• Marc-Karim Bendiane, Anne Galinier, Yolande Obadia, Roger Favre, Claude Ribiere, Jean-Paul Moatti, Patrick Peretti-Watel, and Comité de pilotage Soins palliatifs Paca 2005-2006.
• Observatoire régional de la santé Provence Alpes Côte d'Azur (ORS Paca), Marseille. bendiane@marseille.inserm.fr
• Presse Med. 2007 Sep 1; 36 (9 Pt 1): 1196-202.

BackgroundNurses play a crucial role in end-of-life care, especially for outpatients. It is important to assess their knowledge and attitudes regarding pain management during the end-of-life period.MethodsA random national sample of 602 French nurses providing home care responded to a telephone survey. The questionnaire included a scale of knowledge about pain and a short clinical case related to severe pain management, requiring WHO level 3 analgesia, for a dying patient.ResultsThe pain knowledge score depended on nurses' training and was higher for those living with another health professional. For the clinical case, only 60% of nurses favored the prescription of the analgesia recommended by international guidelines. This support depended on objective skills in pain management, but was less frequent for elderly or women patients.DiscussionAttitudes toward pain management at the end of life do not depend only on book learning. They are also influenced by more subjective factors that may cause inequality in care for women and the elderly. Nurse training programs should take such factors into account.

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