Preventive Care in Nursing and Midwifery
مجله مراقبت های پیشگیرانه در پرستاری و مامایی
Prev Care Nurs Midwifery
Medical Sciences
http://nmcjournal.zums.ac.ir
1
admin
2588-4441
2588-445X
10.66224/pcnm
14
8888
13
en
jalali
1405
7
1
gregorian
2026
10
1
16
4
online
1
fulltext
en
Indirect Associations of Knowledge and Attitudes With Pain Management Practice Through Self-Efficacy Among ICU Nurses: A Cross-Sectional Study Using Two Single-Mediator Models
Nursing
Orginal research
<div style="text-align: justify;"><span style="line-height:2;"><span style="font-family:Times New Roman;"><span style="font-size:14px;"><span style="background:white"><span style="color:#2980b9;"><strong>Background:</strong></span><span style="color:#0f1115"> Pain management in intensive care units (ICUs) depends on nurses' knowledge, attitudes, and confidence. Whether self-efficacy accounts for part of their association with practice remains unclear.</span></span><br>
<span style="background:white"><span style="color:#2980b9;"><strong>Objectives:</strong> </span><span style="color:#0f1115">This study examined how ICU nurses' knowledge and attitudes relate to pain management practice through self-efficacy, using two single-mediator models (PROCESS Model 4), each adjusted for the other predictor.</span></span><br>
<span style="background:white"><span style="color:#2980b9;"><strong>Methods:</strong> </span><span style="color:#0f1115">This cross-sectional study included 525 ICU nurses from seven hospitals affiliated with Tehran University of Medical Sciences </span>between April 2025 and August 2026<span style="color:#0f1115">, recruited by census. Data were collected with the McMillan knowledge and attitude questionnaires, the Persian Pain Management Self-Efficacy Questionnaire, and a 14-item practice checklist completed through observation, record review, and nurse interviews. Mediation was tested with PROCESS Model 4 in two separate single-mediator models, one for knowledge and one for attitude, adjusting for age, gender, work experience, education, and hospital.</span></span><br>
<span style="background:white"><span style="color:#2980b9;"><strong>Results:</strong></span><span style="color:#0f1115"> Mean (SD) scores were 18.3 (4.7) for knowledge, 56.8 (9.1) for attitude, 52.7 (12.4) for self-efficacy, and 8.4 (2.3) for practice. Indirect effects through self-efficacy were B = 0.096 (95% CI: 0.061–0.138) for knowledge and B = 0.038 (95% CI: 0.014–0.072) for attitude. Direct effects remained significant (knowledge: B = 0.222, p < 0.001; attitude: B = 0.089, p = 0.027). The full outcome model, including covariates, explained 42.1% of the variance in practice (R² = 0.421).</span></span><br>
<span style="background:white"><span style="color:#2980b9;"><strong>Conclusion:</strong> </span><span style="color:#0f1115">Self-efficacy showed significant indirect associations between knowledge and attitudes and pain management practice. Given the cross-sectional design, these findings indicate associations, not causal pathways; longitudinal and interventional studies are needed.</span></span></span></span></span><br>
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Self-Efficacy, Pain Management, Intensive Care Units, Nurses, Knowledge, Attitude.
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http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-103-6&slc_lang=en&sid=1
Yasaman
Shafie Motlagh Kashani
y_motlagh@yahoo.com