Abstract
Introduction: Even though establishing good pain control is an important priority for patients with cancer, there are barriers for under treatment including poor attitudes towards pain and opioid analgesia and barriers which exist within the professionals. So, this assessment is conducted to assess the attitude, practice of nurses’ and barriers regarding cancer pain management at selected health institutions offering cancer treatment in Addis Ababa city, Ethiopia, 2013. Methods: Cross-sectional study design was conducted. Anonymously structured self-administered questionnaire and focus group discussion was carried out among 82 nurses. Nurses’ Knowledge and Attitudes Survey Regarding Pain (NKARSP) questionnaire was used for data collection. Epi info version 3.5.4 and SPSS version 20 statistical software’s were used for data entry and analysis. to identify factors associated with attitude towards cancer pain management bivariate and multivariate logistics regression was computed. P-value and 95% confidence interval was used to determine the association. Results: 45(54.9%) of the study participants were from the governmental hospital and the rest 37(45.1%) respondents were from private heath institutions. More than half, 53.7%, of the nurses’ have a negative attitude, towards cancer pain management. Similarly 65.9% of nurses’ had poor cancer pain management practice. Lack of courses related to pain in the under graduate classes, lack of continuing training, patient and work overload, role confusion, lack of motivation including salary were the identified barriers for adequate pain management. Monthly income of greater than 1500 Ethiopian Birr (ETB) were found to be associated with attitude towards cancer pain management (AOR=0.16, 95% CI=0.03-0.78). Conclusion: Negative attitude of nurses regarding cancer pain management were observed. The practice of nurses’ was also poor. The main barriers which hinder good cancer pain management were lack of motivation including salary, role confusion, and lack of continuing training. An effort to improve educational development of nurses’ like in service trainings on cancer pain management and familiarization with WHO guidelines should be given to nurses who are working in cancer units.
Highlights
Even though establishing good pain control is an important priority for patients with cancer, there are barriers for under treatment including poor attitudes towards pain and opioid analgesia and barriers which exist within the professionals
From the five health institutions included in the study, 45(54.9%) of the study participants were from the governmental hospital and the rest 37(45.1%) respondents were from private heath institutions
Lack of courses related to pain in the under graduate classes, lack of continuing training, patient and work overload, lack of human resource, inadequate knowledge or information gap, role confusion, fear of side effects of cancer treatments, absence of specialized nurse in oncology nursing, lack of equipment’s, lack of motivation including salary were the identified barriers for adequate pain management
Summary
Even though establishing good pain control is an important priority for patients with cancer, there are barriers for under treatment including poor attitudes towards pain and opioid analgesia and barriers which exist within the professionals. This assessment is conducted to assess the attitude, practice of nurses’ and barriers regarding cancer pain management at selected health institutions offering cancer treatment in Addis Ababa city, Ethiopia, 2013. 12.5% of all deaths are caused by cancer, which is more than HIV/AIDS, tuberculosis, and malaria combined [5]. By 2050, three quarter of all cancer deaths will be from low income developing countries [8]
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