Study On The Correlation Between The Cognition Of Breakthrough Cancer Pain And The Practice Level Of Evidence-based Pain Management In Nurses Of Oncology Department

[Objectives]The aim of this study was to investigate the nursing staffs cognition level and influencing factors of breakthrough cancer pain(BTcP)in a oncology specialist hospital of First-class Hospital at Grade 3 in Jinan and to analyze the practice level and influencing factors of evidence-based pain management.Analysis of the correlation between the cognitive level of BTcP and the level of evidence-based pain management practice.Based on the training history and willingness of nursing staff for BTcP,it provided theoretical basis for the effective development of BTcP related training and clinical evidence-based management practice.[Methods]A cross-sectional study design method was used to apply a convenient sampling method to a questionnaire survey of 300 clinical nurses in a oncology specialist hospital of First-class Hospital at Grade 3 in Jinan.Departments include internal medicine,surgery,gynecology,radiotherapy,special needs ward,and intensive care etc.The questionnaire included a general information questionnaire,a questionnaire on the knowledge of BTcP,a Chinese version of the Carlson Evidence-Based Pain Management Practice Prerequisites Scale(C-CPCIs),a history of cancerous burst pain training,and a training willingness questionnaire.Data statistical analysis:Epidata V3.1 software was used to enter data for two people and establish a database.Categorical variables were described statistically by frequency(percentage).If continuous variables follow a normal distribution,used the mean ± standard deviation description.If they do not follow the normal distribution,used the median ± quartile interval description,using t test or analysis of variance was used to compare groups of continuous variables.Multiple linear regression models were used to identify the influencing factors,Pearson correlation analysis was used to analyze the correlation between variables.All statistical analysis was performed using SAS 9.4 software.P<0.05 indicates that the difference is statistically significant.[Results]1.A total of 300 questionnaires were distributed in this survey,and 284 questionnaires were recovered,of which 278 were valid questionnaires,accounting for 97.89%of the number of recovered questionnaires.2.The oncology nurse’s total score for BTcP was 8.11± 2.50 points,and the scores of each dimension were ranked from highest to lowest:analgesic treatment dimension score was 3.65 ± 1.65;general knowledge dimension score was 2.01 ± 1.04;basic The feature dimension score was 1.83 ± 0.95;and the evaluation dimension score was 0.66 ± 0.61.Employment methods,different departments,and "the use of pain assessment tools to assess the pain of patients" had significant influence on the awareness of cancerous burst pain in oncology nurses(P<0.05).3.The total score of C-CPCIs was 3.61 ± 0.33 points.The scores of the four sub-scales were in order of 4.50 ± 0.45 in the previous practice scale,3.91 ± 0.82 in the work norms scale,2.98± 0.48 in the innovation spirit scale,and pain need/problem scale was 2.35 ±0.55.Among them,the evaluation dimension score in the previous practice subscale was 4.68 ± 0.46,the control/intervention dimension was 4.57 ± 0.59,and the feedback/communication dimension was 4.15± 0.86.For the total score of C-CPCIs,gender,hierarchy,different departments,and whether or not to acquire pain-related knowledge from academic journals were significant influential factors of evidence-based pain management practice level(P<0.05).Multiple linear regression analysis found that female nurses had higher total scores than male’s scales;the frequency of obtaining pain-related knowledge from academic journals was "less than once every six months" than "not acquiring pain-related knowledge from academic journals " group scales,which could explain oncology nurses evidence-based pain management practices score a variation of 20.73%.4.There was a correlation between the score of BTcP and the evidence-based pain management practice prerequisites scale(C-CPCIs)score:the score of BTcP was positively correlated with the score of the work norm subscale(r=0.139,P<0.05);the cognitive score of BTcP was negatively correlated with the score of pain demand/problem scale(r=-0.246,P<0.05);There was no significant correlation between the total score of BTcP and the total score of the C-CPCIs scale and the scores of the remaining subscales(P>0.05).5.0f the 278 nursing staff who participated in the survey,125 had previously participated in BTcP training(44.96%),of which 67.20%were less than 1 day of training.Forums lectures and didactical clinical consultations were the main training forms.The 89.93%research subjects were willing to participate in training on BTcP and hoping to obtain relevant knowledge about evaluation of BTcP,analgesic methods,etc.Most nurses want to trained in the form of short-term training courses(60.07%)and special lectures(52.16%).[Conclusions]1.The oncology nurses who participated in this survey had insufficient overall knowledge of BTcP.Employment methods,different departments,and "with or without pain assessment tools for pain assessment of patients" had a significant effect on the awareness of BTcP in oncology nurses(P<0.05).2.In this survey oncology nurses had a good level of evidence-based pain management practice and in the stage of frequent application.The support of the nurse’s system is high,which can promote the nurses to adopt evidence-based pain management practice to a certain extent.However,its ability to change the existing status is insufficient.It may hinder or promote the adoption of evidence-based pain management practices by nurses.Nurses were satisfied with themselves and others’ pain management practices.3.The nurses in oncology department whose awareness of BTcP was related to the level of evidence-based pain management practice(P<0.05).Oncology nurses’ consciousness of BTcP can promote the standardization of evidence-based pain management practice level and affect the degree of satisfaction with evidence-based pain practices for yourself and others.Nurses’ low evaluation level of their own and others’ satisfaction with pain management practices may cause nurses to have a certain level of awareness of cancerous pain,but the degree of satisfaction is too low,and they will not actively adopt evidence-based pain management practices.4.The nurses of oncology department had a strong demand for training on BTcP.They hope to obtain knowledge about BTcP on pain assessment,analgesic methods,and other aspects.Most research subjects hope trained in a short-term training course or forum lecture.