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Table 3 Frequency of correctly answered questions (N = 126)

From: Emergency nurses´ knowledge, attitude and perceived barriers regarding pain Management in Resource-Limited Settings: cross-sectional study

Question Items (Knowledge and Attitude)

N (%)

Least answered items (< 50%)

 32B

Your assessment for Andrew is made two hours after he received morphine 2 mg IV. Half hourly pain ratings following the injection ranged from 6 to 8 and he had no clinically significant respiratory depression, sedation, or other untoward side effects. Check the action you will take now.

10 (7.9)

 30

Following abrupt discontinuation of opioid, physical dependence is manifested by the following:

17 (13.5)

 33B

Your assessment, for Robert, is made two hours after he received morphine 2 mg IV. Half hourly pain ratings following the injection ranged from 6 to 8 and he had no clinically significant respiratory depression, sedation, or other untoward side effects. Check the action you will take now

23 (18.3)

32A

Andrew is 25 years old and this is his first day following abdominal surgery. He smiles at you and continues talking and joking with his visitor. He rates his pain as 8. Circle the number that represents your assessment of Andrew’s pain.

27 (21.4)

 4

Patients may sleep despite severe pain

31 (24.6)

 23

A 50-mg dose of IV pethidine is approximately equivalent to

33 (26.2)

 28

How likely is it that patients who develop pain already have an alcohol and/or drug abuse problem?

40 (31.7)

 16

If the source of the patient’s pain is unknown, opioids should not be used during the pain evaluation period, as this could mask the ability to diagnose the cause of pain correctly.

42 (33.3)

 10

Elderly patients cannot tolerate opioids for pain relief

43 (34.1)

 17

Anticonvulsant drugs such as Carbamazepine produce optimal pain relief after a single dose

44 (34.9)

 15

Giving patients sterile water by injection (placebo) is a useful test to determine if the pain is real.

47 (37.3)

 24

Analgesics for postoperative pain should initially be given

48 (38.1)

 8

The usual duration of analgesia of 1–2 mg morphine IV is 4–5 h.

52 (41.3)

 12

Children less than 11 years old cannot reliably report pain so clinicians should rely solely on the parent’s assessment of the child’s pain intensity.

52 (41.3)

 9

Opioids should not be used in patients with a history of substance abuse

56 (44.4)

 33A

Robert is 25 years old and this is his first day following abdominal surgery. As you enter his room, he is lying quietly in bed and grimaces as he turns in bed. He rates his pain as 8. Circle the number that represents your assessment of Robert’s pain

56 (44.4)

 27

Which of the following describes the best approach for cultural considerations in caring for patients in pain?

57 (45.2)

 11

Patients should be encouraged to endure as much pain as possible before using an opioid

58 (46.0)

 1

Vital signs are always reliable indicators of the intensity of a patient’s pain

62 (49.2)

Items received 50 to 80% correct answers

 25

The most likely reason a patient with pain would request increased doses of pain medication is

65 (51.6)

 3

Patients who can be distracted from pain usually do not have severe pain.

67 (53.2)

 13

Patients’ spiritual beliefs may lead them to think pain and suffering are necessary.

68 (54.0)

 7

Combining analgesics that work by different mechanisms (e.g., combining a NSAID with an opioid) may result in better pain control with fewer side effects than using a single analgesic agent.

69 (54.8)

 26

The most accurate judge of the intensity of the patient’s pain is

74 (58.7)

 6

Respiratory depression rarely occurs in patients who have been receiving stable doses of opioids over a period of months.

77 (61.1)

 18

Benzodiazepines are not effective pain relievers and are rarely recommended as part of an analgesic regiment.

78 (61.9)

 2

Because their nervous system is underdeveloped, children under two years of age have decreased pain sensitivity and limited memory of painful experiences.

83 (65.9)

 5

Aspirin and other Nonsteroidal anti-inflammatory agents are Not effective analgesics for musculoskeletal pain

87 (69.0)

 31

Which statement is true regarding opioid induced respiratory depression?

92 (73)

 29

The time to peak effect for morphine given IV is

94 (74.6)

Most Answered Items (> 80)

 14

After an initial dose of opioid analgesic is given, subsequent doses should be adjusted in accordance with the individual patient’s response.

102 (81.0)

 19

Narcotic/opioid addiction is defined as a chronic neurobiological disease, characterized by behaviours that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

102 (81.0)

 22

The recommended route administration of opioid analgesics for patients with brief, severe pain of sudden onset such as trauma or postoperative

107 (84.9)

 21

Sedation assessment is recommended during opioid pain management because excessive sedation precedes opioid-induced respiratory depression.

108 (85.7)

 20

The term ‘equianalgesia’ means approximately equal analgesia and is used when referring to the doses of various analgesics that provide approximately the same amount of pain relief.

112 (88.9)

  1. These items were adopted from Ferrell et al [21] with permission from the owners