Doctors and Nurses Knowledge and Use of Pain Assessment Tools: A Case Study of Two Tertiary Hospitals

This study was necessitated by many gaps in pain research in Zambia. The percentage of doctors and nurses that assess pain using any indicator and what doctors and nurses do to treat pain. Therefore this study sought to answer the following overarching question. What do doctors and nurses do to patients that have pain?

A cross-section non interventional comparative study in three clinical areas (medicine, surgery and oncology) was done using a 33 item survey questionnaire. SPSS software, version 17.0 (SPSS, Chicago, IL), was used for statistical analyses. The Pearson’s Chi-squared test was used to compare proportions. The cut off point for statistical significance was set at 5%.

Totals of 26 doctors and 76 nurses took part in the study. Concerning knowledge of the World Health Organization Pain Relief ladder, the proportions of doctors and nurses who reported to be aware of it was surprising low across the two professions (Fisher’s exact test, p=0.246) with 26.9% of doctors and 15.8% of nurses reporting being familiar with the WHO ladder. Significantly more nurses (27.6%) than doctors (3.8%) reported that doctors and nurses rated pain (c2=6.48, p=0.011). Most respondents (26.3% of doctors and 32.4% of nurses) treated pain just like all other manifestations.

Pain assessment and management are poorly done by both nurses and doctors. Though pain is assessed, it is not by using any pain assessment tools. The doctors and nurses seem to use subjective assessments in their practice. The hospital authorities ought to endeavour to facilitate the development of pain management tools and guidelines based on local practices or consider the use of the five tools which are: Visual Assessment Scale, the Visual Rating Scale and the Numeric Pain Inventory Scale (NPIS), the Simple Descriptive Pain Intensity Scale (SDPIS) and the WHO pain ladder management tool.