Clinicians’ perspective on factors affecting pain management among patients with terminal illness admitted at Longisa County Referral Hospital, Kenya

Abstract

The study sought to explore clinicians’ perspective on factors affecting pain management on terminally ill patients admitted at Longisa County Referral Hospital in southern part of Rift Valley region in Kenya. Factors that facilitates pain management are: use of WHO guidelines, education of clinicians on pain management and incorporating pain assessment as the fifth vital sign. Conversely, barriers leading to under treatment of pain include: lack of knowledge on pain management, lack of pain assessment tools/guidelines, misconceptions of narcotics among clinicians, lack of essential medicines, understaffing, patients and family beliefs of pain, inconsistent supply of opioids and restrictive regulation of opioids. This was an exploratory qualitative study in which in-depth interviews were conducted with clinicians who were purposively sampled to include those who worked in areas with palliative care patients until thematic saturation was achieved.  Data was analyzed through thematic content analysis and presented in form of narrative. The study revealed that clinician do not treat pain adequately. Additionally, significant knowledge deficiencies exist regarding current principles of pain management practices and presence of beliefs that interfere with optimal care. Significant knowledge deficiencies are evident regarding currently accepted principles of pain management practices, as well as beliefs and lack of essential drugs including opioids which hinders pain management therefore clinicians must be educated continuously especially with ongoing educational sessions with a focus on knowledge of current pain management principles.