PURPOSE: This study investigated long-term care hospital nurses' knowledge and practice of pain management and their attitudes towards the job with an ultimate aim to provide fundamental information for development of a pain education program. METHODS: A cross-sectional survey was carried out with 120 nurses from four long-term care hospitals. Nurses' knowledge of and attitudes towards pain management was measured using a tool developed by Watt-Watson. To examine their pain management practice, an instrument was developed based on the pain management guidelines used by the long-term care settings. RESULTS: For pain management knowledge, the participants gave an average of 26.2 (±13.10) correct answers out of 40 questions. The most frequently missed question was one about subjectivity of pain, “Patients' physiological and behavioral reactions to pain hint at the presence and intensity of pain” (89.2%), and 56.7% of the nurses believed that increasing tolerance for a narcotic analgesic means addiction. Regarding attitudes towards and practice of pain management, 80.2% of the nurses used placebos to patients who complain about pain often. CONCLUSION: This study revealed poor level of pain management knowledge of and attitude among long-term care hospital nurses. This might negatively affect their pain management practice. From the educational perspective, nurses should be provided with education on pain management education with emphasis on the nature of pain and misuse of placebo drugs.
Cross-Sectional Studies ; Education ; Humans ; Long-Term Care* ; Pain Management* ; Placebos ; Practice Patterns, Nurses'

PURPOSE: To evaluate predictors of severe or moderate coronary artery disease (CAD) in individuals with zero or very low (<10) coronary artery calcium (CAC) scores. MATERIALS AND METHODS: The 1175 asymptomatic persons with zero or very low (<10) CAC scores were analyzed for CAD stenosis using coronary computed tomography angiography. Moderate and severe CADs were defined as having more than 50% and more than 70% stenosis in any of the major coronary arteries, respectively. Age, gender, body mass index, hypertension, type II diabetes, dyslipidemia, lipid profile, creatinine, and smoking status were evaluated as predictors for moderate and severe CAD. RESULTS: In the study population, moderate and severe CADs were found in 7.5% and 3.3%, respectively. Among evaluated risk factors, age [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.02−1.07, p<0.001], current smoking status (OR 3.12, 95% CI 1.82−5.34, p<0.001), and CAC 1−9 (OR 1.80, 95% CI 1.08−3.00, p=0.024) were significantly associated with moderate CAD. Meanwhile, age (OR 1.05, 95% CI 1.02−1.08, p=0.003), low high density lipoprotein (HDL) (OR 0.96, 95% CI 0.93−0.99, p=0.003), and current smoking status (OR 2.34, 95% CI 1.14−5.30, p=0.022) were found to be significantly associated with severe CAD. Improvement of discrimination power for predicting severe CAD was observed when smoking and HDL cholesterol were serially added into the age model. CONCLUSION: Smoking showed significant correlations with moderate or severe CAD, and low HDL cholesterol also proved to be a predictor of severe CAD in asymptomatic individuals with extremely low CAC scores.
Angiography ; Asymptomatic Diseases ; Body Mass Index ; Calcium ; Cholesterol, HDL ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Creatinine ; Discrimination (Psychology) ; Dyslipidemias ; Humans ; Hypertension ; Lipoproteins ; Risk Factors ; Smoke ; Smoking