Abstract
Pain is one of the most prevalent symptoms in cancer patients and may be directly related to cancer or to the procedures needed for its diagnosis and treatment. It is estimated that about 40% of cancer patients receive inadequate treatment for painful conditions. Among the barriers to adequate pain management are inadequate knowledge and the dysfunctional beliefs of healthcare professionals. Therefore, the present study aims to assess the knowledge of oncology nurses on the management of pain, as well as the factors associated with it. It is a cross-sectional study with 126 nurses working at a High Complexity Oncology Centre in Brazil. Knowledge about the management of cancer pain was evaluated through the instrument ‘Nurses’ Knowledge on Cancer Pain Management—World Health Organization—developed by Ramos (1994). In the analysis of the association between knowledge about pain management and the independent variables, Poisson regression was used with robust variance, and values of p ≤ 0.05 were considered statistically significant. Adequate knowledge prevalence was 54.1% confidence intervals (CI 5.40%–62.80%). These nurses differed in relation to those with inadequate knowledge regarding the source of knowledge about pain, the ethical aspects in the treatment of the patient with oncologic pain, and non-pharmacological methods (coeliac plexus neuroleptic block) for pain control. Also, the factors associated with adequate knowledge were longer professional experience time ([10–19 years (ratio prevalence (RP) = 1.72, 95% CI: 1.05–2.81), 20–29 years (RP = 2.56, 95% CI: 1.63–4.02), 30–39 years (RP = 3.45, 95% CI: 2.25–5.29]), and not believing that the use of opioids causes harm to patients corresponded with a greater chance prevalence ratio (PR = 1.20, 95% CI: 1.12–1.20) of having adequate knowledge. The findings of the study point to the need for continuing education, updated education, and reflection, especially for nurses with less professional experience.
Highlights
Cancer pain can be defined as ‘total pain’, representing a syndrome that goes beyond nociception, involving physical, emotional, social and spiritual factors [1]
It is estimated that about 43% of people living with cancer receive inadequate treatment for their pain, an unacceptable reality considering that since 1986, there is a treatment protocol advocated by the World Health Organization (WHO), which promotes pain control in 70%– 90% of patients, when applied correctly [2, 3]
Studies advocate that barriers to the proper management of painful conditions in cancer patients are due to lack of knowledge and dysfunctional beliefs about pain and analgesia related to patients, family members and health professionals [2, 4,5,6]
Summary
Cancer pain can be defined as ‘total pain’, representing a syndrome that goes beyond nociception (injury), involving physical, emotional, social and spiritual factors [1]. It is estimated that in recent decades this symptom has affected around 17 million people in the world, and its prevalence increases progressively with the disease, ranging from 39.3% of patients reporting pain during curative treatment to 66.4% in metastatic disease or end-of-life patients [2]. It is estimated that about 43% of people living with cancer receive inadequate treatment for their pain, an unacceptable reality considering that since 1986, there is a treatment protocol advocated by the World Health Organization (WHO), which promotes pain control in 70%– 90% of patients, when applied correctly [2, 3]. Studies advocate that barriers to the proper management of painful conditions in cancer patients are due to lack of knowledge and dysfunctional beliefs about pain and analgesia related to patients, family members and health professionals [2, 4,5,6]
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