Knowledge and Attitudes about Pain Management among Canadian Nursing Students.

BACKGROUND: Poorly managed pain is a problem that affects individuals, entire health care systems, and societies worldwide. Nurses are involved in pain management, yet little is known about the knowledge and attitudes of nursing students. AIMS: The aim of this study was to examine preregistration nursing students' knowledge and attitudes about the assessment and management of pain. DESIGN: This was a cross-sectional, descriptive survey. SETTINGS: Four education sites from two post-secondary institutions in Ontario, Canada. PARTICIPANTS/SUBJECTS: A convenience sample of 336 final year Bachelor of Science in Nursing and practical nursing students. METHODS: Participants were recruited in the classroom setting to complete the Knowledge and Attitudes Survey Regarding Pain. A score of eighty percent is considered a pass. RESULTS: Ninety percent of students who were in class on the day of the survey agreed to participate (n = 336/373). Fifteen (4.5%) participants passed the Knowledge and Attitudes Survey Regarding Pain, and the mean score was 66.7% (standard deviation 9.1). English as primary language, institution attended, and prior experience caring for someone with pain were independently associated with higher scores (p < .05). Students were found to have major gaps in knowledge and attitudes related to understanding the risk of respiratory depression after opioid therapy, calculating medication dosages, administrating medication, and understanding pharmacology. CONCLUSIONS: The majority of nursing students in this sample did not have adequate knowledge and positive attitudes about pain assessment and management.

Myofascial pain in patients waitlisted for total knee arthroplasty.

BACKGROUND: Knee pain is one of the major sources of pain and disability in developed countries, particularly in aging populations, and is the primary indication for total knee arthroplasty (TKA) in patients with osteoarthritis (OA). OBJECTIVES: To determine the presence of myofascial pain in OA patients waitlisted for TKA and to determine whether their knee pain may be alleviated by trigger point injections. METHODS: Following ethics approval, 25 participants were recruited from the wait list for elective unilateral primary TKA at the study centre. After providing informed consent, all participants were examined for the presence of active trigger points in the muscles surrounding the knee and received trigger point injections of bupivacaine. Assessments and trigger point injections were implemented on the first visit and at subsequent visits on weeks 1, 2, 4 and 8. Outcome measures included the Timed Up and Go test, Brief Pain Inventory, Centre for Epidemiologic Studies Depression Scale, State-Trait Anxiety Inventory and Short-Form McGill Pain Questionnaire. RESULTS: Myofascial trigger points were identified in all participants. Trigger point injections significantly reduced pain intensity and pain interference, and improved mobility. All participants had trigger points identified in medial muscles, most commonly in the head of the gastrocnemius muscle. An acute reduction in pain and improved functionality was observed immediately following intervention, and persisted over the eight-week course of the investigation. CONCLUSION: All patients had trigger points in the vastus and gastrocnemius muscles, and 92% of patients experienced significant pain relief with trigger point injections at the first visit, indicating that a significant proportion of the OA knee pain was myofascial in origin. Further investigation is warranted to determine the prevalence of myofascial pain and whether treatment delays or prevents TKA.