Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Mary Jo Clark, PhD, RN, Chairperson; Jane M. Georges, PhD, RN; Donna L. Agan, EdD


assessment skills, attitudes, Cancer pain, cultural competence, knowledge, nursing, Oncology nurses, Pain management


Effective pain management requires appropriate knowledge, attitudes, and assessment skills. The purposes of this study were to obtain information about the knowledge and attitudes of oncology nurses related to cancer pain and its management, to evaluate oncology nurses' cultural competence, and to investigate relationships between oncology nurses' cultural competence and their pain management knowledge and attitudes. Ferrell and McCaffery's (2008) Nurses' Knowledge and Attitude Survey Regarding Pain (NKASRP), the Cultural Competence Assessment Survey (CCA) (Doorenbos, Schim, Benkert, & Borse, 2005; Schim, Doorenbos, Miller, & Benkert, 2003), and a demographic questionnaire were used to measure oncology registered nurses' cultural competence and their pain management knowledge and attitudes. E-mail invitations to participate in the study were sent to 4,000 randomly selected members of the Oncology Nursing Society. A total of 320 nurses provided at least partially complete responses, for a response rate of 8%. Two hundred twenty-five nurses completed all portions of the survey, including demographic information. Only 21% (n = 47) believed they were very effective in managing cancer pain. The results suggest deficiencies in the knowledge and attitudes of the nurses regarding cancer pain and pain management. More than 50% of the nurses identified inadequate pain medication orders and lack knowledge by healthcare providers, patients, and their families as the most prevalent barriers to effective pain management. While 85% of the participants reported that had they participated in prior cultural diversity training, only 63% (n = 150) felt competent working with people from different cultures. There was a positive correlation between scores on the NKAS and the CAS subscale scores indicating that nurses who were more culturally aware and sensitive had more positive attitudes toward and adequate knowledge of cancer pain management. The results of this study suggest that oncology nurses' knowledge and attitudes toward cancer pain management may be linked to some of the key components of cultural competence; thus oncology nurses should be aware of the cultural differences in reports of cancer pain and the effects of culture on their pain management behaviors. Major knowledge deficits and flawed beliefs still exist among oncology nurses, impeding cancer pain management. Findings from this study could be employed by the ONS to design nursing courses on cancer pain management and cultural competence to augment the OCN and the AOCN curricula. The findings can also serve as a foundation for developing an ONS Cancer Pain CNS program.

Document Type

Dissertation: Open Access



Included in

Nursing Commons