title: A theory-based educational intervention targeting nurses' attitudes and knowledge concerning cancer-related pain management: a study protocol of a quasi-experimental design.
abstract: BACKGROUND
  Pain is one of the most frequent problems among patients diagnosed with cancer. Despite the availability of effective pharmacological treatments, this group of patients often receives less than optimal treatment. Research into nurses' pain management highlights certain factors, such as lack of knowledge and attitudes and inadequate procedures for systematic pain assessment, as common barriers to effective pain management. However, educational interventions targeting nurses' pain management have shown promise. As cancer-related pain is also known to have a negative effect on vital aspects of the patient's life, as well as being commonly associated with problems such as sleep, fatigue, depression and anxiety, further development of knowledge within this area is warranted.
  
  
  METHODS
  A quasi-experimental study design will be used to investigate whether the implementation of guidelines for systematic daily pain assessments following a theory-based educational intervention will result in an improvement in knowledge and attitude among nurses. A further aim is to investigate whether the intervention that targets nurses' behaviour will improve hospital patients' perception of pain. Data regarding nurses' knowledge and attitudes to pain (primary outcome), patient perception regarding pain (secondary outcome), together with socio-demographic variables, will be collected at baseline and at four weeks and 12 weeks following the intervention.
  
  
  CONCLUSIONS
  Nursing care is nowadays acknowledged as an increasingly complicated activity and "nursing complexity is such that it can be seen as the quintessential complex intervention." To be able to change and improve clinical practice thus requires multiple points of attack appropriate to meet complex challenges. Consequently, we expect the theory-based intervention used in our quasi-experimental study to improve care as well as quality of life for this group of patients and we also envisage that evidence-based guidelines targeting this patient group's pain will be implemented more widely.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01313234.
authors.affiliation: School of Health Science, Blekinge Institute of Technology, SE-379 71 Blekinge, Sweden. gunilla.borglin@bth.se
authors.forename: Gunilla
authors.initials: G
authors.lastname: Borglin
authors.forename: Markus
authors.initials: M
authors.lastname: Gustafsson
authors.forename: Hans
authors.initials: H
authors.lastname: Krona
mesh_terms: D000698:Analgesia / Q000451:nursing; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D016022:Case-Control Studies; D059350:Chronic Pain / Q000209:etiology / Q000451:nursing* / Q000628:therapy; D003162:Competency-Based Education; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000175:diagnosis; D009720:Nurse Clinicians / Q000193:education; D059408:Pain Management / Q000451:nursing*; D011361:Professional Competence; D012016:Reference Values; D012107:Research Design; D013548:Sweden