الفهرس 
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Abstract
Pain is an underappreciated problem among the critically ill. An AMI defines as the death of a portion of the heart muscle due to prolonged ischemia. The most common symptom of AMI is sudden onset of severe retrosternal chest pain. It is described as a heavy, squeezing, tightness, crushing, stabbing or burning pain.
Using nursing models and assessment tools to assess pain help to optimize the quality of care and improve the outcome for patients. If nurses assess the patients’ pain correctly, the pain can be treated more effectively and the patients will report less pain and suffering. Nursing management of pain consists of both pharmacological and non-pharmacological methods.
Aim of the study:
The study was aimed to:
1- Assess the nurses’ performance regarding pain management of patients with acute myocardial infarction.
2- Identify the factors affecting the nurses’ performance regarding pain management of patients with acute myocardial infarction.
Research questions:
This study was based on answering the following questions:
1- What is the nurses’ level of performance regarding pain management of patients with acute myocardial infarction?
2- What are the factors affecting the nurses’ performance regarding pain management of patients with acute myocardial infarction?
Subjects and Methods
• Research Design:
In the present study a descriptive study design was used to achieve aim of this study.
• Setting:
This study was carried in the CCU in Beni Swef University Hospital, Beni Swef Insurance Hospital and Beni Swef General Hospital.
• Subjects:
All nurses working at CCU and caring for patients with AMI in the previously mentioned settings (55 nurses) were agreed to participate in this study.
• Tools of data collected
Two tools were constructed and tested by the investigator to collect data pertinent to this study, these tools are:-
I): Self-administered questionnaire sheet:
It compromised Arabic structured items related to different aspects of assessment knowledge about pain management associated with AMI. It consisted of the following:
Part I: demographic data.
Part II: was concerned with assessment of the following:
• Knowledge related to anatomy of the heart and coronary arteries.
• Knowledge related to AMI.
• Knowledge related to pain management of patient with AMI.
Part III: It was used to assess the nurses’ attitude regarding pain management of patients with AMI.
Part IV: It was used to assess the factors affecting nurses’ performance regarding pain management of patients with AMI.
II. Nurses’ practice observational checklists
It comprised 5 parts covering the following:-
• Nursing assessment of pain associated with AMI.
• Pharmacological intervention for pain associated with AMI.
• Non pharmacological intervention for pain associated with AMI.
• Documentation regarding pain associated with AMI.
• Reporting regarding pain associated with AMI.
Results
The finding demonstrate that (74.5%) of nurses their age ranged between (20<30) with a mean age of 26.07± 5.03 years and were females. (58.2%) of them were married, (45.5%) were holding diploma of nursing degree. Moreover (45.5%) of nurses their years of experience in CCU ranged between (1<5) years with a mean of 3.52± 3.24 and (69.1%) were not having training courses about nurses role in pain management.
Concerning total level of knowledge (25%) of the studied nurses were having satisfactory level of total knowledge and (75%) of them were having unsatisfactory level of total knowledge. While all of them had got unsatisfactory level of practice and negative attitude. Many factors affecting negatively on their performance; job satisfaction related factors, work organization related factors and professional support related factors (96.4%, 87.3% &78.2%) respectively, while communication related factors affecting positively on their performance (93.9%).
There was no statistically significant relation between total level of the nurses’ knowledge and demographic characteristics except work settings and qualifications. In addition to there was no statistically significant relation between total level of the nurses’ practice, attitude and demographic characteristics. Moreover there was statistically significant correlation between total level of the nurses’ knowledge, practice, attitude and factors affecting on their performance.
Conclusion
Based on the findings of the current study, it can be included that three quarter of the nurses were having unsatisfactory level of knowledge regarding pain management of patients with AMI, while all of them had got unsatisfactory level of practice and negative attitude. Many factors affecting negatively on their performance namely job satisfaction related factors, work organization related factors and professional support related factors
Recommendation
Based on results of the present study the following recommendations can be suggested:
1- Continuous evaluation of nurses’ knowledge, practice and attitude is essential to identify their needs in CCU about pain assessment and management associated with AMI.
2- Availability of standardized nursing care protocol to guide nurses in dealing with pain associated with AMI specially in CCU
3- Further research is recommended to evaluate the effect of training program on nurse’s performance regarding management of pain associated with AMI.