Attitudes towards morphine use among nurses and physicians working in French-speaking Switzerland

Abstract

There is little information regarding risk perceptions and attitudes towards morphine use in Switzerland. Thus, we aimed at assessing such attitudes in a sample of health professionals drawn from five nonuniversity hospitals in the French-speaking canton of Valais, Switzerland. The sample included 431 nurses and 40 physicians (age range: 20-63 years), and risk perceptions and attitudes towards morphine use were assessed using a validated questionnaire. More than half of the participants showed a negative attitude regarding most adverse events related to morphine. In bivariate analyses, participants working in geriatrics showed a more negative attitude towards use of morphine than did participants working in medicine and surgery. Compared with Swiss participants, non-Swiss participants also showed a more negative attitude regarding use of morphine. Conversely, no differences were found between the sexes, professions (nurses versus physicians), years of experience (#14 years versus .14 years), or religions (Catholic versus other/no religion). These findings were further confirmed by multivariate adjustment. Our results indicate that attitudes regarding morphine use are mainly driven by its potential adverse effects and vary according to specialty and nationality. Educational measures directed at health professionals working in geriatrics or coming from abroad might reduce the high morphinophobia levels observed in these groups.

Opiophobia in Emergency Department Healthcare Providers: A Survey in Western Switzerland

“…In addition, the minimal clinically relevant difference of the score, i.e., representative of a true change in attitude and not just a statistically significant difference, is not defined. Compared to the scores in the two studies published previously [9,18], the total score in our study was similar for physicians, but four points lower for nurses. If these differences correspond to actual differences in pain management at the bedside remains an open question.…”

“…Fears of sedation and respiratory depression are also widespread, both among healthcare providers and the general population [9,10,18,25,26]. Opioid-induced respiratory depression is rare but can be fatal.…”

“…This reluctance to use narcotic analgesics has been reported in a majority of ED doctors [5], due to a lack of knowledge and training of ED doctors, or even prejudice against the use of opioid analgesics. This prejudice, or opiophobia, is defined variously in the literature as underutilization linked to the irrational fear of addiction [6], to an exaggerated fear of side effects [7], to moral reasons or to the legal risks associated with their prescription [8][9][10]. Whatever its cause, opiophobia contributes to oligoanalgesia [6,7].…”