Evaluation of perioperative pain management practices and associated factors among health care providers at Mnazi mmoja hospital in Zanzibar, Tanzania.

Abstract

ABSTRACT Background: Optimum pain control in the perioperative period is crucial to ensure pain free state for patients undergoing surgical procedures where poorly controlled postoperative pain can lead to extended hospital stays or even life-threatening complications, including death.Healthcare providers play a crucial role in ensuring optimal pain control, so as to improve patient outcome in the perioperative period. However, multiple evidence globally have shown that the level of pain management practice among health professionals remains suboptimal across various settings (1)(2)(3).Various factor influence their level of practice so as to ensure effective pain control i.e. knowledge level, attitude, familiarity with pain assessment tools, availability of guidelines, and participation in training. It is imperative to address these factors to guarantee a pain-free state for patients undergoing surgical procedures Objective: To evaluate perioperative pain management practices and associated factors among health care providers at Mnazi Mmoja Hospital-Zanzibar Methodology: An analytical cross-sectional hospital-based research study was conducted at MMH-Zanzibar. The participants were healthcare providers working in the surgical units of MMH. The participants were selected through a consecutive sampling method. Data collection was done using a structured questionnaire that was adapted from previous studies .Data analysis was carried out using SPSS version 23. Statistical significance was determined by Pearson chi square test and logistic regression was used for associations between the dependent and independent variable. P values <0.05 and a 95% confidence interval were considered to be statistically significant. Ethical approval from Muhimbili University IRB, Zanzibar health research institute (ZAHRI) and the Research and publication department of MMH was requested. Results: Among the 114 health care providers who were included in the study, 98 (86.0%) exhibited poor perioperative pain management practices. An overwhelming majority of healthcare providers (93.0%) were not using the validated pain assessment tools in the assessment of pain. Knowledge (AOR (95% CI) = 32.795 (6.496-165.574)), Attitude (AOR (95% CI) = 5.014 (1.125-22.358)) and familiarity with pain assessment (AOR (95% CI) xii =5.264(1.101-25.168)).were significantly associated with good levels of perioperative pain management practices. Conclusion and recommendation: The study revealed a poor overall level of perioperative pain management practices among healthcare providers in the study area, with only 14% exhibiting good practices. Notably, knowledge, attitude, and familiarity with pain assessment tools emerged as significant factors associated with good practice levels. Based on these findings, it is imperative to enhance the level of practice among healthcare providers. This can be achieved by empowering their knowledge through on-site or off-site training and continuous medical education (CME) focused on the assessment and management of perioperative pain. Additionally, ensuring the availability of pain assessment tools and guidelines in healthcare facilities is crucial to support effective pain management practices. By implementing these recommendations, healthcare providers can improve the quality of perioperative pain management, ultimately enhancing patient outcomes.