Nursing Students' Pain Management Knowledge and Attitudes: A Systematic Review and Meta-Analysis

To systematically evaluate nursing students' knowledge and attitudes toward pain management and provide evidence to guide educational and clinical improvements.

A systematic review and meta-analysis.

Ten databases (PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, Scopus, Chinese Biomedical Database, China National Knowledge Infrastructure, and Wanfang) were searched through February 2025.

Two reviewers independently screened studies, extracted data, and assessed quality using the Agency for Healthcare Research and Quality checklist. Data were synthesized using R (version 4.3.2) with random-effects models. Subgroup and meta-regression analyses explored heterogeneity, and sensitivity analyses evaluated robustness. Publication bias was examined using Egger's test.

Twenty-six cross-sectional studies from nine countries, encompassing 5,270 nursing students, met the inclusion criteria. The pooled correct response rate for the Knowledge and Attitudes Survey Regarding Pain was 45% (95% CI: 42%-49%). Among the six Knowledge and Attitudes Survey Regarding Pain subscales, the highest pooled scores were observed for spiritual/cultural (65%; 95% CI: 58%-73%) and pathophysiology (52%; 95% CI: 41%-63%), whereas the lowest scores pertained to intervention (26%; 95% CI: 22%-30%) and addiction-related knowledge (37%; 95% CI: 27%-47%). Subgroup and meta-regression analyses identified the country and continent as significant moderators.

This study identified significant gaps in nursing students' knowledge and attitudes about pain management, particularly regarding intervention strategies. The findings underscore the urgent need for structured, evidence-based pain education frameworks and cross-cultural curricular reforms to standardize and enhance global pain care practices.