Nurses' Pain Knowledge, Attitudes, and Perceived Barriers to Timely Analgesia in a Saudi Tertiary Hospital: A Cross-Sectional Study.

Pain is highly prevalent during hospitalization, and inadequate assessment contributes to avoidable suffering, prolonged length of stay, and increased resource use. Nurses play a central role in pain assessment, timely analgesic administration, patient education, and escalation of care. Background/

Objectives

This study assessed nurses' knowledge and attitudes regarding pain assessment and management and examined perceived causes of delayed pain treatment and perceived barriers to timely pain control at a tertiary hospital in Saudi Arabia.

Methods

A descriptive cross-sectional study was conducted in inpatient and outpatient departments at King Abdulaziz Medical City, Jeddah, Saudi Arabia (August-December 2023). Registered nurses providing direct patient care were recruited via convenience sampling. Data were collected using a demographic and clinical practice questionnaire, the Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP), and an adopted instrument assessing perceived causes of delayed pain treatment and perceived barriers. Data were analyzed using descriptive statistics, two-tailed t-tests, one-way ANOVA with assumption checks and post hoc testing, Pearson correlations, and multiple linear regression.

Results

A total of 125 nurses participated; 95.2% were female and 80.8% held a bachelor's degree. The mean NKASRP composite score was 46.69% (SD = 9.90), indicating a suboptimal knowledge-and-attitudes profile. Age group was significantly associated with NKASRP scores (F = 5.136, p = 0.007), and age remained the only significant independent predictor in the multivariable model (b = 0.055, p = 0.006). The most frequently perceived delay was contacting a physician for opioid prescription (58.4%), followed by obtaining opioids from the pharmacy (46.4%). Major perceived barriers included insufficient staff-patient communication (60.0%), insufficient patient knowledge of pain control (52.8%), and inadequate staffing (49.6%).

Conclusions

Nurses demonstrated a low composite knowledge-and-attitudes score and reported communication, workflow, and system-related barriers relevant to timely analgesia. These findings support further prospective evaluation of targeted educational and system-level strategies in similar settings.