Cancer Pain Management at Oncology Units: Comparing Knowledge, Attitudes and Perceived Barriers Between Physicians and Nurses

Abstract

Pain is a major symptom that causes suffering among patients diagnosed with cancer. Identifying physicians' and nurses' knowledge, attitudes, and their perceived barriers of cancer pain management is considered an essential step in improving cancer pain relief. The purposes of this study are to compare physicians' and nurses' knowledge and attitudes toward cancer pain management (CPM) and describe their perceived barriers to CPM at oncology units. A descriptive cross-sectional design was utilized to obtain data through self-report questionnaire. The total number of sample size was 207 participants (72 physicians and 135 nurses). Findings revealed that both physicians and nurses had fair knowledge and attitudes toward CPM. Physicians had significantly higher knowledge and better attitudes than nurses (62.3 vs. 51.5%, respectively). Physicians were knowledgeable about pharmacological pain management and opioid addiction but had negative attitudes toward pain assessment. Nurses' knowledge was better in regard of CPM guidelines, while they had poor knowledge about pharmacological pain management and opioid addiction. Physicians and nurses perceived knowledge deficit, lack of pain assessment, opioid unavailability, and lack of psychological interventions as the most common barriers to CPM. It is recommended to integrate recent evidence-based guidelines about CPM in oncology units that aim to improve practice. Offering continuing education courses in hospitals guided by pain teams is another essential recommendation for effective CPM.

Physicians’ knowledge, perceived barriers, and practices regarding cancer pain management: a cross-sectional study from Palestine

“…A similar situation of poor knowledge relating to chronic pain management and the use of analgesics among medical residents was also reported by a recent study conducted in Iran [31]. However, these results indicate a deeper knowledge gap compared to more recent studies conducted in Korea [5] and Jordan [32]. Addressing such knowledge problem among physicians can benefit from the experiences of other countries where similar problems were recognized and improved upon.…”

Managing Pain in People with Cancer—a Systematic Review of the Attitudes and Knowledge of Professionals, Patients, Caregivers and Public

“…The barriers most commonly cited by professionals [11,22,28,44,48,59,98,100], patients and their caregivers [20,55,57,95] and the general public [51] were the fear of poor tolerance, side effects of opioids and drug addiction. However, the most common barriers cited by professionals were contrary to other similar studies, which have suggested that the most important barriers were poor assessment of pain and its management, patient reluctance to take opioids and inadequate staff knowledge of CPM [14,22,27,32,34,44,45,104]. Furthermore, a previous systematic review by Jacobsen et al [42] showed that physicians from countries, such as some states in the USA, Australia and Denmark were more often prescribing strong opioids in efficient doses, as they were less concerned about opioid addiction [42].…”

“…Another interesting outcome was that several studies showed physicians had a better level of attitudes and knowledge towards CPM than nurses [22,32,44,45]. There was also a difference between oncologists and surgeons regarding their level of knowledge about cancer pain and its management [33].…”

“…For instance, it has been reported that physicians who work at oncology units had higher understanding and knowledge about CPM than nurses. The mean scores on the KAS (range 0-39) for physicians was 24.3 (62.3%) compared with 20.08 (51.5%) for nurses (p < 0.001) [22]. The outcomes also showed that oncologists recorded higher knowledge of CPM than surgeons (p < 0.001) [33].…”

“…Several studies showed that physicians had better knowledge and attitudes towards CPM compared with nurses [22,32,44,45]. For instance, it has been reported that physicians who work at oncology units had higher understanding and knowledge about CPM than nurses.…”