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Predictors of nurses intentions to administer PRN opioid analgesics for pain relief to postoperative orthopedic patients in the acute care setting

Taylor, Colleen Y
http://orcid.org/0000-0002-6211-4009
http://rave.ohiolink.edu/etdc/view?acc_num=toledo1430507903

Abstract Details

2015, Doctor of Philosophy, University of Toledo, Health Education.
Abstract Patients undergoing orthopedic surgery experience severe postoperative pain that is frequently undertreated. Nurses play an important role in the management of postoperative pain in hospitalized patients because they perform pain assessments on patients, administer pain medications and inform physicians when patients experience inadequate pain relief from prescribed medications. The objective of this study was to determine what constructs from the Integrated Behavioral Model (IBM) are predictors for intentions to administer PRN opioid analgesics for pain relief to hospitalized postoperative orthopedic patients. This study utilized a non-experimental quantitative format. A representative national random sample of nurses who regularly provide care for postoperative orthopedic patients who are hospitalized were selected to participate in the study. There were 420 surveys returned for a 53% response rate, with the majority of participants being female (92.3%), Caucasian (86.8%), and having earned a bachelor’s degree (55.7%). A statistically significant association was found with the demographic characteristics of age, level of education, hospital type and having orthopedic surgery and staying in the hospital and nurses’ intentions to administer PRN opioid analgesics for pain. A statistically significant association was found with nurses’ self-efficacy and their intentions to administer PRN opioid analgesics when there were time and dosage stipulations. Other constructs from the IBM that were found to have statistically significant associations with nurses’ intentions to administer PRN opioids included nurses’ normative beliefs and its factors, perceived control, and instrumental attitude. No statistically significant association was found between nurses’ knowledge or their underlying beliefs and their intentions to administer PRN opioid analgesics. The significant predictors for nurses’ intentions to administer opioid analgesics included self-efficacy, perceived control, normative beliefs total score, and behavioral beliefs (instrumental attitude). Salience of the behavior, knowledge, education, number of years caring for postoperative orthopedic patients, and orthopedic surgery requiring an overnight stay in the hospital were also significant predictors of nurses’ intentions in this study. Path analysis was done separately for each intention item (intention to administer PRN opioids, intention to administer PRN opioids with a dosage stipulation and intention to administer PRN opioid with a timing stipulation). The significant predictors for nurses’ intention to administer opioid analgesics without a time or dosage stipulation include self-efficacy (ß=0.15), normative beliefs (ß=0.21) and salience of the behavior (ß=0.25). The significant predictors for nurses’ intentions to administer opioids when there was a dosage stipulation include salience (ß=0.12) and normative beliefs (ß=0.19). Finally, the significant predictors that had a direct effect on intention when there was a time stipulation are salience (ß=0.11) and self-efficacy (ß=0.12.) Results from this study showed that while nearly all nurses intended to administer PRN opioids for pain relief, the predictors of their intentions varied when there were time and dosage stipulations. The study showed that the IBM constructs are useful for predicting intentions towards performance of a professional behavior. The inclusion of self-efficacy, underlying beliefs, and salience of the behavior were new and unique contributions for this study to the existing body of knowledge.
Jiunn-Jye Sheu (Committee Chair)
198 p.
Health Education
Musculoskeletal, orthopedic, postoperative, acute pain, intentions, Integrated Behavioral Model

Recommended Citations

Citations

  • Taylor, C. Y. (2015). Predictors of nurses intentions to administer PRN opioid analgesics for pain relief to postoperative orthopedic patients in the acute care setting [Doctoral dissertation, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1430507903

    APA Style (7th edition)

  • Taylor, Colleen. Predictors of nurses intentions to administer PRN opioid analgesics for pain relief to postoperative orthopedic patients in the acute care setting. 2015. University of Toledo, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=toledo1430507903.

    MLA Style (8th edition)

  • Taylor, Colleen. "Predictors of nurses intentions to administer PRN opioid analgesics for pain relief to postoperative orthopedic patients in the acute care setting." Doctoral dissertation, University of Toledo, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1430507903

    Chicago Manual of Style (17th edition)

toledo1430507903
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© 2015, all rights reserved.
This open access ETD is published by University of Toledo and OhioLINK.