Introduction: Pain is a distressing feeling often caused by intense or damaging stimuli. Pain is a universal phenomenon; likewise effective pain management should be universal response by nurses. Nurses must be highly competent, knowledgeable and possess positive attitudes towards pain management so that patients receive high quality pain management practices to facilitate optimal patient health outcomes.

Aim and objectives: The present study aims to assess the knowledge and attitude of staff nurses regarding pain management at Kular Hospital, Bija (Punjab).

Material and methods: A descriptive survey approach was used for the study. Convenient sampling was used to select 50 staff nurses working in at Kular Hospital, Bija (Punjab). Data was collected using self structured tools.

Results: The results of the study revealed that the majority of the respondents i.e. 33(66%) had average knowledge, 10(20%) had poor knowledge and only 07(14%) of respondents had good knowledge related to pain management. The majority of respondents i.e 37(74%) was having a negative attitude towards pain management only 13(26%) was having a positive attitude towards pain management. The knowledge of staff nurses was found to be associated with their attitude towards pain management.

Conclusion: The study result concluded that 66% staff nurses had average knowledge and 13% staff nurses had positive attitude towards pain management. So, it is necessary to develop continuing education programmes for staff nurses to increase their knowledge regarding pain management and to develop a positive attitude among staff nurses.

Keywords: pain management, attitude, knowledge, staff nurses, Punjab

Pain is a distressing feeling often caused by intense or damaging stimuli. According to International Association for the study of Pain, Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in the terms of such damage.¹

It is a major symptom in many medical conditions, and can interfere with a person’s quality of life.² Inadequate treatment of pain is widespread throughout surgical wards, intensive care units, accident and emergency departments, in general practice, in the management of all forms of chronic pain including cancer pain and in end of life care.³ The International Association for the study of Pain advocates that the relief of the pain should be recognized as a human right that chronic pain should be considered a disease in its own right, and that pain medicine should have the full status of a specialty.⁴

Pain management is an integral part of nursing and nurses have responsibility to effectively manage patient’s pain. Effective pain management demands knowledge, commitment, persistence and creativity.⁵ Untreated and undertreated Pain has debilitating effects and significantly interferes with the patient’s physical, emotional and spiritual wellbeing thus can alter the patient’s quality of life.^6–9 Despite having many researches and scientific advancement in pain management over the years, inadequate knowledge remains a major barrier to achieving effective pain management. Knowledge and attitude of nurses towards pain management have an influence on how pain is managed. Negativity and knowledge deficit can be a barrier to effective pain management.

Pain is a universal phenomenon; likewise effective pain management should be universal response by nurses. Nurses must be highly competent, knowledgeable and possess positive attitudes towards pain management so that patients receive high quality pain management practices to facilitate optimal patient health outcomes. Therefore present study was conducted to assess the knowledge and attitude of staff nurses regarding pain management.

A descriptive study to assess the knowledge and attitude regarding pain management among staff nurses at Kular Hospital, Bija, Punjab and India.

The purpose of the study was to assess the knowledge and attitude regarding pain management among staff nurses at Kular Hospital, Bija, Punjab and India.

A descriptive research design was selected to conduct the present study. Before conducting the study A sample of 50 staff nurses who were fulfilling the inclusion sampling criteria was selected conveniently at Kular Hospital. A self administered questionnaire was prepared to collect data. The questionnaire was developed from relevant literature, consisted of 2 sections:

1. Knowledge (Section A).
2. Attitude (Section B).

Section A was consisting of 25 questions related to definition of pain, Pain assessment, pharmacological and non pharmacological management of pain. Section B was consisting of 10 statements on five point Likert scale. To ensure the content validity of the tool was given to 5 experts from the field such as Nursing, Medicine and Surgery. The experts were chosen on the basis of clinical experience. Appropriate modifications were made according to the expert’s opinions. Reliability of the tool was computed by applying split half method. The reliability of tool regarding knowledge was 0.83 and regarding attitude was 0.75.

The responses were quantified by giving score as follows: Strongly Agree=5, Agree=4, Uncertain=3, Disagree=2 and Strongly Disagree=1. The negative statements were scored reversely. Attitude Score less than 50% was considered as negative attitude and more than 50% was considered as positive attitude. The data was collected from the 50 staff nurses selected conveniently during the time of data collection period i.e. 02 June 2016 to 16 June 2016. The question naire were given to the staff nurses working in the Kular Hospital and they were asked to answer the questions.

Inclusion sampling criteria

1. Staff Nurses working at Kular Hospital, Bija.
2. Staff nurses who were present at the time of data collection.
3. Staff nurses who can understand English.

Exclusion sampling criteria

1. Staff nurses who were not willing to participate.

Knowledge of pain management

The total mean knowledge score was 16.18. The majority of the respondents i.e. 33 (66%) had average knowledge related to pain management with score of 15-20, 10 (20% ) had poor knowledge related to pain management with the score of 0-15, and only 07 (14%) of respondents had good knowledge related to pain management with the score of 20-25.

Attitude related to pain management

The total mean attitude score was 28.84. The majority of respondents i.e 37(74%) was having a negative attitude towards pain management only 13(26%) was having a positive attitude towards pain management.¹⁰

Association of knowledge and attitude towards pain management

In order to explore association of knowledge with attitude of staff nurses, chi -square was calculated. The chi-square value of 16.36 was found to be significant at p value<0.05 level.

This study provides important information about the level of knowledge and attitudes regarding pain management of staff nurses at Kular Hospital, Bija and Punjab.¹¹

The study revealed that nurses have average knowledge about pain management which was supported by findings in other studies that showed that nurses’ knowledge of pain management was poor ranging from 39.7 to 72.3.^12,13 This is supported by a study done in Hong Kong that showed that nurses are deficit in knowledge and attitude related to pain management.⁹ Another study which was conducted in Zimbabwe showed that nurses have inadequate knowledge with mean knowledge score of 64.5 and attitude regarding pain management with mean attitude score of 56%.¹⁰ A study done in Zimbabwe showed that knowledge of pain management was highly associated with nurses’ attitudes towards pain management.¹⁰

Nursing implications

The present study has several nursing implications which are as follows:

1. Continuing education programme should be conducted for staff nurses regarding pain and its management.
2. Findings of the study will act as a catalyst to carry out more extensive research on large population sample and in other settings.
3. Very few studies have been done in Punjab. So more study can be done on the knowledge and attitude regarding pain management by nursing researcher.

Nurses’ knowledge and attitudes towards pain management was average. This is a cause for concern since nurses play a pivotal role in the pain management. Absence of pain is a basic human right therefore nurses need to be equipped with the necessary information so that they are able to effectively manage pain in patients.

I wish to acknowledge the support of Dr. KS Kular, Managing Director cum chief Bariatric Surgeon, Kular Hospital, towards the completion to this study.

The ethical approval was taken from ethical committee of Kular Hospital, Bija and Punjab. Apart from this, informed consent was taken from each respondent to participate in the study.

The author declares no conflict of interest.

1. Karamjeet Kaur. International Association for the study of pain. The need of taxonomy. Pain. 1976;6(3):247–248.
2. Breivik H, Borchgrevink PC, Allen SM, et al. Assessment of Pain. Br J Anaesth. 2008;101(1):17–24.
3.  Amanda K Brown, Paul J Christo, Christopher L Wu. Strategies for post operative pain management. Best practice research in clinical anesthesiology. 2004;18(4):703–717.
4. Hoffmann DE, Tarzian AJ. The girl who cried pain: a bias against women in the treatment of pain. J Law Med Ethics. 2001;29(1):13–27.
5. Jenifar Ward. The Nurses Role in Pain Management; 2012.
6. Ho SE, Ho CC, Pang Yuen H, Lexshimi R, et al. A study of knowledge and attitudes of registered nurses towards pain management in an urban hospital. Clin Ter. 2013;164(3):215–219.
7. Yava A, Cizek H, Ozcan C, et al. Knowledge and attitudes of nurses about pain management in Turkey. International Journal of Car Sci. 2013;6:494–505.
8. Alexandria de Jesus SL, Jacinta PM. Pain: Knowledge and attitudes of nursing students, 1 year follow-up. Text Context Nurs. 2013;22(2):311–317.
9. Lui LY, So WK, Fong DY. Knowledge and attitudes regarding pain management among nurses in Hong Kong medical units. J Clin Nurs. 2008;17(15):2014–2021.
10. Ancia Manwere, Tirivanhu Chipfuwa. Knowledge and attitude of registered nurses regarding pain management of adult medical units: a case of Bindura hospital. Health Science Journal. 2015;9(4):3.
11. Lin PC, Chiang HW, Chen CS. Pain management: evaluating the effectiveness of educational programme for surgical nursing staff. J Clin Nurs. 2008;17(15):2032–2041.
12. Jho HJ, Kin Y, Kong KA, et.al. Knowledge, practices, and perceived barriers regarding cancer pain management among physicians and nurses in Korea: A nationwide multicenter survey. PLos One. 2014;9(8):e105900.
13. Deandrea S, Montanari M, Moja L, et al. Prevalence of under treatment in cancer pain. A review of published literature. Ann Oncol. 1985;19(12):1985–1991.