title: Nurses' competence in pain management in patients with opioid addiction: A cross-sectional survey study.
abstract: BACKGROUND
  There may be up to 21 million opioid abusers in the world. Drug abuse and associated health-related problems are increasing. Opioid addiction can cause serious bacterial infection, injury and trauma, conditions that can trigger pain. Opioid abusers experience pain differently from non-addicts. There is limited research on nurses' competence to provide pain treatment to patients with opioid addiction.
  
  
  OBJECTIVE
  To report on a Norwegian pilot study examining nurses' knowledge about pain and competence in treating pain in patients who abuse opioids.
  
  
  METHODS
  A descriptive cross-sectional survey design was employed.
  
  
  METHODS
  Nurses at medical (n=64) and orthopaedic (n=34) units at two urban, public Norwegian hospitals.
  
  
  METHODS
  Data were collected in January 2010 using a self-administered questionnaire. Sample selection was determined by purposive sampling. The response rate was 54%.
  
  
  RESULTS
  Eighty-eight percent of nurses did not have sufficient knowledge about pain treatment in patients with opioid addiction. Eight-eight percent and seventy-seven percent regarded work-place experience and colleagues as the primary contributors to their knowledge about pain treatment, respectively. Work-place experience contributed most to nurses' competence. Ninety percent, 70% and 84% of nurses responded that education, literature and information technology, respectively, played a minor role in obtaining knowledge about pain management. Sixty-five percent of the respondents had basic skills for evaluating pain, although 54% could not evaluate the degree of pain. Almost 62% of nurses did not trust the pain experience self-reported by patients who were opioid abusers.
  
  
  CONCLUSIONS
  Our study shows shortcomings in the nurses' competence to evaluate and treat pain, suggesting that patients with opioid addiction may not receive adequate pain management. Nurses' competence to offer pain treatment to opioid abusers could be characterized as experience-based rather than evidence-based.
authors.affiliation: Faculty of Health Studies, Sogn og Fjordane University College, P. O. Box 523, N-6803 Førde, Norway. Electronic address: kurt.arild.krokmyrdal@hisf.no.
authors.forename: Kurt A
authors.initials: KA
authors.lastname: Krokmyrdal
authors.affiliation: Faculty of Health Science, Department of Nursing, Oslo and Akershus University College of Applied Sciences, Norway.
authors.forename: Randi
authors.initials: R
authors.lastname: Andenæs
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D009741:Nursing Staff, Hospital / Q000193:education; D009293:Opioid-Related Disorders / Q000451:nursing* / Q000523:psychology; D059408:Pain Management / Q000451:nursing*; D010147:Pain Measurement / Q000451:nursing*; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Competence; Education; Knowledge; Nurses; Opioid abuse; Pain treatment