Orthopedic Professionals’ Recognition and Knowledge of Pain and Perceived Barriers to Optimal Pain Management at Five Hospitals

Abstract

Pain is a challenge for orthopedic healthcare professionals (OHCP). However, pain studies examined the competencies of a single OHCP category, did not consider various pain management domains or barriers to optimal pain service, and are deficient across the Arabic Eastern Mediterranean region. We surveyed OHCP’s recognition and knowledge of pain and perceived barriers to optimal pain service (361 OHCP, five hospitals). Chi square compared doctors’ (n = 63) vs. nurses/physiotherapists’ (n = 187) views. In terms of pain recognition, more nurses had pain management training, confidently assessed pediatric/elderly pain, were aware of their departments’ pain protocols, and felt that their patients receive proper pain management. More doctors comfortably prescribed opiate medications and agreed that some nationalities were more sensitive to pain. For pain knowledge, more nurses felt patients are accurate in assessing their pain, vital signs are accurate in assessing children’s pain, children feel less pain because of nervous system immaturity, narcotics are not preferred due respiratory depression, and knew pre-emptive analgesia. As for barriers to optimal pain service, less nurses agreed about the lack of local policies/guidelines, knowledge, and skills; time to pre-medicate patients; knowledge about medications; complexity of the clinical environment; and physicians being not comfortable prescribing pain medication. We conclude that doctors required confidence in pain, especially pediatric and geriatric pain, using vital signs in assessing pain and narcotics use. Their most perceived barriers were lack of local policies/guidelines and skills. Nurses required more confidence in medications, caring for patients on narcotics, expressed fewer barriers than doctors, and the complexity of the clinical environment was their highest barrier. Educational programs with clinical application could improve OHCPs’ pain competencies/clinical practices in pain assessment and administration of analgesics.

PAIN-AGE, a Controlled Before/After Study Assessing an Audit and Feedback Perioperative Pain Management Intervention in Older Patients with Hip Fracture.

“…A dedicated study should be conducted to assess the impact of the A&F intervention on complications. Finally, in contrast to other studies [24], we examined both prescription and medication distribution, thus considering the behaviors of both doctors and nurses.…”

Surgical Nurses’ Pain Related Knowledge, Attitude and Clinical Decision Making Skills

“…In the study by Shogurat, majority of the surgical nurses also answered the same question correctly (5). In the study by Bouri, 61.8% of the orthopedic nurses answered this question incorrectly (19). Lack of knowledge and inaccurate beliefs on opioids are important problems in pain management (20).…”

Knowledge and associated factors towards post-operative pain management among nurses working at referral hospitals, Ethiopia

“…Self-administered questionnaire was used to collect the data from nurses. The questionnaire contains two parts which include nurses' socio-demographic status, knowledge of POP assessment and management, The questionnaires was adapted after an intense review of the related literatures [23,27,28]. It was prepared in English.…”