Knowledge, attitudes and practices of nurses and midwives regarding neonatal pain management in two Hospital Neonatal wards in Kigali, Rwanda.

Abstract

The understanding of neonatal pain and its management has been developing since the mid- 1970s. But in resource-limited countries, the care of preterm and high-risk neonates in intensive care units (NICUs) is a new field. The focus has been just on saving the lives of these newborns, therefore, pain management has not been part of the plan of care. In fact, some providers may not know or believe that neonates experience pain. Research has shown that fetuses experience pain as early as 20 weeks of gestation. Neonates in the NICU experience pain from both medical interventions and invasive procedures many times a day. It is the professional and ethical responsibility of nurses and midwives to be able to recognize and deal with neonatal pain. This can be especially challenging as newborns are unable to self- report. Therefore nurses and midwives must be knowledgeable on the management of neonatal pain. Aim: To assess the knowledge, attitudes, and practices of nurses and midwives regarding neonatal pain management. Methodology: A quantitative cross-sectional descriptive design was used. Data were collected from 66 nurses and midwives in the neonatal and pediatric units of a district and referral hospital in Kigali, Rwanda using self-administered questionnaire. Descriptive (frequency count, mean, percentages) and inferential (Chi-square, Fisher‘ Exact test) was used to analyze the data. Results: The majority (74.2%) of nurses and midwives had a low level of knowledge related to pain management in neonates. Of the 66 participants, 51.5% had a positive attitude toward neonatal pain management while 84.8% had a low level of practice. A statistically significant association was found between knowledge and practice (p-value 0.026), attitude and practice (pvalue 0.011). In consideration of the study findings, nurses and midwives need training programs regarding neonatal pain management that could finally influence the effective nursing practice of neonatal pain management.