DOI QR코드

DOI QR Code

Pain Management Knowledge, Attitudes, and Performance of Nurses in Long-Term Care Hospitals

요양병원 간호사의 통증관리에 대한 지식, 태도, 수행정도

  • Cho, Hyeonju (Yeungnam University Yeongcheon Hospital) ;
  • Kwon, So-Hi (College of Nursing, Kyungpook National University)
  • Received : 2016.07.06
  • Accepted : 2016.11.21
  • Published : 2016.12.01

Abstract

Purpose: This study investigated long-term care hospital nurses' knowledge and practice of pain management and their attitudes towards the job with an ultimate aim to provide fundamental information for development of a pain education program. Methods: A cross-sectional survey was carried out with 120 nurses from four long-term care hospitals. Nurses' knowledge of and attitudes towards pain management was measured using a tool developed by Watt-Watson. To examine their pain management practice, an instrument was developed based on the pain management guidelines used by the long-term care settings. Results: For pain management knowledge, the participants gave an average of 26.2 (${\pm}13.10$) correct answers out of 40 questions. The most frequently missed question was one about subjectivity of pain, "Patients' physiological and behavioral reactions to pain hint at the presence and intensity of pain" (89.2%), and 56.7% of the nurses believed that increasing tolerance for a narcotic analgesic means addiction. Regarding attitudes towards and practice of pain management, 80.2% of the nurses used placebos to patients who complain about pain often. Conclusion: This study revealed poor level of pain management knowledge of and attitude among long-term care hospital nurses. This might negatively affect their pain management practice. From the educational perspective, nurses should be provided with education on pain management education with emphasis on the nature of pain and misuse of placebo drugs.

목적: 본 연구는 요양병원 간호사의 통증관리 지식, 태도, 수행정도를 파악하여 추후 요양병원 통증관리 교육을 설계하는데 기초자료로 활용하고자 실시되었다. 방법: 본 연구는 4개 요양병원에서 근무하는 간호사 120명을 대상으로 한 횡단적 조사연구이다. 통증관리 지식과 통증관리 태도는 원래 연구도구는 Watt-Watson이 개발한 도구를 사용하였고, 통증관리 수행정도는 요양병원에서의 통증관리 가이드라인들을 근거로 연구자가 개발하여 사용하였다. 결과: 본 연구의 결과 통증관리 지식은 40점 만점 평균 26.2점이었다. 가장 많이 틀린 문항은 통증의 주관성에 대한 항목으로 '통증에 따르는 환자의 생리적, 행동적 반응을 보고 통증의 유무와 강도를 파악할 수 있다(89.2%)'였고, 56.7%는 내성의 증가는 마약성 진통제 중독을 의미한다고 생각하였다. 통증관리 태도와 실무에 관해서는, 80.2%가 통증을 자주 호소하는 환자에게 위약을 사용한다고 하였고, 위약사용은 간호사가 두 번째로 자주 사용하는 통증관리 방법이었다. 결론: 본 연구는 요양병원 간호사의 통증관리 지식이 낮고 태도가 부적절한 것으로 나타났고, 이는 통증관리 실무에 부정적 영향을 미칠 수 있다. 요양병원 간호사들에게 통증관리 교육, 특히 통증의 속성과 위약남용에 대한 교육이 시급하다.

Keywords

References

  1. Korea Health Industry Development Institute. 2014 Handbook of medical resources statistics. Cheongju:Korea Health Industry Development Institute;2014. p. 4-5.
  2. Ministry of Health and Welfare, Korea Institute for Healthcare Accreditation. Manual of long term care hospitals accreditation. Seoul:Korea Institute for Healthcare Accreditation;2012. p. 4.
  3. Ministry of Health and Welfare: Hospice demonstration project in geriatric hospitals [Internet]. Sejong: Ministry of Health and Welfare; 2016 Sep 22 [updated 2016 Sept 23; cited 2016 Oct 11]. Available from: https://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=334328&page=1.
  4. AGS Panel on Persistent Pain in Older Persons. The management of persistent pain in older persons. J Am Geriatr Soc 2002;50(6 Suppl):S205-24. https://doi.org/10.1046/j.1532-5415.50.6s.1.x
  5. Zanocchi M, Maero B, Nicola E, Martinelli E, Luppino A, Gonella M, et al. Chronic pain in a sample of nursing home residents: prevalence, characteristics, influence on quality of life (QoL). Arch Gerontol Geriatr 2008;47:121-8. https://doi.org/10.1016/j.archger.2007.07.003
  6. Kim ER. Social capital as a moderator of the relationship between self-rated health and depression among elderly with chronic arthritis. Health Social Science 2013;33:59-83.
  7. Kim YS, Byeon HS. Effects of pain on memory, physical function, and sleep disturbance in older adults with chronic disease: the mediating role of depression. J Korean Gerontol Nurs 2014;16:59-67. https://doi.org/10.17079/jkgn.2014.16.1.59
  8. Oh JH, Lee MS. Structural equation modeling on quality of life in older adults with osteoarthritis. J Korean Acad Nurs 2014;44:75-85. https://doi.org/10.4040/jkan.2014.44.1.75
  9. KMA Research Institute for Healthcare Policy. Patient care and management in long term care hospitals. Seoul:Korean Medical Association Research Institute for Healthcare Policy;2015. p. 46.
  10. Ryoo EN, Park KS. Validity, reliability and efficiency of pain self-report scale in elderly with dementia. Korean J Adult Nurs 2011;23:111-22.
  11. Ruzicka S, Sanchez-Reilly S, Gerety M. Holistic assessment of chronic pain among elders. Am J Hosp Palliat Care 2007;24:291-9. https://doi.org/10.1177/1049909106299061
  12. Horgas AL, Elliott AF, Marsiske M. Pain assessment in persons with dementia: relationship between self-report and behavioral observation. J Am Geriatr Soc 2009;57:126-32. https://doi.org/10.1111/j.1532-5415.2008.02071.x
  13. Cohen-Mansfield J, Creedon M. Nursing staff members' perceptions of pain indicators in persons with severe dementia. Clin J Pain 2002;18:64-73. https://doi.org/10.1097/00002508-200201000-00010
  14. Monroe TB, Misra SK, Habermann RC, Dietrich MS, Cowan RL, Simmons SF. Pain reports and pain medication treatment in nursing home residents with and without dementia. Geriatr Gerontol Int 2014;14:541-8. https://doi.org/10.1111/ggi.12130
  15. Han JY, Park HS, Jin MJ. Nurses' knowledge and performance of pain management at a general hospital. J Korean Acad Fundam Nurs 2016;23:6-11. https://doi.org/10.7739/jkafn.2016.23.1.6
  16. Jeong SJ, Kim KH. Knowledge and performance of cancer pain management of nurses and nurses' aids in long term care hospitals. J Korean Contents Association 2014;14:649-60. https://doi.org/10.5392/JKCA.2014.14.10.649
  17. Kim HK, Lee HS, Hwang GH, Yu YS, Lee SM. Pain management-related factors of cancer patients and nurses. J Korean Acad Fundam Nurs 2006;13:68-75.
  18. Kim HJ, Park IS, Kang KJ. Knowledge and awareness of nurses and doctors regarding cancer pain management in a tertiary hospital. Asian Oncol Nurs 2012;12:147-55. https://doi.org/10.5388/aon.2012.12.2.147
  19. Watt-Watson JH, Donovan MI. Pain management: nursing perspective. St Louis:Mosby Year Book;c1992.
  20. Hyeon J. Clinical nerses' knowledge and attitudes on pain management [master's thesis]. Seoul: Chung-Ang Univ.;1998. Korean.
  21. Nam MS. A survey about nurses' knowledge and attitudes of cancer pain management [master's thesis]. Seoul: Yonsei Univ.;2003. Korean.
  22. American Medical Directors Association (AMDA). Pain management in the long term care setting. Columbia, MD: American Medical Directors Association; 2012 [cited 2016 May 10] Available from: https://www.guideline.gov/content.aspx?id=45524.
  23. Hooten WM, Timming R, Belgrade M, Gaul J, Goertz M, Haake B, et al. Assessment and management of chronic pain. Bloomington (MN):Institute for Clinical Systems Improvement;2013. Available from: https://www.icsi.org/_asset/bw798b/ChronicPain.pdf.
  24. National Human Rights Commission of Korea. National survey on senior citizens' human rights. Seoul:National Human Rights Commission of Korea;2014.
  25. Montes-Sandoval L. An analysis of the concept of pain. J Adv Nurs 1999;29:935-41. https://doi.org/10.1046/j.1365-2648.1999.00971.x
  26. Jun MH, Park KS, Gong SH, Lee SH, Kim YH, Choi JS. Knowledge and attitude toward cancer pain management: clinical nurses versus doctors. J Korean Acad Soc Nurs Edu 2006;12:115-23.
  27. Ferrell B, Coyle N. Textbook of palliative nursing. 2nd ed. New York;Oxford University Press;2006. P. 1036.
  28. Choi HY. Market analysis of narcotic analgesics in Korea using HIRA claims data [master's thesis]. Seoul: Sungkyunkwan Univ.; 2015. Korean.
  29. Hallingbye T, Martin J, Viscomi C. Acute postoperative pain management in the older patient. Aging Health 2011;7:813-28. https://doi.org/10.2217/ahe.11.73
  30. CMS.gov. Five-star nursing home rating system [Internet]. Baltimore: Center for Medicare & Medicaid Services; c2013 [cited 2016 May 16]. Available from: https://www.cms.gov/medicare/provider-enrollment-and-certification/certificationandcomplianc/fsqrs.html.

Cited by

  1. Factors Influencing Performance of Pain Assessment and Pain Intervention for Dementia Patients among Long-term Care Hospital Nurses vol.32, pp.3, 2020, https://doi.org/10.7475/kjan.2020.32.3.283
  2. Development of Knowledge and Attitudes Survey on Pain Management for Korean Long-term Care Professionals vol.14, pp.2, 2020, https://doi.org/10.1016/j.anr.2020.04.002
  3. The Effect of Pain Management Education on the Knowledge and Attitude toward Pain Management of the Nursing Staff in a Long-term Care Hospital vol.22, pp.1, 2016, https://doi.org/10.17079/jkgn.2020.22.1.56