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KNOWLEDGE, ATTITUDE AND PRACTICE OF PAIN ASSESSMENT AND MANAGEMENT AMONG NURSES IN ESUT PARKLANE TEACHING HOSPITAL ENUGU

Project topic for Nursing Science department.

CHAPTER ONE

  • INTRODUCTION

Pain is a major symptom in many disease conditions and it can interfere with patient’s quality of life, deficient knowledge and inability to possess right attitude by nurses towards a patient in pain affect the patient recovery negatively. Also right assessment of pain by nurses enhances adequate treatment thereby improves patient quality of life.  Nurses are always in a position to assess pain because they have the most contact with the patient. Most nurses believed that some of the patient’s complaint of pain is not real. They see patient’s complaint of pain as psychological more than physical, most patient exaggerate symptom.

Many factors affect nurses’ assessment of pain such as age, communication skill, inappropriate documentation and failure to reassess the patient. Nurses are always in a position to assess pain because they have the most contact with the patient. Pain is the most common symptoms experience by children and adult in the hospital.

The international association for study of pain (IASP) define pain as an unpleasant sensory and emotional experience associated with actual or pontential tissue damage. Pain can be acute or chronic in nature. Acute pain (noiciception) occurs when there is tissue damage and inflammatory response, it has a short duration, it is self limiting and does not involve neural tissue (Merskey H. and N. Bogduk, 1994). Pain is multidimensional therefore, its assessment most include the following: the intensity duration, location and description, its impact on patient’s activity and also factors that may influence patient perception of pain (Sueann Penrose, 2019) There are some influences in the hospital especially among the nurses, in family and society that can alter pain perception and coping strategies, such influences include nursing intervention, social history of the patient, cultural and religious beliefs, past experience and first experience. Also family of the patient can have a negative or positive influence.

However, it has been observed that most nurses does not have adequate knowledge about pain assessment while some nurses attitude towards the pain delays the treatment and prolong patient stay in the hospital.  Consequently, the study is aimed at determining the knowledge, attitude and practice of pain assessment among nurses in ESUT Teaching Hospital.

According to Alauddin, (2018), the perception and tolerance of pain may vary because of different psychological and social influences of the patient. Therefore it is important for healthcare provides to assess the pain and being knowledgeable, so that individualized management intervention can be provided.

Pain assessment and management are essential part of nursing care and two of the most fundamental patient right (Awafeh and Khraisat, 2017). It is unethical to let a patient suffer from pain without taking appropriate measures to relief him or her pain. Nurses spend a significant decision making process regarding pain assessment and management (Gibbson, 2012). Thus, they have a vital role in the decision making process. Inadequate pain management has shown to effect patient outcomes by potentially increasing hospital stay and delaying recovery. Thus the assessment and management of pain has major implication for nursing (Leuthwaite and Jamsch, 2011). Nurses are the only one who may hear of pain by the patient or patient whom expresses pain either by verbalization or advice of the physician on pain management (Kiivanuka and Mababa, 2016). Therefore, the knowledge and practice are very important in pain assessment and management.  

  • Statement of the problem

Observation shows that most patients who complain of pain are wrongly assessed and this lead to poor management of pain. Also most stay more than expected. Hospitalized patients are noted to have moderate to severe pain for the majority of their hospital stay. Effective pain management is important to all individauls suffering from pain whether acute or chronic irrespective of their age, race or gender. Patients experience moderate to severe pain and often, in the face of life threatening illness or injury, pain and its treatment are forgotten or at least under appreciated by the health care team (Robleda 2016; Chanques 2007). Despite pain being a significant problem within the hospital, inaccurate pain assessment and the resuting inadequate treatment among patients, have been found to have serious physiological and phychological sequelae (Thomas, 2008). The cornerstone for adequate pain relief among patients is systematic and consistent assessement and documentation. Knowledge of pain, its assessment and mangement, as well as positive attitude is the key to successful pain management. Therefore, it is imperative that health care providers assess pain accurately in patients (Arif, Grap and Ralm, 2010). This prompted the researcher to write on knowledge; attitude and practice of pain assessment among nurses in ESUT Teaching hospital, with a view to produce appropriate solution, to reduce patient stay in hospital and further damage caused by prolong pain.

Purpose of the study

The purpose of the study is to examine the knowledge, attitude and practice of pain assessment and its management among nurses in ESUT Teaching Hospital Parklane Enugu  and also to highlight factors that may affect their decision making process in pain management.

1.4 Objectives of the study

  • To ascertain the level of knowledge, nurses have towards pain assessment.
  • To determine their source of information.
  • Examine their attitude towards pain assessment
  • Determine their understanding about consequences of wrong assessment of pain.

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