ASSESSMENT OF KNOWLEDGE AND APPROACHES OF NURSES TOWARDS CANCER PAIN MANAGEMENT IN ELDERLY PATIENTS

(A CASE STUDY OF AHMADU BELLO UNIVERSITY TEACHING HOSPITAL, ZARIA KADUNA STATE)

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Author

Presented To

Department of Medicine

ABSTRACT
Pain is the most disturbing and annoying symptom experienced by cancer patients, yet it is poorly managed. About 60-70% of cancer cases in Nigeria present in advance stage; at least 30% of such cases experience one or more types of pain, which is almost pathognomic of the disease state. As a result, the study aimed at assessing nurses? knowledge, approaches rendered to elderly patient with pain and the challenges they encounter during cancer pain assessment and managementat Ahmadu Bello University Teaching Hospital, Zaria. A cross sectional descriptive research design was used where both questionnaire and observation were used to obtain information from 73 nurses. The data obtained were analysed using descriptive and inferential statistics with the aid of SPSS version 22.0 as a tool for analysis. Findings on level of knowledge revealed that only 24 (32.8%) of the nurses have knowledge on cancer pain in elderlywhich is below average.The challenges nurses encountered during pain assessment includetoo many patients to assess (mean 4.1); absence of time for assessing patients with pain (mean 4.0); inconsistency of pain report by cognitive impaired patients(mean 3.8);lack of institutional policies for accountability for pain assessment(mean 3.6); and communication barrier between nurses and patients(mean 3.5). The challenges they encountered during cancer pain management include; none availability/inadequatemedications(mean 3.5) andinadequate trained nurses on cancer pain management(mean 4.0). Based on the result of the observation, the approaches nurses rendered includereassuring patient (that pain is real and will assist him or her in dealing with it)(mean 2.95);administering balanced analgesic agents as prescribed to promote optimal pain relief(mean 3.0); anddocumenting severity of patient?s pain on chart(mean 2.14). It can therefore be concluded that, nurses? knowledge on cancer pain is below optimal. This was found to be hindered by certain factors during assessment and in the course of rendering their care to elderly patients with cancer. It is therefore recommended that there should be frequent formal training of nurses on cancer pain management. This could be at the local level such as in both pre service and in service trainings. Pain assessment tools should be available to nurses and adequate staff nurses should be postedto all wards with oncology cases.