Knowledge and Attitudes of Nurses and Pain Management

Among the most fearsome symptoms many people do fear is pain, and untreated pain has many negative consequences. The World Health Organization (WHO) postulates that people with little or no access to pain management end up dying. Pain causes physical, social, financial and psychological well being of a person. According to Argoff (2007), unrelieved pain causes discomfort depriving individuals of sleep, causes depression, increases anxiety, leads to morbidity and eventually death. Long & Morgan (2008) argues that some people may think that pain is a punishment for past misdeeds. This basically implies that pain is a deeply personal experience and a sensitive issue that need to be discussed in-depth by healthcare professionals. It is evident that poorly managed pain may have adverse effects like loss of energy, decreased quality of life, loss of concentration, and inability to live a normal life.

Effective pain management is important from people suffering from either acute or chronic pain irrespective of their gender, race or age. The main reason for this study is because of lack of sufficient knowledge as well as attitude from the nurses as shown from previous studies. It has been documented and is a well known fact that ineffective pain management does affect thousands and perhaps millions of people negatively in many different ways. As compares to other professionals, nurses are in a better position to manage pain effectively. This is because of their close relationship with the affected patients. Positive attitudes and knowledge of pain is the key to successful and effective pain management.  Nurses play a main role in the management of pain in patients. This necessitates the fact that the nurses should portray excellence in every sector of management of pain hence enabling effective and appropriate patient’s pain management. In the contemporary times, it seen that unrelieved acute postoperative pain is a central health-care problem. Furthermore, the nurses play a particularly significant role in the patient’s pain management; say for example after surgery undertaking, taking care of the involved patients under a 24- hour care. The findings from the researches will help understand the role of nurses in pain management. Therefore, the results from these researches are of so much assistance as it helps the nurses know how to provide the appropriate patient health care and appropriate postoperative pain management.

Practical placements do expose nursing students during the course of their career to an array of experiences that have an effect on the quality of life of their patients in different ways. The researcher took an initiative that aimed to establish the definite cause of the problem after it was exposed that patients were suffering due to untreated pain during practical placements.  The most common entity under pain in relation to nurses is the excessive pain following a surgery. However, even after 40 years, there seems to be little improvement to relieving pain as a small percentage of patients were satisfied with their pain as having been relieved. The multifarious nature of pain is physiological and has undergone an exponential growth while understanding it. This has paralleled the very important advancements in science the management of pain interventional. Even with the efforts pain after a surgery is conducted. The morbidity and mortality of patients is contributed to highly by the unalleviated pain that is experienced by the patient after undergoing a surgery. The effects of pain on the patients can either be long term or short term, and they are massive. The types of pain experienced by the patients also include chronic and acute pain, and there is evidence that acute pain can progress to chronic pain with time (Hollen, 1998). There is also documented evidence in literature that after a surgery has been carried out it is then followed by chronic pain. A very key role is played by the nurses in the management of pain; therefore it is of the essence to ensure highly high and quality standards of the management of pain.

Pain is highly subjective and yet objective and it embraces the fact that pain includes both emotions and sensation as well. Charlton (2005) underestimated the importance of pain being recognized as a bio psychosocial experience with extremely crucial sensory, cognitive, behavioral and affective constituents. In the 1970's, the bio psychosocial model was invented, and this contested the traditional biomedical model of illness. This was based on biological indices, as the only determinant of defining a disease or a particular illness. The bio psychosocial model has a central component that the biological factors are not explained by the outcomes of health, rather, the factors as well as the social and psychological factors are considered as interconnected entity. In the determination of pain, the bio psychosocial model suggests that biologic aspects as well as social, psychological variables and behavioral, thus should be considered in pain determination. Pain is broadly classified into two classes which include; acute and chronic pain. There is such a distinctive difference between acute and chronic pain.  After a surgical intervention then the pain is associated to trauma or injury from a tissue. Acute pain serves as unpleasant, and its aim is to alert the potential or actual body tissue injury that is imperative of survival. On the other end chronic differs from acute pain as it as it serves no biological response.

Chronic pain is or may be caused by an illness or a disease but can be likely perpetuated by factors that are physically and pathologically remote from the originating cause. Extends for more than 3 months which often has low levels of underlying pathology that is facilitated by malignant or non-malignant causes, these are the characteristics of chronic pain. As research has been carried out, it shows that chronic pain can cause the epidemiological problems. This is based on a study that was carried out in Ireland. The study was meant to show the effect that chronic pain had on the community. Thus from the report it was deduced that chronic pain is a significant cause of healthcare problem. To add to the findings it was found out that the analysis indicated that chronic pain was associated with psychological and functional disabilities (Marie, 2002). There are various initiators of chronic pain, they include a malignant condition, non-life threatening conditions for example(facial pain, vascular pain and headache and injuries might initiate or result to a chronic pain (e.g. trauma, surgical intervention), non-life-threatening conditions, and malignant conditions (e.g. musculoskeletal, peripheral nerve pain, vascular pain, facial pain, and headaches) there is no adaptive or functional purpose that is served by chronic pain unlike with acute pain, Various physiological interactions that are complex and the processes always instigate chronic pain. Moreover, the unified factors, including, environmental, cognitive, and psychological factors will always interact with sensitized nervous system contributing to persistence and continuation of the pain in psychological factors that play an integral role in the perception of pain mostly in the chronic pain asserts. Excruciating pain can be triggered by non-noxious stimulus and pain can occur without any apparent stimulus. There are pain theories that are involved. The theories being specificity theory which is the traditional pain theory mainly states that, pain is transmitted through an independent pathway (Eliopoulos, 2010). Thus, pain is carried from the designated pain receptors from the periphery (skin) to a pain centre in the brain. The evidence of conditions such as neuralgia, causalgia and a phantom limb has given a good refutation of the pain concept as a direct specific-line nervous system.

The main objective of this thesis is to describe the attitudes and level of knowledge regarding the nurses working in the healthcare sector and who are in charge of patients going through pain. Therefore, this paper will find out the registered nurses’ level of education and their attitudes towards management of pain. The paper will also highlight the factors that may affect nurses’ decision making process regarding management of pain. It is our hope that the results of this study will benefit not only the nurses and their patients but also other healthcare professionals in the industry and all stakeholders. 

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