Knowledge and Attitudes of Ethiopian Nursing Staff Regarding Post-Operative Pain Management: A Cross-Sectional Multicenter Study

Figures & data

Table 1 Socio-Demographic Data of Participants (n=395)

Variables		Frequency	Percent
Sex	Male	142	35.9
	Female	253	64.1
Age (in years)	21–29	249	63.0
	30–40	135	34.2
	>40	11	2.8
Level of education	Diploma	23	5.8
	Bachelor	358	90.6
	Postgraduate	14	3.5
Nursing grade	Staff nurse	245	62.0
	Staff midwife	150	38.0
Work experience (in years)	<1	77	19.5
	1–5	231	58.5
	6–10	70	17.7
	11–15	11	2.8
	16–20	3	0.8
	>20	3	0.8
Work experience in surgical unit (in years)	<1	208	52.7
	1–5	184	46.6
	≥6	3	0.8
Working unit	Recovery	46	11.6
	General surgery	77	19.5
	Orthopedic and trauma	57	14.4
	Obstetrics	154	39.0
	Fistula & gynecology	46	11.6
	Ophthalmology	15	3.8
Access to read journals or articles in the last year/month/week	Yes	76	19.2
	No	319	80.8
Previous training on POP	Yes	66	16.7
	No	329	83.3

Table 2 Nurse’s Knowledge on POP Management (n = 395)

Knowledge About POP Management	True (%)	False (%)	Correct Answer
1. Pain is what the patient says it is.	331 (83.8)	64 (16.2)	T
2. Acute pain lasts for 20 to 30 days.	143 (36.2)	252 (63.8)	T
3. The most accurate judge of the intensity of the patient’s pain is the patient’s primary nurse.	255 (64.6)	140 (35.4)	F
4. Vital signs are always reliable indicators of the intensity of a patient’s pain.	274 (69.4)	121 (30.6)	F
5. Pain assessment includes onset, duration, variability, location, and intensity of pain.	346 (87.6)	49 (12.4)	T
6. Glasgow Coma Scale is a pain assessment tool.	191 (48.4)	204 (51.6)	F
7. When using the WHO pain ladder to treat acute pain, treatment should go from bottom to top.	258 (65.3)	137 (34.7)	T
8. Using a pain management assessment tool is not integral to POP management.	144 (36.5)	251 (63.5)	F
9. Untreated POP delays recovery.	292 (73.9)	103 (26.10)	T
10. Effective analgesia is an essential part of POP management.	342 (86.6)	53 (13.4)	T
11. The recommended route of administration of opioid analgesics with brief, severe pain of sudden onset such as POP is intramuscular.	234 (59.2)	161 (40.8)	F
12. Analgesics for POP should initially be given around the clock on a fixed schedule.	268 (67.8)	127 (32.2)	T
13. Naloxone antagonizes (reverses) all opiates, but its effect quickly wears off.	187 (47.3)	208 (52.7)	F

Table 3 Factors Associated with Nurses’ POP Management Knowledge (n = 395)

Variables		Knowledge Status		Odds Ratio (95% CI)
		Inadequate	Adequate	COR	AOR
Sex	Male	74	68	1.00
	Female	98	155	1.72(1.136–2.607)*	***
Level of education	Diploma	19	4	1.00	1.00
	Bachelor and above	153	219	6.79(2.27–20.38)*	8.20(2.51–26.83)**
Access to journals or articles	No	150	169	1.00	1.00
	Yes	22	54	2.18(1.27–3.75)*	1.83(1.01–3.30)**
Training	No	165	164	1.00	1.00
	Yes	7	59	8.48(3.76–19.12)*	8.63(3.67–20.28)**
Curriculum	No	170	212	1.00
	Yes	2	11	4.41(0.95–19.96)*	***

Notes: 1.00=Reference, *p-value<0.2, **p-value<0.05, ***Did not appear.

Table 4 Attitudes of Nursing Staff Regarding Postoperative Pain Management (n = 395)

Attitude Towards POP Management	SA (%)	A (%)	N (%)	D (%)	SD (%)
1. Your cultural background affects your nursing care of a patient’s report of pain.	134 (33.9)	136 (34.4)	22 (5.6)	74 (18.7)	29 (7.3)
2. Your patient should experience discomfort before giving the next dose of pain medications.	69 (17.5)	166 (42.0)	48 (12.2)	94 (23.8)	18 (4.8)
3. Your visual assessment of the patient reporting pain influences your response and treatment of postoperative pain.	81 (20.5)	190 (48.1)	43 (10.9)	70 (17.7)	11 (2.8)
4. The type of surgery done affects your response to pain management.	137 (34.7)	155 (39.2)	34 (8.6)	49 (12.4)	20 (5.1)
5. The patient who frequently requests pain medication influences your response time to analgesic administration.	86 (21.8)	211 (53.4)	41 (10.4)	43 (10.9)	14 (3.5)
6. You anticipate pain in all surgical procedures before you assess and treat pain in a patient.	96 (24.3)	160 (40.5)	43 (10.9)	76 (19.2)	20 (5.1)
7. Using pain measurement instruments is integral in post-operative pain management.	111 (28.1)	186 (47.1)	44 (11.1)	48 (12.2)	6 (1.5)
8. Patients should be encouraged to endure as much pain as possible before using an opioid.	54 (13.7)	162 (41.0)	58 (14.7)	93 (23.5)	28 (7.1)
9. A patient’s spiritual beliefs may lead them to think pain and suffering are necessary.	17 (4.3)	70 (17.7)	61 (15.4)	154 (39.0)	93 (23.5)
10. Lack of pain expression does not mean a lack of pain.	100 (25.3)	152 (38.5)	57 (14.4)	69 (17.5)	17 (4.3)
11. Analgesic opioids should not be administered to patients with a history of substance abuse.	64 (16.2)	123 (31.1)	50 (12.7)	127 (32.2)	31 (7.8)
12. Morphine is a very strong drug. 13. Patients in postoperative pain would be content with just one dose.	93 (23.5)	128 (32.4)	47 (11.9)	93 (23.5)	34 (8.6)
13. It is a patient’s right to expect total postoperative pain relief as a consequence of treatment.	113 (28.6)	202 (51.1)	31 (7.8)	37 (9.4)	12 (3.0)
14. Effective analgesia is an essential part of postoperative management.	210 (53.2)	122 (30.9)	31 (7.80)	18 (4.6)	14 (3.5)

Abbreviations: SA, strongly agree; A, agree; N, neutral; D, disagree; SD, strongly disagree.

Table 5 Factors Associated Nurse’s Attitude Regarding the POP Management (n = 395)

Variables		Level of Attitude		Odds Ratio (95% CI)
		Positive	Negative	COR	AOR
Sex	Male	137	5	1.00
	Female	223	30	3.69 (1.40–9.73)*	***
Level of education	Diploma	17	6	1.00	1.00
	Bachelor and above	343	29	0.24 (0.088–0.65)*	1.65 (0.06–0.49)**
Nursing grade	Midwifery	145	5	1.00
	Nurses	215	30	4.05 (1.53–10.67)*
Access to journals or articles	No	299	20	1.00	***
	Yes	61	15	3.68 (1.78–7.58)*	2.38 (1.04–5.42)**
Training	No	311	18	1.00	1.00
	Yes	49	17	5.99 (2.89–12.42)*	5.00 (2.25–11.10)**
Curriculum	No	354	28	1.00	1.00
	Yes	6	7	14.75 (4.64–46.88)*	6.97 (1.94–25.03)**

Notes: 1.00=Reference, *p-value<0.2, **p-value<0.05, ***Did not appear.