Factors associated with Intensive care nurses' use of non-pharmacological methods of pain management: A multinomial...

Although there are numerous studies in the literature on the roles, methods used and attitudes of nurses in pain management, the factors related to the use of non-pharmacological methods (NPMs) are not well-documented.

This research aims to determine the factors related to the use of NPMs by intensive care nurses in Turkey.

This descriptive and cross-sectional study was conducted with the participation of 385 intensive care unit nurses. Data were collected by using the 'Sociodemographic Data Form', 'Non-Pharmacological Methods Form' and 'Pain Beliefs Questionnaire' (PBQ) between January-December 2022. Multiple multinomial logistic regression analysis was used to identify factors associated with non-pharmacological methods. Pain management was categorized as pharmacological, non-pharmacological and both. The use of pharmacological methods (PMs) was taken as the reference category. The STROBE checklist was adhered to in this study.

It was found that in pain management in the ICU, 33% used pharmacological methods, and 62.1% used both methods. The most frequent barriers experienced in the use of NPMs were 'heavy workload' (82.9%), 'inadequate time' (82.9%) and 'patients being unstable' (69.6%). Receiving pain management training increased the nurses' use of NPMs by 237% compared to pharmacological methods (RRR = 2.377, 95% CI = 1.200-4.707; p = .013). Regarding the barriers to the use of NPMs, 'the lower priority of NPMs compared to emergency practices (RRR=0.333, 95% CI=0.191-0.579; p=.000) and Deficiency in resources (materials and equipment)' (RRR = 0.454, 95% CI = 0.244-0.846; p = .013) decreased the use of NPMs. The Psychological Beliefs subscale of the PBQ increased the use of NPMs (RRR = 2.094, 95% CI = 1.152-3.803; p = .015).

Nurses should be provided with training on non-pharmacological methods as well as pharmacological methods in pain management, barriers to the use of non-pharmacological methods should be eliminated and psychological beliefs regarding pain should also be addressed.

There is a need to solve the problems of lack of education, legal barriers and lack of resources in increasing the use of non-pharmacological pain methods by nurses in intensive care units.