The Practice of Nurses and Associated Factors towards Pain Assessment in Critically Ill Adult Patients in Referral Hospitals of Amhara Region, Ethiopia, 2019

Background: Pain is quite a predominant problem in critically ill patients. Failure to assess and relieve pain results in multisystem effects that weaken a patient’s recovery and discharge time. Nurses play a crucial role in the assessment, relief and evaluation of pain by realizing subjective responses from the patient. Methods: Institution based quantitative cross-sectional study design was conducted among nurses working in units where adult critical patients get care. Data were collected using self-administered questionnaire and entered in Epi data version 3.1 software, exported to statistical product and service solution version 25 for analysis. Bivariable and multivariable logistic regression analysis were carried out. Variables having p value <0.05 were interpreted as having statistically significant association and the magnitude was displayed by adjusted odds ratio with 95% confidence interval. Results: A total of 422 Nurses participated in this study and, 241(57.1%) (95% CI= (52%-62%)) had inadequate pain assessment practices. Knowledge of behaviors indicative of pain [AOR=2.38; 95% CI= (1.55-3.65)], work experience [AOR=1.67; 95% CI= (1.08-2.60)], lack of familiarity to pain assessment tools [AOR= 1.76; 95% CI= (1.13-2.72)], low priority given to pain assessment [AOR=2.08; 95% CI= (1.27- 3.41)] and lack of protocols and guidelines [AOR= 2.18; 95% CI = (1.33-3.55)] were significantly associated with pain assessment practices at p-value <0.05. Conclusion: This study revealed that pain assessment practice was found inadequate in referral hospitals of Amhara region. Inadequate knowledge of behaviors indicative of pain, lack of guidelines and protocols, low prioritization given to pain assessment and lack of familiarity with pain assessment tools were significantly associated with inadequate pain assessment practices in critically ill adult patients