Pain Management Practices and Perceived Barriers among the Health Professionals in Different Hospitals of Nepal UC01-UC05
Dr. Ninadini Shrestha,
EPC NO: 1789 GPO: 8975 977-9803517471, Kathmandu, Nepal.
Introduction: Despite the availability of resources and protocol, and advances in pain management, improvement in pain management practice is still lacking especially in developing countries like Nepal. Certain barriers act as obstacle to adequate pain management. The barriers can be classified into three categories: barrier related to patient, health care professionals and health care system. There are very few literature that focuses on pain as public health problem in Nepal. So there is need for such multicentre study in the country.
Aim: To assess the pain management practices of the health professionals in different hospitals of Nepal and to identify different types of perceived barriers which prevent adequate pain management of the patients.
Materials and Methods: A cross-sectional multi-centre study was conducted among 292 health professionals of five different hospitals of Nepal. Simple random sampling technique was used to select the participants from each hospital. Data collection was done by using structured self administered questionnaire. Descriptive and bi-variate analysis was done.
Results: Out of 292 participants (182 doctors, 102 nurses and 10 health assistants), only 56 (19.2%) had participated in pain management training. Only 39.7% always used pain scale for assessment of pain. The documentation of pain was also poor with only 22.3% always doing documentation. The documentation of pain assessment was better among nurses when compared with doctors (p<0.005). The pain scale was always used for reassessment by 33.2%. The main barriers to pain management as perceived by the participants were opioids being strictly regulated (75.7%), insufficient staff in the hospital (73.4%), lack of knowledge among patients about pain management (66.8%) and least priority for pain management by hospital (60.1%).
Conclusion: The barriers that prevent pain management exist at all three levels - patient barrier, health professionalâ€™s related barrier and health system barrier and to overcome all these should be given equal importance. The use of multidimensional approach would help to break the barriers.