Nurses knowledge, attitudes and education needs towards acute pain management in hospital settings: A meta-analysis

Effective pain assessment and management is widely reported as sub optimal due to inadequate knowledge and negative attitudes among nurses.

To determine nurses' attitudes, knowledge and education needs towards acute pain management in acute hospital settings METHODS: PRISMA (2021) and guidelines from the University of York, CRD (2009) informed the design and conduct of this review. We included studies with registered nurses involved in direct adult patient care and acute pain management in hospital settings. Seven databases were searched (10 June 2020 and 21 January 2022): Medline (EBSCO), EMBASE (Ovid), CINAHL Complete (EBSCO), PsycINFO (EBSCO), Applied Social Science Index and Abstracts (ASSIA), Web of Science and the WHO Library Global Index Medicus. The review outcomes were nurses' knowledge, attitudes and education needs towards acute pain assessment and management. The CASP Cohort Assessment tool was used to independently conduct a quality assessment of included studies. Data extraction was conducted by paired reviewers working independently of each other. A meta-analysis of findings relating to nurses' knowledge and attitudes towards acute pain management was undertaken using MedCalc software.

Ten articles with 1,478 participants met the inclusion criteria. Five studies addressed the review items of knowledge and attitudes while the remaining studies focused on knowledge alone. No study measured educational needs. This meta-analysis found that only 45.59% (95% CI: 20.46-71.97) of the 1090 respondents had adequate or above adequate levels of knowledge about acute pain management. The proportion of participants with positive attitudes was 25.76% (95% CI: 11.01-44.12).

High levels of variability exists across the included studies which reduces their comparability. To improve homogeneity and comparability, adaptation of instruments should be kept to a minimum. Reporting knowledge and attitudes separately may highlight education, both theoretical and clinical as the focus for improving assessment and management of acute pain.