Knowledge, Attitude, and Practice Among Healthcare Workers on Procedural Pain Management Among Paediatric Oncology Patients in Kenyatta National Hospital (Knh)

Abstract

ABSTRACT Background: The practice in paediatric oncology entails carrying out several procedures, both therapeutic and diagnostic. The management of procedural pain is a healthcare worker's responsibility. Appropriately addressing procedural pain will significantly improve the quality of life among paediatric oncology patients. The lack of knowledge on these methods or negative deviances in attitude among healthcare workers is an essential contributor to poor procedural pain management practices. Study Objectives: To assess the level of knowledge, attitude, and practice among healthcare workers on procedural pain management among paediatric oncology patients in Kenyatta National Hospital and to examine the factors that influence the knowledge, attitude and practice among HCWs. Methods: This was a cross-sectional study that employed a quantitative approach to data collection using self-administered questionnaires (electronic and paper). The study included HCWs who gave informed consent and have more than one month work experience within the study units (general paediatric wards and paediatric oncology wards). We excluded healthcare workers who had no work experience managing paediatric oncology patients. Simple random sampling was used to reach a minimum required sample size of 126, calculated using Fisher’s formula. The key outcomes of interest were the aspects of knowledge (good vs poor), the favourable or unfavourable attitudes, and practices (good vs poor) on procedural pain management. The data were analyzed using R version 4.1.2, and presented as frequencies and proportions for categorical data. Correct responses were given a score of one. Knowledge, attitudes and practices were calculated as a percentage, and a score of <60% (poor), (60-79%) moderate and good (≥80%). Results: One hundred and fifty-six healthcare workers participated in the study. The majority of the respondents were aged between 31 to 40 years (54%) and female (63%). The median number of years of work experience was 8 years. The median number of years of experience in paediatric oncology was 2 years. The majority of respondents had not received any prior training in procedural pain (76%). We found that the HCWs had an overall good score on knowledge (51%), overall unfavourable attitudes (90%) and overall poor score on practice of procedural pain management (92%). The most worrying gap in knowledge found in this study was knowledge on the recommended pain management strategies that should be used when performing a lumbar puncture. We found that HCWs with higher education (OR 0.45) (95% CI 0.21, 0.95) and more than five years work experience had better knowledge (OR 0.33) (95% CI 0.12, 0.90). There was no significant association between attitudes and sociodemographic factors. The HCWs who had received training on procedural pain have 16-fold odds of good practices compared to those who had been trained (OR 15.93) (95% CI 3.30, 51.26). Conclusion and Recommendations: Knowledge of procedural pain management was good. Healthcare workers with more than five years work experience and higher education had better knowledge. The attitude on procedural pain management was poor. None of the factors assessed were significantly associated with attitude on procedural pain management. The practices on procedural pain management were poor. HCWs who had been trained on procedural pain were more likely to have good practice. We recommend an enhancement of the training offered to healthcare workers on pain among paediatric patients and continuing medical education (CMEs) and practical in-service training.