DOI QR코드

DOI QR Code

Nurses' Awareness and Performance about Evidence-based Pain Management in Older Adults

병원 간호사의 근거중심 노인통증관리 지침에 대한 인지도와 수행도

  • Kim, Eun-Kyoung (Department of Nursing, Keimyung University, Dongsan Medical Center) ;
  • Park, Myong-Hwa (College of Nursing, Chungnam National University)
  • Received : 2011.11.21
  • Accepted : 2012.02.07
  • Published : 2012.02.29

Abstract

Purpose: This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. Methods: The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: There were statistically significant differences between awareness and performance in pain assessment (t=17.31, $p$ <.001), patient and family education (t=17.33, $p$ <.001), pharmacologic management (t=12.99, $p$ <.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, $p$ <.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. Conclusion: The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.

Keywords

References

  1. Chang, H. K. (2006). A study on chronic pain, pain beliefs, pain coping and fatigue in the elderly. Korean Journal of Adult Nursing, 18 (3), 377-385.
  2. Chen, Q., Hayman, L. L., Shmerling, R. H., Bean, J. F., & Leveille, S. G. (2011). Characteristics of chronic pain associated with sleep difficulty in older adults: The maintenance of balance, independent living, intellect, and zest in the elderly (MOBILIZE) Boston Study. Journal of the American Geriatrics Society, 59 (8), 1385-1392. https://doi.org/10.1111/j.1532-5415.2011.03544.x
  3. Choi, A. L. (2005). Recognition and performance of the clinical nurses about the management of nosocomial infection . Unpublished master's thesis, Ewha Womans University, Seoul.
  4. Cunningham, J. B., & McCrum-Gardner, E. (2007). Power, effect and sample size using G Power: Practical issues for researchers and members of research ethics committees. Evidence Based Midwifery, 5 , 132-136.
  5. Eaton, L. H., & Tipton, J. M. (2009). Putting evidence into practice improving oncology patient outcomes. Pittsburgh, PA: Oncology Nursing Society.
  6. Han, H. J. (2009). Knowledge and attitude toward the elderly in nurses for tertiary hospital, and survey on the educational need degree of nursing for the elderly. Unpublished master's thesis, Chung-Ang University, Seoul.
  7. Health Insurance Review & Assessment Service. (2010). Elderly medical expenses. Retrieved October 30, 2011, from http://www.hira.or.kr/common/dummy.jsp
  8. Herr, K. (2010). Pain in the older adult: An imperative across all health care settings. Pain Management Nursing, 11 (2), 1-10. https://doi.org/10.1016/j.pmn.2009.12.002
  9. Herr, K., Coyne, P. J., Manworren, R., McCaffery, M., Merkel, S., Pelosi-Kelly, J., et al. (2006). Pain assessment in the nonverbal patient: position statement with clinical practice recommendations. Pain Management Nursing, 7 (2), 44-52. https://doi.org/10.1016/j.pmn.2006.02.003
  10. Herr, K., Titler, M. G., Schilling, M. L., Marsh, J. L., Xie, X., Ardery, G., et al. (2004). Evidence-based assessment of acute pain in older adults: Current nursing practices and perceived barriers. Clinical Journal of Pain, 20 (5), 331- 340. https://doi.org/10.1097/00002508-200409000-00008
  11. Herr, K., Titler, M., Sorofman, B., Ardery, G., Schmitt, M., Young, D., et al. (2000). Evidence based protocol-acute pain management in the elderly. Iowa: University of Iowa gerontological nursing intervention research center, Research Dissemination Core.
  12. Jablonski, A., & Ersek, M. (2009). Nursing home staff adherence to evidence-based pain management practices. Journal of Gerontological Nursing, 35 (7), 28-34.
  13. Jeon, H. Y. (2010). Pain among elderly with degenerative arthritis and conditions of using complementary and alternative therapy. Unpublished master's thesis, Ewha Womans University, Seoul.
  14. Jung, K. H. (2006). Nurses' knowledge of pain and attitude of pain management. Unpublished master's thesis, Kyungbook National University, Daegu.
  15. Kaye, A. D., Baluch, A., & Scott, J. T. (2010). Pain management in the elderly population: A review. The Ochsmner Journal, 10 (3), 179-187.
  16. Kim, J. S., Kim, K. H., Kim, M. H., & Kim H. S. (2010). Nurse education needs knowledge and practice of gerontological nursing. Journal of Korean Gerontological Nursing, 12 (2), 177-189.
  17. Kwon, E. S. (2005). A study on the hospital nurses' knowledge, perception and performance of pressure ulcer care. Unpublished master's thesis, Hanyang University, Seoul.
  18. Lee, J. K. (2007). Evaluation of pain assessment education program for nurses. Korean Journal of Adult Nursing, 19 (1), 66-77.
  19. Lim, L. M., Chiu, L. H., Dohrmann, J., & Tan, K. L. (2010). Registered nurses' medication management of the elderly in aged care facilities. International Nursing Review, 57 (1), 98-106. https://doi.org/10.1111/j.1466-7657.2009.00760.x
  20. Lim, S. J. (2010). A comparison of educational needs for geriatric nursing in family caregivers and nurses. Unpublished master's thesis, Hanyang University, Seoul.
  21. McConnell, E. S., Lekan, D., Bunn, M., Egerton, E., Corazzini, K. N., Hendrix, C. D., et al. (2009). Teaching evidencebased nursing practice in geriatric care settings: The geriatric nursing innovations through education institute. Journal of Gerontological Nursing, 35 (4), 26-33.
  22. Ministry of Health and Welfare. (2011). Senior health and welfare business guide. Retrieved October 30, 2011, from http://www.mw.go.kr/front/mw_sch/index.jsp
  23. Oh, E. G., Oh, H. J., & Lee, Y. J. (2004). Nurses' research activities and barriers of research utilization. Journal of Korean Academy of Nursing, 34 (5), 838-848. https://doi.org/10.4040/jkan.2004.34.5.838
  24. Registered Nurses' Association of Ontario. (2007). RNAO assessment and management of pain best practice guideline with supplement. Retrieved October 30, 2011, from http://ltctoolkit.rnao.ca/resources/pain#Evaluation.
  25. Ryoo, E. N., & Park, K. S. (2011). Validity, reliability and efficiency of pain self-report scale in elderly with dementia. Korean Journal of Adult Nursing, 23 (2), 111-122.
  26. Schmitt, M. B., Titler, M. G., Herr, K., & Ardery, G. (2004). Challenges of web based education in educating nurses about evidence based acute pain management practices for older adults. The Journal of Continuing Education in Nursing, 35 (3), 121-127.
  27. Son, H. J. (2004). Evaluating the NGCTM evidence based acute pain management guideline in the elderly for use in Korea. Unpublished master's thesis, Keimyung University, Daegu.
  28. Song, S. S. (2010). Pain management knowledge and attitude of internal medicine and surgery stream nurses. Unpublished master's thesis, The Catholic University of Korea, Seoul.
  29. Yang, J. H. (2004). A study of pain, depression and self-efficacy according to the classifications of pain among chronic pain patients. Korean Journal of Adult Nursing, 16 (2), 202-210.
  30. Yi, J. E., & Park, M. H. (2011). Nurses' access & use of information resources and barriers & competency of evidence based practice. Korean Journal of Adult Nursing, 23 (3), 255-266.

Cited by

  1. Nurses' Evidence-Based Pain Management Knowledge, Performance and EBP Attitude in Small-medium Sized Hospitals vol.3, pp.4, 2015, https://doi.org/10.15205/kschs.2015.3.4.476
  2. Geriatric Hospital Nurses' Empathy, Attitude and Pain Management for Patients with Dementia vol.28, pp.4, 2016, https://doi.org/10.7475/kjan.2016.28.4.388
  3. Performance of Evidence-based Pain Assessment and Management Guidelines among Medical-Surgical Nurses vol.28, pp.5, 2016, https://doi.org/10.7475/kjan.2016.28.5.546
  4. Factors Influencing Nurses' Implementation of Evidence-based Fall Management in Geriatric Hospitals vol.23, pp.3, 2017, https://doi.org/10.11111/jkana.2017.23.3.270
  5. Adaptation of a Translated Guideline on Screening for Delirium, Dementia, and Depression in Older Adults vol.17, pp.2, 2012, https://doi.org/10.17079/jkgn.2015.17.2.76
  6. 혈액투석실에서 근무하는 간호사의 특성이 근거기반 혈액투석간호지식과 수행정도에 미치는 영향 vol.22, pp.2, 2016, https://doi.org/10.22650/jkcnr.2016.22.2.225
  7. 요양병원 간호사의 치매환자 통증관리 수행에 영향을 미치는 요인 vol.17, pp.9, 2012, https://doi.org/10.5762/kais.2016.17.9.253
  8. Nonverbal Pain Measurement for Elders: A Literature Review vol.18, pp.3, 2016, https://doi.org/10.17079/jkgn.2016.18.3.147
  9. Factors Influencing Nurses’ Implementation of Evidence-based Restraint Use in Long-term Care Hospitals vol.18, pp.3, 2016, https://doi.org/10.17079/jkgn.2016.18.3.172
  10. 응급의료센터에 내원한 복부통증 노인 환자에 대한 간호기록 분석 vol.26, pp.1, 2012, https://doi.org/10.5953/jmjh.2019.26.1.27