Pain Management in Nursing


General researches that address pain management after cardiac surgery have been conducted. However, few studies that focus on the nurses working in cardiac setting have been carried out. Therefore, this study will target nurses working in Cardiac Critical Care Unit. It will mainly explore nurses’ knowledge of pain management and identify factors that may impede and facilitate effective post operative pain management following a CABG survey. In order to do this, Data will be collected through semi-structured interview by employing convenience sampling where by a sample of 10 nurses will be considered. In addition to this, to obtain optimum data, the Nurses’ Knowledge and Attitude Survey (NKAS) tool will be applied. In terms of issues of reliability and validity, after conducting extensive literature review, the content of the interview will be reviewed by a group of experienced researchers. The research will also address the issue of ethics in the entire research process.


About 75% of surgical patients have experienced moderate to severe pain post operation. Tsui et al. (1995), (Apfelbaum, Chen, Mehta, Gan, 2003). Despite advanced and growing research in pain, treatment options, educational development, and technological development, patients experience poorly controlled pain after surgery. Watt-Watson, Stevens, Garfinkel, Streiner, & Gallop (2001), Nash et al. (1999). Pain management is an important aspect of nursing care and nurses play the greatest role in relieving the pain experienced by the patients. Effective pain management is greatly associated with adequate knowledge of the nurse. Awareness of the perceived barriers has also a great contribution to effective management of the pain. Lack of adequate knowledge of pain management and barriers can greatly compromise patients’ well being after the surgery. Research on nurses’ knowledge and perceived barriers and facilitators to management of pain in general, and local research on post op pain management of patients perception after cardiac surgery has been conducted (Saliba, 2003), but, till up to date few research has been conducted specifically on nurses working in cardiac setting, and none of this studies were carried out in Malta.



The purpose of this study will be to explore nurses’ knowledge of pain management and to identify factors that may impede or facilitate effective post operative pain management following a CABG surgery. To prepare this Literature review, various database searches were carried out using Cumulative Index of Nursing and Allied Health Literature (C.I.N.A.H.L.), Medline, and E.B.S.C.O. A manual search was also carried out at the UOM Faculty of Health Care and the Medical School Library. The key search words and phrases used for this study include “pain management” and “knowledge”, “barriers” and ”pain management”, ”post operative” and ”pain”, ”facilitators” and ”pain”, ”pain knowledge” and ”nurse,” and “CABG” and “pain”. The literature search for this study has been carried out with in the time frame of 1994 and 2010.


A non experimental exploratory pilot study was done by puls-McColl, Holden & Buschmann (2001), a likert scale consisted twelve questions was provided to the nurses to identify perceived barriers to adequate treatment of pain. The highest rated barrier stated was nurses’ care responsibility towards other acutely ill patients. The subsequent rated barriers were: inadequate assessment, nurses’ lack of time to adequately assess and control pain, and patients’ reluctance to report pain respectively. However, since barriers were pre-determined in the questions asked by the researchers, it is possible that other barriers could have been left unmentioned by the respondents that they could state if they had been asked to mention themselves.

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