Table 2.
Percentage of Nurses with Correct Responses on Each Question of the KASRP (n=154)
| Frequency (n) | Percentage (%) | ||
|---|---|---|---|
| KASRP classification | |||
| Poor knowledge and attitudes | 111 | 72.2 | |
| Fair knowledge and attitudes | 43 | 27.8 | |
| Item | Content (correct answer) | Correct (n) | Accuracy (%) |
| Cancer related pain | |||
| 25 | Analgesic medications are considered for the treatment of prolonged moderate to severe pain for cancer patients (morphine)b | 128 | 83.1 |
| 30 | Useful for treatment of cancer pain (All of the above)b | 97 | 63.4 |
| 5 | Aspirin and other non-steroidal anti-inflammatory agents are NOT effective analgesics for painful bone metastases (F)a | 84 | 54.6 |
| 28 | The likelihood of the patient developing clinically significant respiratory depression in the absence of new comorbidity comorbidity (less than 1%)b | 39 | 25.3 |
| 23 | The recommended route of administration of opioid analgesics for patients with persistent cancer-related pain (oral)b | 9 | 5.8 |
| Pain assessment | |||
| 12 | Children less than 11 years old cannot reliably report pain so clinicians should rely solely on the parent’s assessment of the child’s pain intensity (F) a | 77 | 50.0 |
| 1 | Vital signs are always reliable indicators of the intensity of a patients’ pain (F)a | 76 | 49.4 |
| 2 | Because their nervous system is underdeveloped, children under two years of age have decreased pain sensitivity and limited memory of painful experiences (F)a | 65 | 42.2 |
| 32 | The best approach for cultural considerations in caring for patients in pain (Patients should be individually assessed to determine cultural influences)b | 64 | 41.6 |
| 4 | Patients may sleep in spite of severe pain (T)a | 56 | 36.4 |
| 3 | Patients who can be distracted from pain usually do not have severe pain (F)a | 45 | 29.2 |
| 31 | The most accurate judge of the intensity of the patients’ pain (the patient)b | 39 | 25.3 |
| 39a | Case study 39a (8)b | 31 | 20.1 |
| 38b | Case study 38a (8)b | 4 | 2.6 |
| Pharmacology | |||
| 14 | After an initial dose of opioid analgesic is given, subsequent doses should be adjusted in accordance with the individual patients’ response (T)a | 120 | 77.9 |
| 7 | Combining analgesics that work by different mechanisms (eg, combining an NSAID with an opioid) may result in better pain control with fewer side effects than using a single analgesic agent (T)a | 113 | 73.4 |
| 13 | Patients’ spiritual beliefs may lead them to think pain and suffering are necessary (T)a | 106 | 68.8 |
| 21 | The term “Equianalgesia” means approximately equal analgesia and is used when referring to the doses of various analgesics that provide approximately the same amount of pain relief (T)a | 105 | 68.2 |
| 10 | Elderly patients cannot tolerate opioids for pain relief (F)a | 100 | 64.9 |
| 18 | Anticonvulsant drugs such as gabapentin (Neurontin) produce optimal pain relief after a single dose (F)a | 98 | 63.6 |
| 19 | Benzodiazepines are not effective pain relievers and are rarely recommended as part of an analgesic regiment (F)a | 97 | 63.0 |
| 24 | The recommended route administration of opioid analgesics for patients with brief, severe pain of sudden onset such as trauma or postoperative pain (intravenous)b | 91 | 59.1 |
| 29 | The most likely reason a patient with pain would request increased doses of pain medication (The patient is experiencing increased pain)b | 84 | 54.6 |
| 16 | Vicodin (hydrocodone 5 mg + acetaminophen 300 mg) PO is approximately equal to 5–10 mg of morphine PO (T)a | 82 | 53.3 |
| 6 | Respiratory depression rarely occurs in patients who have been receiving stable doses of opioids over a period of months (T)a | 75 | 48.7 |
| 34 | The time to peak effect for morphine given IV (15min)b | 72 | 46.8 |
| 27 | Analgesics for post-operative pain should initially be given (around the clock on a fixed schedule)b | 69 | 44.8 |
| 35 | The time to peak effect for morphine given orally (1–2 hour)b | 64 | 41.6 |
| 9 | Opioids should not be used in patients with a history of substance Abuse (F)a | 62 | 40.3 |
| 15 | Giving patients sterile water by injection (placebo) is a useful test to determine if the pain is real (F)a | 61 | 39.6 |
| 37 | Opioid induced respiratory depression (Obstructive sleep apnea is an important risk factor)b | 56 | 36.4 |
| 11 | Patients should be encouraged to endure as much pain as possible before using an opioid (F)a | 55 | 35.7 |
| 8 | The usual duration of analgesia of 1–2 mg morphine IV is 4–5 hours (F)a | 54 | 35.1 |
| 17 | If the source of the patient’s pain is unknown, opioids should not be used during the pain evaluation period, as this could mask the ability to correctly diagnose the cause of pain (F)a | 50 | 32.5 |
| 26 | A 30 mg dose of oral morphine is approximately equivalent to (Morphine 10 mg IV)b | 44 | 28.6 |
| 39b | Case study 39b (Administer morphine 3 mg IV now)b | 25 | 16.5 |
| 38b | Case study 38b (Administer morphine 3 mg IV now)b | 2 | 1.3 |
| Substance abuse/physical dependence | |||
| 22 | Sedation assessment is recommended during opioid pain management because excessive sedation precedes opioid-induced respiratory depression (T)a | 113 | 73.4 |
| 20 | Narcotic/opioid addiction is defined as a chronic neurobiologic disease, characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving (T)a | 109 | 70.8 |
| 33 | Patients develop pain already have an alcohol and/or drug abuse problem (5–15%)b | 81 | 52.6 |
| 36 | Physical dependence is manifested by (sweating, yawning, diarrhea and agitation with patients when the opioid is abruptly discontinued)b | 47 | 30.5 |
Notes: aThe item is a judgment question. T stands for right and F stands for wrong. bThe item is a single choice.