title: A Survey of Knowledge and Attitudes of Nurses About Pain Management in End-Stage Liver Disease in a Geriatric Palliative Care Unit.
abstract: BACKGROUND
  Palliative care is often initiated late for patients with end stage liver disease (ESLD) with pain being a common morbidity that is under-treated throughout the disease trajectory. When admitted to a palliative care unit (PCU), nurses play a pivotal role and must be highly informed to ensure effective pain management. The aim of this study is to determine the baseline level of knowledge and attitudes of PCU nurses regarding pain management in patients with ESLD.
  
  
  METHODS
  A descriptive, cross-sectional self-administered survey design was used for this study. The sample comprised 35 PCU nurses working at a continuing chronic care facility in Toronto, Ontario, Canada. Data on the knowledge and attitudes of the nurses regarding pain management in patients with ESLD, was obtained using a modified version of the "Nurses Knowledge and Attitudes Survey Regarding Pain" (NKASRP) tool.
  
  
  RESULTS
  Thirty-one PCU nurses were included for the analysis, giving a response rate of 89%. The mean total percentage score for the nurses on the modified version of the NKASRP was 72%. Only 26% of the nurse participants obtained a passing score of 80% or greater. There were no significant differences in mean total scores by age, gender, years of nursing experience or education level.
  
  
  CONCLUSIONS
  The findings of this study provide important information about the inadequate knowledge and attitude in nurses regarding pain management for patients with ESLD. It is suggested that targeted educational programs and quality improvement initiatives in pain management for patients with ESLD could improve knowledge and attitudes for PCU nurses.
authors.affiliation: 1 Baycrest Health Sciences, Division of Palliative Care, Department of Family Medicine and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Giulia-Anna
authors.initials: GA
authors.lastname: Perri
authors.affiliation: 2 Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Herman
authors.initials: H
authors.lastname: Yeung
authors.affiliation: 3 Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Yoel
authors.initials: Y
authors.lastname: Green
authors.affiliation: 1 Baycrest Health Sciences, Division of Palliative Care, Department of Family Medicine and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Abby
authors.initials: A
authors.lastname: Bezant
authors.affiliation: 1 Baycrest Health Sciences, Division of Palliative Care, Department of Family Medicine and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Carman
authors.initials: C
authors.lastname: Lee
authors.affiliation: 1 Baycrest Health Sciences, Division of Palliative Care, Department of Family Medicine and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: Berall
authors.affiliation: 1 Baycrest Health Sciences, Division of Palliative Care, Department of Family Medicine and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jurgis
authors.initials: J
authors.lastname: Karuza
authors.affiliation: 4 Division of Critical Care Medicine, Department of Medicine, Western University, London, Ontario, Canada.
authors.forename: Houman
authors.initials: H
authors.lastname: Khosravani
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D058625:End Stage Liver Disease / Q000503:physiopathology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009864:Ontario; D059408:Pain Management / Q000379:methods*; D010166:Palliative Care / Q000379:methods*
keywords: end-stage liver disease; nurses pain attitudes; nurses pain knowledge; pain management; palliative care; palliative care unit