Knowledge and attitudes of healthcare workers at Kenyatta national hospital on pain assessment and management in children

Abstract

Objectives To evaluate the knowledge and attitudes of different healthcare workers regarding pain assessment and management in children. Additionally, to determine if socio- demographic factors such as cadre of HCW and the number of years in clinical practice are variables that have an independent association with level of knowledge and attitudes in pain management. Methods This was a quantitative cross-sectional survey using a standardized survey questionnaire, the Paediatric Nurses’Knowledge and Attitudes Survey (PNKAS)©, supplemented with focus group discussions(FGDs) conducted among health care workers, including nurses, paediatric post-graduate students and paediatric consultants who care for children within the general paediatric wards at Kenyatta National Hospital, Nairobi, Kenya. Results On average, health workers responded correctly to 16 out of the 34 questionnaire items, resulting in a mean score of 47.2% (SD 13.0). When controlling for healthcare worker cadre, there was a significant difference in performance levels with doctors performing significantly better than nurses on the questionnaire (χ² (2, N = 96) = 16.55, p < .001). More years in clinical practice were also associated with poorer scores on the survey questionnaire. Notable areas of weakness in paediatric pain management as identified by the survey questionnaire and FGDs included: inadequate knowledge and attitudes of pain assessment in children, inadequate knowledge of pharmacologic treatment of pain such as scheduling protocols and duration of analgesics as well as misconceptions about the side effects of opioids such as respiratory depression and addiction. Conclusion Significant knowledge deficiencies exist regarding currently accepted principles of pain management practice, as well as beliefs that could interfere with optimal care.