Nurses' Knowledge, Attitudes and Practices of pain assessment and management in the Intensive Care Unit: A Study at Kasama General Hospital, Zambia

Abstract

Background: Critically ill patients have challenges reporting pain given their physical state. The complex nature of critical illness and diverse needs of patients may impact on the effectiveness of pain assessment and management in the intensive care units (ICU). Effective pain assessment culminates in effective pain management and nurses play an important role in ensuring effective pain management. Existing literature has shown gaps in the practice of pain assessment and management and efforts have ben made to try to mitigate the inefficiencies among nurses, yet their knowledge, attitudes and practices (KAP) in this domain variable and impact patient outcomes. This study therefore, sought to assess the nurses knowledge, attitudes and practices towards pain assessment and management in ICUS at Kasama General Hospital.

Methods: A quantitative study using a cross sectional analytical study design guided the study. The study was conducted on a population of 53 nurses selected using census sampling method. A self administered questionnaire was used following approval from local ethics committee. Written consents were obtained before commencement of the study. Data was analyzed using SPSS version 26 and Binary Logistic regression and Chi square were employed.

Results: The results revealed significant associations (p<0.05) between Gender (p=0.014), years of experience (p=0.046), attitude (p=0.002) and practice of pain assessment and management. Binary Logistic regression revealed that females (AOR: 6.247, p=0.030), nurses with more than 10 years of experience (AOR: 3.962, p=0.002) and nurses working in the Pediatric Intensive care unit (AOR: 3.504, p=0.019) and Neonatal Intensive care unit (AOR; 6.098, p=0.002) had significantly higher odds of good practice. In addition, positive attitude (AOR: 2.007, p=0.0160 and possessing knowledge (AOR: 3.267, p=0.004) about pain assessment and management was significantly associated with higher odds of good practice.

Conclusion: The study revealed that pain assessment and management practices among nurses is influenced by knowledge and attitudes. Therefore, there is need for intensifying professional development programs and increasing educational opportunities for nurses working in the ICUS.