Associated factors with the knowledge of nurses of a high complexity oncology centre in Brazil, on the management of cancer pain

Flávia Dos Santos Ferreira; Karina Cardoso Meira; Rayane Saraiva Félix; Iara Rayane Silva de Oliveira; Cecilia Maria Izidoro Pinto; Magda Aparecida Dos Santos Silva; Juliano Dos Santos

doi:10.3332/ecancer.2019.928

Associated factors with the knowledge of nurses of a high complexity oncology centre in Brazil, on the management of cancer pain

Ecancermedicalscience. 2019 May 9:13:928. doi: 10.3332/ecancer.2019.928. eCollection 2019.

Authors

Affiliations

¹ Florence Clinic: Rehabilitation and Palliative Care, Bela Vista do Cabral Street, 271, Nazaré, BA, Brazil.
² https://orcid.org/0000-0002-6022-8803.
³ Health School Rio Grande do Norte Federal University, Senador Salgado Filho, Avenue, s/n Lagoa Nova, Natal, RN, Brazil.
⁴ https://orcid.org/0000-0002-1722-5703.
⁵ https://orcid.org/0000-0003-2025-8642.
⁶ https://orcid.org/0000-0001-5490-0803.
⁷ Medical-surgical Nursing Department, Anna Néry Nursing School/UFRJ, Afonso Cavalcanti Street, 275-Cidade Nova, Rio de Janeiro, RJ, Brazil.
⁸ https://orcid.org/0000-0003-2433-2811.
⁹ Nursing Department of Paulista University- Jacery Street, 247-Morumbi, São Paulo, SP, Brazil.
¹⁰ José de Alencar Gomes da Silva National Institute of Cancer-INCA Cruz Vermelha Square, 23-Centro, Rio de Janeiro, RJ, Brazil.
¹¹ https://orcid.org/0000-0001-9961-3576.

Abstract

Pain is one of the most prevalent symptoms in cancer patients and may be directly related to cancer or to the procedures needed for its diagnosis and treatment. It is estimated that about 40% of cancer patients receive inadequate treatment for painful conditions. Among the barriers to adequate pain management are inadequate knowledge and the dysfunctional beliefs of healthcare professionals. Therefore, the present study aims to assess the knowledge of oncology nurses on the management of pain, as well as the factors associated with it. It is a cross-sectional study with 126 nurses working at a High Complexity Oncology Centre in Brazil. Knowledge about the management of cancer pain was evaluated through the instrument 'Nurses' Knowledge on Cancer Pain Management-World Health Organization-developed by Ramos (1994). In the analysis of the association between knowledge about pain management and the independent variables, Poisson regression was used with robust variance, and values of p ≤ 0.05 were considered statistically significant. Adequate knowledge prevalence was 54.1% confidence intervals (CI 5.40%-62.80%). These nurses differed in relation to those with inadequate knowledge regarding the source of knowledge about pain, the ethical aspects in the treatment of the patient with oncologic pain, and non-pharmacological methods (coeliac plexus neuroleptic block) for pain control. Also, the factors associated with adequate knowledge were longer professional experience time ([10-19 years (ratio prevalence (RP) = 1.72, 95% CI: 1.05-2.81), 20-29 years (RP = 2.56, 95% CI: 1.63-4.02), 30-39 years (RP = 3.45, 95% CI: 2.25-5.29]), and not believing that the use of opioids causes harm to patients corresponded with a greater chance prevalence ratio (PR = 1.20, 95% CI: 1.12-1.20) of having adequate knowledge. The findings of the study point to the need for continuing education, updated education, and reflection, especially for nurses with less professional experience.

Keywords: nursing care; nursing education; oncology nursing; pain management; teaching.