Wilson Benita
Faculty of Health and Social Care, The University of Hull, Hull, UK.
J Clin Nurs. 2007 Jun;16(6):1012-20. doi: 10.1111/j.1365-2702.2007.01692.x.
The aim of this study was to establish if postregistration education and clinical experience influence nurses' knowledge of pain.
Inadequacies in the pain management process may not be tied to myth and bias originating from general attitudes and beliefs, but reflect inadequate pain knowledge. Design. A pain knowledge survey of 20 true/false statements was used to measure the knowledge base of two groups of nurses. This was incorporated in a self-administered questionnaire that also addressed lifestyle factors of patients in pain, inferences of physical pain, general attitudes and beliefs about pain management.
One hundred questionnaires were distributed; 86 nurses returned the questionnaire giving a response rate of 86%. Following selection of the sample, 72 nurses participated in the study: 35 hospice/oncology nurses (specialist) and 37 district nurses (general). Data were analysed using SPSS.
The specialist nurses had a more comprehensive knowledge base than the general nurses; however, their knowledge scores did not appear to be related to their experience in terms of years within the nursing profession.
Whilst educational programmes contribute to an increase in knowledge, it would appear that the working environment has an influence on the development and use of this knowledge. It is suggested that the clinical environment in which the specialist nurse works can induce feelings of reduced self-efficacy and low personal control. To ease tension, strategies are used that can result in nurses refusing to endorse their knowledge, which can increase patients' pain.
Clinical supervision will serve to increase the nurses' self-awareness; however, without power and autonomy to make decisions and affect change, feelings of helplessness, reduced self-efficacy and cognitive dissonance can increase. This may explain why, despite educational efforts to increase knowledge, a concomitant change in practice has not occurred.
本研究旨在确定注册后教育和临床经验是否会影响护士对疼痛的认知。
疼痛管理过程中的不足可能并非源于一般态度和信念中的误解与偏见，而是反映出疼痛知识的欠缺。设计。一项包含20道是非题的疼痛知识调查被用于测量两组护士的知识基础。这被纳入一份自填式问卷中，该问卷还涉及疼痛患者的生活方式因素、身体疼痛的推断、对疼痛管理的一般态度和信念。
发放了100份问卷；86名护士返回了问卷，回复率为86%。在选取样本后，72名护士参与了研究：35名临终关怀/肿瘤护士（专科护士）和37名社区护士（普通护士）。数据使用SPSS进行分析。
专科护士比普通护士拥有更全面的知识基础；然而，他们的知识得分似乎与他们在护理行业内的工作年限经验无关。
虽然教育项目有助于知识的增加，但工作环境似乎会对这些知识的发展和运用产生影响。有人认为，专科护士工作的临床环境可能会引发自我效能感降低和个人控制感不足的情绪。为了缓解紧张情绪，会采用一些策略，这可能导致护士拒绝认可自己的知识，从而增加患者的疼痛。
临床督导将有助于提高护士的自我意识；然而，如果没有做出决策和影响变革的权力与自主权，无助感、自我效能感降低和认知失调感可能会增加。这或许可以解释为什么尽管在增加知识方面做出了教育努力，但实践中却没有随之发生相应的改变。
