Knowledge Attitude and Practice towards total pain assessment among Health Professionals Providing Palliative Care Service
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Date
2025
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Addis Ababa Uinverstiy
Abstract
The concept of total pain assessment entails assessment of physical, psychosocial,
and spiritual pain in patients suffering from life threatening and serious illnesses. It is crucial to
assess pain holistically to alleviate pain and suffering to increase quality of life. The aim of this
study was to assess the practical implementation of total pain assessment.
Objective; To assess knowledge, attitude and practice towards total pain assessment among
health professionals providing palliative care service, in Tikur Anbessa Specialized Hospital,
Addis Ababa.
Methods; A cross sectional study was done in Tikur Anbessa Specialized Hospital palliative
care unit from September to October 2025.Sample size of 69 calculated using single population
formula, data was collected using self-administered questionnaire, data was cleaned, and entered
using SPSS version 26. Data analysis was done with descriptive statistics using frequencies,
percentages and mean. Association between the dependent and independent variables was
determined using odds ratio at 95% level of confidence interval and P value 0.05 for
significance.
Result; 63 participants out of 69 with response rate of 91.3% participated in the study. 46(73%)
were nurses and 17(27%) residents.38 (60.31%), 25(39.68%), and 30(47.6%) have adequate
knowledge, favorable attitude and good practice respectively. Being a nurse was associated with
unfavorable attitude with adjusted odds ratio of 0.004(0.005, 0.382) and p value 0.002.
Conclusions and recommendations; This study showed health professionals working at
palliative care unit in Tikur Anbessa specialized hospital have adequate knowledge, but
unfavorable attitude, and poor practice , it is recommended to give proper training and
developing guide lines and protocols to assess pain holistically in palliative care unit of TASH.
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1. Introduction
1.1. Back ground
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue
damage or described in terms of such damage as defined by the International Association for the
Study of pain (IASP)(1).The IASP also classifies pain as acute, which lasts for short time and
chronic lasting more than 3 month which passed healing time(2).The treatment approach also
differs (2).The term total pain refers to pain perception not only as a physical pain but that it has
psychological, spiritual and social consequences(1).
Pain is the most prevalent symptom among cancer patients receiving palliative care .Around
50%-60 % of patients with cancer suffer from pain. Uncontrolled pain triggers physiological
stress response, causes emotional and social distress and decreases quality of life of patients
which is described as total pain(3).Hence goals of pain management in cancer patients includes
relieving physical pain and also restoring physical, emotional and social function(3,4) .
Different Studies show poor knowledge and attitude towards cancer pain and its treatment
among health professionals, patients, and family(5).Among health professionals there are
misconceptions regarding cancer pain assessment and management. Many health professionals
believe that patients exaggerate their pain, and many believe opioids and other analgesics used
for cancer pain treatment cause tolerance and addiction(6). There was also gap in knowledge of
health professionals regarding pharmacology of common analgesics used for cancer pain
treatment and pain assessment in pediatrics(6).
Health professionals especially nurses and residents spend most of the time with patients, so
assessing their knowledge ,attitude and practice towards pain assessment is critical for effective
pain relief(2) .Proper pain management requires adequate knowledge and positive attitude of
health professionals(7).However , many studies show low score of health professionals on
important aspects of pain management, including initial pain assessment, treatment, reassessment
and knowledge regarding pharmacology of analgesic drugs like narcotics(7).These findings from
other studies indicate the need for assessing health professionals knowledge, attitude and practice
towards pain assessment(7).
Thus the main aim of this study is to assess knowledge, attitude and practice of health
professionals providing palliative care service towards total pain assessment at Tikur Anbessa
Specialized Hospital, Addis Ababa Ethiopia.
Description
Keywords
Knowledge of Health Professionals Providing Palliative Care Service towards Pain Assessment in Patients with Life Threatening Illness.