Nurses’ barriers and facilitators to management of pain in children in two selected referral hospitals in Rwanda.

Abstract

Background: Pain in children is a major health concern since this causes negative impacts on thelife of children and adolescents worldwide today. Nurse’s barriers and facilitators to managementof pain in children are rarely documented in Rwanda, despite its multiple consequences on childrenand their parents. However, previous studies have shown that nurses are key players, and theycontinue to rely on their own experiences. And yet, adequate pain management or pain relief is a basic fundamental right to everyone. The purpose of the study: To assess the barriers and facilitators of pain management in childrenamongst nurses working at two selected referral hospitals in Rwanda. Methods: This was a descriptive cross-sectional study design conducted in two referral hospitals in Kigali. The data were provided by the nurses, using a convenient sampling technique with totalpopulation. The data was analyzed using SPSS version 16. Results: The majority of participants 74 (91, 4%) were female. The main facilitators of pain management were using pain assessment tool 77 (95.1%), doctors writing the correct prescriptions for pain 72 (88.9 %) and reassessment of pain after administration of pain medication 71 (87.7%). Results regarding knowledge barriers showed that 51 (63%) of respondents were concerned aboutlethal side effects, while 46 (56.8%) were afraid of opioid overdose (opiophobia). In practice, 35 (43.2%) of respondents indicated that patients were reluctant to report pain and 25 (30.8%) of the respondents reported that there was no clear cut of care escalation. Respondents identified that the most institutional barriers were no clear cut of care escalation 27 (33.4%) and lack of in service training 24 (29.6%). Conclusion: The participants of this study identified facilitators which would allow for better pain management in children if they were put in place, but also showed barriers in different aspects, those related to knowledge, practice and institution. This study also revealed that nurses, like other hospital staff, have gaps in the management of pain in children. Based on the results of our research, it is important and urgent to provide nurses advanced training in pain management in children and to provide training sessions for parents in this area. It is also necessary to make facilitators available to overcome the obstacles encountered in the management of pain.