Knowledge, Attitudes and Practices towards Assessment and Management of Chronic Pain amongst Clinicians Working In Tenwek Hospital, Kenya.

Abstract

Chronic Pain is one among the leading causes of hospitalization, increased cost of health care, socioeconomic deprivation and health burden to patients, clinicians and the health care facilities globally. The management of chronic pain remains a subject of controversy, as clinicians across the globe continues to exhibit varied levels of knowledge, varied attitudes, and varied management approaches that subsequently leads to poor chronic pain management outcomes to the patients. To-date there is paucity of data on the level of knowledge, attitudes and practices in management of chronic pain in Kenya and Tenwek Hospital in particular hence the basis of this study. In carrying out this study a cross-sectional descriptive study design was adopted. The study area was Tenwek hospital a referral faith based hospital in Bomet county-Kenya. A sample size of 153 respondents that included doctors, nurses, physiotherapists, clinical officers and dentist were interviewed. A census technique was adopted in recruiting the study participants. A structured questionnaire adopted from the revised pain knowledge and attitudes questionnaire (RPKAQ) (Clenzo et al., 2016) was used as the data collection tool. The questionnaire captured the social demographic characteristics of the participants alongside the three thematic domains of the study that included knowledge, attitudes and practices in the management of chronic pains. After collecting the data, it was then entered into the computer using Microsoft access then exported for statistical analysis into the Statistical package for social sciences (SPSS) Version 24 for windows Chicago, Illinois. In assessing the association between levels of knowledge and practices in the management of chronic pains, Chi-Square test was applied and P-value that was less than 0.05 was considered statistically significant. The findings of the study shown that 76.5% of the respondents had relatively fair levels of knowledge and attitudes in pain management whereas only 9% (n= 14) were found to have adequate knowledge, positive attitudes and applied standard method of pain management as per WHO. 62% of the respondents exhibited good practices with regards to management of cognitive or behavioral chronic pains while only 9% (n=14) used best practice in diagnosing of chronic pain. The findings of the study also shown that there were statistically significant association between levels of education (p-value 0.008), age range (p-value 0.008), cadre (p-value 0.035) and the level of clinicians’ knowledge, attitudes and practices towards assessment and management of chronic pain. In conclusion majority of the clinicians (76.5%) at Tenwek hospital only exhibit a fair level of knowledge, attitudes and practices in management of chronic pains. The study recommends that targeted in-service and continuous trainings in chronic pain management be organized for the clinicians at Tenwek hospital. This is to acquit them with required levels of knowledge, develop positive attitudes and contemporary methods of chronic pain management approaches for purposes of harmonizing knowledge, attitudes and practices of chronic pain management in the hospital.