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Mekonen WM, Muhye AB, Gobeza MB. Nurses' knowledge and practice about neonatal pain management in public hospitals in West Oromia, Ethiopia, 2022: multi-centered cross-sectional study. BMC Nurs 2024; 23:292. [PMID: 38724983 PMCID: PMC11080202 DOI: 10.1186/s12912-024-01972-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND In low-and middle-income countries inadequate neonatal pain management persists as a significant public health issue despite the availability of guidelines. Newborns often experience pain from routine medical and surgical procedures, with limited nurses' knowledge and suboptimal practices posing common obstacles to effective neonatal pain management in hospital settings. Hence, this study aimed to evaluate nurses' knowledge and practices related to neonatal pain management and the factors influencing them in public hospitals in West Oromia, Ethiopia, in 2022. METHODS A multicenter cross-sectional study was conducted among 203 nurses working in public hospitals in West Oromia from 8th May-6th June 2022. Data was gathered using structured, self-administered questionnaire and sampled through simple random sampling. The collected data were coded and entered into a computer using Epi-Data version 4.6 Statistical Software. They were analyzed using the Statistical Package for Social Science (SPSS; IBM Corporation) version 26. Binary logistic regression was used to identify significant independent variables at p < 0.05. FINDINGS In this study, 127 (62.6%) exhibited adequate knowledge, while 33 (16.3%) nurses demonstrated good practice in neonatal pain management. Attending lectures or receiving training about neonatal pain management was found to be significantly associated with nurses' knowledge of neonatal pain management [AOR, 2.31, 95%CI; 1.29-4.27]. On the other, having adequate knowledge of neonatal pain management [AOR, 3.3, 95%CI; 1.14-9.32]; the presence of a pain management policy in place [AOR, 5.44, 95% CI; 1.92-15.37] and attending lectures on neonatal pain management [AOR, 2.55, 95% CI; 1.09-5.97] were found to be significantly associated to nurses' practices. CONCLUSION Given the substandard level of nurses' practice in neonatal pain management. It is suggested to enhance the nurses' knowledge and practice about neonatal pain management by providing refreshment courses, training sessions, or facilitating nurses' opportunity access to reading resources about neonatal pain management.
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Affiliation(s)
- Wandimu Muche Mekonen
- Department of Pediatrics & Neonatal Nursing, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Addis Bilal Muhye
- Department of Pediatrics & Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistu Berhanu Gobeza
- Department of Pediatrics & Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Rede FM, Goshu EM, muzien SJ. Severity and associated factors of postoperative pain in paediatric surgical patients aged 2 months-7 years at selected Addis Ababa Public Hospitals: a multicenter prospective longitudinal study. Ann Med Surg (Lond) 2024; 86:1275-1282. [PMID: 38463099 PMCID: PMC10923381 DOI: 10.1097/ms9.0000000000001742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
Background Postoperative pain is a common and distressing consequence of surgery in children. It can lead to suffering, prolonged recovery, impaired physical functioning, and even chronic pain. Effective postoperative pain management is crucial for improving patient outcomes. However, several factors hinder the accurate assessment and management of pain in children, particularly in low-income countries. This study aims to evaluate the severity of postoperative pain in paediatric patients and identify its predictors. Materials and methods A longitudinal study was conducted on 235 paediatric surgical patients aged 2 months-7 years in Public Hospitals of Addis Ababa from January to April 2023. The primary outcome, pain severity, was assessed at three different times using a pain assessment tool. Cochran's q-test was used to compare postoperative pain incidences. The Generalized Estimating Equation was used to determine predictor variables' effects on pain severity over time. The study demonstrated the direction of association and significance using an AOR with a 95% CI at a P value of 0.05. Result The incidence of moderate to severe postoperative pain was 36.6% at 12 h, 20% at 24 h, and 10% at 36 h. Patients with preoperative pain and preoperative anxiety were more likely to experience moderate to severe postoperative pain [adjusted odds ratio (AOR)=3.41, CI=1.15, 10.00 and AOR=2.28, CI=1.219, 4.277, respectively). Intraoperative predictors of postoperative pain severity included longer duration of surgery (AOR=6.62, CI=1.90, 23.00) and major surgery (AOR=5.2, CI=2.11, 12.88). Postoperative pain severity was reduced in patients receiving multimodal analgesia (AOR=0.24; CI=0.091, 0.652) and in patients assessed frequently in the postoperative period (AOR=0.09; CI=0.022, 0.393). Conclusion A significant portion of paediatric surgical patients in this study experienced high levels of postoperative pain, particularly within the first 24 h. The most influential factors affecting pain severity were postoperative pain management strategies and assessment practices.
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Affiliation(s)
- Fassil Mihretu Rede
- Wollo University, College of Medicine and Health Sciences, Department of Anesthesia, Dessie
| | - Eyayalem Melese Goshu
- Addis Ababa University, College of Health Sciences, Department of Anesthesia, Addis Ababa, Ethiopia
| | - Sulaiman Jemal muzien
- Addis Ababa University, College of Health Sciences, Department of Anesthesia, Addis Ababa, Ethiopia
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Abebe D, Orcho A, Chane J, Mesfin S, Seifu W. Neonatal pain management practices in Somali region of Ethiopia: insights from neonatal intensive care unit providers. Front Pediatr 2024; 12:1344244. [PMID: 38370140 PMCID: PMC10869538 DOI: 10.3389/fped.2024.1344244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
Background Neonates admitted to neonatal intensive care units experience an average of 8-17 moderate to severe painful procedures per day. Because neonates lack the cognitive capacity to express their pain's location or severity, they are very dependent on healthcare providers to recognize, assess, and manage their pain. The health and development of newborns are negatively impacted by persistent or untreated pain experienced early in life. Therefore, studying neonatal pain management practices and associated factors in healthcare is critical to tackling workforce problems, enhancing neonatal care, and lowering the long-term health impacts of neonates. Method From January 1 to 30, 2023, a facility-based cross-sectional study design was used at six public hospitals in the Somali region of Ethiopia. A total of 336 healthcare providers enrolled using a simple random sample technique. A self-administered, structured questionnaire was utilized to collect the data. The analyses used bivariate and multivariate logistic regression. To find the association between the outcome and predictor factors, the odd ratio and the 95% CI were computed. Result The study revealed that 35.4% [95% CI 30.4%-40.5%] of respondents reported that they had good neonatal pain management practices. Ever having undergone training in neonatal pain assessment and management [AOR = 2.26 (95% CI 1.259, 4.07)], availability of pain assessment tools [AOR = 3.05 (95% CI 1.249, 7.469)], and having a favorable attitude toward neonatal pain management practice [AOR = 3.71 (95% CI 1.525, 9.035)] were found to be factors with a significant association with neonatal pain management practice. Conclusion Based on the study's findings, there is a low level of neonatal pain management practice among healthcare providers in the Somali region. The study emphasizes the significance of having access to pain assessment tools and the requirement for healthcare professionals to get training on neonatal pain assessment and management.
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Affiliation(s)
- Dawit Abebe
- School of Nursingand Midwifery, College of Health and Medical Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Afework Orcho
- School of Public Health, Department of Epidemiology, College of Health and Medical Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Jemberu Chane
- School of Nursingand Midwifery, College of Health and Medical Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Wubareg Seifu
- School of Public Health, Department of Epidemiology, College of Health and Medical Sciences, Jigjiga University, Jigjiga, Ethiopia
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Kebede SM, Degefa M, Getachew T, Lami M, Tadesse B, Bekele H. Neonatal pain management practice in the neonatal intensive care unit of public hospitals: a survey of healthcare providers in eastern Ethiopia. Int Health 2023:ihad095. [PMID: 37855453 DOI: 10.1093/inthealth/ihad095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/16/2023] [Accepted: 09/27/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Newborns experience multiple painful and stressful procedures during their hospitalization in neonatal intensive care units (NICUs). Repeated or untreated pain can have negative consequences for the health and development of newborns. Despite the growing knowledge of pain assessment and intervention, several studies have shown that the practice of neonatal pain management among healthcare providers is poor. Therefore, data regarding neonatal pain management practice and affecting factors are essential for taking appropriate actions. This study assessed neonatal pain management practice and associated factors among healthcare providers working in the NICUs of public hospitals in eastern Ethiopia from 1 January to 28 February 2022. METHODS An institution-based cross-sectional study design was used among 372 randomly selected healthcare providers working in the NICUs of public hospitals in eastern Ethiopia. Data were collected using a pre-tested structured self-administered questionnaire and an observation checklist. The collected data were reviewed, coded and entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. Bivariate and multivariable logistic regression were used to identify the associations between outcome and predictor variables at a 95% confidence level and P-values <0.05 were considered statistically significant. RESULTS The study found that 185 (53.9%; 95% confidence interval [CI] 48.4 to 59.2) of the 343 respondents had good neonatal pain management practice with a mean of 11.38 (standard deviation 3.64). Receipt of in-service training in neonatal pain management (adjusted odds ratio [AOR] 2.12 [95% CI 1.15 to 3.91]), availability of protocols and guidelines in the NICUs (AOR 2.94 [95% CI 1.74 to 4.91]) and accessibility of analgesics in the NICUs (AOR 4.302 [95% CI 2.46 to 7.53]) were significantly associated with good neonatal pain management practice. CONCLUSIONS The overall practice of healthcare providers in neonatal pain management in public hospitals in eastern Ethiopia is relatively high compared with previous studies conducted in Ethiopia. Improving the availability of analgesics as well as neonatal pain management protocols and guidelines in NICUs will aid in the promotion of good neonatal pain management practices. In addition, providing ongoing in-service training on neonatal pain management will allow healthcare providers to better care for newborns in pain.
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Affiliation(s)
- Sinetibeb Mesfin Kebede
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Meron Degefa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Magarsa Lami
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Barkot Tadesse
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Gao L, Mu H, Lin Y, Wen Q, Gao P. Review of the Current Situation of Postoperative Pain and Causes of Inadequate Pain Management in Africa. J Pain Res 2023; 16:1767-1778. [PMID: 37273275 PMCID: PMC10237197 DOI: 10.2147/jpr.s405574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/16/2023] [Indexed: 06/06/2023] Open
Abstract
Postoperative pain is one of the most prevalent complications following surgery, and more than 47% of surgical patients endure postoperative discomfort worldwide. In Africa, due to resource shortages and other issues, postoperative pain is substantially more common when compared to developed countries. Severe postoperative pain has many negative effects, including possibly death, which can burden both individuals and society as a whole. Therefore, effectively controlling postoperative pain is becoming increasingly important. To enhance the effectiveness of future pain management, a thorough analysis of the current reasons for inadequate postoperative pain management is necessary. In this article, the present situations of occurring postoperative pain, children's postoperative pain, and pain management in Africa are reviewed, based on relevant and recent literature. In particular, the reasons for inadequate postoperative pain management in Africa are detailed in this article from five perspectives: the inadequate assessment of postoperative pain, the knowledge gap among medical professionals, the patients' misconceptions, the scarcity of resources, and the lack of medications. Additionally, we offer appropriate solutions following various factors.
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Affiliation(s)
- Lejun Gao
- Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Huaixin Mu
- Emergency Department, Shenyang Children’s Hospital, Shenyang, People’s Republic of China
| | - Yun Lin
- Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Qingping Wen
- Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
- Department of Anesthesiology, Dalian Medical University, Dalian, People’s Republic of China
| | - Peng Gao
- Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
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Sasidharan R, Gupta N, Yadav B, Chawla D, Singh K, Kumarendu Singh A. 25% Dextrose Versus 24% Sucrose for Heel Lancing in Preterm Infants: A Noninferiority RCT. Pediatrics 2022; 149:186819. [PMID: 35451020 DOI: 10.1542/peds.2021-054618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To compare the efficacy of 25% dextrose with 24% sucrose for heel-lance analgesia in preterm infants admitted to the NICU. METHODS In this noninferiority, double-blind, randomized controlled trial, preterm infants born at 28 weeks and 0 days to 35 weeks and 6 days of gestation who were due for a scheduled heel-lance procedure were enrolled. Infants randomly assigned to the intervention arm received 0.5 mL 25% dextrose, whereas infants in the active control group received 0.5 mL 24% sucrose orally just 2 minutes before the heel-lance procedure. The primary outcome was Premature Infant Pain Profile (PIPP) score 30 seconds after the procedure. Secondary outcomes included PIPP scores at 60 and 120 seconds, PIPP-Revised scores at 30, 60, and 120 seconds, and any adverse events. RESULTS Sixty-four infants were enrolled (32 in each group). The mean (SD) PIPP score at 30 seconds was 6.41 (2.56) in the dextrose group and 7.03 (2.23) in the sucrose group (mean difference, -0.63 (95% confidence interval, -1.85 to 0.60; P = .31). The upper margin of the confidence interval did not cross the predefined noninferiority margin of 2. The mean PIPP scores at 60 (5.03 [2.18] vs 5.39 [1.48]) and 120 (4.75 [1.97] vs 4.94 [1.46]) seconds were also similar. The PIPP-Revised scores between the 2 groups at all time intervals were comparable. One infant in the intervention group had a transient coughing episode. CONCLUSIONS In preterm infants under intensive care, 25% dextrose is noninferior to 24% sucrose for heel-lance analgesia as assessed by PIPP score.
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Affiliation(s)
| | | | | | - Deepak Chawla
- Department of Neonatology, Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - Kuldeep Singh
- Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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