Health  Vol.8 No.6 , April 2016
Pain-Related Knowledge and Barriers among Jordanian Nurses: A National Study
Abstract: The purpose of this study is to explore Jordanian nurses’ knowledge and attitudes regarding pain assessment, and barriers to intervention at different hospitals representing health care sectors in Jordan. A descriptive cross-sectional design was used in this study utilizing self-administered questionnaires to collect data from nurses working in public, University-affiliated, and private hospitals located on the north, mid, and south of Jordan using Nurses’ Knowledge and Attitudes Survey Regarding Pain, (n = 439). The mean of total correct answers on the 32 knowledge questions was 13.39 (SD = 4.31). Nurse-related barriers to effective pain management include patient history of alcohol abuse or drug addiction, and nursing staff reluctant to contact physician for analgesic order. Nurses working in surgical units, employed at private hospitals, holding a master degree, or who attended educational course or program scored significantly higher than other nurses. The results demonstrated knowledge deficit and attitude and that nurses underestimated and undertreated patients’ pain. Serious efforts should be taken in nursing schools and hospitals to prepare nurses and equip them with comprehensive knowledge tools to assess and manage pain appropriately.
Cite this paper: D’emeh, W. , Yacoub, M. , Darawad, M. , Al-Badawi, T. and Shahwan, B. (2016) Pain-Related Knowledge and Barriers among Jordanian Nurses: A National Study. Health, 8, 548-558. doi: 10.4236/health.2016.86058.

[1]   Chung, J. and Lui, J. (2003) Postoperative Pain Management: Study of Patients’ Level of Pain and Satisfaction with Health Care Providers’ Responsiveness to Their Reports of Pain. Nursing and Health Sciences, 5, 13-21.

[2]   Darawad, M., Al-Hussami, M., Saleh, A., Al-Sutari, M. and Mustafa, W. (2015) Predictors of ICU Patients’ Pain Management Satisfaction: A Descriptive Cross-Sectional Survey. Australian Critical Care, 28, 129-133.

[3]   Panteli, V. and Patistea, E. (2007) Assessing Patients’ Satisfaction and Intensity of Pain as Outcomes in the Management of Cancer-Related Pain. European Journal of Oncology Nursing, 11, 424-533.

[4]   Coker, E., Papanaioannou, A., Kaasalainen, S., Dolovich, L., Turpie, I. and Taniguchi, A. (2010) Nurses’ Perceived Barriers to Optimal Pain Management in Older Adults on Acute Medical Units. Applied Nursing Research, 23, 139-146.

[5]   Gauthier, L., Rodin, G., Zimmermann, C., Warr, D., Moore, M., Shepherd, F., et al. (2009) Acceptance of Pain: A Study in Patients with Advanced Cancer. Pain, 143, 147-154.

[6]   Li, D., Miaskowski, C., Burkhardt, D. and Puntillo, K. (2009) Evaluations of Physiologic Reactivity and Reflexive Behaviors during Noxious Procedures in Sedated Critically Ill Patients. Journal of Critical Care, 24, E9-E13.

[7]   Marmo, L. and Fowler, S. (2010) Pain Assessment Tool in the Critically Ill Post-Open Heart Surgery Patient Population. Pain Management Nursing, 11, 134-140.

[8]   The Institute of Medicine (IOM) (2011) Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. National Academic Press, Washington DC.

[9]   Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (2000) Joint Commission on Accreditation of Healthcare Organizations. Pain Assessment and Management: An Organizational Approach. Joint Commission Resources, Washington DC.

[10]   Blondal, K. and Halldorsdottir, S. (2009) The Challenge of Caring for Patients in Pain: From the Nurse’s Perspective. Journal of Clinical Nursing, 18, 2897-2906.

[11]   Dreidi, H. and Hamdan-Mansour, A. (2015) Pain, Sleep Disturbance, and Quality of Life among Palestinian Patients Diagnosed with Cancer. Journal of Cancer Education.

[12]   Niemi-Murola, L., Poyhia, R., Onkinen, K., Rhen, B., Makela, A. and Niemi,T. (2007) Patient Satisfaction with Postoperative Pain Management-Effect of Preoperative Factors. Pain Management Nursing, 8, 122-129.

[13]   European Association of Palliative Care (2007) Half of European Cancer Patients Have Moderate to Severe Pain: One in Five Patients Does Not Receive Treatment. Journal of Pain & Palliative Care, 21, 51-53.

[14]   Hamill-Ruth, R. and Marohn, M. (1999) Evaluation of Pain in the Critically Ill Patient. Critical Care Clinic, 15, 35-54.

[15]   Pasero, C. (2003) Pain in the Emergency Department: Withholding Pain Medication Is Not Justified. American Journal of Nursing, 103, 73-74.

[16]   Coulling, S. (2005) Nurses’ and Doctors’ Knowledge of Pain after Surgery. Nursing Standard, 19, 41-49.

[17]   McCaffery, M. and Robinson, E. (2002) Your Patient Is in Pain: Here’s How You Respond. Nursing, 32, 36-47.

[18]   Lui, L., So, W. and Fong, D. (2008) Knowledge and Attitudes Regarding Pain Management among Nurses in Hong Kong Medical Units. Journal of Clinical Nursing, 17, 2014-2021.

[19]   Vincent, C. (2005) Nurses’ Knowledge, Attitudes, and Practices: Regarding Children’s Pain. MCN American Journal of Maternal & Child Nursing, 30, 177-183.

[20]   Elcigil, A., Maltepe, H., Esrefgil, G. and Mutafoglu, K. (2011) Nurses’ Perceived Barriers to Assessment and Management of Pain in a University Hospital. Pediatric Hematology Oncology, 33, S33-S38.

[21]   McCaffery, M. and Pasero, C. (1999) Pain Clinical Manual. Mosby, St. Louis.

[22]   He, H., Jahja, R., Lee, T., Ang, E., Sinnappan, R., Vehvilainen-Julkunen, K. and Chan, M. (2010) Nurses’ Use of Non-Pharmacological Methods in Children’s Postoperative Pain Management: Educational Intervention Study. Journal of Advanced Nursing, 66, 2398-2409.

[23]   Rejeh, N., Ahmadi, F., Mohammadi, E., Kazemnejad, A. and Anoosheh, M. (2009) Nurses’ Experiences and Perceptions of Influencing Barriers to Postoperative Pain Management. Scandinavian Journal of Caring Sciences, 23, 274-281.

[24]   Wang, H. and Tsai, Y. (2010) Nurses’ Knowledge and Barriers Regarding Pain Management in Intensive Care Units. Journal of Clinical Nursing, 19, 3188-3196.

[25]   Matthews, E. and Malcolm, C. (2007) Nurses’ Knowledge and Attitudes in Pain Management Practice. British Journal of Nursing, 16, 174-179.

[26]   Moceri, J. and Drevdahl, D. (2014) Nurses’ Knowledge and Attitudes toward Pain in the Emergency Department. Journal of Emergency Nursing, 40, 6-12.

[27]   Yava, A., Cizek, H., Ozcan, C., Yildiz, D. and Dizer, B. (2013) Knowledge and Attitudes of Nurses about Pain Management in Turkey. International Journal of Caring Sciences, 6, 494-505.

[28]   Bernardi, M., Catania, G., Lambert, A., Tridello, G. and Luzzani, M. (2007) Knowledge and Attitudes about Cancer Pain Management: A National Survey of Italian Oncology Nurses. European Journal of Oncology Nursing, 11, 272-279.

[29]   AlQadire, M. and Alkhalaileh, M. (2012) Jordanian Nurses Knowledge and Attitude Regarding Pain Management. Pain Management Nursing, 15, 220-228.

[30]   Darawad, M., Al-hussami, M., Saleh, A. and Al-Sutari, M. (2012) Jordanian Patients’ Pain Management Satisfaction. Pain Management Nursing, 15, 116-125.

[31]   Hweidi, I. (2007) Jordanian Patients’ Perception of Stressors in Critical Care Units: A Questionnaire Survey. International Journal of Nursing Studies, 44, 227-235.

[32]   Abdalrahim, M., Majali, S. and Bergbom, I. (2008) Documentation of Postoperative Pain by Nurses in Surgical Wards. Acute Pain, 10, 73-81.

[33]   Al-Shaer, D., Hill, P. and Anderson, M. (2011) Nurses Knowledge and Attitudes Regarding Pain Assessment and Intervention. Medsurg Nursing, 20, 7-11.

[34]   Ferrell, B. and McCaffery, M. (2008) The Nurses’ Knowledge and Attitudes Survey Regarding Pain.

[35]   Lai, H., Chen, M., Tsai, L., Lo, L., Wei, L., Hong, M., et al. (2003) Are Nurses Prepared To Manage Cancer Pain? A National Survey of Nurses’ Knowledge about Pain Control in Taiwan. Journal of Pain and Symptom Management, 26, 1016-1025.

[36]   Démeh, W. and Rosengren, K. (2015) The Visualisation of Clinical Leadership in the Content of Nursing Education—A Qualitative Study of Nursing Students’ Experiences. Nurse Education Today, 35, 888-893.

[37]   Yildirim, Y., Fadiloglu, C. and Uyar, M. (2008) Knowledge and Attitudes of Turkish Oncology Nurses about Cancer Pain Management. Pain Management Nursing, 9, 17-25.

[38]   McCaffery, M. and Beebe, A. (1989) Pain: Clinical Manual for Nursing Practice. Mosby, St. Louis.

[39]   Bouvette, M., Fothergill-Bourbonnais, F. and Perreault, A. (2002) Implementation of the Pain and Symptom Assessment Record (PSAR). Journal of Advanced Nursing, 40, 685-700.

[40]   Sutari, M., Abdul-Rahim, M., Hamdan-Mansour, A. and Ayasreh, S. (2014) Pain among Mechanically Ventilated Patients in Critical Care Units. Journal of Research in Medical Sciences, 19, 726-732.

[41]   Lewthwaite, B., Jabusch, K., Wheeler, B., Schnell-Hoehn, K., Mills, J. and Estrella-Holder, E. (2011) Nurses’ Knowledge and Attitudes Regarding Pain Management in Hospitalized Adults. Journal of Continuing Education in Nursing, 42, 251-257.

[42]   Patiraki, E., Papathanassaoglou, E., Tafas, C., Akarepi, V., Katsaragakis, S., Kampitsi, A. and Lemonidou, C. (2006) A Randomized Controlled Trial of an Educational Intervention on Hellenic Nursing Staff’s Knowledge and Attitudes on Cancer Pain Management. European Journal of Oncology Nursing, 10, 337-352.

[43]   Tsai, F., Tsai, Y., Chien, C. and Lin, C. (2007) Emergency Nurses’ Knowledge of Perceived Barriers in Pain Management in Taiwan. Journal of Clinical Nursing, 16, 2088-2095.

[44]   Yacoub, M., Demeh, W., Darawad, M., Barr, J., Saleh, A. and Saleh M. (2014) An Assessment of Diabetes-Related Knowledge among Registered Nurses Working in Hospitals in Jordan. International Nursing Review, 61, 255-262.

[45]   Aiken, L., Cimiotti, J., Sloane, D., Smith, H., Flynn, L. and Neff, D. (2011) Effects of Nurse Staffing and Nurse Education on Patient Deaths in Hospitals with Different Nurse Work Environments. Medical Care, 49, 1047-1053.

[46]   Twycross, A. (2013) Nurses’ Views about the Barriers and Facilitators to Effective Management of Pediatric Pain. Pain Management Nursing, 14, 164-172.

[47]   Manias, E. (2003) Medication Trends and Documentation of Pain Management Following Surgery. Nursing & Health Sciences, 5, 85-94.

[48]   Ratrout, H., Hamdan-Mansour, A., Samer, S., Seder, S. and Salim, W. (2013) Patient Satisfaction about Using Patient Controlled Analgesia in Managing Pain Post Surgical Intervention. Clinical Nursing Research, 23, 353-368.

[49]   Duignan, M. and Dunn, V. (2009) Perceived Barriers to Pain Management. Emergency Nurse, 16, 31-35.