Evaluating the Knowledge, Attitude, and Practice of Healthcare Workers on Opioid Analgesics Usage: Case of Nanyuki Teaching and Referral Hospital, Laikipia County

Abstract

Effective pain management using opioid analgesics remains critical for quality healthcare, yet concerns about misuse, underutilization, and regulatory barriers persist globally and in Kenya. This study evaluated healthcare workers' knowledge, attitudes, practices, and challenges regarding opioid analgesic usage at Nanyuki Teaching and Referral Hospital, Laikipia County. Four specific objectives guided the research: (1) to assess healthcare workers' level of knowledge about opioid analgesics, (2) to determine their attitudes toward prescribing and administering opioids, (3) to analyse their clinical practices in opioid pain management, and (4) to establish the challenges they face in accessing opioid analgesics. Grounded in the Health Belief Model and Social Learning Theory, the study employed a descriptive cross-sectional design targeting medical officers, clinical officers, nurses, and pharmacists. Using stratified proportional sampling, 86 healthcare professionals were selected from a target population of 452. Data collection utilized structured questionnaires with closed-ended and open-ended items. Quantitative data were analysed using descriptive statistics and Pearson correlation, while qualitative responses underwent thematic content analysis. Findings revealed foundational knowledge of opioid indications and addiction risks, yet significant gaps existed in safe dosing and storage practices. Overconfidence in self-rated knowledge negatively correlated with guideline consultation frequency, indicating potential patient safety risks. While 86.1% acknowledged opioid efficacy, 41.9% expressed addiction fears and 47.7% supported opioid use only as last resort patterns explained by Health Belief Model constructs of perceived severity and susceptibility. Clinical practices showed strong protocol adherence but frequent neglect of patient-centered care elements like pain reassessment and side-effect education, reflecting social learning influences within clinical teams. Major challenges included frequent opioid stock-outs, absence of Naloxone, inadequate training, and regulatory fears. The study recommends mandatory practical training programs, institutionalizing guideline consultation, addressing fear-based attitudes through education, ensuring consistent drug availability, and conducting further research on cultural and social influences. These interventions could significantly improve pain management outcomes at Nanyuki Teaching and Referral Hospital and similar healthcare settings.