Institutional commitment for cancer pain management by hospice nurses
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Ineffective pain management continues to pose a significant public health problem. Barriers to pain management include physicians and nurses, patients and families, and regulations. Even nurses who have learned to manage pain may not do it effectively because they feel that it is not a priority within their institution. The purpose of this study was to assess what hospices do to support pain management and hospice nurses' knowledge of pain management.
The research questions assessed pain management knowledge of hospice nurses compared to that of other nurses; source of knowledge; the relationship between pain management knowledge and nurse variables; what hospices do to support pain management; the relationship between what organizations do to support pain management and nurses' knowledge; the relationship between nurses' perceptions of organizational support and what their organizations report; and the relationship between support for pain management and hospice demographic variables.
This exploratory study was consisted of a two-part nurses' survey and an administrator survey. The nurse perception survey and the administrator survey were developed by the investigator using recommendations from literature; the knowledge survey was from Ferrell and McCaffery's Knowledge and Attitudes Survey. Participants were 890 nurses and 78 administrators in North and South Carolina.
Nurses' knowledge score was 81%. They scored slightly better than health care providers in a 1995 study for the top 10 correctly answered questions and, in the 10 least correctly answered, better in seven of 10. Nurses learn pain management on the job; the more years a nurse has worked in hospice, the better the pain management knowledge.
Many hospices do not have all recommended policies and procedures or pain management resources. Most provide pain management education, but few assess competency. Few address pain management in annual performance appraisals, although almost two-thirds include it in their job descriptions. No relationships were demonstrated between knowledge or perception of support and what hospices do to support pain management. There is an association between what hospices do and budget.
In the surveyed hospices, institutional commitment to pain management needs to be strengthened with implementation of the recommended framework.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3006007; ProQuest document ID: 275883699. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Other |
Research Approach | Pilot/Exploratory Study |
Keywords | Hospice Nurses; Pain Management; Cancer Patients; Hospice Care |
Grantor | University of South Carolina |
Advisor | Stoskopf, Carleen; Samuels, Michael; Faust, Katherine; Boyd, Suzan |
Level | PhD |
Year | 2000 |
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