Determinants of Postoperative Pain Assessment Practices: A Study of Surgical Nurses in Nigerian Tertiary Hospitals

Abstract

Background: Accurate postoperative pain assessment is essential for effective pain management and optimal surgical outcomes. However, nurses' pain assessment practices remain inconsistent, particularly in low- and middle-income countries. Objective: This study assessed postoperative pain assessment practices and identified nurse-related predictors among surgical nurses in tertiary hospitals in Oyo State, Nigeria. Methods: A multi-centre cross-sectional study was conducted among 156 surgical nurses selected using total enumeration from two tertiary hospitals. Data were collected using a structured, self-administered questionnaire. Data were analysed using descriptive statistics (frequencies, percentages, and mean ± standard deviation) and inferential statistics (logistic regression analysis) at a significance level of 0.05. Results: The results showed that 116 (74.4%) of the surgical nurses had good knowledge, and 85 (54.5%) had a positive attitude towards postoperative pain management. Overall, 62.2% of respondents demonstrated good postoperative pain assessment practice. Most respondents routinely assessed pain characteristics and behavioural and physiological indicators, and evaluated pain at least once per shift. However, only 51.9% consistently used standardised pain assessment tools, while 48.1% reported using none. The Numerical Rating Scale was the most frequently used tool (37.2%). Independent predictors of good practice were postgraduate qualification (AOR = 0.22, 95% CI: 0.06–0.76), Principal Nursing Officer grade (AOR = 2.65, 95% CI: 1.00–7.00), and working in the Critical Care Unit (AOR = 3.11, 95% CI: 1.02–9.49). Conclusions: Although most surgical nurses demonstrated good postoperative pain assessment practice, important gaps remain in the routine use of standardised pain assessment tools. Strengthening continuing professional education, implementing standardised pain assessment protocols, and improving access to validated assessment tools may enhance postoperative pain assessment and improve surgical care.