Nurses' knowledge of pain

Aim. The aim of this study was to establish if postregistration education and clinical experience influence nurses' knowledge of pain. Background. Inadequacies in the pain management process may not be tied to myth and bias originating from general attitudes and beliefs, but reflect inadequate pain knowledge. Design. A pain knowledge survey of 20 true/false statements was used to measure the knowledge base of two groups of nurses. This was incorporated in a self-administered questionnaire that also addressed lifestyle factors of patients in pain, inferences of physical pain, general attitudes and beliefs about pain management. Method. One hundred questionnaires were distributed; 86 nurses returned the questionnaire giving a response rate of 86%. Following selection of the sample, 72 nurses participated in the study: 35 hospice/oncology nurses (specialist) and 37 district nurses (general). Data were analysed using SPSS. Results. The specialist nurses had a more comprehensive knowledge base than the general nurses; however, their knowledge scores did not appear to be related to their experience in terms of years within the nursing profession. Conclusion. Whilst educational programmes contribute to an increase in knowledge, it would appear that the working environment has an influence on the development and use of this knowledge. It is suggested that the clinical environment in which the specialist nurse works can induce feelings of reduced self-efficacy and low personal control. To ease tension, strategies are used that can result in nurses refusing to endorse their knowledge, which can increase patients' pain. Relevance to clinical practice. Clinical supervision will serve to increase the nurses' self-awareness; however, without power and autonomy to make decisions and affect change, feelings of helplessness, reduced self-efficacy and cognitive dissonance can increase. This may explain why, despite educational efforts to increase knowledge, a concomitant change in practice has not occurred.