The 2 factsheet groups demonstrated more knowledge ( P < 0.05 ) about effective pain management ( mean without pretest : 5.6 [ SD = 2.0 ] ; with pretest : 6.9 [ 1.6 ] ) compared with the 2 control groups ( without pretest : 3.2 [ 2.2 ] ; with pretest : 3.4 [ 2.5 ] ) immediately after review ; and the factsheet and pretest group scored higher than the factsheet only group .