Internship Doctors’ Knowledge and Attitudes Toward Pain Management in Cancer Patients at General Hospitals in Northeast Thailand

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Panaratana Ratanasuwan Yimyaem
Thitinat Tassakhon
Wimonrat Sriraj
Malinee Wongswadiwat
Sasiwimon Pongjanyakul
Raruen Sankhot
Akkharawat Sinkueakunkit
Somboon Thienthong

Abstract

Background and Objective : Cancer pain can affect many adverse consequences. The internship doctors have a major role in cancer pain management at rural and general hospital. The internship doctor must have good/correct/adequate knowledge and good attitudes toward pain relief for effective pain management. This study aims to evaluate the knowledge, attitudes, limitations and suggestions of physicians regarding cancer pain management

Methods : A questionnaire was sent to all internship doctors who work at general hospitals in the northeastern region of Thailand and informed consents were also obtained from all participants. The demographic data, previous pain management education, clinical experience, knowledge of pain management (20 points), attitude towards cancer pain management and other relating variables were collected and analyzed. The Chi square and Mann-Whitney test were used to test for significant differences and p < 0.05 was considered statistically significant.

Results : The response rate of questionnaires is 43.1% (122 of 283). Most internship doctors (76.2%) who participated this study have 1-3 months of doctor career experience after graduation. The majority of internship doctors (69.7%) have been already educated pain management from their graduated medical schools. Additionally, most of them (81.1%) had an experience of pain management of malignant patients. The mean (SD) score of pain management among these doctors is 11 (2.66). There are 5 questions of pain assessment, however, only 55.7% can give correct answers for just 2 or 3 questions and only one-third of them have the knowledge of opioids dependence. Question which has the lowest proportion is that vital signs is an accurate indication for pain severity (33.6%). Data analysis showed that there is a statistically significant between the scores from questionnaires and previous education of pain management from their medical schools (p= 0.03). The attitude about pain management among these doctors is moderately satisfied and there is no limitation in pain treatment. In addition, these doctors suggested that they required the clinical practice guideline for cancer pain management and also further pain management training.

Conclusions : The knowledge of cancer pain management is required to be improved among the internship doctors especially in aspects of pain assessment and dependence relating to opioids usage. Hence, regular pain management training should be provided for the internship doctors and the standard clinical practice guideline should be also developed to effectively improve the quality of cancer pain management.

Keywords : internship doctors, knowledge, attitude, cancer pain

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