Reorganising In-hospital Pain Management: Evaluation of a Novel Nurse-Based Pain Management Programme in an Ethiopian University Medical Centre

Abstract

Pain is a common problem for hospitalized patients worldwide. Despite the efforts made to improve pain management in Ethiopia, the number of patients who report having pain remains high. This thesis contributes to a better knowledge of pain management in an Ethiopian hospital, where nurses play a pivotal role in providing care for the patients in their recovery process. The aim of the thesis was to evaluate a nurse-based pain management programme, which consisted of two components: 1) an in-service nursing education programme and 2) reorganizing the nursing care services to rounding. This study was conducted in the Ethiopian University Medical Center (JUMC) and is the first of its kind to address professional and systemic impediments to adequate pain management in a resource-limited hospital setting. We found that the context-specific in-service nursing education programme had strengthened the nurses’ knowledge and attitude towards pain management. Based on the data collected from patients’ samples before and after the implementation of the programme, we observed that the patients reported lower pain intensity and interference with physical and emotional functions, and the level of pain interference with relationships and negative feelings, such as anxiety, depression, feeling frightened and helpless, became significantly lower. Moreover, the patients experienced an increased use of pharmacological agents. Similarly, the response time for the nurses to provide pain relief was shortened and the patients expressed increased satisfaction with the information and care they received in general. Overall, the findings from this study highlight the importance of contextualising pain management programmes. The lessons learned from the study may be useful in improving pain management as a continuous effort in Ethiopia.