Volume 10, Issue 1 (Winter 2024)                   JCCNC 2024, 10(1): 25-34 | Back to browse issues page


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1- Critical Care Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
2- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
3- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. , bahramnezhad.f@gmail.com
Abstract:   (424 Views)
Background: Although patients› self-report is the gold standard for pain, many patients admitted to the intensive care units are unable to communicate and express their pain. Accordingly, the nurse must have special abilities to diagnose and manage pain in such conditions. This study assesses nurses’ knowledge, attitude, and performance regarding pain management of non-verbal critically ill adult patients in intensive care units.
Methods: This cross-sectional descriptive study was conducted from February to May 2020 among nurses working in four national referral hospitals in Dar es Salaam, Tanzania. The study sample included 202 intensive care unit nurses who were recruited by the census. The data was collected using pre-validated questionnaires, including the knowledge and attitudes survey regarding pain tools, and a performance tool by Eunkyoung. The data were analyzed using the chi-square test, one sample t-test, and Spearman correlation coefficient in the SPSS software, version 20. The significance level was set at P<0.05.
Results: The mean knowledge and attitude score was 13.26±2.75, indicating inadequate knowledge and negative attitude. The mean performance score was 2.08±0.16, indicating low performance. No significant relationship was detected between nurses’ knowledge and attitude and their performance according to the t-test (t=2.84, P=0.09) and the Spearman correlation coefficient (r=0.12, P=0.102). Meanwhile, no significant relationships were found between the nurses’ knowledge, attitude, and performance and their demographic characteristics.
Conclusion: Planning to increase knowledge and improve the attitude and performance of ICU nurses for better pain management of non-verbal patients is necessary. It is recommended to evaluate the pain of these patients based on the observation of behavioral indicators of pain and choose the appropriate tool for pain assessment.
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● Pain control of non-verbal patients in the intensive care unit is often neglected by the medical staff, especially nurses.
● The attitude, knowledge, and performance of nurses toward pain control of non-verbal patients in intensive care units are poor.
● Nurses in Tanzania and other nurses with low knowledge, negative attitudes, and poor performance in pain management of non-verbal critically ill patients need appropriate in-service training to prevent harm to patients.
Plain Language Summary 
The pain of non-verbal patients in intensive care units may go unnoticed and even change the patient’s treatment. To assess and manage the pain of these patients, there is a need for special tools and special knowledge. In this study, we assessed the knowledge, attitude, and performance of nurses working in the intensive care units of hospitals in a city in Tanzania, and the findings showed that the nurses of these departments have poor knowledge, attitude, and performance concerning the pain management of these patients. It is recommended that nurses apply appropriate tools to assess the pain of these patients and use correct communication strategies to manage the pain of non-verbal critically ill patients in intensive care units. Holding continuous in-service training regarding pain management of non-verbal critically ill patients is also recommended.

Type of Study: Research | Subject: General
Received: 2022/10/30 | Accepted: 2023/08/29 | Published: 2024/01/10

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