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Nursing attitudes and beliefs in pain assessment and management


  • Jennifer Layman Young RN, BSN,

  • Faith M. Horton RN, BSN,

  • Ruth Davidhizar RN, DNS, ARNP, BC, FAAN

Jennifer Layman Young,
Women's Center Coordinator,
Women's Center,
Lakeland Regional Health System,
3055 West Bertrand Road,
Michigan 49120,


Aims.  This paper reports a study to determine nurses’ attitudes towards pain assessment tools and the relationship of these attitudes to education and experience.

Background.  The issue of pain management is of interest to caregivers nationally and internationally. For example, in the United States of America, the National Health and Medical Research Council set guidelines to assist clinicians in pain management. Research on whether healthcare teams use pain assessment tools has yielded contradictory findings.

Methods.  Using an open-ended questionnaire developed for this study, which was based on Fishbein and Ajzen expectancy-value model, a convenience sample of 52 nurses on an acute care unit were asked: (1) What do you believe about the assessment of pain? (2) What do you believe about the use of pain assessment tools? and (3) What do you believe about the use of pain assessment tools in improving the patient's outcome? The nurses then rated their attitudes about each belief and how each belief made them feel. The data were collected in 2003.

Results.  When Fishbein and Ajzen's formula for calculating attitude was used, attitude scores ranged from −6 to 28 with an overall mean score of +8·3. The amount of education and experience of each nurse and the attitude measure in regard to the use of pain assessment tools were compared.

Conclusions.  The Fishbein and Ajzen model provides a useful way to obtain information on the attitude of nurses towards the use of pain assessment instruments. To provide further information, this study with an open-ended instrument should be followed with a fixed-response survey with a larger sample size and in various settings.