Development and psychometric evaluation of a tool to measure pain-management competency of surgical nurses

Postoperative pain is a common symptom in surgical patients. Effective postoperative pain management can facilitate quick recovery of patients and enhance their comfort. Nurses' pain-management competency is crucial for ensuring the effective implementation of postoperative pain management; however, there is no effective tool to evaluate competency. In this study, we developed and validated the Surgical Nurses' Pain-Management Competency (SNPMC) tool for assessing surgical nurses' competency in pain management and evaluated competency levels and associated factors among Chinese surgical nurses.

This study comprised two phases. (a) Measurement tool development, where items were generated through literature review and interviews, refined by expert discussions and two rounds of Delphi consultations, and finalized using the analytic hierarchy process. (b) Measurement validation and application, which evaluated content validity, construct validity, internal consistency, and test-retest reliability of the SNPMC. Using a multistage, geographically stratified convenience sampling strategy, 1,885 surgical nurses were surveyed from 48 hospitals across 15 regions representing the eastern, central, and western economic regions of China.

The final instrument included 78 items across seven dimensions: routine pain assessment, assessment and management of movement-evoked and unexpected pain, pharmacological pain management, patient-controlled analgesia management, non-pharmacological pain management, pain education, and professional development. The final SNPMC demonstrated excellent psychometric properties. Internal consistency was high (corrected item-total correlations: 0.672-0.847). Exploratory factor analysis supported the seven-dimensional structure (loadings ≥0.40). Content validity was strong (item-level content validity index: 0.80-1.00; scale-level content validity index: 0.98). The test-retest reliability over 14 days indicated strong stability. Chinese surgical nurses exhibited moderate to high levels of pain-management competency. Factors associated with competency included economic region, age, professional title, department, years of experience, education level, prior pain-management training, and prior pain management continuing education.

The SNPMC effectively evaluates surgical nurses' pain-management competencies, highlighting the current competency levels and its contributing factors.