Comparison of knowledge on chronic pain amongst health care clinicians working in Malta : a nationwide survey

Abstract

• Objectives – Chronic pain is a prevalent condition affecting 20% of the Maltese population. Studies abroad reported a lack of the clinicians’ knowledge of chronic pain management. Locally, studies were limited to the nurses working within specialised settings. This study aimed to determine and compare the level of knowledge on chronic pain and its management amongst doctors, physiotherapists, and nurses in Malta. • Methods – An online cross-sectional survey was distributed through professional organizations to doctors, nurses, and physiotherapists working in Malta, Europe. The data collection period spanned from September 2020 to November 2020. • Results – A total of 287 participants completed the survey. These represented 3.1% of medical doctors, 1.8% of nurses and 28.1% of physiotherapists. Participants frequently encounter persons with chronic pain (64.1%) in their clinical practice. The questionnaire’s median score was 13.0/21 (IQR 12.0 to 15.0). There was a statistically significant difference (p<0.001) in the overall scores of the three professions. Both physiotherapists and doctors achieved the highest median score of 14.0 (physiotherapists IQR 13.0 to 15.0, doctors IQR 12.0 to 15.0), while nurses achieved the lowest score (12.0, IQR 11.0 to 14.0). Overall, there was a homogeneity of knowledge gaps across the participants. These spanned traits of the biomedical model, the risk of addiction to prescribed opioid analgesics and the relationship between pain, behaviour, and disability. Knowledge gaps in managing chronic pain concerned the benefit of transcutaneous electrical nerve stimulation (TENS), pharmacological treatments, and the misbelief to avoid pain-inducing activities. • Conclusion – The study identified domains meriting attention by healthcare management as these portray critical educational needs for the three professions. This is the first study to evaluate the level of knowledge on pain and its management across various professions in Malta. The research used a previously validated biopsychosocial tool, which identified a homogenous low level of knowledge among the participants. This study adds to the body of literature within the Maltese context that identifies important knowledge gaps for managing persons with chronic pain.