Utilization of non-pharmacological methods and the perceived barriers for adult postoperative pain management by the nurses at selected National Hospitals in Asmara, Eritrea

Abstract

Background Pharmacological methods are widely used for postoperative pain management however, poorly controlled pain continues to pose a significant challenge. Non pharmacological methods could contribute to the unresolved postoperative pain management in assisting nurses’ routine care and reducing the need for medication. This study aimed to assess nurses’ utilization of non-pharmacological methods in postoperative pain and the perceived barriers for their implementation at the National Hospitals. Methods This was a descriptive cross sectional study conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses’ utilization of selected non-pharmacological methods and the perceived barriers for the implementation was used to collect data. Descriptive statistics for the demographic data, independent samples t-test, one way ANOVA and factorial ANOVA were used to analyze the data. Statistical significance level was set at P < 0.05. Results The study found out that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were mostly used while, cognitive-behavioral (5.9%) and physical methods (5.8%) were hardly used. The results also showed that, characteristics such as, age (p = 0.013), level of education (p = 0.012), work experience (p = 0.001) and place of work (p = 0.001), were significantly related to the use of non-pharmacological methods at bivariate level. However, hospitals were the only determinants of the non-pharmacological methods at multivariable level with a statistical significance of (p < 0.001). On the perceived barriers; heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), patient’s uncooperative behavior (57.1%), language difference (64.4%), nurse’s lack of knowledge (50%) and experience (40.3%) were identified. Conclusion The use of non-pharmacological methods in the studied hospitals varied greatly due to knowledge and experience of the nurses. Therefore, it is recommended that exposure and training for all health care providers at all level is a paramount importance in order to appreciate the benefits of non-pharmacological methods applicable to postoperative pain management. This could be achieved through on job training, seminars, scientific conferences and other brainstorming forums.

Knowledge, Attitude, and Associated Factors towards Nonpharmacological Pain Management among Nurses Working at Amhara Region Comprehensive Specialized Hospitals, Ethiopia

“…Nurses who had master's degrees were nearly four times more likely, and BSc nurses were about three times more likely to have adequate knowledge as compared to diploma nurses. This is similar to studies conducted in Benishangul-Gumuz [ 8 ], Eritrea [ 22 ], Saudi Arabia [ 17 ], China [ 23 ], and the USA [ 24 ]. The possible justification for this could be that as nurses' educational status increases, they could have a higher probability of getting up-to-date information regarding nonpharmacological pain management, as well as they might have a higher chance to review different kinds of literature regarding the topic and are more likely to apply their knowledge in practice to treat the patient's pain.…”

Are nurses utilizing the non-pharmacological pain management techniques in surgical wards?

“…Interestingly, the current study findings about preferred nonpharmacological pain management techniques among nurses support results of Kidanemariam et al, 2020, who highlighted that among cognitive-behavioral methods, breathing techniques, relaxation, (81.7% and 72.1%), for physical positioning, followed by thermal regulation, heat/cold, and massage (84.4%, 23.4%, and 18.8%), whereas emotional support was reported as the highest score (92.2%) [ 23 ].…”

Knowledge and Practice of Nurses towards Non-Pharmacological Pain Management Methods and Associated Factors at West Arsi Zone Public Hospitals, Oromia, Ethiopia, 2021: A Cross-Sectional Institution Based Study

“…books and get updated information in non-pharmacological pain management; therefore they could have achieved good scores in practice questions.Those nurses between the age of 30-39years were 2.276(AOR = 2.276, 95%=1.344-3.855) times more likely to have good practice as compared to the nurses between the age of 20-29 years. This nding is similar to the study conducted in Singapore(28) and the USA(5), and Eritrea(19) which found out nurses age had effects on the practice of non-pharmacological pain management. This is maybe because as age increases they are more eager in practicing these methods.…”

“…Degree holder nurses were 2.554 (AOR = 2.554, 95%CI = 1.465-4.452) more likely to have good practice as compared to a diploma. This study result is supported by the study done in the USA(5), Singapore(28), Cairo(25), Eretria(19). The possible reason could be nurses with higher educational levels had higher opportunities to review different…”

“…A self-administered and pretested questionnaire was used to collect data from participants. It was Adapted by reviewing related literature with some modi cations by a researcher ( Jira et al, 2020;Kidanemariam et al, 2020). The tool was prepared in English, consisted of closed-ended questions, and has four parts which include: part-1 socio-demographic characteristics which contain 6 items; part-2 nurses' knowledge assessment questions, which contains 12 items; knowledge level of nurses was evaluated based on the score of mean value.…”