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Factors Influencing Nurses' Adherence to Pain Management Protocols: A Cross-Sectional Study in Two Secondary Hospitals, Nigerian

Oyate G. B, Ifiabor W., Edebiri O. E., Omo I. P., Okakwu-Okwuobi E., Ajetunmobi F. O.

Abstract


Background: Pain remains a prevalent and distressing experience for hospitalized patients, frequently underscored by suboptimal management. Nurses are pivotal to pain relief, yet their adherence to management protocols is often mediated by a complex interplay of personal, patient-related, and institutional factors.

Objective: This study investigated the determinants influencing nurses' adherence to pain management protocols within the Nigerian healthcare context.

Methods: A descriptive cross-sectional design was utilized to survey 167 nurses across various medical units in two selected secondary hospitals in Delta State. Data were obtained through a structured survey evaluating socio-demographic characteristics, knowledge, attitudes, clinical applies, and perceived barriers. Analysis was achieved using descriptive and inferential statistics, including t-tests and chi-square analyses, with significance set at p < 0.05.

Results: High workload emerged as a critical barrier, significantly limiting the frequency of pain assessments (Mean = 3.10, SD = 0.78, p< 0.001). Deficits in continuous professional development were evident, as inadequate training on contemporary protocols negatively impacted clinical practice (Mean = 2.68, SD = 0.98, p = 0.007). Institutional resource constraints, specifically the shortage of essential analgesics, were strongly associated with hindered management outcomes (Mean = 3.45, SD = 0.74, p ˂ 0.001). Furthermore, inter professional collaboration was a positive predictor, with physician cooperation significantly improving protocol adherence (Mean = 2.74, SD = 0.97, p = 0.002). The implementation of electronic health records demonstrated no statistically significant influence on adherence levels (Mean = 2.37, SD = 1.03, p = 0.125).

Conclusion: Nurses' adherence to pain management protocols is multifaceted, driven primarily by workload intensity, educational preparation, resource availability, and the quality of interprofessional relationships. Strengthening protocol-based care requires targeted interventions focusing on staff support, mandatory continuous education, and the consistent provision of pharmacological resources to optimize patient outcomes.


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References


American Pain Society. Principles of analgesic use in the treatment of acute pain and cancer pain. 6th ed. Glenview (IL): American Pain Society; 2008.

International Association for the Study of Pain (IASP). IASP terminology [Internet]. Washington: IASP; 2020 [cited 2026 Apr 18]. Available from: https://www.iasp-pain.org/resources/terminology/

Kumar KH, Elavarasi P. Definition of pain and classification of pain disorders. J AdvClin Res Insights. 2016;3(3):87-90.

Gordon DB, Dahl JL, Miaskowski C, McCarberg B, Todd KH, Paice JA, et al. American Pain Society recommendations for improving the quality of acute and cancer pain management. Arch Intern Med. 2005;165(14):1574-80.

Herr K, Coyne PJ, McCaffery M, Manworren R, Merkel S. Pain assessment in the patient unable to self-report: Clinical practice recommendations. Pain ManagNurs. 2011;12(4):230-50.

Basak T, Aciksoz S, Tosun N, Erdogan S. The effect of pain management education program on nurses’ pain management knowledge, attitudes and clinical decision-making skills. J ClinNurs. 2019;28(9–10):1923-32.

World Health Organization. WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses. Geneva: WHO Press; 2018.

Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287-333.

Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. AnesthAnalg. 2003;97(2):534-40.

van den Beuken-van Everdingen MH, Hochstenbach LM, Joosten EA, Tjan-Heijnen VC, Janssen DJ. Update on prevalence of pain in patients with cancer: Systematic review and meta-analysis. J Pain Symptom Manage. 2016;51(6):1070-90.


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