Elsevier

Pain Management Nursing

Volume 15, Issue 4, December 2014, Pages e25-e36
Pain Management Nursing

Original Article
Nurses' Knowledge and Attitudes Regarding Pain in Saudi Arabia

https://doi.org/10.1016/j.pmn.2014.05.014Get rights and content

Abstract

Unrelieved pain is a worldwide health care problem that can lead to unnecessary complications and increased health care expenditure. The aim of this study was to examine nurses' knowledge and attitudes toward pain in Saudi Arabia. A descriptive design was employed using the Nurses' Knowledge and Attitudes Survey regarding pain. The study took place in a tertiary teaching hospital in Saudi Arabia. All nurses employed in the hospital were eligible to participate. A total of 775 questionnaires were distributed to nurses working in acute care, intensive care, and nursing education and administration settings. In all, 593 respondents completed the questionnaires, representing a response rate of 76.5%. Data were analyzed using descriptive and inferential statistics. Most participants were from overseas (97.5%), speaking 23 different languages; 36.5% of nurses held a bachelors of science degree in nursing or the equivalent. The mean score of correctly answered items in was 16.9 (95% confidence interval, 16.6-17.31) out of a total possible score of 40. Nurses demonstrated some misconceived attitudes such as not giving the required dose of morphine to a smiling patient despite the patient being in pain. It is of concern that the findings identified problems of inadequate knowledge and inappropriate attitudes regarding pain assessment and management in Saudi Arabia. Considering these problems, the development of pain programs and policies affecting national and international nurses is highly imperative.

Section snippets

Background

More than 50% of patients experience chronic and acute pain ranging from moderate to severe intensity during hospitalization (Couceiro et al., 2009, Gianni et al., 2010, Sommer et al., 2008, Strohbuecker et al., 2005, Wadensten et al., 2011). Patient pain is influenced by physiologic, psychological, social, chronobiologic, ethnic, and cultural factors, as well as circadian rhythms (Arendt-Nielsen and Lautenbacher, 2004, Bond and Simpson, 2006, Engel, 1977, International Association for the

Research Question

What are nurses' knowledge and attitudes regarding pain assessment and management in Saudi Arabia?

Research Design

This study involved a quantitative, nonexperimental, descriptive design using a survey method. This approach facilitated an understanding of how assessment and management of pain were influenced by nurses' characteristics.

Sample

The study was conducted in a tertiary hospital located in Jeddah on the western coast of Saudi Arabia. The hospital is a teaching and tertiary health institution, affiliated with

Results

In all, 593 completed questionnaires were returned, representing a response rate of 76.5%. The respondents had a mean age of 34. In all, 94.1% were women, 3.9% were men, and 2% did not identify their sex. Demographic details are shown in Table 1. A high percentage of nurses were from outside Saudi Arabia (94.1%). Nurses spoke a total of 23 different languages, with the most common being Malayalam, Tagalog, and English. In all, 48.1% of nurses were able to speak both English and Arabic. Of the

Discussion

Overall, there was a lack of knowledge and misconceived attitudes toward pain among nurses in Saudi Arabia. Nurses underestimated postoperative patients' pain intensity, and lacked pharmacologic information concerning opioids and their side effects. Findings also suggested that pain management courses did not appear to influence NKASP scores and some demographic characteristics such as nationality may have contributed to nurses' NKASP scores.

To our knowledge, this is the first time that nurses'

Implications for Nursing

This study offers potential insights into how programs can be tailored to improve nurses' knowledge about pain and to address their misconceptions. This is necessary if successful implementation of guidelines is to be achieved (Bucknall, Manias, & Botti, 2001). In education, gaps in pain assessment and management were identified that could be used to guide the development of pain management education programs at the hospital, or at a national level to overcome inadequacies in knowledge. These

Conclusions

Lack of knowledge regarding appropriate pain management practices was evident in this study. Although pain management is a fundamental aspect of nursing practice there are significant challenges in Saudi Arabia resulting from the large number of international nurses from broad educational backgrounds. Implementation of standard operating procedures may improve pain management practices. It is also clear that ongoing education about pain management must be periodically undertaken to enhance and

Acknowledgment

The authors acknowledge King Abduaziz University Hospital and King Abdulaziz University, Jeddah, Saudi Arabia who sponsored Dr Thurayya Eid's PhD program at The University of Melbourne.

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    This study was completed as a part of PhD thesis at the University of Melbourne. PhD student Thurayya Eid held a King Abdulaziz University scholarship for The Ministry of Higher Education of Saudi Arabia. The scholarship was awarded for PhD degree at the University of Melbourne. There were no other funding sources for this project.

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