Nurses knowledge and attitude toward pain management: Cross sectional, multi-center study from Palestine

Pain is one of the most common and debilitating experiences for patients in the hospital setting, leading to significant adverse effects on patients' physical, emotional, and psychological health. Although pain management has improved significantly worldwide, issues remain regarding assessment and treatment of pain. Nurses, as direct caregivers, play an important role in assessing and managing pain, and it is possible that their beliefs, knowledge, and barriers at the systems level can influence the effectiveness of pain management. The purpose of this study was to assess nurses' knowledge, attitudes, and barriers related to pain management practices in hospitals located in the northern West Bank, Palestine.

A descriptive cross-sectional study design was used to survey 199 registered nurses providing care in emergency, medical-surgical, and critical care settings. Nurses were surveyed using convenience sampling. A modified KASRP tool (33 items) was used to measure knowledge, attitudes, and barriers. Descriptive statistics, t-tests, and ANOVA were used to analyze the data.

The overall mean score for knowledge and attitude was 44.75%, which reflects a low adherence to appropriate practice, or standards of practice regarding pain management. Postgraduate educational level of nurses in the study had a significant association with high scores compared to lower educational levels (p = 0.016). In addition, scores in knowledge and attention to income had a significant association (p = 0.043). There were notable areas of knowledge gap, including concerns about opioid addiction (29.1% correct), as well, as the lack of understanding about benzodiazepine efficacy (34.2% correct). The most frequently reported barriers included concerns about addiction (61.5%), lack of IV access (61.4%) and time (59.3%).

Nurses in the northern West Bank demonstrate considerable deficits in pain management knowledge and systems-related barriers. The need for educational initiatives, trauma informed and updated policies, and standard clinical guidelines for evidence-based pain management, is urgent. By improving nurses' competency, pain suffering may decrease and clinical outcomes improve.