PERCEIVED NEONATAL PAIN MANAGEMENT PRACTICES AMONG NURSES WORKING IN NEWBORN UNITS IN NYANZA AND WESTERN KENYA

Abstract

Neonates in neonatal units (NBUs) are treated to several invasive and non-invasive procedures as part of their medical care. These treatments, which include blood draws, intubation, mechanical breathing, and operations, can result in substantial pain for the newborns. Previous research have revealed that untreated pain in newborns can lead to severe physiological and psychological effects, including increased pain sensitivity, behavioral difficulties, and delayed neurodevelopment. Despite the increased awareness of the need for efficient pain management, there is still a shortage of standardized pain assessment instruments and processes in many healthcare settings. This study intended to analyze the opinions and practices of nurses working in NBUs in Nyanza and Western Kenya towards newborn pain care. This was a descriptive cross-sectional study that used both qualitative and quantitative methodologies. The study targeted 89 nurses working in NBUs across multiple hospitals in Nyanza and Western Kenya. Data gathering methods included pre-tested self-administered questionnaires and in-depth interviews. Spearman Correlation was utilized to analyze the relationship between the variables and p value of ≤ 0.05 was regarded statistically significant. Qualitative data from the interviews were evaluated thematically to discover emergent patterns and themes. The study indicated a large gap between nurses' views and their actual behaviors in addressing newborn pain. Although 75% of nurses accepted that neonates experience pain, fewer than half (44.9%) perceived basic operations as painful. This disparity in perception was reflected in the utilization of pain management techniques; whereas a large proportion of nurses were aware of pharmacologic (41.6%) and non-pharmacologic (42.7%) interventions for controlling newborn pain, the practical application of these strategies was markedly absent. A substantial negative connection was established between nurses' understanding of pain treatment and the actual use of pain assessment tools (p = 0.01). There was a notable gap between knowledge and practice; although nurses knew about both pharmacologic and non-pharmacologic therapies, they infrequently employed them in practice (p < 0.0001 and p = 0.03, respectively). The findings of this study show a large disparity between the theoretical understanding and perceived neonatal pain treatment methods among nurses. To solve these concerns, it is advised that the national and county governments work to create standardized neonatal pain assessment instruments and organize frequent training sessions for nurses. Additionally, adding a module on newborn pain management into the nursing curriculum and offering on-the-job training could boost nurses' proficiency and confidence in handling neonatal pain.