Pain Management Training Research Articles

Postoperative pain assessment and management among nurses in selected hospitals in Benin City, Edo State, Nigeria

ABSTRACTObjective:This study was designed to determine the nurse assessment of postoperative pain and its management in selected hospitals, Benin City, Edo State, Nigeria.Materials and Methods:A descriptive cross-sectional survey was adopted. The target population consist of 222 purposely nurses who are in the cadre of nursing officer II to chief nursing officer who works in the various surgical wards/units of the selected health facilities. The data were collected from the participants using the pretested structured questionnaire developed by the researcher.Results:Results showed that 66.2% of nurses had a poor level of knowledge on postoperative pain assessment. The McGill Pain Questionnaire was the most used pain assessment tool with a mean score of 2.84 whereas the Dallas Pain Questionnaire was the least used with a mean score of 1.90. “Providing clean, calm, and well-ventilated ward environment” (3.69 ± 0.61) was the most used nonpharmacological method for postoperative pain management, followed by “distraction, relaxation, and guided imagery” (3.52 ± 0.50), “dressing, bandage, splint, and reinforce wound sites postoperatively” (3.39 ± 0.54), and “early ambulation/exercise” (3.20 ± 0.62). The most used pharmacological interventions were “acetaminophen” (3.63 ± 0.55), “topical anesthetic” (2.92 ± 0.62), “nonselective nonsteroidal anti-inflammatory drugs” (2.87 ± 0.43), and “mixed opioid agonist–antagonist” (2.56 ± 0.56).Conclusion:There is a poor level of knowledge on postoperative pain assessment among nurses in this study setting. It is, therefore, pertinent for hospitals to organize continuous in-service training for postoperative pain assessment and management, especially on nonpharmacological approaches among nurses.

Nurses' knowledge and attitude towards children pain management: a multi-site survey study.

Adequate children's pain management is universally considered an ethical obligation. In evaluating and treating children's pain, nurses invest more time and take a leading role. This study aims to evaluate the knowledge and attitudes of nurses towards the treatment of pediatric pain. A total of 292 nurses working at four South Gondar Zone hospitals of Ethiopia was surveyed. To gather information from study participants, the Pediatric Nurses' -Knowledge and Attitudes- Survey Regarding Pain (PNKAS) was employed. Frequency, percentage, mean, and standard deviation of the data were used for descriptive analysis, while Pearson correlation, one-way between-groups analysis of variance, and independent-samples t-test were used for inferential analysis. A large percentage of nurses (74.7%) lacked adequate knowledge and attitudes (PNKAS score <50%) for pediatric pain treatment. The mean ± SD accurate response score of 43.1% ± 8.6% was achieved by nurses. An increase in pediatrics nursing experience was significantly correlated with nurses' PNKAS score (p < 0.001). The mean PNKAS scores of nurses who had official pain management training differed in a statistically significant way as compared to its counterpart (p < 0.001). Nurses who are working South Gondar Zone of Ethiopia have insufficient knowledge and attitudes towards treatment of pediatric pain. Therefore, pediatric pain treatment in-service training is urgently needed.

Evaluation of the Effectiveness of Promoting Pain Self-Management on Functional Self-Efficacy of Nursing Students in the Care of Patients

Introduction: Pain management training can change the judgment and confidence of nursing students about their talents and abilities in caring for heart surgery patients. Aim of this study was determining the effectiveness of promoting pain self-management on functional self-efficacy of nursing students in the care of coronary artery bypass patients. Methods: This interventional study was conducted on all final year nursing students of Urmia Azad University. Sampling by census in the period from June to December 2022 and all final year nursing students were randomly divided into intervention and control groups. At the beginning of the study, students in both groups completed the demographic information questionnaire and clinical performance self-efficacy questionnaire. The validity of the questionnaire has been confirmed through its content, form and final validity with Cronbach's alpha coefficient of 0.96. The students of the intervention group received the necessary training as a group for 6 sessions of 45 minutes and twice a week with an interval of two days, and the control group received the usual training according to the curriculum and educational topics. At the end of the intervention, students in both groups completed the clinical functional self-efficacy questionnaire again. Statistical analysis of data has been done by paired group t test and independent group t test through SPSS. Results: The results showed that there was no significant difference in the average clinical self-efficacy scores of nursing students between the intervention and control groups before the implementation of pain management training (p=0.53 and t=11.02), while the average The overall clinical performance self-efficacy scores were significantly different between the intervention and control groups after the implementation of pain management training (p=0.003 and t=3.36). Conclusion:. According to the findings, the pain management training program is effective on the clinical performance self-efficacy of nursing students. Therefore, pain management training can help in the development of nursing students' abilities in academic environments and improve the beliefs of nursing students in relation to their ability to perform their specialized duties in the management of cardiac patients after surgery.

Cancer pain: way to overcome

Cancers are among the leading causes of morbidity and mortality worldwide. Cancer itself or cancer treatment often causes pain which can affectthe quality of life. Cancer pain management is an essential part of cancer treatment and palliative care. Cancer patients may require pain management at any stage of their disease, not only at the end. Expert opinion and statistics from country experiences from numerous low-income countries, where treatment coverage is typically inadequate or non-existent, indicate that around 80% of cancer patients feel moderate or severe pain that lasts on average 90 days. As a result, cancer pain is a major source of avoidable unnecessary suffering. Cancer pain management plans often involve pharmacological and nonpharmacological therapies and psycho-social and spiritual support. Palliative care and pain management are critical components of Universal Health Care. The medical use of narcotic drugs is essential for the treatment of pain and suffering. Therefore appropriate provisions must be made to assure their availability for such purposes. Some obstacles exist that limit the appropriate management of cancer-related discomfort. Communication difficulties, lack of pain management training and education, ethnic/cultural/ religious disparities, opiophobia among health professionals and the general public, and restricted availability to opioids are the primary barriers to successful cancer pain treatment. To combat cancer pain and reduce the suffering of these incurable people, education and training of health professionals on cancer pain management, provision of suitable holistic supports, opioids should be made accessible and available, and general awareness development are some examples. All government and nongovernment players must come forward and work together to win this battle. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 187

Factor that associated with Knowledge and Attitude toward pediatric pain management among nurses in Hiowt Fana Specialized Referral Hospital, Harar, Ethiopia

Introduction: - Thoughtful management Analgesia is essential for ill persons due of its physiologic and psychological benefits. So, the objective of this study is to determine the knowledge and attitude toward pediatric pain management among the nurses in Hiowt Fana Specialized Referral Hospital, Harar, Ethiopia. Methods: - An institutional-based cross-sectional study was conducted from 10 to 20 September 2023 among 198 participants. A simple random sampling technique was used to select the study subjects. The data were collected by using a structured, pretested, self-administered questionnaire. Data analyzed by using SPSS 24. Mono, bi and multivariate analyses were performed. Variables with a p&lt;0.05 in bi-variate analysis were entered into multiple logistic regression and variables with a p&lt;0.05 in multivariate analysis were considered statistically significant associations. Result: - A total of 122(63%) respondents had good knowledge and 262 (66.7%) had a favorable attitude toward pediatric pain management. Educational status of respondents [AOR=3.1; 5% CI :( 1.52, 4.21)], working place ( ward )[AOR=3.27; 95% CI: (2.01, 5.89)] and in-service training [AOR= 5.29; 95% CI: (1.28, 10.34)] were significantly associated with knowledge on pediatric pain management and Service years (work experience) [(AOR = 3.42; 95% CI (1.23–7.35)] and Training [AOR = 2.17; 95% CI (1.13–3.59)], had significantly association with attitude on pediatric pain management. Conclusion: - Around two third of the participants and slightly greater than half of the respondents had good attitude and positive attitude toward pediatric pain management respectively. Educational status of respondents, working place and in-service training were significantly associated with knowledge on pediatric pain management and service years (work experience) and training had significantly association with attitude on pediatric pain management Therefore, for better pediatric pain management, it is recommended to provide continuous training for nurses.

Patient, family member, and ambulance staff experiences of prehospital acute pain management in adults: A systematic review and meta-synthesis.

We aimed to synthesize the qualitative experiences of patients, their family members, and ambulance staff involved in the prehospital management of acute pain in adults and generate recommendations to improve the quality of care. A systematic review was conducted following the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) guidelines. We searched from inception to June 2021: MEDLINE, CINAHL Complete, PsycINFO and Web of Science (search alerts were screened up to December 2021). Articles were eligible for inclusion if they reported qualitative data and were published in the English language. The Critical Appraisal Skills Program for qualitative studies checklist was used to assess risk of bias, thematic synthesis was performed on included studies and recommendations for clinical practice improvement were generated. Twenty-five articles were included in the review, representing over 464 patients, family members, and ambulance staff from 8 countries. Six analytical themes and several recommendations to improve clinical practice were generated. Strengthening the patient-clinician relationship by building trust, promoting patient empowerment, addressing patient needs and expectations, and providing a holistic approach to pain treatment is key to improving prehospital pain management in adults. Shared pain management guidelines and training across the prehospital and emergency department intersection should improve the patient journey. Interventions and guidelines that strengthen the patient-clinician relationship and span the prehospital and emergency department phase of care are likely to improve the quality of care for adults suffering acute pain in the prehospital setting.

The effectiveness of a training program based on the Human Caring Theory to caring behaviors and post-cesarean caring outcomes

This study was conducted to determine the effects of the Human Caring Theory-based post-cesarean caring and pain management training on caring behaviors and caring outcomes. The sample consisted of 25 nurses, midwives and 208 women who had cesarean. Nurses and midwives were given training based on Human Caring Theory, which consisted of three sessions. Nurses and midwives caring behavior scores increased after the training. Midwives’ self-rating scores, the rate of using a scale to assess pain and recording information on pain assessment increased. Caring satisfaction and perception of the caring behavior of women who had cesarean increased and their pain levels decreased.

Otago Home Exercise Program along with other physiotherapy interventions for the management of prolapsed intervertebral disc and its associated symptoms in an elderly: a case report

Prolapsed intervertebral disc or herniated disc (PIVD) is a common cause of back pain between the ages of 30 and 50 years. But, in the elderly PIVD is associated with associated symptoms whose management is often ignored. We reported a case of an 85 years old male patient with existing symptoms of PIVD for the last 5 years. However, the patient has never gone for physiotherapy treatment for the past 5 years due to unawareness and ignorance of the same. Since it was a geriatric case, the patient presented with associated symptoms along with PIVD. We tried to focus on the associated symptoms of the patient as well along with PIVD like fall risk and balance. The intervention program constituted 3 weeks of physiotherapy intervention focusing on pain management, strength conditioning, and balance training followed by an Otago Home Exercise Program.

The study of nurses’ knowledge and attitudes regarding pain management and control in emergency departments

BackgroundGiven the importance and pivotal role of nurses in pain management and control, this study was conducted to determine the nurses’ knowledge and attitudes toward in emergency departments.MethodsThis study was designed and conducted as a descriptive-analytical cross-sectional study. Nurses’ attitude and knowledge towards pain management and control and relationship between their demographic characteristics have been assessed. Nurse Attitude Survey (NAS) and Pain management and control principles assessment Test (PMPAT) questionnaires were used.ResultsTotally 400 volunteers, including 148 (37.2%) male and 250 (62.8%) female nurses recruited from 23 hospitals in East Azerbaijan, Iran, with a mean age of 30.88 years (± 6.04 SD) and age range between 22 and 53 years old. The crude mean score of participants’ knowledge of pain management and control was 12.51 (± 2.77 SD), and standardized mean score was 40.34 (± 8.92 SD), which was low at 84.8% and moderate in 15.3% of the participants. Older nurses and nurses who previously participated in pain retraining courses had significantly less knowledge about pain management and control (r= -0.104, P = 0.038), and (r= -0.148, P = 0.003) respectively. The crude mean score of participants’ attitudes toward pain control and management was 15.22 (± 2.56 SD), and standardized mean score was 60.87 (± 10.26 SD). Nurses’ attitudes have become more negative with the increase of their work experience (r = -0.168, P = 0.001), and previously participation in pain retraining courses (r =-0.207, P < 0.001). Older nurses and highly educated nurses had significantly more negative attitudes towards pain control and management (r = -0.153, P = 0.002), and (r= -0.126, P = 0.005), respectively.ConclusionsThe current study revealed that pain management and control knowledge in most emergency nurses was low, and most of them had a moderate attitude. We need more scientific and comprehensive pain management and control training courses to improve knowledge and attitude among health workers and nurses.

Acute Traumatic Pain in the Emergency Department.

Trauma is a major cause of mortality throughout the world. Traumatic pain-acute, sudden, or chronic-is defined as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage". Patients' perceptions of pain assessment and management have become an important criterion and relevant outcome measure for healthcare institutions. Several studies show that 60-70% of ER patients experience pain, and more than half of them express a feeling of sorrow, which can be moderate or severe, at triage. The few studies that have analyzed how pain is assessed and managed in these departments agree that approximately 70% of patients receive no analgesia or receive it with remarkable delay. Specifically, less than half of the patients receive treatment for pain during admission and 60% of discharged patients have higher intensity pain than at admission. Trauma patients are also the ones who most commonly report low satisfaction with pain management. Associated with this lack of satisfaction, we can describe the poor use of tools for measuring and recording pain, poor communication among caregivers, inadequate training in pain assessment and management, and widespread misconceptions among nurses about the reliability of patients' estimation of pain. The aim of this article is to review the scientific literature to explore the methodologies of pain management in trauma patients attending the emergency room and analyzing their weaknesses as a starting point to improve the approach to this, unfortunately too often, underestimated issue. A literature search was performed using the major databases to identify relevant studies in indexed scientific journals. The literature showed that the multimodal approach in trauma patients is the best approach to pain management. It is becoming increasingly crucial to manage the patient on multiple fronts. Drugs acting on different pathways can be administered together at lower doses, minimizing risks. Every emergency department must have staff trained in the assessment and immediate management of pain symptoms as this allows the reduction of mortality and morbidity and shortens hospital stays, contributing to early mobilization, reduced hospital costs, and enhanced patient satisfaction and quality of life.

The impact of physical and psychological pain management training on pain intensity, anxiety and disability in patients undergoing lumbar surgeries

BACKGROUND/CONTEXTLumbar surgery is one of the interventions performed for patients with degenerative conditions. PURPOSEThis study aimed to investigate the effect of pain management education on pain intensity, anxiety, and disability after the lumbar surgery. STUDY DESIGN/SETTINGThis randomized controlled trial was performed on 70 30-65-year-old patients with lumbar canal stenosis and lumbar disc herniation from 2018 to 2019. PATIENT SAMPLESeventy participants were randomly divided into a control and an intervention group by a randomized block design. Participants in the intervention group received in-person pain management training twice a week for seven 60-90-minute sessions. OUTCOME MEASURESAll participants in the two groups completed the study instruments (numeric rating scale [NRS], Oswestery disability index [ODI], and pain anxiety symptoms scale [PASS]) before, immediately after, and 3 months after the study. METHODSParticipants in the intervention group received in-person pain management training twice a week for seven 60-90-minute sessions. To analyze the treatment effects, repeated-measures multivariate analysis of variance (MANOVA) and effect sizes were used where appropriate and calculated by Partial ɳ2. Clinical outcome (MDC) for pain intensity and PASS was also reported. For participants lost to follow-up, we also used an “intention-to-treat” (ITT) approach. RESULTSThe results of MANOVA indicated that there were significant differences between the two groups on ratings of pain intensity, anxiety, and disability. According to the MDC, the mean differences of pain intensity for the intervention group was also clinically improved. Meanwhile, the mean differences in pain anxiety between three different times in the two groups were not above the MDC (20.14), suggesting that the clinical improvements were not significant. The results were confirmed for all outcome measures; a statistically significant difference was found between the groups in ITT analyses (p<.001). CONCLUSIONSPhysical and psychological pain management education was shown to be effective in decreasing pain intensity, anxiety, and disability. This strategy may be beneficial for such patients. Variables such as smoking behavior, past history of psychological disorders, and previous surgeries should be considered in future studies.

Community Pharmacy Professional's Knowledge, Attitude, and Practice with Regard to Pediatric Pain Management.

Effective pain relief is an essential component of high-quality healthcare delivery, and pharmacists must be well versed in pain mechanisms, assessment, and management. This study examined community pharmacy professional's (CPPs) knowledge and attitude towards pediatric pain management in Community pharmacies (CPs) and Drug Retail Outlets (DRO) of Ambo and Ginchi towns, west central Ethiopia. A cross sectional study was conducted in Ambo and Ginchi towns, the western part of the nation's capital. All voluntary CPPs working by CPs and DRSs in the towns of Ambo and Ginchi were included in the current study. SPSS version 25 was then used to process, analyze, and interpret the data. Among the 131 CPPs who were approached for the study, 104 agreed to participate and returned the questionnaire. CPPs mean knowledge score on pediatric pain management was 6.69 ±1.92, with a minimum score of 2 and a maximum score of 17. The majority of CPPs 82 (87.2%) in the study did not correctly answer half of the questions. Most of CPPs, 98 (94.3%), admitted they had no training in pain management, and 102 (98.2%) of the respondents said the same about pediatric pain management. The finding indicated that CPPs work experience in CP or DROs had impact on their knowledge about pediatric pain management and similarly, the mean knowledge score of pharmacists was higher than that of pharmacy technicians. This study revealed that CPPs have inadequate knowledge and attitude to provide effective pediatric pain management service. To bridge the knowledge gap and effectively control pediatric pain, pharmacists who are actively practicing their profession are advised to continue their medical education and training.

The role of cancer nurses in cancer-related pain management in Europe.

Cancer pain is a common symptom in patients with cancer and can largely affect their quality of life. Pain management is important to minimize the impact of pain on daily activities. Cancer nurses are significantly involved in all steps of pain management and contribute to the success of therapy through their knowledge and expertise. While they generally play an important role in the screening, assessment, diagnosis, treatment and follow-up of patients and their (pain) symptoms, this varies from country to country in Europe. An important aspect is their role in educating patients and their families about what pain is, what impact it can have, how it can be treated pharmacologically or non-pharmacologically and what effects or problems can occur during treatment. While there is a great discrepancy between education and training opportunities for cancer nurses in different European countries, there is a continued need for education and training in pain management. Cancer is increasingly becoming a chronic disease, and the management of pain in cancer survivors will be crucial to maintain an adequate quality of life. With this, the crucial role of cancer nurses is becoming even more important.

Pain Interventions for people with dementia: a quasi-experimental study

BackgroundDue to the complexity of the provision of care for people with dementia, pain assessment and management is still considered to be lacking. An optimal way to support frontline staff in providing pain assessment and management for people with dementia living in nursing homes has not yet been identified. The success of supporting interventions seems dependent on contextual factors in the nursing homes. This study, therefore, analyzes the feasibility of a nurse-led training intervention, using repeated on-site case studies, in modifying pain intensity and frequency in people with dementia.MethodsUsing a quasi-experimental design, we undertook a multi-center study of nurse-led training in pain management, with subsequent on-site case studies. Healthcare workers from 3 nursing homes assessed pain in 164 residents with dementia over 147 days. We used mixed-effect growth curve models with spline regression to analyze the data.ResultsWe found that on-site case studies support frontline staff with pain management and assessment. Repeated reflection in case studies led to significantly longer pain free intervals (from 4.7 at baseline to 37.1 days at second follow-up) and decreased frequency of pain events (OR 0.54 at first follow-up and 0.43 at second follow-up). However no trends regarding pain intensity could be found. Therefore, on-site case studies may be valuable for improving pain frequency and pain-free intervals over time.ConclusionThis feasibility study shows the potential of on-site support for frontline nursing home staff. On-site case studies may also affect health outcomes in people with dementia. However, the complexity of dementia care necessitates the management of a broader range of needs.Trial registrationThe study was retrospectively registered on the tenth of January 2017 with the German registry of clinical trials (DRKS00009726).

Access to opioid analgesics for medical use at hospital level in the Democratic Republic of Congo: An exploratory mixed-method study.

To investigate the availability of and access to opioid analgesics at hospital level in the Democratic Republic of Congo. Exploratory mixed-method study combining a descriptive survey of the availability of opioid analgesics at hospital pharmacies with a qualitative survey that explored the experiences and perceptions of healthcare workers, managers, patients and caregivers, by means of a short questionnaire and of semi-structured interviews. The study was conducted in a convenience sample of 12 hospitals, located in five different provinces, in 2021. The quality and completeness of stock data for opioid analgesics were generally poor. Stock-outs were frequent. Only five hospital pharmacies had records on prescriptions of opioids in 2020. In-patients and caregivers indicated they generally must purchase opioids out-of-pocket, sometimes far from the place of residence. Doctors and nurses confirmed that prescribed opioids are often unavailable at the hospital pharmacy. Furthermore, they suggested an important need of training in pain management with opioids, and of effective regulation to ensure opioid availability. Pharmacists and managers recognised important weaknesses in the processes of needs quantification, stock management, planning and supply. Our exploratory study suggests the need of a complex set of coordinated actions to be undertaken by all relevant actors in DRC to correct the poor practices in opioids' management and to improve opioids' availability, affordability and adequate use. This will require a change of mindset to overcome the neglect of the health needs of persons with acute and chronic pain.

Nurses’ Experiences of Providing Pain Management to Pediatric Patients in Indonesia

Inadequate pain management has been a worldwide concern for hospitalized children. Little is known about pain management for pediatric patients in Indonesia. This study explored nurses' experiences providing pain management in the pediatric unit. A qualitative descriptive approach was used. Fifteen nurses who worked in the pediatric intensive care unit and the pediatric, maternal-child, and general wards of the Islamic Teaching Hospital in Indonesia were interviewed by telephone due to the COVID-19 pandemic period. Based on content analysis, five themes were extracted from the data: ways to assess pain vary, working with colleagues, attitudes toward pain-relief strategies, enhancing parental understanding and involvement, and desire to have age-specific pain management training for pediatric patients. The results revealed issues nurses face in real contexts. Pediatric nurses need pain management training to improve their knowledge and skills.

Knowledge, Attitude, Practice and Perceived Barriers on Palliative Care Pain Management among the Healthcare Providers: A Single Centre Study

Healthcare providers’ knowledge and attitude on cancer pain control remain a debatable topic. The study aims to determine the knowledge, attitude, practice and perceived barriers among the healthcare providers in delivering effective analgesic in palliative care. A cross-sectional study was conducted among the specialists and post-graduate students from the medical and surgical programme using the convenience sampling method. A set of questionnaires related to the pain management in palliative patients was distributed. The questionnaire covered demographic characteristics, knowledge, attitudes, practice, and perceived barrier regarding cancer pain management. A total of 300 questionnaires were analysed with 75% response rate. About two-third (66.3%) of the respondents have knowledge deficit to prescribe opioids in pain management of palliative care patients. The medical specialty and lacking pain management training were significant factors associated with knowledge deficit. About half (48.3%) of the respondents thought that cancer pain therapy could be satisfactorily achieved as an outcome and 58.7% respondents admitting to practice daily pain assessment in patients with cancer. The main perceived barriers in managing pain for palliative patients were inadequate pain assessment (71.2%) and inadequate staff knowledge (53.6%). The knowledge differences among the different medical specialties and lack of pain management training have significantly impacted the pain management in palliative patients. A targeted educational strategy for pain management in palliative care patients is needed to improve physicians’ knowledge and clinical practice.

Current Attitudes of Chinese Dairy Practitioners to Pain and Its Management in Intensively Raised Dairy Cattle.

Pain in dairy cattle is gaining attention globally. This study investigated the current attitudes of Chinese dairy practitioners to pain and its management in intensively raised dairy cattle. A total of 465 valid questionnaires with 26 painful conditions scored on numerical rating scales were collected from dairy practitioners. Data were analysed by descriptive statistics, analysis of variance, principal component analysis, and multivariate regression models. Dystocia was perceived as the most painful, while mild mastitis with milk changes only was perceived as the least painful. Respondents who agreed with the statement "pain management is worthwhile" tended to give a higher pain score. Young respondents (≤23 years old) and those from farms with ≤1000 cattle had lower pain scores for conditions with severe pain and low variability but higher pain scores for conditions with less severe pain and high variability, whereas highly educated respondents had consistently lower pain scores. As for pain management, older respondents (≥24 years old) tended to choose non-steroidal anti-inflammatory drugs, and farms with &gt;1000 cattle were more likely to use analgesics. Training in pain perception and management should be emphasised with the hope of promoting animal welfare and reducing unnecessary production losses.

A survey study on knowledge and attitude towards pain management and associated factors among emergency Nurses,2021. Multi-center cross-sectional study

BackgroundPoor knowledge and attitude of nurses regarding pain may contribute to inadequate pain management. Nurses, as the primary caregivers in the emergency department, should have adequate knowledge and a good attitude towards pain management. The aim of this study was to determine the level of knowledge and attitude towards pain management and other factors among emergency nurses. MethodsA multi-center, institutional based, cross-sectional study was conducted on 153 nurses from May 01 to May 30, Ethiopia, 2021. Self–completed survey questionnaires were distributed using a modified and validated ‘Knowledge and Attitudes Survey Regarding Pain (KASRP)’ tool and analyses were performed using SPSS version 20. Descriptive statistics were used to summarize the characteristics of the participants, and the results were prepared using narrations, percentages, and tables. To demonstrate the strength of the association, the crude odds ratio and adjusted odds ratio with the corresponding 95% CI were calculated. Variables with a p-value of <0.05 were considered statistically significant after multivariate analysis. ResultThe mean percentage score of knowledge and attitude towards pain management was 52.8% (SD = 13). Prior pain management, training, and years of work experience as an emergency nurse were associated with good pain management knowledge and attitude. Conclusion and recommendationsThe level of knowledge and attitude of emergency nurses toward pain management were poor. So, we suggest all stakeholders who participate in nursing education work together to educate nurses to a higher level of education and deliver pain management training to enhance their knowledge and attitude towards pain management.

Current attitudes towards the use of perioperative analgesics in small animals by Uruguayan veterinarians

In recent decades, several articles have reported significant progress regarding pain treatment in veterinary medicine. This study aims to analyse the attitudes of veterinarians working in small animal practices in Uruguay towards the use of analgesics during the perioperative period. Veterinarians in charge of clinics performing surgeries were interviewed, including clinics located in the capital city, Montevideo (n=59) and the rest of the country (n=81), based on data obtained from the National Veterinary Census in 2010. Most interviews were conducted in person, and if not possible, they were carried out through video calls. According to gender, 54% of interviewees were women and 46% were men, with 95% of them practising in urban areas. The most used drugs were nonsteroidal anti-inflammatory drugs (NSAIDs), with dipyrone (89%) being the most popular. Amongst opioids, pure agonists presented minimal inclusion in analgesic treatment (13%), with tramadol (93%) being the most used opioid. Drugs belonging to other groups were less mentioned. Thirty-eight per cent of the respondents considered that their training in pain management was inadequate. Veterinarians categorised the intensity of pain caused by several surgical procedures as “severe”, however, they used weak opioids such as tramadol or NSAIDs as a single therapy to treat most cases. The scarce use of analgesic drugs and techniques that provide profound analgesia (such as mu-opioid receptor agonists) by Uruguayan veterinarians reveals the need for open discussion, adjustment of attitudes and continuing education on pain management.