Can a theory-based educational intervention change nurses’ knowledge and attitudes concerning cancer pain management? A quasi-experimental design

Abstract

BackgroundRegistered Nurses (RNs) play an important role in caring for patients suffering from cancer pain. A lack of knowledge regarding pain management and the RNs’ own perception of cancer pain could act as barriers to effective pain management. Educational interventions that target RNs’ knowledge and attitudes have proved promising. However, an intervention consisting of evidence-based practice is a multifaceted process and demands behavioural and cognitive changes to sustain the effects of the intervention. Therefore, our study aimed to investigate if a theory-based educational intervention could change RNs’ knowledge and attitudes to cancer pain and pain management, both four and 12 weeks after the start of the intervention.MethodsA quasi-experimental design with non-equivalent control groups was used. The primary outcome was measured using a modified version of the instrument Nurses’ Knowledge and Attitudes Survey Regarding Pain (NKAS) at baseline, four weeks and 12 weeks after the start of the intervention to evaluate its persistence. The intervention’s educational curriculum was based on the principles of Ajzen’s Theory of Planned Behaviour and consisted of interactive learning activities conducted in workshops founded on evidence-based knowledge. The RN’s own experiences from cancer pain management were used in the learning process.ResultsThe theory-based educational intervention aimed at changing RNs knowledge and attitudes regarding cancer pain management measured by primary outcome NKAS resulted in a statistical significant (p<0.05) improvement of total mean score from baseline to four weeks at the intervention ward.ConclusionsThe findings of this study, suggest that a theory-based educational intervention focused at RNs can be effective in changing RN’s knowledge and attitudes regarding cancer pain management. However, the high number of dropouts between baseline and four weeks needs to be taken into account when evaluating our findings. Finally, this kind of theory-based educational intervention with interactive learning activities has been sparsely researched and needs to be evaluated further in larger projects.Trial registrationClinical Trials. Gov: NCT01313234

Converged Study on the Nurses' Knowledge and Performance of Cancer Pain Management in one city

“…Therefore, it is necessary to expand the role of nurses to overcome the obstacles for managing pain in clinical practice [5]. Insufficient knowledge and the prejudice of nurses on cancer pain could be an obstacle to an effective pain management [12]. Only 20∼30% of health care workers received education of cancer pain management.…”

Evidence For The Cancer Patients’ Pain Management: An Integrative Review

“…Results of health education for nurses showed that the professionals who participated in the programs reported greater confidence to assess the pain, to have a more effective attitude to management this symptom, and they also reported reduction of barriers [17][18][19]. As an effective result, higher patient satisfaction was obtained, which was caused by two aspects.…”

“…Among the interventions that were made in the studies, 5 (26.3%) evaluated Educational Programs, which include the implementation of scales and other features that allow a better assessment and management of pain [11,13,15,17,19]; 2 (10.5%) implemented evidence-based educational interventions, which include focus groups and application of guidelines with the professionals [18,20]; 2 (10.5%) applied cognitive-behavioral interventions, with a focus on understanding the nature of symptoms and improving the ability to control the symptoms [14,16]; and 1 (5.2%) applied daily pain management journals [12]. Table 2 highlights the main outcomes related to the studies included in the review.…”

Holistic Total Pain Management in Palliative Care: Cultural and Global Considerations

“…Education has been shown to improve attitudes about pain. 43 Finally, education is important in improving health care professional knowledge and opioids, which opioids to prescribe, and co-analgesics that can improve overall comfort. Pain management is both an art and a science and requires specific education.…”