Institutional Factors that Influence Pain Valuation for Severely Sick Patients among Nurses at Selected Hospitals in Kiambu County, Kenya

Abstract

The incidence of pain ranges from 47% to 100%, presenting a challenge across all demographics. Inadequate pain assessment can delay management, increasing anguish and potentially worsening pain. Nurses have professional and ethical responsibilities to ensure effective pain relief, relying on their understanding, consistent assessment, and documentation. This study aims to assess institutional factors influencing pain assessment and understand nurses’ factors affecting pain assessment in selected hospitals in Kiambu County, Kenya. Utilizing a descriptive research design, the study focused on 168 nurses selected through a census technique. A five-point Likert scale questionnaire was administered, and data were analyzed using SPSS Version 22 with descriptive statistics, including mean, percentages, tabulations, and frequencies. Findings revealed that hospitals employ various pain assessment tools for critically ill patients, with the behavioral pain assessment tool being the most common, followed by the critical-care pain observational tool and nonverbal pain assessment tool. Institutional factors such as pain evaluation procedures, communication channels, staffing levels, availability of equipment, teamwork, supervision, work regulations, and hospital environment significantly influenced pain assessment. Additionally, nurses’ demographic factors, including experience and personal pain encounters, impacted assessment practices. Statistical analysis showed a significant relationship between pain assessment tools and outcomes, highlighting the importance of tool selection for effective pain management. The study concludes that tool types, institutional factors, and nurses’ characteristics influence pain assessment and management among critically ill patients in Kiambu County. Recommendations include implementing capacity-building programs for nurses and prioritizing staffing, ethical practices, equipment provision, work culture, and safety. Incorporating pain management education into training for healthcare practitioners is also advised.