Knowledge of cancer pain management among nurses in a Nigerian tertiary health institution

Abstract

Background: Pain is a symptom of both physical and psychological disorder in patients. Pain may be acute or chronic. Chronic pain can also be the consequence of progressive diseases such as cancer. Cancer pain can be defined as a complex sensation that reflects both damage to the body and the body's response to the damage. Proper pain management is crucial in the overall care of patients. The doctor-patient ratio is still low in Nigeria according to World Health Organization (WHO) 2012, we have 1:3500 doctor-patient ratio as against the standard 1:600, but that of nurse-patient is better, 1:30 as against WHO standard of 1:6, however more nurses are needed to meet the need of the rising population of Nigeria. Incidence of cancer is rising worldwide and majority of the advanced cases occur in the developing countries like Nigeria. In order to uphold the standard of cancer pain management in our patients, active participation of the nurses is essential. More importantly all health professionals need to serve as advocates for adequate cancer pain  control and should ensure that pain treatment is based on ethical principles and evidence-based standards. However nurses play a critical role in effective pain management because they have more contact time with patients in any healthcare setting. This vantage position gives the nurse a unique privilege to identify patients who have pain, assess the pain and its impact on the patients and their family members, thus initiate actions to manage the pain and evaluate the effectiveness of those actions.

Aims and Objectives: This study is aimed at assessing the level of knowledge of cancer pain management among trained Nurses at the University College Hospital (UCH), Ibadan, Nigeria.

Materials and Methods: Trained nurses who consented to take part in the study were tested using self-administered questionnaire. The questionnaires consisted of 3 major sections namely (a) Demography, (b) Pain assessment, (c) Cancer Pain management. Their individual level of knowledge of cancer pain management was thereafter assessed from their response to the questionnaires.

Results: 119 Nurses completed the questionnaire. 105 (88.24%) were double qualified, Registered Nurse (RN) and Registered Midwife (RM), while 10 (8.40%) had only RN certificate. Approximately 21 (18%) respondents had additional formal training in pain management. 100 (84%) respondents gave correct definition of pain and out of these, only 2 (2%) could give a good account on the management for cancer pain. 24 (20%) of the respondent could use Visual Analogue Scale (VAS) for pain assessment. Only 23 (19%) could state the relevance of opioids in cancer pain management.

Conclusion: This study revealed inadequate knowledge in cancer pain management among the nurses. To achieve holistic care for cancer patients in all health care delivery centers, additional training in pain management is required.