Postoperative Pain Management: Clinicians’ Knowledge and Practices on Assessment and Measurement at Moi Teaching and Referral Hospital.

Abstract

Background: Pain is the cardinal symptom common to diverse disease conditions and it is what drives many patients to seek treatment. It, therefore, commands a central position in health seeking behavior. In the post-operative period, the main concern about pain is not only the suffering it causes, but also because of its negative effects on the process of recovery. Its management has, however, remained a major challenge. Numerous myths and insufficient knowledge of pain assessment, measurement and treatment contribute to the challenges encountered by health providers in their service to patients. This study was aimed at determining the knowledge and practices among clinicians who manage postsurgical pain in a hospital setting at The Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya. It was a cross-sectional survey. Methods: The study population consisted of Nurses, Clinical Officers and Doctors working in the post-operative areas at MTRH. A standardized questionnaire was administered to 236 hospital – based clinicians including medical doctors, nurses and clinical officers. The questionnaire consisted of diverse objective questions set according to internationally recognized pain assessment instruments. Results: Among the 236 health care professionals who were included in the study, 38 (16%) were doctors, 170 (72%) nurses and 28 (12%) clinical officers. On average the duration of time since they were engaged as healthcare providers was 9.3 years (SD=+6.7yrs). Almost all (96%) confirmed that they routinely managed post-operative pain. Clinicians who indicated that they had knowledge on how to assess and manage postoperative pain constituted 88%. Among doctors, 54% felt that they had sufficient knowledge to recognize and manage post-operative pain while the proportions of nurses and clinical officers were 41% and 43% respectively. Fifty seven percent of the participants indicated that they had inadequate knowledge regarding the tools that may be employed for pain assessment and measurement. Those who had never had any formal teaching in relation to pain evaluation and management constituted 21%. Conclusion: Overall, a significant proportion of clinicians indicated an inadequacy of knowledge regarding objective evaluation and management of post-operative pain.