Determinants of critical care nurses' pain management behaviour

Aust Crit Care. 2000 Nov;13(4):144-51. doi: 10.1016/s1036-7314(00)70642-4.


Research findings over the last 20 years show that critical care nurses (CCNs) continue to underestimate and under medicate their patients' pain, despite an allegedly strong commitment to pain relief. This literature review investigates the determinants of CCNs' pain assessment and management behaviours. Fishbein and Ajzen's theory of reasoned action' and Ajzen's theory of planned behaviour have been used as models to facilitate understanding of this phenomenon. Fishbein and Ajzen highlight attitudes, beliefs, subjective norms and the motivation to comply to the anticipated expectations of significant others as the determinants of intention to perform behaviour. Attitudinal barriers, knowledge deficits and the influence of peers affect CCNs' pain management behaviours, resulting in inadequate pain assessment and management practices. CCNs' attitudes about narcotic analgesia and how this interacts with gender, age and culture are also explored. Through an analysis of the behavioural determinants following the models described by Fishbein and Ajzen, strategies can be formulated to address CCN deficiencies, improve patient outcomes and satisfaction with nursing care and CCN fulfilment. Cervantes was quoted as saying "It's a long way from saying to doing". This report aims to improve on this idea.

Publication types

  • Review

MeSH terms

  • Analgesia / methods
  • Analgesia / nursing
  • Analgesics / therapeutic use
  • Attitude of Health Personnel
  • Clinical Competence
  • Critical Care / organization & administration*
  • Critical Care / psychology
  • Decision Making
  • Education, Nursing, Continuing
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Needs and Demand
  • Humans
  • Internal-External Control
  • Interprofessional Relations
  • Male
  • Models, Nursing
  • Models, Psychological
  • Motivation
  • Nursing Evaluation Research
  • Nursing Methodology Research
  • Nursing Staff, Hospital* / education
  • Nursing Staff, Hospital* / organization & administration
  • Nursing Staff, Hospital* / psychology
  • Organizational Objectives
  • Pain / diagnosis
  • Pain Management*
  • Pain Measurement / methods
  • Pain Measurement / nursing
  • Pain Measurement / psychology
  • Total Quality Management


  • Analgesics