Factors associated with Intensive care nurses' use of non-pharmacological methods of pain management: A multinomial logistic regression analysis.

Background: Although there are numerous studies in the literature on the roles, methods used and attitudes of nurses in pain management, the factors related to the use of non-pharmacological methods (NPMs) are not well-documented.

Aim: This research aims to determine the factors related to the use of NPMs by intensive care nurses in Turkey.

Study design: This descriptive and cross-sectional study was conducted with the participation of 385 intensive care unit nurses. Data were collected by using the 'Sociodemographic Data Form', 'Non-Pharmacological Methods Form' and 'Pain Beliefs Questionnaire' (PBQ) between January-December 2022. Multiple multinomial logistic regression analysis was used to identify factors associated with non-pharmacological methods. Pain management was categorized as pharmacological, non-pharmacological and both. The use of pharmacological methods (PMs) was taken as the reference category. The STROBE checklist was adhered to in this study.

Results: It was found that in pain management in the ICU, 33% used pharmacological methods, and 62.1% used both methods. The most frequent barriers experienced in the use of NPMs were 'heavy workload' (82.9%), 'inadequate time' (82.9%) and 'patients being unstable' (69.6%). Receiving pain management training increased the nurses' use of NPMs by 237% compared to pharmacological methods (RRR = 2.377, 95% CI = 1.200-4.707; p = .013). Regarding the barriers to the use of NPMs, 'the lower priority of NPMs compared to emergency practices (RRR=0.333, 95% CI=0.191-0.579; p=.000) and Deficiency in resources (materials and equipment)' (RRR = 0.454, 95% CI = 0.244-0.846; p = .013) decreased the use of NPMs. The Psychological Beliefs subscale of the PBQ increased the use of NPMs (RRR = 2.094, 95% CI = 1.152-3.803; p = .015).

Conclusion: Nurses should be provided with training on non-pharmacological methods as well as pharmacological methods in pain management, barriers to the use of non-pharmacological methods should be eliminated and psychological beliefs regarding pain should also be addressed.

Relevance to clinical practice: There is a need to solve the problems of lack of education, legal barriers and lack of resources in increasing the use of non-pharmacological pain methods by nurses in intensive care units.