Practice Of Pain Management And Associated Factors Among Health Care Providers Working In Public Hospitals Of West Shoa Zone, Oromia Regional State, Ethiopia, 2021

Abstract

Background: - Pain management is a health care involving relief of pain in various dimensions, from acute and simple to chronic and challenging pain. Health care providers should be able to assess and manage pain, for each patient. They should use easily administered rating scales and document the efficacy of pain relief at regular intervals after starting or changing treatment. However, despite many patients in middle and low-income countries suffering and dying from pain, health care providers appear underprepared, uncomfortable and mostly do not treat pain. Objective: To assess the practice of pain management and associated factors among health care providers working in Public Hospitals of West Shoa Zone, Ethiopia, 2021. Methods:-An institution based cross-sectional study was conducted among 422 nurses and physicians working in public hospitals of West Showa Zone. The study participants were selected using stratified simple random sampling technique. Data were collected using a pre-tested structured self-administered questionnaire. The data was collected from July 01 to October 01/2021. The collected data were coded and entered into Epi-data version 3.1 and then exported to SPSS version 20 for analysis. Descriptive statistics were computed using frequency distribution, percentages and proportions. Bivariable and multivariable binary logistic regression analysis was used to determine association between practice of pain management and associated factors. Odds ratio was calculated at 95% CI to measure an association and p-value < 0.05 was used to declare statistical significance. Results were presented in frequency tables, graphs and charts. Results: Data were obtained from 397 health care providers with a response rate of 94%. The overall level of good practice towards pain management was 50.40% (95% CI: 45.00-55.00). Work experience (<5years) AOR=0.066 (95% CI, 0.006-0.770) compared to >11 years of experience, qualification of diploma or Bachelor degree AOR=0.018 (95% CI, 0.002-0.157) compared to MD or post graduate degree, working in the ICU AOR=10.758 (95% CI, 1.751-16.096) compared to working in the inpatient units, lack of morphine AOR=0.017 (95% CI; 0.004-0.077), lack of pain management guideline AOR=0.089 (95% CI; 0.026-0.304), poor pain management knowledge AOR=0.251 (95% CI; 0.079- 0.800), unfavorable attitude AOR=0.152 (95% CI; 0.048-0.478) were factors associated with practice of good pain management among the study participants. Conclusion: The findings of this study showed that practice of pain management among health workers, in Public Hospitals of West Shoa Zone, varied. Health workers who had the qualifications of diploma or Bachelor degree, (compared to health workers who had the qualifications of MSc, MD or MD with specialization), were less likely to practice good pain management. Moreover, lack of guidelines, poor level of knowledge and unfavorable attitude; were found to be significantly associated with poor practice of pain management. Therefore, stakeholders need to work to escalate practice of health care providers on pain management through improved availability of pain medications, protocols, guidelines as well as better training and educational opportunities for health care providers.