Fang Liang-Yu, Xu Yin-Chuan, Lin Dan-Ni, Jin Jing-Feng, Yan Min
Department of Acute Pain Service, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China; Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
Department of Cardiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
Pain Manag Nurs. 2017 Aug;18(4):250-259. doi: 10.1016/j.pmn.2017.01.001. Epub 2017 Apr 23.
Optimal pain management is a priority in effective nursing care. Lack of sufficient pain knowledge associated with inadequate pain management has been proved. However, the intention, defined as the predictor of behavior, regarding pain management remains unknown. Therefore, the study was to determine the attitude and intention regarding pain management among Chinese nursing students and investigate the underlying determinants and their interactions in terms of intention toward pain management. The Pain Management Survey Questionnaire, comprising the key determinants of the theory of planned behavior-that is, direct attitude, belief-based intention, subjective norm, direct control, and indirect control-was used to collect data from 512 nursing students who undertook clinical rotation in an affiliated hospital of a medical college in China. Data were analyzed using descriptive statistics, independent sample t test, Pearson correlation analysis, or structural equation modeling analysis. Chinese nursing students reported negative attitudes and behavioral intentions toward pain management. Direct control, subjective norm, belief-based attitude, and indirect control independently predicted nursing students' intention to treat patients with pain. Direct control was the strongest predictor. Structural equation modeling analysis further revealed 39.84% of the variance associated with intention that could be explained by determinants of the theory of planned behavior. Additionally, educational school level and previous pain management training had great effects on pain management intention. Overall, this study identified intention as an important factor in effective pain treatment. Chinese nursing students have negative attitudes and insufficient intention to pain management. Therefore, hospitals and universities in China should manage these factors to improve nursing students' practice regarding pain management.
最佳疼痛管理是有效护理的重点。已证实缺乏足够的疼痛知识与疼痛管理不足有关。然而，作为行为预测指标的疼痛管理意向仍不明确。因此，本研究旨在确定中国护理专业学生对疼痛管理的态度和意向，并从疼痛管理意向方面调查潜在的决定因素及其相互作用。采用包含计划行为理论关键决定因素的疼痛管理调查问卷，即直接态度、基于信念的意向、主观规范、直接控制和间接控制，对在中国某医学院附属医院进行临床实习的512名护理专业学生进行数据收集。数据分析采用描述性统计、独立样本t检验、Pearson相关分析或结构方程模型分析。中国护理专业学生对疼痛管理的态度和行为意向呈消极状态。直接控制、主观规范、基于信念的态度和间接控制分别独立预测护理专业学生治疗疼痛患者的意向。直接控制是最强的预测因素。结构方程模型分析进一步显示，计划行为理论的决定因素可解释与意向相关的39.84%的方差。此外，教育学校水平和以前的疼痛管理培训对疼痛管理意向有很大影响。总体而言，本研究确定意向是有效疼痛治疗的一个重要因素。中国护理专业学生对疼痛管理的态度消极且意向不足。因此，中国的医院和大学应管理这些因素，以改善护理专业学生在疼痛管理方面的实践。
