Nurses’ Perspectives on the Barriers and Facilitators of Pain Management in Hospitalized Patients

Background: Pain management is among the key tasks of nurses. Numerous studies have investigated the barriers and facilitators of pain management with conflicting results. The current study investigated the Iranian nurses’ perspectives in terms of the barriers and facilitators of pain management in hospitalized patients. Methods: This was a cross-sectional study. A total of 321 nurses working in a large general teaching hospital were recruited by the census method. A two-part, self-report questionnaire, including questions on nurses' characteristics and barriers and facilitators of pain management, was applied to collect data. The questionnaire was developed by researchers using a literature review. The questionaries’ reliability was assessed through a test-retest with a correlation coefficient of 0.89. SPSS was used for statistical data analysis. Descriptive statistics (frequency, percentage, mean, and standard deviation) were applied to analyze the data.  Results: Insufficient nurse/patient ratio (Mean±SD: 3.31±0.87), excessive demand for pain medications by the patients (3.12±0.95), the spoken language difference between physician and patient (3.01±0.85), the ignorance of pain as a priority in care (2.94±0.98), and failure to precise pain assessment (2.90±0.89) were determined by the nurses, as the main barriers to pain management, respectively. The studied nurses also perceived the attendance of in-service courses of pain management (3.39±0.63), having sufficient pain management skills (3.24±0.76), motivation for relieving the patient’s pain (3.24±0.81), effective nurse-physician relationship (3.26±0.68), proper supervision of the organization on a timely patient visit by the physician (3.12±0.92), and patient cooperation in pain management (3.21±0.75), as the main facilitators of pain management, respectively. Conclusion: The establishment of in-service education programs on pain management and strengthening the managerial processes, such as staffing and supervision, can facilitate pain management in hospitalized patients by nurses.