Relationship between nurses’ pain knowledge and pain management outcomes for their postoperative cardiac patients

Authors

  • Judy Watt-Watson RN PhD,

    1. Associate Professor, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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  • Bonnie Stevens RN PhD,

    1. Professor, Faculty of Nursing, University of Toronto, Signy Hildur Eaton Chair in Pediatric Nursing Research, Toronto, Ontario, Canada
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  • Paul Garfinkel MD FRCP(C),

    1. Professor, Department of Psychiatry, University of Toronto and President and CEO, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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  • David Streiner PhD,

    1. Professor, Department of Psychiatry, University of Toronto and Director, Kunin-Lunenfeld Applied Research Unit, Assistant Vice President for Research, Baycrest Centre for Geriatric Care, Toronto, Ontario Canada
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  • Ruth Gallop RN PhD

    1. Professor, Associate Dean of Research, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Judy Watt-Watson, Faculty of Nursing, University of Toronto, 50 St George Street, Toronto, Ontario, Canada M5S 3H4. E-mail: j.watt.watson@utoronto.ca

Abstract

Relationship between nurses’ pain knowledge and pain management outcomes for their postoperative cardiac patients

Nurses’ knowledge and perceived barriers related to pain management have been examined extensively. Nurses have evaluated their pain knowledge and management practices positively despite continuing evidence of inadequate pain management for patients. However, the relationship between nurses’ stated knowledge and their pain management practices with their assigned surgical cardiac patients has not been reported. Therefore, nurses (n=94) from four cardiovascular units in three university-affiliated hospitals were interviewed along with 225 of their assigned patients. Data from patients, collected on the third day following their initial, uncomplicated coronary artery bypass graft (CABG) surgery, were aggregated and linked with their assigned nurse to form 80 nurse–patient combinations. Nurses’ knowledge scores were not significantly related to their patients’ pain ratings or analgesia administered. Critical deficits in knowledge and misbeliefs about pain management were evident for all nurses. Patients reported moderate to severe pain but received only 47% of their prescribed analgesia. Patients’ perceptions of their nurses as resources with their pain were not positive. Nurses’ knowledge items explained 7% of variance in analgesia administered. Hospital sites varied significantly in analgesic practices and pain education for nurses. In summary, nurses’ stated pain knowledge was not associated with their assigned patients’ pain ratings or the amount of analgesia they received.

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