Abstract:
The study investigated nurses’ perception of patients’ pain assessment in routine care. It was a cross-sectional descriptive research design. Four hundred and fifty (450) nurses working in the two tertiary institutions in Ebonyi State were used. Two instruments were used for data collection. The researcher developed questionnaire and in depth interview guide to validate further the qualitative responses. Reliability of the quantitative instrument was established using test-retest technique. Spearman’s product moment correlation yielded a co-efficient of 0.86. The qualitative instrument was also test-retested using four unit heads from UNTH Enugu. Their opinions did not vary between test periods (two weeks), the instrument was therefore considered reliable. Quantitative data were analyzed using descriptive (mean and percentages) and inferential statistics (T-test and ANOVA) for testing at 0.05 level of significance. Content analysis of qualitative data was done using thematic approach. Nurses from the two hospitals were aware of the basic components of pain assessment with mean scores of (3.58, 3.00, 4.28 and 3.86). They agreed to assertion that they assess pain routinely when other vital signs are checked, during initial health assessment, when patients complain of pain, before and after giving pain relieving drugs (3.99, 4.17, 4.11 and 4.13) respectively. However, nurses’ perceived barrier to pain assessment was burden of having so many patients to care for (3.17). They are quite aware that patients are the best assessors of their pain (3.88). However, they had fear of patients getting addicted to pain relieving drugs (3.80). Majority of the nurses use mainly patients’ verbal report of pain (87%) and simple descriptive pain intensity scale (57%) as their pain assessment tools. They rarely document patients pain data on patients’ case note (44%) where other health professionals can easily access and use it for clinical decision in pain management. The quantitative and qualitative findings are in agreement except on assessing pain routinely. Nurses’ acceptance that they assess pain routinely with other vital signs was not validated by the qualitative study. This revealed that despite the awareness of nurses on what they ought to do in pain assessment, they do not do it especially when they have so many patients to care for. There was no significant statistical difference in perception of pain assessment between the nurses of the two hospitals (P<0.05), and also between the nurses’ demographic variables within groups (P<0.05). The study concluded that the nurses’ response to patients’ report was affected by their fear of patients getting addicted to pain relieving drugs. It was recommended that an intensive training for nurses on pain assessment with emphasis on pharmacological and practical aspect of pain assessment should be organized by nurse managers to bridge the identified gap.
