Saint Vincent Hospital, Department of Medicine, Worcester, MA
Ying Ning , Haritha Ackula , Vishal Jindal , Mu Li , Pengyang Li , Ahmad Daniyal Siddiqui
Background: Our study used KAP model to evaluate differences of Knowledge, Attitude, and Practice regarding cancer pain management among care providers in a community teaching hospital. Methods: A 32-question KAP survey was designed with 3 demographic, 15 Knowledge, 9 Attitude and 5 Practice questions. It was administered randomly and anonymously to attending physicians of medicine, medical residents and medical nurses. 106 effective questionnaires (24 attending, 41 residents and 41 nurses) were analyzed and compared with percentage by Chi-Squared Test using SPSS 25. Results: Majority of all 3 groups believe only 50-60% of cancer pain can be effectively managed, while the actual effectiveness is close to 90% with proper management. Demographically, female predominates in nurses as expected, there is no statistical difference in previous pain/palliative education. Years of experience vary considerably (P < 0.001). Attending perform best in Knowledge (60% correctness), but not statistically better (P = 0.361), a common area of weakness is low awareness of alternative management besides medication. Attending and nurses have more positive attitude compared to residents (P = 0.002). Nurses perform best in Practice mainly demonstrated by higher awareness and consistency in pain evaluation and documentation (P < 0.001). Finally, overall performance is consistent with self-reported confidence. Conclusions: Knowledge is relatively easy to acquire since residents have comparable level to attending, although further education is indicated for all the providers. More care experience and a positive attitude better predicts practice performance. All 3 group seems to lack belief and confidence in effective cancer pain management, another area to be addressed for quality improvement.
Attending | Residents | Nurses | P value | ||
---|---|---|---|---|---|
Belief only 50-60% effectiveness in cancer pain management | 70.8% | 85.4% | 85.4% | 0.267 | |
Demographics (Percentage) | Female | 37.5% | 53.7% | 90.2% | < 0.001 |
Practice > 10 yrs. | 75% | 9.8% | 68.3% | < 0.001 | |
Previous pain/palliative education | 66.7% | 36.6% | 46.3% | 0.096 | |
KAP questions (Percentage of correct answers) | Knowledge | 60% | 55.8% | 55.8% | 0.361 |
Attitude | 85.7% | 77.4% | 87.8% | 0.002 | |
Practice | 58.3% | 43.4% | 67.3% | < 0.001 | |
Overall performance | 66.4% | 59.1% | 66.2% | 0.001 | |
Self-reported confidence | 50% | 12.2% | 51.25% | < 0.001 |
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