Effect of an Educational Program on Nurses’ Level of Knowledge about Pain Assessment and Management: A Quasi-Experimental Study

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Allobaney, Raya Yousef AL-HUSBAN, Rosario A. Macaaly, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5231832/v4 This work is licensed under a CC BY 4.0 License Status: Posted Version 4 posted You are reading this latest preprint version Show more versions Abstract Background Pain is universally acknowledged as one of the most distressing experiences individuals encounter, often leading to significant psychological and physical implications. Effective pain management is essential in healthcare, and it is imperative that nursing professionals possess the requisite knowledge and skills to assess and manage pain effectively. This study aimed to evaluate the impact of a structured educational program on nurses' performance levels in pain assessment and management. Methods A quasi-experimental, one-group pre- and post-test intervention design was used to facilitate this investigation. The research was conducted in the inpatient medical and surgical units in a main tertiary governmental hospital in Jordan. A total of 106 male and female nurses who provided direct nursing care in medical and surgical wards voluntarily participated in the study. Two instruments were utilised for data collection. A questionnaire was designed to assess nurses' knowledge regarding pain assessment and management, and an observational checklist was used to evaluate the practical application of pain management techniques by nurses. Results The study focused on a sample predominantly comprising female nurses, most of whom held a Bachelor of Science in Nursing degree and had 2–5 years of clinical experience. Notably, 88.7% of participants had not previously attended educational sessions centred on pain assessment and management. Following an educational intervention, statistical analysis revealed a significant improvement in the mean knowledge scores (P<0.001). Furthermore, all dimensions of nursing practices related to pain management showed statistically substantial enhancement after the training, demonstrating a strong correlation between knowledge and practice levels before and after the educational program. Conclusion The educational program's implementation resulted in more thanhalf of the participating nurses achieving a commendable level of knowledge and satisfactory practices in pain assessment and management. This underscores the program's effectiveness in enhancing both theoretical knowledge and practical skills. It is recommended that nursing professionals engage in ongoing training and educational opportunities focused on pain assessment and management to further refine their competencies and improve patient outcomes. Nursing Pain Management Program (PMP) Nursing Performance Pain Assessment and Management Introduction Pain is commonly regarded as one of the most unpleasant experiences that people fear but will have to be addressed at some point in their lives, with variable intensity and duration. The International Association for the Study of Pain (Raja, 2020) defines pain as a distressing sensory and emotional experience caused by real or potential tissue damage. Despite pharmacological breakthroughs in pain therapy, research from throughout the world has demonstrated that pain is still undermanaged owing to a lack of information about pain and how to control it. (Gustafsson &Shahriary 2015). Acute and chronic pain have different mechanisms and durations. Acute pain is a physiological response to tissue damage. (Pergolizzi, Raffa & Taylor, 2014). Poorly handled acute postoperative pain may reduce participation in rehabilitation treatments such as physiotherapy and deep breathing. (Francis & Fitzpatrick, 2013). It can progress to chronic pain; however, the transition from acute to chronic pain is poorly understood. (Voscopoulos & Lema, 2010). The presence of pain before surgery, the nature of the surgery, nerve injury, adjuvant radiation treatment, anxiety, and depression are all factors that increase the chance of chronic postsurgical pain. (VanDenKerkhof, Peters & Bruce, 2013). Chronic pain was defined as pain that lasted longer than the 'normal' healing timetable or discomfort that lasted more than three months. (Cohen, Quinter & Buchanan, 2013). Chronic pain can begin in the nerves or be caused by nerve injury, illness, or disease. (Scholz, 2014). Various arthritic and inflammatory conditions (31%), low back or spinal conditions (21%), injury and postoperative sequelae (13%), migraines or headaches (11%), neuropathic or neurological problems (11%), and soft tissue pain (11%) are the most commonly reported causes of chronic pain (8%) (Boulanger, Clark, Squire, Cui & Horbay, 2007). Chronic pain can have a negative impact on one's quality of life, can be linked to depression and suicide, and can limit one's capacity to work. (Choiniere, 2010). Nurses must have sufficient pain assessment and management knowledge to provide quality care for patients with pain using pharmacological or nonpharmacological therapies. Nurses play a key role in pain treatment because they monitor patients and offer care 24 hours daily. (Lewthwaite, et al., 2011; Mazilu et al, 2018). However, worldwide, nurses were found to lack expertise in pain assessment due to misunderstandings about pharmacologic therapy, notably fear of drug addiction, underdosing, and fear of opioid analgesic side effects. (Abdelrahim, 2011; Al-Shaer, 2011; Amponsah, 2019; Khalil & Mashaqbeh, 2019). The knowledge of a caregiver about the physiological repercussions of pain is crucial . Different pain treatment strategies are used, and their success requires frequent monitoring and evaluation. A person's knowledge reflects their views and thoughts, and it is mirrored in their actions and emotions. A nurse's performance about many caring issues, such as sensitivity to patients' pain and society's ideas, values, customs, and culture in general, are influenced by various circumstances. As a result, examining nurses' knowledge of and practices related to pain makes it possible to identify the factors that influence attitudes and changes. (Kamali and Mashayekhi, 2018). For instance, a cross-sectional study in Taiwan utilising the Nurses' Knowledge and Attitudes Survey-Taiwanese version revealed that 53.4% of nurses working in intensive care units needed more pain management knowledge. (Wang & Tsai, 2010). The knowledge, attitudes, and beliefs of West African-born nurses working in the U.S. were compared to those of their American-born counterparts. In both groups of nurses, there was a lack of understanding about pain management. Moreover, only four nurses (1 percent of the entire sample) scored 80% or higher on the Nurses' Knowledge and Attitudes test in Jordan, according to a study of 417 nurses. The majority of people have unfavourable attitudes and beliefs about pain, according to a survey on the subject. (Khalil & Mashaqbeh, 2019). The Department of Health and Human Services (HHS) has approved initiatives to increase pain management knowledge through research, prevention, and improved treatment options (Joint Commission statement on pain management, 2016). Each patient has the right to be pain-free. As a result, maintaining comfort and managing pain are key difficulties in nursing, and pain control has always been the responsibility of nurses. (Tilahun, Nasrabaid, Alamayehu, Teklu, Charania, 2016). This study aimed to determine the effect of implementing an educational program on the performance of Jordanian nurses in the AL-Zarqa Governmental Hospital medical and surgical general wards in pain assessment and management. Methods and Method Approval was obtained from the Research Ethics Committee of inpatient medical and surgical units in a main tertiary governmental hospital in Jordan. and from the authors of the tools used in the present research. The survey was modified based on the literature reviews (Kamali and Mashayekhi, 2018). The nurses were invited to participate in the study. Through official hospital organisational emails by their respected head nurses after providing informed consent. The total study sample (106) was estimated based on the Epi info 7 program statistical calculation using the following parameters: population size: 137 over three months, expected frequency: 50%, acceptable error: 5%, confidence coefficient: 95%. Five experts in medical-surgical nursing at the Faculty of Nursing, University of Alexandria, tested all tools for content validity to assure content validity, clarity of items, comprehensiveness, appropriate translation, and necessary modifications. The reliability of the tools was tested using Cronbach's alpha test (0.92) to measure their internal consistency and evaluate how well the tools consistently measure what they were designed to measure. A pilot study was carried out on 10% of the participants (n=11) to test the tools' clarity, feasibility, and applicability. The necessary modifications were made accordingly. Nurses included in the pilot study were excluded from the total sample. Program development Based on a literature review, an educational program to enhance nurses’ performance in pain assessment and management in medical and surgical departments, in collaboration with pain management teams and education departments, was developed (International Association for the Study of Pain, 2020; Wood, 2019; Gosselin, 2014; and Ferrell, 2014). The educational program aimed to enhance nursing skills in pain management by addressing the complex and individual-specific nature of pain. Key objectives included defining pain-related terminology, understanding the societal impact of pain, and recognising the nurse's role in assessment and management. Participants learned to use reliable assessment tools, incorporate patient preferences, and identify factors affecting pain management. The program covered pharmacological and nonpharmacological approaches, emphasised empathetic communication, and promoted patient involvement in decision-making. Nurses were trained to develop personalised treatment plans that consider the benefits and risks of therapies, focusing on continuous monitoring and adjustment based on patient outcomes. To fulfil the study aim, the actual study was carried out in four phases: assessment, planning, implementation, and evaluation phase. Phase 1: Assessment phase: The study involved individual interviews with participants, where the researcher introduced himself, explained the study's purpose, and obtained verbal informed consent. Before the educational program, participants underwent an initial assessment of their knowledge and practices regarding pain management using specific tools. The hospital administrator provided a conference room for this purpose. Additionally, the researcher obtained approval from unit directors and head nurses to observe the practices of approximately five nurses per day over 21 days for those who agreed to participate. Phase II: Planning Phase: Based on initial assessments, educational programs were developed to enhance nurses' pain assessment and management skills in medical and surgical departments, collaborating with pain management teams and education departments. The program, informed by relevant literature (International Association for the Study of Pain, 2020; Wood, 2019; Gosselin, 2014; and Ferrell, 2014), included 10 theoretical and 10 practical sessions, each lasting one hour. Sessions were conducted in two groups of 11 nurses per day, five times a week, to accommodate all 106 participants in the study. Phase III: Implementation phase: The training sessions were incorporated into mandatory 2-hour education periods for 22 nurses, divided into two groups. Held five times a week during the morning shift, each session included one hour of theoretical instruction and one hour of practical training. Theoretical sessions featured group discussions and PowerPoint presentations on pain assessment, management, types of pain, and reassessment. Practical sessions utilised demonstrations with real materials and case scenarios, focusing on developing skills in subjective and objective assessments, interventions, and reassessment. Each session lasted 60 minutes. Phase IV: Program evaluation: To evaluate the expected outcome of the program. All the study tools were used to test nurses' knowledge and performance related to pain assessment and management post-educational program immediately and one month after the end of the program. The appropriate statistical tests were used to analyse the obtained data. The Statistical Package for Social Science (SPSS) will be utilised for statistical analysis and tabulation. Comparisons between the pre-and postintervention findings were carried out using appropriate statistical analysis (t-test) to determine the difference in the mean score and to measure the impact of using an educational program on nurses' knowledge and practices related to pain assessment and management. Data processing and Statistical analysis After the data were collected, they were coded and transferred into special design formats suitable for computer feeding. Following the data entry, checking and verification processes were carried out to avoid errors during the data entry. The data were computed and statistically analysed using the Statistical Package for Social Sciences (SPSS) software version 20. Descriptive statistics: Quantitative data are presented in the range (minimum and maximum), mean, and standard deviation. The significance of the obtained results was judged at the 5% level. Analytical statistics: McNemar and Marginal Homogeneity Tests: Used to analyse the significance of differences between the different stages ; paired t test: For normally distributed quantitative variables, two periods were compared, ANOVA with repeated measures was used for normally distributed quantitative variables to compare more than two periods or stages, The Friedman test was used for nonnormally distributed quantitative variables to compare more than two periods or stages. Results Table 1 shows the frequency distribution of the studied nurses according to their characteristics. The study's demographic findings indicated that nearly half (43.4%) of the nurses were aged 25 to less than 30 years, while about one-fourth (21.7%) were 30 or older, with a mean age of 30 ± 1.23 years. Most participants (70.8%) were female, and approximately three-quarters (71.7%) held a Bachelor of Science in Nursing degree. In terms of experience, nearly one-third (33.0%) had 2-5 years of clinical experience, while only 14.2% had less than 2 years of experience in pain assessment and management. Notably, about 88.7% of participants had not attended any educational sessions on pain assessment and management in the past two years, with only around one-eighth (11.3%) having participated in such programs during that time. Table 1 Distribution of the studied nurses according to their sociodemographic characteristics (n = 106). Nurses’ sociodemographic characteristics Studied nurses’ (n=106) No % Age (in years) 20-25 Years 37 34.9 25-30 Years 46 43.4 30> Years 23 21.7 Min–Max Mean ± SD 20-50 30± 1.23 Gender Male 31 29.2 Female 75 70.8 Level of qualification Diploma of Nursing 23 21.7 Bachelor of Science in Nursing 76 71.7 Master of Science in Nursing 7 6.6 Year of Experience Less than 2 Years 15 14.2 2- 5 Years 35 33.0 5- 10 Years 25 23.6 >10 years 31 29.2 Attended any educational programs about pain assessment and management within the last 2 years No 94 88.7% Yes 12 11.3% Table (2): Illustration of the relationships between the studied nurses according to their overall mean scores for their knowledge before, after, and after one-month post-implantation of the educational program. The findings of this study showed that there was no statistically significant relationship between the overall mean score for the studied nurses' knowledge before, after, or after one-month post-implantation of the educational program regarding pain assessment and management and the participants’ sociodemographic characteristics, as P values > 0.05. Table 2: Relationships between the overall mean scores of the studied nurses' knowledge before, after, and after one-month post-implantation of the educational program Nurses' knowledge of pain assessment and management (total grade 37) Nurses' Socio-demographic characteristics Pre educational program post educational program immediately After one-month post of the post-educational program Mean ± SD Mean ± SD Mean ± SD Age (years) 20-25 Years 18.62±5.21 34.00±2.12 33.51±2.47 25-30 Years 18.35± 5.41 33.57±2.31 33.39±2.76 30> Years 18.59±5.58 33.93±2.24 33.57±2.83 F(p) 0.020(0.980) 0.301(0.741) 0.032(0.968) Gender Male 18.52±5.71 33.84±2.40 33.52±2.78 Female 18.56±5.26 33.89±2.13 33.51±2.64 t(p) 0.04(0.97) 0.12(0.91) 0.02(0.99) Level of qualification Diploma of Nursing 19.09±5.85 34.22±2.28 33.83±2.81 Bachelor of Science in Nursing 18.37±5.32 33.78±2.21 33.42±2.68 Master of Science in Nursing 18.71±4.86 33.86±2.04 33.43±2.23 F(p) 0.159(0.853) 0.351(0.705) 0.204(0.816) Year of experience Less than 2 Years 18.33±5.21 33.47±2.42 33.27±2.66 2- 5 Years 17.83±5.49 33.60±2.17 33.14±2.69 5- 10 Years 19.88±4.93 34.56±1.98 34.16±2.32 >10 years 18.39±5.70 33.84±2.27 33.52±2.92 F(p) 0.735(0.534) 1.173(0.324) 0.753(0.523) Attended any educational programs No 16.25±5.15 32.75±2.09 32.33±2.39 Yes 18.84±5.35 34.02±2.18 33.66±2.67 t(p) 1.586(0.116) 1.910(0.059) 1.635(0.105) Table (3) shows the frequency distribution of the studied nurses according to their overall knowledge before, after, and one month after the implantation of the educational program regarding pain assessment and management. It revealed that 79.3% of the nurses studied had poor knowledge before implementing the educational program, and 20.7% had fair knowledge. Immediately after the academic program, a significant improvement was observed. A drastic decline occurred; more than two-thirds of the studied nurses had poor knowledge compared to those without knowledge (0%). Additionally, those with fair knowledge remained relatively stable from one-fifth to one-sixth (15.1%), while none of the nurses had good knowledge before. This change greatly accelerates and dominates the majority (83.9%) of the studied nurses. Table (3): Frequency distribution of the studied nurses according to their overall knowledge before, after, and after one-month post-implantation of the educational program regarding pain assessment and management Nurses' knowledge of pain assessment and management Pre- educational program Post-educational program immediately After one-month post of the post-educational program No % No % No % Poor knowledge (Less than 60%) 84 79.3% 0 0 0 0 Fair knowledge (60- 85%) 22 20.7% 17 15.1% 20 18.9 % Good knowledge (More than 85%) 0 0 89 83.9% 86 81.1% Total 106 100 106 100 106 100 Table 4 shows a significant difference in the overall mean scores for all dimensions of the studied participants according to the nurses’ practices related to pain assessment and management. The overall mean pain assessment and management scores increased before, after, and one month after the implementation of the educational program (25.68 ± 3.485, 60.21± 2.377, and 59.96± 2.423, respectively). The results show statistically significant differences in the mean pain assessment and management scores immediately between the pre-and post-educational program groups and between the pre-and post-educational program groups for all the items about pain assessment and management after receiving the pain. education program (p ≤ 0.001). Nurses' practice about pain assessment and management Pre- educational program post educational program immediately After one month post educational program Test Sig. bet. periods Mean ± SD Mean ± SD Mean ± SD F p p 1 p 2 p 3 Initial Assessment 5.43 ± 0.805 9.08 ± 1.061 9.02 ± 1.087 371.75 *<.001 *<.001 *<.001 0.326 self- reported assessment of pain 2.04 ± 0.935 3.64 ± 0.733 3.65 ± 0.704 98.89 *<.001 *<.001 *<.001 1.000 investigate for potential of pain or discomfort 2.02 ± 0.743 7.63 ± 0.667 7.59 ± 0.714 1964,08 *<.001 *<.001 *<.001 0.308 Observes the patient’s behaviors 7.72 ± 1.766 19.57 ± 1.441 19.53 ± 1.468 1738.98 *<.001 *<.001 *<.001 0.308 Nonpharmacological interventions to alleviate pain 2.02 ± 1.033 8.63 ± 1.482 8.59 ± 1.459 858.90 *<.001 *<.001 *<.001 1.000 Uses pharmacological to alleviate pain 2.45 ± 0.745 3.49 ± 0.605 3.44 ± 0.618 13.789 *<.001 *<.001 *<.001 0.074 Reassessment of pain 0.78 ± 0.414 1.82 ± 0.385 1.79 ± 0.407 213 . 19 *<.001 *<.001 *<.001 0.25 0 Assess possible side effects 2.28 ± 1.271 6.34 ± 0.994 6.31 ± 1.018 369.24 *<.001 *<.001 *<.001 0.250 Overall Practice (72) 25.68 ± 3.485 60.21 ± 2.377 59.96 ± 2.423 4956.5 *<.001 *<.001 *<.001 0.081 Table 4: Distribution of the studied nurses according to their overall mean score for the observed nurses' practices before, after, and after one-month post-implantation of the educational program regarding pain assessment and management Table 5 shows the relationships between the studied nurses according to their overall mean scores for the observed nurses' practices before, after, and after one month post-implantation of the educational program regarding pain assessment and management and their sociodemographic characteristics. The findings of this study revealed that there were no statistically significant differences in the participants' practices before or after one-month post-implantation of the educational program for pain assessment and management or in their sociodemographic characteristics, as P values were > 0.05. Table 5: Relationships between the scores of the nurses according to their overall mean scores for the observed nurses' practices before, after, and one month after the educational program was implemented regarding pain assessment and management and t. Nurses' practices (total grade 72) Nurses' Socio-demographic characteristics Pre- educational program post educational program immediately After one-month post of the post-educational program Mean ± SD Mean ± SD Mean ± SD Age (years) 20-25 Years 26.14±3.32 60.89±2.99 60.35±2.34 25-30 Years 26.00±3.67 60.70±2.77 60.00±3.02 30> Years 26.13±3.51 60.85±3.04 60.09±3.28 F(p) 0. 013(0.987) 0.033(0.967) 0.107(0.899) Gender Male 26.19±3.62 60.84±3.13 59.97±3.41 Female 26.07±3.40 60.83±2.84 60.24±3.10 t(p) 0.17(0.86) 0.02(0.99) 0.40(0.69) Level of qualification Diploma of nursing 26.35±3.51 61.17±3.10 62.43±3.26 Bachelor of Science in Nursing 26.04±3.51 60.72±2.92 62.04±3.22 Master of Science in Nursing 26.00±2.94 60.86±2.41 62.57±2.70 F(p) 0.073(0.930) 0.208(0.813) 0.196(0.822) Year of experience Less than 2 Years 25.93±3.56 60.60±2.90 62.00±3.32 2- 5 Years 25.54±3.50 60.37±3.09 61.63±3.40 5- 10 Years 27.04±2.96 61.72±2.37 63.24±2.47 >10 years 26.06±3.70 60.74±3.09 61.97±3.29 F(p) 0.935(0.427) 1.111(0.348) 1.353(0.262) Attended any educational programs No 25.54±3.38 59.50±3.18 58.77±3.54 Yes 26.18±3.47 61.00±2.87 60.35±3.09 t(p) 0.629(0.530) 1.305(0.195) 1.700(0.092) Table 6 explores the distribution of observed nurses according to their satisfaction level of practice before, after, and one month after implementing the educational program for pain assessment and management. It reveals that 100% of the studied nurses had unsatisfactory levels of pre-educational program implementation. Immediately after the educational program, 86% of the studied nurses achieved a satisfactory level, and only 14% had an unsatisfactory level. In addition, the majority (83%) of the studied nurses had relatively satisfactory outcomes after one month of education, and only 17% had unsatisfactory outcomes. Table 6: Distribution of observed nurses according to their level of satisfaction with their practices in relation to before, after, and one month after the implementation of the educational program about pain assessment and management Nurses' practices observation about pain assessment and management Pre- educational program post educational program immediately After one-month post educational program No % No % No % Unsatisfactory level (Less than 85%) 106 100% 15 14% 18 17% Satisfactory level (> 85%) 0 0% 91 86% 88 83% Total 106 100 106 100 106 100 Table 7 reveals the correlation between overall knowledge and overall practices among the studied nurses. The table shows that there was a statistically significant positive correlation between nurses’ overall knowledge and overall practices (p<0.001 * ). Table 7: The correlation between overall knowledge and overall practices in the studied nurses’ pre- and post-educational program regarding pain assessment and management. Overall Practices Pre- educational program Post-educational program immediately After one-month post of the post-educational program Overall Knowledge R 0.956 ** 0.969 ** 0.954 ** P <.001 <.001 <.001 Discussion Pain is widely recognised as one of the most distressing experiences individuals encounter and is often accompanied by significant fear and anxiety. According to the International Association for the Study of Pain (Raja, 2020), pain is defined as a distressing sensory and emotional experience associated with actual or potential tissue damage. Despite advancements in pharmacological therapies, global research indicates that pain remains inadequately managed, primarily due to a lack of knowledge regarding pain management strategies (Gustafsson & Shahriary, 2015). Every patient possesses the fundamental right to be free from pain. Consequently, one of the major challenges in nursing practice is effectively managing and alleviating pain. Pain control is traditionally viewed as a core responsibility of nurses, making it one of the most critical aspects of nursing care (Brennan, 2019). To provide high-quality care for patients experiencing pain, nurses must possess a thorough understanding of pain assessment and management techniques, including both pharmacological and nonpharmacological approaches. Given their continuous patient monitoring and care responsibilities, nurses play a pivotal role in pain management (Mazilu et al., 2018). Effective educational techniques are crucial for successful learning outcomes (Shirani Bidabadi, 2016). Incorporating simulation in educational programs has enhanced learning experiences, leading to increased self-efficacy, satisfaction, and confidence among learners (Cameron ID, 2018). Simulations are particularly beneficial for improving healthcare providers' diagnostic and technical skills (Chernikova O, 2020). Thus, it is essential for nurses to be equipped with the knowledge and skills necessary for effective pain assessment and management and to foster competence and confidence in their practice (Alqahtani M, 2015). The findings from this study demonstrated the effectiveness of a well-structured educational program on nurses' pain assessment and management performance. More than half of the participating nurses displayed a good overall knowledge level regarding pain management, and a significant proportion achieved satisfactory practice levels in caring for patients experiencing pain. The majority of the participating nurses were aged between 25 and 30, with only a small percentage over 30. This demographic trend may be influenced by increased responsibilities and financial pressures contributing to higher turnover rates among older nurses (Alreshidi, 2016). Furthermore, the low recruitment levels from the government amidst a nursing shortage likely explain the prevalence of younger nurses in hospital settings. Approximately two-thirds of the participants were female, reflecting a trend noted in Jordanian nursing, where the profession is predominantly female (Saleh, 2020). This gender distribution may be attributed to socioeconomic factors that lead many male nurses to seek employment opportunities abroad (Samarkandi, 2021). Regarding educational qualifications, the majority of nurses held a Bachelor of Science in Nursing (BSN). As the nursing profession evolves and demands for qualified nurses increase globally, this trend aligns with findings from previous studies that similarly noted a predominance of B.S.N.-qualified nurses in clinical settings (Abdul-Jaleel, 2020). Most participants reported having between 2 and 5 years of experience, with fewer having less than 2 years. Hospitals typically prefer hiring experienced nurses to ensure quality patient care with minimal supervision, which may explain this finding (Nimer & Ghrayeb, 2017). The results indicated that before the educational program, nurses exhibited limited knowledge regarding pain assessment and management. However, significant improvements were observed in the mean scores for pain assessment techniques following the program (mean rank = 0.63) and in the use of pain education (mean rank = 0.92). Standardised procedures for pain evaluation and management are vital for closing knowledge gaps (Tobis, 2019). Furthermore, a notable increase in knowledge about the effective duration of opioid analgesics was documented (mean rank = 0.85), reflecting an area of previous deficiency among participants (Saifan, 2018). The study underscores that many nurses lack adequate training in sedation assessment for patients receiving opioid pain management. This finding is consistent with the literature highlighting education as a critical barrier to effective pain management (Rabba, 2021). Implementing the educational program resulted in approximately 84% of participants demonstrating good knowledge immediately following the intervention, with 81.2% retaining this knowledge one month later. This retention indicates that educational initiatives can successfully foster long-term learning in nursing practice (Michael, 2023). Postintervention assessments indicated a significant improvement in nurses' practices regarding pain assessment and management. Approximately two-thirds of the nurses achieved satisfactory practice levels immediately after the educational program and maintained this level one month later. This enhancement reflects the successful application of acquired knowledge in clinical practice, as indicated by increased mean scores for pain reassessment techniques (mean = 1.82) following the program (Mahmoud, 2020). A strong correlation was established between knowledge and practice regarding pain assessment and management (P < .001) after the educational intervention. This underscores the importance of integrating knowledge and practical skills through comprehensive educational programs, as emphasised in the literature (Rahman, 2021; Issa, 2019). Conclusion The findings of this study support these hypotheses, demonstrating that the educational program significantly enhanced nurses’ knowledge and practices regarding pain assessment and management. Continuous evaluation and competency development in pain management should be prioritised to improve patient outcomes and alleviate suffering. The successful implementation of this educational initiative has positively impacted the nursing workforce and, consequently, patient care. Declarations Author Contributions: Hussein Alomari: conceptualisation, data curation, investigation, methodology,Nabeel F. Allobaney; Methodology, Writing - original draft, Raya Yousef Al-Husban; Supervision., Rosario A. Macaaly; Formal analysis, Visualization, Esmat Swallmeh; Software, Validation; Visualization. Funding: This research received no external funding. Institutional Review Board Statement: Before the study started, ethical approval was obtained from the healthcare facility's research ethics committee. Informed Consent Statement: Informed consent was obtained from all the subjects involved in the study. Data availability statement: Not applicable. Conflicts of interest: The authors declare no conflicts of interest. References Abdul-Jaleel, M. K., & Rajha, A. (2020). Effectiveness of nursing educational program on nurses’ knowledge regarding pain management for postoperative patients. Annals of tropical medicine and public Health, 23 (05), 210–217. https://doi.org/10.36295/asro.2020.23525 Achaliwie, F., et al. (2023). 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International Association for the Study of Pain (IASP). Iasp-Pain.org, 2019, www.iasp-pain.org/ . Issa, M. R., Awajeh, A. M., Khraisat, F. S., Rasheed, A. M., Amirah, M. F., Hussain, A., Alharthy, A. (2019). Impact of an Educational Program on the Knowledge and Attitude About Pain Assessment and Management Among Critical Care Nurses. Dimens Critical Care Nurse. 2019 Sep/Oct; 38(5): 271-277. doi: 10.1097/DCC.0000000000000375. PMID: 31369448. Jacques, E. (2022). 10 Common Types of Pain Scales. Verywell Health , Verywell Health, 4 Jan. 2022, www.verywellhealth.com/pain-scales-assessment-tools-4020329. Jang, J-H., Kim, S. S., Kim, S. (2020). Educational simulation program based on Korean triage and acuity scale. Int J Environ Res Public Health . 2020; 17: 9018. https://doi.org/10.3390/ijerph17239018 . Karaman, E., Vural Doğru, B., Yıldırım, Y. (2019). Knowledge and attitudes of nursing students about pain management. Agri Agri Algoloji Derneginin Yayin Organidir J Turk Soc Algol. 2019; 31:70- 8. https://doi.org/10.5505/agri. 2018.10437 Karcioglu, O., Topacoglu, H., Dikme, O., Dikme, O. (2018). A systematic review of the pain scales in adults: Which to use? Am J Emerg Med . 2018 Apr; 36 (4): 707-714. doi: 10.1016/j.ajem.2018.01.008. Epub 2018 Jan 6. PMID: 29321111. Khalil, H., & Mashaqbeh, M. (2019). Areas of Knowledge Deficit and Misconceptions About Pain among Jordanian Nurses. Pain Management Nursing . https://doi.org/10.1016/j.pmn.2019.02.010 Knowledge and Attitudes Survey Regarding Pain developed by Betty Ferrell, RN, PhD, FAAN and Margo McCaffery, RN, MS, FAAN, (http://prc.coh.org), revised 2014. LeMone, P., Burke, K. M., Bauldoff, G. & Gubrud-Howe, P. M. (2015). Medical-surgical nursing: Clinical reasoning in patient care. Sixth edition. Boston: Pearson. Lourens, A, Hodkinson, P., & Parker, R. (2020). Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A knowledge, attitudes and practices survey. BMC Emergency Medicine, 20 , 31. López-Liria, R., Torres-Álamo, L., Vega-Ramírez, F. A., García-Luengo, A. V., Aguilar-Parra, J. M., Trigueros-Ramos, R., Rocamora-Pérez, P. Efficacy of Physiotherapy Treatment in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health . 2021 Jul 23; 18(15):7832. doi: 10.3390/ijerph18157832. PMID: 34360122; PMCID: PMC8345570. MacDonald, A., McGill, P. & Murphey, G. (2018). An evaluation of staff training in positive Behavioral support. Journal of Applied Research in Intellectual Disabilities 31 , 1– 16. Nimer, A., & Ghrayeb, F. A. (2017). Palestinian Nurses Knowledge and Attitudes Regarding Pain Management. Penrose, S. (2019). Clinical Guidelines (Nursing): Pain Assessment And Measurement. [online] Rch.org.au. Available at: [Accessed 21 April 2020]. Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., et al. (2020). The revised international association for the study of pain definition of pain: concepts, challenges, and compromises. Pain. 161: 1976–82. https://doi.org/10.1097/j.pain.0000000000001939. Registered Nurses’ Association of Ontario, (2013). Assessment and Management Of Pain. 3 rd ed. Ontario: RNAO. Samarkandi, O. A. The factors affecting nurses’ assessment toward pain management in Saudi Arabia. Saudi Anaesth 2021 Apr-Jun; 15(2): 165-173: doi 10.4103/sja.sja_2_21. Epub 2021 Apr1. PMID:34188636; PMCID:PMC8191256. Splete, H. (2020). The Emotional Impact of Chronic Low Back Pain. Pract Pain Manag, 20 (2). Wissman, K. M., Cassidy, E., D'Amico, F., Hoy, C., Vissari, T., Baumgartner, M. (2020). Improving Pain Reassessment and Documentation Rates: A Quality Improvement Project in a Teaching Hospital's Emergency Department. J Emerge Nurse. Jul; 46(4): 505-510. doi: 10.1016/j.jen.2019.12.008. Epub 2020 Feb 27. PMID: 32115235. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5231832","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":369154336,"identity":"c9ac9c02-7992-4ee6-8de2-139223a64cce","order_by":0,"name":"Hussein Alomari","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzUlEQVRIiWNgGAWjYBACAwbmBhDNwy8BotiI0sII0SI5g1QtDAY3iNVizn6w8dGNmnsyxrebn274UcYg299AQItlT2Kzcc6xYh6zO8fMbvacYzCecYCQww4ktknnsCXwmN1IMLvB28aQ2EBQy/mHQC3/EniMZ6R/u/kXqGU+QS03gLbktiXwGEjkmN0G2bKBsJaHzca5fQk8Ejdyym7LnJMw3kjYYckHH+d8S7Dnn5G+7eabMhvZeYS0oAMJaDSRAsjQMgpGwSgYBcMdAADAtUbGMUo4lgAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0009-0001-8621-9286","institution":"Hamad medical Corporation","correspondingAuthor":true,"prefix":"","firstName":"Hussein","middleName":"","lastName":"Alomari","suffix":""},{"id":369154337,"identity":"77431a18-baff-4a37-a24c-4ca4b38065bb","order_by":1,"name":"Nabeel F. Allobaney","email":"","orcid":"","institution":"Hamad medical Corporation","correspondingAuthor":false,"prefix":"","firstName":"Nabeel","middleName":"F.","lastName":"Allobaney","suffix":""},{"id":369154338,"identity":"8bf0ef10-e644-4069-939b-4f45084705bf","order_by":2,"name":"Raya Yousef AL-HUSBAN","email":"","orcid":"","institution":"Faculty of Nursing, Zarqa University","correspondingAuthor":false,"prefix":"","firstName":"Raya","middleName":"Yousef","lastName":"AL-HUSBAN","suffix":""},{"id":369154339,"identity":"3d0d9e5f-fcee-41d9-b8f3-033395cfee60","order_by":3,"name":"Rosario A. 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Despite pharmacological breakthroughs in pain therapy, research\u0026nbsp;from\u0026nbsp;throughout\u0026nbsp;the\u0026nbsp;world\u0026nbsp;has demonstrated\u0026nbsp;that\u0026nbsp;pain\u0026nbsp;is\u0026nbsp;still\u0026nbsp;undermanaged\u0026nbsp;owing\u0026nbsp;to\u0026nbsp;a lack of information about pain and how to control it. (Gustafsson \u0026amp;Shahriary\u0026nbsp;2015).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAcute\u0026nbsp;and\u0026nbsp;chronic\u0026nbsp;pain\u0026nbsp;have\u0026nbsp;different\u0026nbsp;mechanisms\u0026nbsp;and\u0026nbsp;durations.\u0026nbsp;Acute\u0026nbsp;pain\u0026nbsp;is\u0026nbsp;a\u0026nbsp;physiological\u0026nbsp;response\u0026nbsp;to\u0026nbsp;tissue\u0026nbsp;damage.\u0026nbsp;(Pergolizzi,\u0026nbsp;Raffa\u0026nbsp;\u0026amp;\u0026nbsp;Taylor,\u0026nbsp;2014).\u0026nbsp;Poorly handled acute postoperative pain may reduce participation in\u0026nbsp;rehabilitation\u0026nbsp;treatments\u0026nbsp;such as\u0026nbsp;physiotherapy\u0026nbsp;and\u0026nbsp;deep\u0026nbsp;breathing.\u0026nbsp;(Francis\u0026nbsp;\u0026amp;\u0026nbsp;Fitzpatrick, 2013). It can progress to chronic pain; however, the transition from\u0026nbsp;acute to chronic pain is poorly understood. (Voscopoulos \u0026amp; Lema, 2010). The\u0026nbsp;presence of pain before surgery, the nature of the surgery, nerve injury,\u0026nbsp;adjuvant radiation treatment, anxiety, and depression are all factors that increase the\u0026nbsp;chance\u0026nbsp;of\u0026nbsp;chronic\u0026nbsp;postsurgical\u0026nbsp;pain.\u0026nbsp;(VanDenKerkhof,\u0026nbsp;Peters\u0026nbsp;\u0026amp;\u0026nbsp;Bruce,\u0026nbsp;2013).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eChronic pain was defined as pain that lasted longer than the \u0026apos;normal\u0026apos; healing\u0026nbsp;timetable or discomfort that lasted more than three months. (Cohen, Quinter \u0026amp; Buchanan, 2013). Chronic pain can begin in the nerves or be caused by nerve\u0026nbsp;injury, illness, or disease. (Scholz, 2014). Various arthritic and inflammatory\u0026nbsp;conditions\u0026nbsp;(31%),\u0026nbsp;low\u0026nbsp;back\u0026nbsp;or\u0026nbsp;spinal\u0026nbsp;conditions\u0026nbsp;(21%),\u0026nbsp;injury\u0026nbsp;and\u0026nbsp;postoperative\u0026nbsp;sequelae (13%), migraines or headaches (11%), neuropathic or neurological\u0026nbsp;problems (11%), and soft tissue pain (11%) are the most commonly reported\u0026nbsp;causes of chronic pain (8%) (Boulanger, Clark, Squire, Cui \u0026amp; Horbay, 2007).\u0026nbsp;Chronic pain can have a negative impact on one\u0026apos;s quality of life, can be linked to\u0026nbsp;depression\u0026nbsp;and\u0026nbsp;suicide,\u0026nbsp;and\u0026nbsp;can\u0026nbsp;limit one\u0026apos;s\u0026nbsp;capacity\u0026nbsp;to\u0026nbsp;work.\u0026nbsp;(Choiniere,\u0026nbsp;2010). Nurses must have sufficient pain assessment and management knowledge\u0026nbsp;to\u0026nbsp;provide quality care for patients with pain using pharmacological or nonpharmacological therapies.\u0026nbsp;Nurses play a key role in pain treatment because they monitor patients and offer care 24 hours daily. (Lewthwaite, et al., 2011; Mazilu et al,\u0026nbsp;2018).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHowever, worldwide, nurses were found to lack expertise in\u0026nbsp;pain\u0026nbsp;assessment due to\u0026nbsp;misunderstandings\u0026nbsp;about\u0026nbsp;pharmacologic therapy, notably fear of drug addiction, underdosing, and fear of opioid\u0026nbsp;analgesic side effects. (Abdelrahim, 2011; Al-Shaer, 2011; Amponsah, 2019;\u0026nbsp;Khalil \u0026amp;\u0026nbsp;Mashaqbeh,\u0026nbsp;2019). The\u0026nbsp;knowledge\u0026nbsp;of\u0026nbsp;a\u0026nbsp;caregiver\u0026nbsp;about\u0026nbsp;the\u0026nbsp;physiological\u0026nbsp;repercussions\u0026nbsp;of\u0026nbsp;pain\u0026nbsp;is\u0026nbsp;crucial\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eDifferent pain treatment strategies are used, and their success requires frequent monitoring and evaluation. A person\u0026apos;s knowledge reflects their views and thoughts, and it is\u0026nbsp;mirrored\u0026nbsp;in\u0026nbsp;their\u0026nbsp;actions\u0026nbsp;and\u0026nbsp;emotions.\u0026nbsp;A\u0026nbsp;nurse\u0026apos;s\u0026nbsp;performance\u0026nbsp;about\u0026nbsp;many\u0026nbsp;caring issues, such as sensitivity to patients\u0026apos; pain and society\u0026apos;s ideas, values,\u0026nbsp;customs, and culture in general, are influenced by various circumstances. As\u0026nbsp;a result, examining nurses\u0026apos; knowledge of and practices related to pain makes it\u0026nbsp;possible\u0026nbsp;to\u0026nbsp;identify\u0026nbsp;the\u0026nbsp;factors\u0026nbsp;that\u0026nbsp;influence\u0026nbsp;attitudes and changes.\u0026nbsp;(Kamali\u0026nbsp;and\u0026nbsp;Mashayekhi,\u0026nbsp;2018).\u003c/p\u003e\n\u003cp\u003eFor\u0026nbsp;instance,\u0026nbsp;a\u0026nbsp;cross-sectional\u0026nbsp;study\u0026nbsp;in\u0026nbsp;Taiwan\u0026nbsp;utilising\u0026nbsp;the\u0026nbsp;Nurses\u0026apos;\u0026nbsp;Knowledge and Attitudes Survey-Taiwanese version revealed that 53.4% of\u0026nbsp;nurses\u0026nbsp;working\u0026nbsp;in\u0026nbsp;intensive\u0026nbsp;care\u0026nbsp;units\u0026nbsp;needed\u0026nbsp;more\u0026nbsp;pain\u0026nbsp;management\u0026nbsp;knowledge. (Wang \u0026amp; Tsai, 2010). The knowledge, attitudes, and beliefs of West\u0026nbsp;African-born\u0026nbsp;nurses\u0026nbsp;working\u0026nbsp;in\u0026nbsp;the\u0026nbsp;U.S.\u0026nbsp;were\u0026nbsp;compared\u0026nbsp;to\u0026nbsp;those\u0026nbsp;of\u0026nbsp;their\u0026nbsp;American-born counterparts.\u0026nbsp;In\u0026nbsp;both groups of\u0026nbsp;nurses,\u0026nbsp;there was\u0026nbsp;a\u0026nbsp;lack of\u0026nbsp;understanding about pain management. Moreover, only four nurses (1 percent of the entire sample) scored 80% or\u0026nbsp;higher on the Nurses\u0026apos; Knowledge and Attitudes test in Jordan, according to a\u0026nbsp;study of 417 nurses. The majority of people have unfavourable attitudes and\u0026nbsp;beliefs about pain, according to a survey on the subject. (Khalil \u0026amp; Mashaqbeh,\u0026nbsp;2019).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Department\u0026nbsp;of\u0026nbsp;Health\u0026nbsp;and\u0026nbsp;Human\u0026nbsp;Services\u0026nbsp;(HHS)\u0026nbsp;has\u0026nbsp;approved\u0026nbsp;initiatives\u0026nbsp;to\u0026nbsp;increase pain management knowledge through research, prevention, and improved\u0026nbsp;treatment\u0026nbsp;options\u0026nbsp;(Joint Commission statement on pain management, 2016). Each patient has the right to be pain-free.\u0026nbsp;As\u0026nbsp;a\u0026nbsp;result,\u0026nbsp;maintaining\u0026nbsp;comfort\u0026nbsp;and\u0026nbsp;managing pain are key difficulties in nursing, and pain control has always been\u0026nbsp;the\u0026nbsp;responsibility\u0026nbsp;of\u0026nbsp;nurses.\u0026nbsp;(Tilahun,\u0026nbsp;Nasrabaid,\u0026nbsp;Alamayehu,\u0026nbsp;Teklu,\u0026nbsp;Charania,\u0026nbsp;2016).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study aimed to determine the effect of implementing an educational program on the performance of Jordanian nurses in the AL-Zarqa Governmental Hospital medical and surgical general wards in pain assessment and management.\u003c/p\u003e"},{"header":"Methods and Method","content":"\u003cp\u003eApproval was obtained from the Research Ethics Committee of inpatient medical and surgical units in a main tertiary governmental hospital in Jordan. and from the authors of the tools used in the present research. The survey was modified based on the literature reviews (Kamali and Mashayekhi, 2018). The nurses were invited to participate in the study. Through official hospital organisational emails by their respected head nurses after providing informed consent. The total study sample (106) was estimated based on the Epi info 7 program statistical calculation using the following parameters: population size: 137 over three months, expected frequency: 50%, acceptable error: 5%, confidence coefficient: 95%.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFive experts in medical-surgical nursing at the Faculty of Nursing, University of Alexandria, tested all tools for content validity to assure content validity, clarity of items, comprehensiveness, appropriate translation, and necessary modifications. The reliability of the tools was tested using Cronbach\u0026apos;s alpha test (0.92) to measure their internal consistency and evaluate how well the tools consistently measure what they were designed to measure.\u0026nbsp;A pilot study was carried out on 10% of the participants (n=11) to test the tools\u0026apos; clarity, feasibility, and applicability. The necessary modifications were made accordingly. Nurses included in the pilot study were excluded from the total sample.\u003c/p\u003e\n\u003cp\u003e\u003cs\u003e\u0026nbsp;\u003c/s\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProgram development\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBased on a literature review, an educational program to enhance nurses\u0026rsquo; performance in pain assessment and management in medical and surgical departments, in collaboration with pain management teams and education departments, was developed\u0026nbsp;(International Association for the Study of Pain, 2020; Wood, 2019; Gosselin, 2014; and Ferrell, 2014).\u003c/p\u003e\n\u003cp\u003eThe educational program aimed to enhance nursing skills in pain management by addressing the complex and individual-specific nature of pain. Key objectives included defining pain-related terminology, understanding the societal impact of pain, and recognising the nurse\u0026apos;s role in assessment and management. Participants learned to use reliable assessment tools, incorporate patient preferences, and identify factors affecting pain management. The program covered pharmacological and nonpharmacological approaches, emphasised empathetic communication, and promoted patient involvement in decision-making. Nurses were trained to develop personalised treatment plans that consider the benefits and risks of therapies, focusing on continuous monitoring and adjustment based on patient outcomes.\u003c/p\u003e\n\u003cp\u003eTo fulfil the study aim, the actual study was carried out in four phases: assessment, planning, implementation, and evaluation phase.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePhase 1: Assessment phase:\u0026nbsp;\u003c/strong\u003eThe study involved individual interviews with participants, where the researcher introduced himself, explained the study\u0026apos;s purpose, and obtained verbal informed consent. Before the educational program, participants underwent an initial assessment of their knowledge and practices regarding pain management using specific tools. The hospital administrator provided a conference room for this purpose. Additionally, the researcher obtained approval from unit directors and head nurses to observe the practices of approximately five nurses per day over 21 days for those who agreed to participate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePhase II: Planning Phase:\u0026nbsp;\u003c/strong\u003eBased on initial assessments, educational programs were developed to enhance nurses\u0026apos; pain assessment and management skills in medical and surgical departments, collaborating with pain management teams and education departments. The program, informed by relevant literature (International Association for the Study of Pain, 2020; Wood, 2019; Gosselin, 2014; and Ferrell, 2014), included 10 theoretical and 10 practical sessions, each lasting one hour. Sessions were conducted in two groups of 11 nurses per day, five times a week, to accommodate all 106 participants in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePhase III: Implementation phase:\u0026nbsp;\u003c/strong\u003eThe training sessions were incorporated into mandatory 2-hour education periods for 22 nurses, divided into two groups. Held five times a week during the morning shift, each session included one hour of theoretical instruction and one hour of practical training. Theoretical sessions featured group discussions and PowerPoint presentations on pain assessment, management, types of pain, and reassessment. Practical sessions utilised demonstrations with real materials and case scenarios, focusing on developing skills in subjective and objective assessments, interventions, and reassessment. Each session lasted 60 minutes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePhase IV: Program evaluation:\u0026nbsp;\u003c/strong\u003eTo evaluate the expected outcome of the program. All the study tools were used to test nurses\u0026apos; knowledge and performance related to pain assessment and management post-educational program immediately and one month after the end of the program. The appropriate statistical tests were used to analyse the obtained data. The Statistical Package for Social Science (SPSS) will be utilised for statistical analysis and tabulation. Comparisons between the pre-and postintervention findings were carried out using appropriate statistical analysis (t-test) to determine the difference in the mean score and to measure the impact of using an educational program on nurses\u0026apos; knowledge and practices related to pain assessment and management.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData processing and Statistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter the data were collected, they were coded and transferred into special design formats suitable for computer feeding. Following the data entry, checking and verification processes were carried out to avoid errors during the data entry. The data were computed and statistically analysed using the Statistical Package for Social Sciences (SPSS) software version 20.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDescriptive statistics:\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eQuantitative data are presented in the range (minimum and maximum), mean, and standard deviation. The significance of the obtained results was judged at the 5% level.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAnalytical statistics:\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eMcNemar and Marginal Homogeneity Tests: Used to analyse the significance of differences between the different stages\u003cstrong\u003e;\u0026nbsp;\u003c/strong\u003epaired t test: For normally distributed quantitative variables, two periods were compared, ANOVA with repeated measures was used for normally distributed quantitative variables to compare more than two periods or stages, The Friedman test was used for nonnormally distributed quantitative variables to compare more than two periods or stages.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable 1 shows the frequency distribution of the studied nurses according to their characteristics.\u0026nbsp;The study\u0026apos;s demographic findings indicated that nearly half (43.4%) of the nurses were aged 25 to less than 30 years, while about one-fourth (21.7%) were 30 or older, with a mean age of 30 \u0026plusmn; 1.23 years. Most participants (70.8%)\u0026nbsp;were female, and approximately three-quarters (71.7%) held a Bachelor of Science in Nursing degree. In terms of experience, nearly one-third (33.0%) had 2-5 years of clinical experience, while only 14.2% had less than 2 years of experience in pain assessment and management. Notably, about 88.7% of participants had not attended any educational sessions on pain assessment and management in the past two years, with only around one-eighth (11.3%) having participated in such programs during that time.\u003cstrong\u003e\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable\u0026nbsp;1\u0026nbsp;Distribution of the studied nurses according to their sociodemographic characteristics (n = 106).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"528\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNurses\u0026rsquo; sociodemographic characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudied nurses\u0026rsquo;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=106)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 528px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (in years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e20-25 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e34.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e25-30 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e43.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e30\u0026gt; Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e21.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin\u0026ndash;Max\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e20-50\u003c/p\u003e\n \u003cp\u003e30\u0026plusmn; 1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 528px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e29.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e70.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 528px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of qualification\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003eDiploma of Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e21.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003eBachelor of Science in Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e71.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003eMaster of Science in Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 528px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear of Experience\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003eLess than 2 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e14.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e2- 5 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e35\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e33.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e5- 10 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e25\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e23.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e\u0026gt;10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e29.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 528px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttended any educational programs about pain assessment and management within the last 2 years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e88.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e11.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable cellpadding=\"0\" cellspacing=\"0\" align=\"left\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd height=\"7\" style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable (2): Illustration of the relationships between the studied nurses according to their overall mean scores for their knowledge before, after, and after one-month post-implantation of the educational program.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe findings of this study showed that there was no statistically significant relationship between the overall mean score for the studied nurses\u0026apos; knowledge before, after, or after one-month post-implantation of the educational program regarding pain assessment and management and the participants\u0026rsquo; sociodemographic characteristics, as P values \u0026gt; 0.05.\u003c/p\u003e\n\u003cp\u003eTable 2: \u0026nbsp;Relationships between the overall mean scores of the studied nurses\u0026apos; knowledge before, after, and after one-month post-implantation of the educational program\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"598\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 399px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNurses\u0026apos; knowledge of pain assessment and management (total grade 37)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNurses\u0026apos; Socio-demographic\u003c/strong\u003e \u003cstrong\u003echaracteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;educational program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003epost educational program immediately\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter one-month post of the post-educational program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e20-25 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e18.62\u0026plusmn;5.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e34.00\u0026plusmn;2.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.51\u0026plusmn;2.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e25-30 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e18.35\u0026plusmn; 5.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e33.57\u0026plusmn;2.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.39\u0026plusmn;2.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e30\u0026gt; Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e18.59\u0026plusmn;5.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e33.93\u0026plusmn;2.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.57\u0026plusmn;2.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF(p)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.020(0.980)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.301(0.741)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.032(0.968)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e18.52\u0026plusmn;5.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e33.84\u0026plusmn;2.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.52\u0026plusmn;2.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e18.56\u0026plusmn;5.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e33.89\u0026plusmn;2.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.51\u0026plusmn;2.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et(p)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.04(0.97)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.12(0.91)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.02(0.99)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of qualification\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003eDiploma of Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e19.09\u0026plusmn;5.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e34.22\u0026plusmn;2.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.83\u0026plusmn;2.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003eBachelor of Science in Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e18.37\u0026plusmn;5.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e33.78\u0026plusmn;2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.42\u0026plusmn;2.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003eMaster of Science in Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e18.71\u0026plusmn;4.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e33.86\u0026plusmn;2.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.43\u0026plusmn;2.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF(p)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.159(0.853)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.351(0.705)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.204(0.816)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear of experience\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003eLess than 2 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e18.33\u0026plusmn;5.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e33.47\u0026plusmn;2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.27\u0026plusmn;2.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e2- 5 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e17.83\u0026plusmn;5.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e33.60\u0026plusmn;2.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.14\u0026plusmn;2.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e5- 10 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e19.88\u0026plusmn;4.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e34.56\u0026plusmn;1.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e34.16\u0026plusmn;2.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026gt;10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e18.39\u0026plusmn;5.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e33.84\u0026plusmn;2.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.52\u0026plusmn;2.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF(p)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.735(0.534)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.173(0.324)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.753(0.523)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttended any educational programs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e16.25\u0026plusmn;5.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e32.75\u0026plusmn;2.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e32.33\u0026plusmn;2.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e18.84\u0026plusmn;5.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e34.02\u0026plusmn;2.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e33.66\u0026plusmn;2.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et(p)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.586(0.116)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.910(0.059)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.635(0.105)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable (3) shows the frequency distribution of the studied nurses according to their overall knowledge before, after, and one month after the implantation of the educational program regarding pain assessment and management.\u0026nbsp;It revealed\u0026nbsp;that\u0026nbsp;79.3% of the nurses studied had poor knowledge before implementing the educational program, and 20.7% had fair knowledge. Immediately after the academic program, a significant improvement was observed. A drastic decline occurred; more than two-thirds of the studied nurses had poor knowledge compared to those without knowledge (0%). Additionally, those with fair knowledge remained relatively stable from one-fifth to one-sixth (15.1%), while none of the nurses had good knowledge before. This change greatly accelerates and dominates the majority (83.9%) of the studied nurses.\u003c/p\u003e\n\u003cp\u003eTable (3): Frequency distribution of the studied nurses according to their overall knowledge before, after, and after one-month post-implantation of the educational program regarding pain assessment and management\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"616\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNurses\u0026apos; knowledge of pain assessment and management\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre- educational program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 133px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-educational program immediately\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter one-month post of the post-educational program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003ePoor knowledge (Less than 60%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e79.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003eFair knowledge (60- 85%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e20.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e15.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e20\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e18.9\u003cspan dir=\"RTL\"\u003e%\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003eGood knowledge (More than 85%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e83.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e86\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e81.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cs\u003e\u0026nbsp;\u003c/s\u003e\u003c/p\u003e\n\u003cp\u003eTable 4 shows a significant difference in the overall mean scores for all dimensions of the studied participants according to the nurses\u0026rsquo; practices related to pain assessment and management.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe overall mean pain assessment and management scores increased before, after, and one month after the implementation of the educational program (25.68 \u0026plusmn; 3.485, 60.21\u0026plusmn; 2.377, and 59.96\u0026plusmn; 2.423, respectively). The results show statistically significant differences in the mean pain assessment and management scores immediately between the pre-and post-educational program groups and between the pre-and post-educational program groups for all the items about pain assessment and management after receiving the pain.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eeducation program (p \u0026le; 0.001).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"608\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNurses\u0026apos; practice about pain assessment and management\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre- educational program\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003epost educational program immediately\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter one month post educational program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSig. bet. periods\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003csub\u003e1\u003c/sub\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003csub\u003e2\u003c/sub\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003csub\u003e3\u003c/sub\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eInitial Assessment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e5.43 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.805\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e9.08 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e1.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e9.02 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e1.087\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e371.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e0.326\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eself- reported assessment of pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e2.04 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.935\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e3.64 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.733\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e3.65 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.704\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e98.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003einvestigate for potential of pain or discomfort\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e2.02 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.743\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e7.63 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.667\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e7.59 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.714\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e1964,08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e0.308\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eObserves the patient\u0026rsquo;s behaviors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e7.72 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e1.766\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e19.57 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e1.441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e19.53\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e1.468\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e1738.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e0.308\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eNonpharmacological interventions to alleviate pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e2.02 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e1.033\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e8.63 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e1.482\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e8.59 \u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e1.459\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e858.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eUses pharmacological to alleviate pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e2.45\u0026nbsp;\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e 0.745\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e3.49\u0026nbsp;\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.605\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e3.44\u0026nbsp;\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.618\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e13.789\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e0.074\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eReassessment of pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e0.78\u0026nbsp;\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e 0.414\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e1.82\u0026nbsp;\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.385\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e1.79\u0026nbsp;\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.407\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e213\u003c/span\u003e.\u003cspan dir=\"RTL\"\u003e19\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e0.25\u003cspan dir=\"RTL\"\u003e0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eAssess possible side effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e2.28\u0026nbsp;\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e 1.271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e6.34\u0026nbsp;\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e0.994\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e6.31\u0026nbsp;\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e1.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e369.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e0.250\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall Practice (72)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e25.68\u0026nbsp;\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e3.485\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e60.21\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e2.377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e59.96\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e2.423\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e4956.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e*\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 4: \u0026nbsp;Distribution of the studied nurses according to their overall mean score for the observed nurses\u0026apos; practices before, after, and after one-month post-implantation of the educational program regarding pain assessment and management\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 5 shows the relationships between the studied nurses according to their overall mean scores for the observed nurses\u0026apos; practices before, after, and after one month post-implantation of the educational program regarding pain assessment and management and their sociodemographic characteristics. The findings of this study revealed that there were no statistically significant differences in the participants\u0026apos; practices before or after one-month post-implantation of the educational program for pain assessment and management or in their sociodemographic characteristics, as P values were \u0026gt; 0.05.\u003c/p\u003e\n\u003cp\u003eTable 5: Relationships between the scores of the nurses according to their overall mean scores for the observed nurses\u0026apos; practices before, after, and one month after the educational program was implemented regarding pain assessment and management and t.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"635\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 70.2362%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNurses\u0026apos; practices (total grade 72)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNurses\u0026apos; Socio-demographic characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre- educational program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u003cstrong\u003epost educational program immediately\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter one-month post of the post-educational program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e20-25 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e26.14\u0026plusmn;3.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e60.89\u0026plusmn;2.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e60.35\u0026plusmn;2.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e25-30 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e26.00\u0026plusmn;3.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e60.70\u0026plusmn;2.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e60.00\u0026plusmn;3.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e30\u0026gt; Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e26.13\u0026plusmn;3.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e60.85\u0026plusmn;3.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e60.09\u0026plusmn;3.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF(p)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.\u003c/strong\u003e\u003cstrong\u003e013(0.987)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.033(0.967)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.107(0.899)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e26.19\u0026plusmn;3.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e60.84\u0026plusmn;3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e59.97\u0026plusmn;3.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e26.07\u0026plusmn;3.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e60.83\u0026plusmn;2.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e60.24\u0026plusmn;3.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003et(p)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.17(0.86)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.02(0.99)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.40(0.69)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of qualification\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003eDiploma of nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e26.35\u0026plusmn;3.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e61.17\u0026plusmn;3.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e62.43\u0026plusmn;3.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003eBachelor of Science in Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e26.04\u0026plusmn;3.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e60.72\u0026plusmn;2.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e62.04\u0026plusmn;3.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003eMaster of Science in Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e26.00\u0026plusmn;2.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e60.86\u0026plusmn;2.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e62.57\u0026plusmn;2.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF(p)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.073(0.930)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.208(0.813)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.196(0.822)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear of experience\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003eLess than 2 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e25.93\u0026plusmn;3.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e60.60\u0026plusmn;2.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e62.00\u0026plusmn;3.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e2- 5 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e25.54\u0026plusmn;3.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e60.37\u0026plusmn;3.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e61.63\u0026plusmn;3.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e5- 10 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e27.04\u0026plusmn;2.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e61.72\u0026plusmn;2.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e63.24\u0026plusmn;2.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u0026gt;10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e26.06\u0026plusmn;3.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e60.74\u0026plusmn;3.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e61.97\u0026plusmn;3.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF(p)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.935(0.427)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.111(0.348)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.353(0.262)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttended any educational programs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e25.54\u0026plusmn;3.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e59.50\u0026plusmn;3.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e58.77\u0026plusmn;3.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29.7638%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e26.18\u0026plusmn;3.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e61.00\u0026plusmn;2.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e60.35\u0026plusmn;3.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29.7638%;\"\u003e\n \u003cp\u003e\u003cstrong\u003et(p)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.7874%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.629(0.530)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.4567%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.305(0.195)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9921%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;1.700(0.092)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 6 explores the distribution of observed nurses according to their satisfaction level of practice before, after, and one month after implementing the educational program for pain assessment and management. It reveals that 100% of the studied nurses had unsatisfactory levels of pre-educational program implementation. Immediately after the educational program, 86% of the studied nurses achieved a satisfactory level, and only 14% had an unsatisfactory level. In addition, the majority (83%) of the studied nurses had relatively satisfactory outcomes after one month of education, and only 17% had unsatisfactory outcomes.\u003c/p\u003e\n\u003cp\u003eTable 6: Distribution of observed nurses according to their level of satisfaction with their practices in relation to before, after, and one month after the implementation of the educational program about pain assessment and management\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"606\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 193px;\"\u003e\n \u003cp\u003eNurses\u0026apos;\u0026nbsp;practices\u0026nbsp;observation\u0026nbsp;about\u0026nbsp;pain\u0026nbsp;assessment\u0026nbsp;and\u0026nbsp;management\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 148px;\"\u003e\n \u003cp\u003ePre- educational program\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 127px;\"\u003e\n \u003cp\u003epost educational program immediately\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 138px;\"\u003e\n \u003cp\u003eAfter one-month post educational program\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 193px;\"\u003e\n \u003cp\u003eUnsatisfactory level (Less than 85%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e14%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 193px;\"\u003e\n \u003cp\u003eSatisfactory level (\u0026gt; 85%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e86%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e83%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 193px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 7 reveals the correlation between overall knowledge and overall practices among the studied nurses. The table shows that there was a statistically significant positive correlation between nurses\u0026rsquo; overall knowledge and overall practices (p\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e).\u003c/p\u003e\n\u003cp\u003eTable 7: The correlation between overall knowledge and overall practices in the studied nurses\u0026rsquo; pre- and post-educational program regarding pain assessment and management.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 366px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ePractices\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre- educational program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-educational program immediately\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter one-month post of the post-educational program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e0.956\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e0.969\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.954\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003ePain is widely recognised as one of the most distressing experiences individuals encounter and is often accompanied by significant fear and anxiety. According to the International Association for the Study of Pain (Raja, 2020), pain is defined as a distressing sensory and emotional experience associated with actual or potential tissue damage. Despite advancements in pharmacological therapies, global research indicates that pain remains inadequately managed, primarily due to a lack of knowledge regarding pain management strategies (Gustafsson \u0026amp; Shahriary, 2015). Every patient possesses the fundamental right to be free from pain.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsequently, one of the major challenges in nursing practice is effectively managing and alleviating pain. Pain control is traditionally viewed as a core responsibility of nurses, making it one of the most critical aspects of nursing care (Brennan, 2019). To provide high-quality care for patients experiencing pain, nurses must possess a thorough understanding of pain assessment and management techniques, including both pharmacological and nonpharmacological approaches. Given their continuous patient monitoring and care responsibilities, nurses play a pivotal role in pain management (Mazilu et al., 2018).\u003c/p\u003e\n\u003cp\u003eEffective educational techniques are crucial for successful learning outcomes (Shirani Bidabadi, 2016). Incorporating simulation in educational programs has enhanced learning experiences, leading to increased self-efficacy, satisfaction, and confidence among learners (Cameron ID, 2018). Simulations are particularly beneficial for improving healthcare providers\u0026apos; diagnostic and technical skills (Chernikova O, 2020). Thus, it is essential for nurses to be equipped with the knowledge and skills necessary for effective pain assessment and management and to foster competence and confidence in their practice (Alqahtani M, 2015).\u003c/p\u003e\n\u003cp\u003eThe findings from this study demonstrated the effectiveness of a well-structured educational program on nurses\u0026apos; pain assessment and management performance. More than half of the participating nurses displayed a good overall knowledge level regarding pain management, and a significant proportion achieved satisfactory practice levels in caring for patients experiencing pain.\u003c/p\u003e\n\u003cp\u003eThe majority of the participating nurses were aged between 25 and 30, with only a small percentage over 30. This demographic trend may be influenced by increased responsibilities and financial pressures contributing to higher turnover rates among older nurses (Alreshidi, 2016). Furthermore, the low recruitment levels from the government amidst a nursing shortage likely explain the prevalence of younger nurses in hospital settings.\u003c/p\u003e\n\u003cp\u003eApproximately two-thirds of the participants were female, reflecting a trend noted in Jordanian nursing, where the profession is predominantly female (Saleh, 2020). This gender distribution may be attributed to socioeconomic factors that lead many male nurses to seek employment opportunities abroad (Samarkandi, 2021). Regarding educational qualifications, the majority of nurses held a Bachelor of Science in Nursing (BSN). As the nursing profession evolves and demands for qualified nurses increase globally, this trend aligns with findings from previous studies that similarly noted a predominance of B.S.N.-qualified nurses in clinical settings (Abdul-Jaleel, 2020).\u003c/p\u003e\n\u003cp\u003eMost participants reported having between 2 and 5 years of experience, with fewer having less than 2 years. Hospitals typically prefer hiring experienced nurses to ensure quality patient care with minimal supervision, which may explain this finding (Nimer \u0026amp; Ghrayeb, 2017). The results indicated that before the educational program, nurses exhibited limited knowledge regarding pain assessment and management. However, significant improvements were observed in the mean scores for pain assessment techniques following the program (mean rank = 0.63) and in the use of pain education (mean rank = 0.92). Standardised procedures for pain evaluation and management are vital for closing knowledge gaps (Tobis, 2019).\u003c/p\u003e\n\u003cp\u003eFurthermore, a notable increase in knowledge about the effective duration of opioid analgesics was documented (mean rank = 0.85), reflecting an area of previous deficiency among participants (Saifan, 2018). The study underscores that many nurses lack adequate training in sedation assessment for patients receiving opioid pain management. This finding is consistent with the literature highlighting education as a critical barrier to effective pain management (Rabba, 2021). Implementing the educational program resulted in approximately 84% of participants demonstrating good knowledge immediately following the intervention, with 81.2% retaining this knowledge one month later. This retention indicates that educational initiatives can successfully foster long-term learning in nursing practice (Michael, 2023).\u003c/p\u003e\n\u003cp\u003ePostintervention assessments indicated a significant improvement in nurses\u0026apos; practices regarding pain assessment and management. Approximately two-thirds of the nurses achieved satisfactory practice levels immediately after the educational program and maintained this level one month later. This enhancement reflects the successful application of acquired knowledge in clinical practice, as indicated by increased mean scores for pain reassessment techniques (mean = 1.82) following the program (Mahmoud, 2020).\u003c/p\u003e\n\u003cp\u003eA strong correlation was established between knowledge and practice regarding pain assessment and management (P \u0026lt; .001) after the educational intervention. This underscores the importance of integrating knowledge and practical skills through comprehensive educational programs, as emphasised in the literature (Rahman, 2021; Issa, 2019).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings of this study support these hypotheses, demonstrating that the educational program significantly enhanced nurses\u0026rsquo; knowledge and practices regarding pain assessment and management. Continuous evaluation and competency development in pain management should be prioritised to improve patient outcomes and alleviate suffering. The successful implementation of this educational initiative has positively impacted the nursing workforce and, consequently, patient care.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHussein Alomari: conceptualisation, data curation, investigation, methodology,Nabeel F. Allobaney; Methodology, Writing - original draft, Raya Yousef Al-Husban; Supervision., Rosario A. Macaaly; Formal analysis, Visualization, Esmat Swallmeh; Software, Validation; Visualization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This research received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutional Review Board Statement:\u003c/strong\u003e Before the study started, ethical approval was obtained from the healthcare facility\u0026apos;s research ethics committee.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement:\u003c/strong\u003e Informed consent was obtained from all the subjects involved in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement:\u003c/strong\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest:\u003c/strong\u003e The authors declare no conflicts of interest.\u003c/p\u003e"},{"header":"References","content":"\u003cp\u003eAbdul-Jaleel, M. K., \u0026amp; Rajha, A. (2020). Effectiveness of nursing educational program on nurses\u0026rsquo; knowledge regarding pain management for postoperative patients. \u003cem\u003eAnnals of tropical medicine and public Health,\u0026nbsp;23\u003c/em\u003e(05), 210\u0026ndash;217.\u0026nbsp;\u003ca href=\"https://doi.org/10.36295/asro.2020.23525\"\u003ehttps://doi.org/10.36295/asro.2020.23525\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eAchaliwie, F., et al. (2023). Does Education Improve Nurses\u0026rsquo; Knowledge, Attitudes, Skills, and Practice in Relation to Pain Management? An Integrative Review. \u003cem\u003ePain Management Nursing\u003c/em\u003e, Jan., https://doi.org/10.1016/j.pmn.2022.12.002. Accessed 9 Jan. 2023.\u003c/p\u003e\n\u003cp\u003eAlReshidi, N. M., (2016). The impact of an interactive educational program on children\u0026rsquo;s nurses\u0026rsquo; knowledge, attitudes, beliefs and perceptions of children\u0026rsquo;s pain, self-efficacy, and perceptions of barriers to optimal postoperative pain management in children (Doctoral dissertation, University of Salford).\u003c/p\u003e\n\u003cp\u003eCohen, M. J. M., Jangro, W. C., \u0026amp; Neff, D. (2018). \u003cem\u003ePathophysiology of Pain\u003c/em\u003e.\u003ca href=\"http://Www.semanticscholar.org\"\u003eWww.semanticscholar.org\u003c/a\u003e.https://www.semanticscholar.org/paper/Pathophysiology-of-Pain-Cohen Jangro/c0 ccf29d91996e5fe6cbf2d6845ce39b1d83e7ff.\u003c/p\u003e\n\u003cp\u003eD\u0026rsquo;emeh, W. M., Yacoub, M. I., Darawad, M. W., Al-Badawi, T. H., \u0026amp; Shahwan, B. (2016). Pain-related knowledge and barriers among Jordanian nurses: a national study. \u003cem\u003eHealth, 8\u003c/em\u003e(06), 548.\u003c/p\u003e\n\u003cp\u003eFookes, C. (2019). Pain Management 101: Types Of Pain And Treatment Options. [online] Drugs.com. Available at: [Accessed 21 April 2020].\u003c/p\u003e\n\u003cp\u003eGuy GP J. R., Zhang, K. (2018). Opioids prescribed by specialty and volume in the U.S. Am J Prev Med. 2018; 55(5):e153\u0026ndash;e155. doi:10.1016/j. amepre.2018.06.008.\u003c/p\u003e\n\u003cp\u003eHassiotis, A.,\u0026nbsp;Poppe, M.,\u0026nbsp;Stydom, A.,\u0026nbsp;Vickerstaff, V.,\u0026nbsp;Hall, I. S.,\u0026nbsp;Crabtree, J.\u0026nbsp;et al. (2018).\u0026nbsp;Clinical outcomes of staff training in positive behavior support to reduce challenging behavior in adults with intellectual disability: cluster randomized controlled trial. \u003cem\u003eThe British Journal of Psychiatry\u003c/em\u003e 212, 161\u0026ndash; 168.\u003c/p\u003e\n\u003cp\u003eHugar, L. A., Wulff-Burchfield, E.M., Winzelberg, G. S., Jacobs, B. L., Davies, B. J. (2021). Incorporating palliative care principles to improve patient care and quality of life in urologic oncology. Nat Rev Urol. 2021 Oct; 18(10): 623-635. doi: 10.1038/s41585-021-00491-z. Epub 2021 Jul 26. PMID: 34312530; PMCID: PMC8312356.\u003c/p\u003e\n\u003cp\u003eInternational Association for the Study of Pain. International Association for the Study of Pain (IASP). Iasp-Pain.org, 2019,\u0026nbsp;\u003ca href=\"http://www.iasp-pain.org/\"\u003ewww.iasp-pain.org/\u003c/a\u003e.\u003c/p\u003e\n\u003cp\u003eIssa, M. R., Awajeh, A. M., Khraisat, F. S., Rasheed, A. M., Amirah, M. F., Hussain, A., Alharthy, A. (2019). Impact of an Educational Program on the Knowledge and Attitude About Pain Assessment and Management Among Critical Care Nurses. Dimens Critical Care Nurse. 2019 Sep/Oct; 38(5): 271-277. doi: 10.1097/DCC.0000000000000375. PMID: 31369448.\u003c/p\u003e\n\u003cp\u003eJacques, E. (2022). 10 Common Types of Pain Scales. \u003cem\u003eVerywell Health\u003c/em\u003e, Verywell Health, 4 Jan. 2022, www.verywellhealth.com/pain-scales-assessment-tools-4020329.\u003c/p\u003e\n\u003cp\u003eJang, J-H., Kim, S. S., Kim, S. (2020). Educational simulation program based on Korean triage and acuity scale. \u003cem\u003eInt J Environ Res Public Health\u003c/em\u003e. 2020; 17: 9018.\u0026nbsp;\u003ca href=\"https://doi.org/10.3390/ijerph17239018\"\u003ehttps://doi.org/10.3390/ijerph17239018\u003c/a\u003e.\u003c/p\u003e\n\u003cp\u003eKaraman, E., Vural Doğru, B., Yıldırım, Y. (2019). Knowledge and attitudes of nursing students about pain management. Agri Agri Algoloji Derneginin Yayin Organidir J Turk Soc Algol. 2019; 31:70- 8.\u0026nbsp;\u003ca href=\"https://doi.org/10.5505/agri.%202018.10437\"\u003ehttps://doi.org/10.5505/agri. 2018.10437\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eKarcioglu, O., Topacoglu, H., Dikme, O., Dikme, O. (2018). A systematic review of the pain scales in adults: Which to use? \u003cem\u003eAm J Emerg Med\u003c/em\u003e. 2018 Apr; \u003cem\u003e36\u003c/em\u003e(4): 707-714. doi: 10.1016/j.ajem.2018.01.008. Epub 2018 Jan 6. PMID: 29321111.\u003c/p\u003e\n\u003cp\u003eKhalil, H., \u0026amp; Mashaqbeh, M. (2019). Areas of Knowledge Deficit and Misconceptions About Pain among Jordanian Nurses. \u003cem\u003ePain Management Nursing\u003c/em\u003e.\u0026nbsp;\u003ca href=\"https://doi.org/10.1016/j.pmn.2019.02.010\"\u003ehttps://doi.org/10.1016/j.pmn.2019.02.010\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eKnowledge and Attitudes Survey Regarding Pain developed by Betty Ferrell, RN, PhD, FAAN and Margo McCaffery, RN, MS, FAAN, (http://prc.coh.org), revised 2014.\u003c/p\u003e\n\u003cp\u003eLeMone, P., Burke, K. M., Bauldoff, G. \u0026amp; Gubrud-Howe, P. M. (2015). Medical-surgical nursing: Clinical reasoning in patient care. Sixth edition. Boston: Pearson.\u003c/p\u003e\n\u003cp\u003eLourens, A, Hodkinson, P., \u0026amp; Parker, R. (2020). Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A knowledge, attitudes and practices survey. \u003cem\u003eBMC Emergency Medicine, 20\u003c/em\u003e, 31.\u003c/p\u003e\n\u003cp\u003eL\u0026oacute;pez-Liria, R., Torres-\u0026Aacute;lamo, L., Vega-Ram\u0026iacute;rez, F. A., Garc\u0026iacute;a-Luengo, A. V., Aguilar-Parra, J. M., Trigueros-Ramos, R., Rocamora-P\u0026eacute;rez, P. Efficacy of Physiotherapy Treatment in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis.\u003cem\u003e\u0026nbsp;Int J Environ Res Public Health\u003c/em\u003e. 2021 Jul 23; 18(15):7832. doi: 10.3390/ijerph18157832. PMID: 34360122; PMCID: PMC8345570.\u003c/p\u003e\n\u003cp\u003eMacDonald, A., McGill, P. \u0026amp; Murphey, G. (2018). An evaluation of staff training in positive Behavioral support. \u003cem\u003eJournal of Applied Research in Intellectual Disabilities\u003c/em\u003e \u003cem\u003e31\u003c/em\u003e,\u0026nbsp;1\u0026ndash;\u0026nbsp;16.\u003c/p\u003e\n\u003cp\u003eNimer, A., \u0026amp; Ghrayeb, F. A. (2017). Palestinian Nurses Knowledge and Attitudes Regarding Pain Management.\u003c/p\u003e\n\u003cp\u003ePenrose, S. (2019). Clinical Guidelines (Nursing): Pain Assessment And Measurement. [online] Rch.org.au. Available at: [Accessed 21 April 2020].\u003c/p\u003e\n\u003cp\u003eRaja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., et al. (2020). The revised international association for the study of pain definition of pain: concepts, challenges, and compromises. Pain. 161: 1976\u0026ndash;82. https://doi.org/10.1097/j.pain.0000000000001939.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRegistered Nurses\u0026rsquo; Association of Ontario, (2013). Assessment and Management Of Pain. 3\u003csup\u003erd\u003c/sup\u003e ed. Ontario: RNAO.\u003c/p\u003e\n\u003cp\u003eSamarkandi, O. A. The factors affecting nurses\u0026rsquo; assessment toward pain management in Saudi Arabia. Saudi Anaesth 2021 Apr-Jun; 15(2): 165-173: doi 10.4103/sja.sja_2_21. Epub 2021 Apr1. PMID:34188636; PMCID:PMC8191256.\u003c/p\u003e\n\u003cp\u003eSplete, H. (2020). The Emotional Impact of Chronic Low Back Pain. \u003cem\u003ePract Pain Manag, 20\u003c/em\u003e(2).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWissman, K. M., Cassidy, E., D\u0026apos;Amico, F., Hoy, C., Vissari, T., Baumgartner, M. (2020). Improving Pain Reassessment and Documentation Rates: A Quality Improvement Project in a Teaching Hospital\u0026apos;s Emergency Department. \u003cem\u003eJ Emerge Nurse.\u003c/em\u003e Jul; 46(4): 505-510. doi: 10.1016/j.jen.2019.12.008. Epub 2020 Feb 27. PMID: 32115235.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Pain Management Program (PMP), Nursing Performance, Pain Assessment and Management","lastPublishedDoi":"10.21203/rs.3.rs-5231832/v4","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5231832/v4","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e Pain is universally acknowledged as one of the most distressing experiences individuals encounter, often leading to significant psychological and physical implications. Effective pain management is essential in healthcare, and it is imperative that nursing professionals possess the requisite knowledge and skills to assess and manage pain effectively. This study aimed to evaluate the impact of a structured educational program on nurses' performance levels in pain assessment and management.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003eA quasi-experimental, one-group pre- and post-test intervention design was used to facilitate this investigation. The research was conducted in the inpatient medical and surgical units in a main tertiary governmental hospital in Jordan. A total of 106 male and female nurses who provided direct nursing care in medical and surgical wards voluntarily participated in the study. Two instruments were utilised for data collection. A questionnaire was designed to assess nurses' knowledge regarding pain assessment and management, and an observational checklist was used to evaluate the practical application of pain management techniques by nurses.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults \u003c/strong\u003eThe study focused on a sample predominantly comprising female nurses, most of whom held a Bachelor of Science in Nursing degree and had 2–5 years of clinical experience. Notably, 88.7% of participants had not previously attended educational sessions centred on pain assessment and management. Following an educational intervention, statistical analysis revealed a significant improvement in the mean knowledge scores (P\u0026lt;0.001). Furthermore, all dimensions of nursing practices related to pain management showed statistically substantial enhancement after the training, demonstrating a strong correlation between knowledge and practice levels before and after the educational program.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion \u003c/strong\u003eThe educational program's implementation resulted in more thanhalf of the participating nurses achieving a commendable level of knowledge and satisfactory practices in pain assessment and management. This underscores the program's effectiveness in enhancing both theoretical knowledge and practical skills. It is recommended that nursing professionals engage in ongoing training and educational opportunities focused on pain assessment and management to further refine their competencies and improve patient outcomes.\u003c/p\u003e","manuscriptTitle":"Effect of an Educational Program on Nurses’ Level of Knowledge about Pain Assessment and Management: A Quasi-Experimental Study","msid":"","msnumber":"","nonDraftVersions":[{"code":4,"date":"2024-11-11 22:00:08","doi":"10.21203/rs.3.rs-5231832/v4","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":3,"date":"2024-10-22 15:33:16","doi":"10.21203/rs.3.rs-5231832/v3","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":2,"date":"2024-10-15 17:40:01","doi":"10.21203/rs.3.rs-5231832/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2024-10-14 09:04:33","doi":"10.21203/rs.3.rs-5231832/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fbecd772-db6b-4d4c-8721-01a4f273b516","owner":[],"postedDate":"November 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":39282700,"name":"Nursing"}],"tags":[],"updatedAt":"2024-10-14T09:04:33+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-11 22:00:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v4","identity":"rs-5231832","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5231832","identity":"rs-5231832","version":["v4"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}