Community nurses' knowledge and perceptions of pain management in terminally ill clients in the community.

Abstract

Community care is an important aspect of the health care system as it provides nursing care in the clients' homes. The majority of clients with advanced cancer experience chronic pain and care from community healthcare teams will be needed at a particular point during the disease. Pain is experienced even when the clients are having pain medications, therefore effective management of pain is an important factor when assisting these clients in their homes. Therefore this study sets to explore the community nurses' knowledge on pain and pain management together with exploring the nurses' perceptions on current practices and tools being used in the community, the education and training needed and the challenges perceived by the nurses which might hinder effective pain management in clients suffering from advanced cancer in the community. A self- administered questionnaire was conveniently distributed to 40 district nurses from the local community nursing service. Data from the close- ended questions were analyzed quantitatively while content analysis of the open-ended questions was carried out. From a response rate of 85%, findings showed that there is not enough knowledge regarding pain management, including knowledge about treatment, making it more difficult for the nurses to feel in control of their clients' pain and additionally resulting in a negative effect on working relationship with other professionals working in the community. Moreover, findings showed that the use of pain assessment tools was not common practice. Furthermore, although the community nurses stated that overall they were satisfied with local current practice of pain management in clients suffering from advanced cancer in the community, they still feel that there is room for improvement and better monitoring of the clients. The nurses also agreed that there needs to be more education and training that would enable them to become more knowledgeable and hence, more confident in their practice. Support from higher authorities towards the reduction of organizational barriers is required and recommended, such as the time constraints that the nurses have to face on a daily basis.