses' knowledge, attitudes, skills, and practices related to pain management .
Wether education has a positive impact on nurses' knowledge, attitudes, skills, and practices related to pain management .
Zahra Rakian,1,*MohammadJavad Ghapanchian,2
1. Student Research Committee , Dezful University of Medical Sciences , Dezful, Iran 2. Student Research Committee , Dezful University of Medical Sciences , Dezful, Iran
Introduction: Pain is a significant symptom associated with disease and injury, often driving individuals to seek healthcare assistance. Despite efforts made in the past decade to enhance pain management through research, technological advancements, and the availability of clinical guidelines, pain continues to be a persistent global health issue. Numerous studies have revealed that patients frequently do not receive appropriate pain management, leading to undertreated pain. One contributing factor to this problem is insufficient knowledge, particularly among nurses who play a crucial role in patient care. Unfortunately, studies conducted worldwide have identified deficiencies in nurses' knowledge and attitudes towards pain management. These knowledge and attitude gaps are often attributed to a lack of comprehensive pain education in nursing curricula resulting in graduates with inadequate knowledge. This review aims to provide an updated understanding of the impact of educating nurses on pain management .
Methods: The key words of nurse, education and pain management were searched in MEDLINE , AMED , EMBASE and PsychINFO databases and after applying the inclusion and exclusion criteria , 35 articles were selected and critically evaluated.
Results: The findings from the reviewed studies indicate that nurses have deficits in pain management knowledge and exhibit poor attitudes towards pain during the initial assessment . Some studies reported very low pre-test knowledge scores, while others had relatively high scores Another significant area where studies reported limited knowledge and low scores among nurses was in misconceptions regarding opioid addiction in pain management.Studies consistently demonstrate that nurses face ongoing challenges when it comes to addressing questions regarding the prevalence of addiction among opioid recipients . Three studies reported relatively low baseline scores, while two studies reported relatively high baseline scores. These differences in scores can be attributed to the participants' educational background, as two of the studies with low scores noted that most participants had not received any pain education, either during their formal education or in clinical settings.While it is true that in many developing countries nurses do not have the authority to prescribe medication and rely on doctors' prescriptions, it remains crucial for nurses to possess knowledge about pharmacological pain agents, their proper administration, and management. This includes being well-informed about the potential side effects associated with these medications.When appropriate pain assessment tools are used, most children above the age of four can provide estimations of their pain intensity. However, due to the subjective nature of pain, the accuracy and acceptability of children's pain reports using pain scales can sometimes be questioned, especially if healthcare personnel's observations do not align with the child's self-reporting. Consequently, some nurses in this review expressed doubts about the reliability of children's self-reporting of pain. Another issue highlighted in the review findings is the long-term retention of knowledge following educational interventions. The goal of these interventions is to improve long-term pain management. It is crucial for participants to retain knowledge over extended periods so that it can be effectively applied in practice . Providing three to four-hour refresher courses on pain management to healthcare professionals at least once a year can help improve knowledge retention.One study mentioned in the review implemented a certification process for nurses who completed pain management training.
Conclusion: The objective of this review was to examine the impact of education on nurses' knowledge, attitudes, skills, and practices related to pain management . the findings of this review are significant as they shed light on issues related to long-term knowledge retention and persistent gaps in pharmacological pain management and opioid use. Some studies have indicated that these gaps persist even after educational interventions . Therefore, it is crucial to organize Continuous Professional Development activities focused on pain management for nurses at least once a year. It is important to note that the recommendation of once a year is not based on an evidence-based optimal time frame for ongoing pain education and should be further researched. Additionally, persistent misconceptions and knowledge gaps regarding pharmacological pain management were observed even after educational interventions. This suggests that some misconceptions are deeply ingrained and require repeated education to overcome. Therefore, when designing training programs for nurses, special attention should be given to these areas.