Determinants of nurses' pain management practices in Jordan: The moderating role of patient's barriers

In spite of the significant advancement in methods and tools associated with pain management, there is still a deficiency in the pain management practices. Therefore, the aim of this study is to empirically determine the level of pain management practices, evaluate the significant predictors of pain management practices (i.e. knowledge, attitude, subjective norm and self-efficacy), examine the moderating effect of patient barriers on the relationship between the predictors and the pain management practices, and to investigate the applicability of Field theory in explaining the pain management practices in Jordan. Six latent variables were involved including five exogenous and one endogenous variables and a cross-sectional survey was used in conducting the study. The instrument is consisted of 93 items adapted from the previous studies. The questionnaires were distributed to 600 nurses in 13 hospitals located in the central region of Jordan. The nurses were selected at random using a multistage cluster technique. Of 600, only 307 questionnaires were returned and used for analysis. Data collection was carried out for the period of six months from October 2014 until March 2015. Data were analyzed using partial least squares-structural equation modeling (PLS-SEM). The findings support the majority of the hypothesized relationships, specifically the hypothesized direct effects of attitude, self-efficacy, knowledge, and subjective norms on the pain management practices. In addition, patient-related barriers moderate one of these relationships. That is, the relationship between attitudes towards the pain management and the pain management practices is weaker for nurses who perceived high barriers from their patients as opposed to nurses who perceived low patient-related barriers. Collectively, the determinant variables of pain management practices accounted for 78% of the variance in the pain management practices. Theoretical, methodological, and practical implications are discussed.