Nursing Students' Pain Management Knowledge and Attitudes: A Systematic Review and Meta-Analysis

Pain Manag Nurs. 2026 Feb 10:S1524-9042(26)00007-X. doi: 10.1016/j.pmn.2026.01.007. Online ahead of print.

ABSTRACT

OBJECTIVES: To systematically evaluate nursing students' knowledge and attitudes toward pain management and provide evidence to guide educational and clinical improvements.

DESIGN: A systematic review and meta-analysis.

DATA SOURCES: Ten databases (PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, Scopus, Chinese Biomedical Database, China National Knowledge Infrastructure, and Wanfang) were searched through February 2025.

REVIEW/ANALYSIS METHODS: Two reviewers independently screened studies, extracted data, and assessed quality using the Agency for Healthcare Research and Quality checklist. Data were synthesized using R (version 4.3.2) with random-effects models. Subgroup and meta-regression analyses explored heterogeneity, and sensitivity analyses evaluated robustness. Publication bias was examined using Egger's test.

RESULTS: Twenty-six cross-sectional studies from nine countries, encompassing 5,270 nursing students, met the inclusion criteria. The pooled correct response rate for the Knowledge and Attitudes Survey Regarding Pain was 45% (95% CI: 42%-49%). Among the six Knowledge and Attitudes Survey Regarding Pain subscales, the highest pooled scores were observed for spiritual/cultural (65%; 95% CI: 58%-73%) and pathophysiology (52%; 95% CI: 41%-63%), whereas the lowest scores pertained to intervention (26%; 95% CI: 22%-30%) and addiction-related knowledge (37%; 95% CI: 27%-47%). Subgroup and meta-regression analyses identified the country and continent as significant moderators.

CONCLUSIONS: This study identified significant gaps in nursing students' knowledge and attitudes about pain management, particularly regarding intervention strategies. The findings underscore the urgent need for structured, evidence-based pain education frameworks and cross-cultural curricular reforms to standardize and enhance global pain care practices.

PMID:41672794 | DOI:10.1016/j.pmn.2026.01.007