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The knowledge, attitude and beliefs of doctors and nurses concerning neonatal pain management

Neonatal pain management has received increasing attention over the past four decades, along with the technological advances made in neonatal care which have increased the survival of neonatal patients. Empirical evidence confirms and acknowledges that the life-saving or life supporting procedures neonates are subjected to, during their admission into neonatal intensive care or high care facilities, are often painful. Research into the effects of neonatal pain emphasises the professional, ethical and moral, obligations by neonatal staff to manage neonatal pain effectively, in order to obtain positive patient outcomes both in the short and long term.
This study used a non-experimental, prospective quantitative survey to investigate the knowledge, attitudes and beliefs of nurses and doctors concerning neonatal pain and its management. To answer the research question posed fully a third objective was included to explore current practice on this topic. The entire population (N=150) of neonatal staff working in neonatal wards of two tertiary hospitals in Gauteng, were invited to participate in the study. The data was collected using self administration of the Infant Pain Questionnaire.
The response rate of this study was 35.33% (n=53).Data was analysed using “STATA” 12. Descriptive findings showed that, the majority of the respondents were female, from the professional nurse category, working in neonatal intensive care units with between 0 – 5 years experience in neonatal care. A significant finding was the unavailability of a pain management guideline in the neonatal units as reported on by 64% of the respondents. Despite this pain neonatal pain is recognised and treated. The main concern raised by this is the accuracy of assessment and adequacy of pain management interventions.
The neonatal staff acknowledges and empathise with neonates’ pain experience. Results from comparative analysis using a Fischer’s exact test, showed a statistically significant (p<0.05) association between procedural pain ratings and the beliefs held by the participants about the increased frequency of pharmacological intervention implementation on five clinical procedures. This positive attitude towards neonatal pain management is important in ensuring consistent and adequate implementation of guidelines, hence adequate treatment of neonatal pain.
A review of the pain management interventions used in the study setting showed preference for pharmacological pain management interventions for moderate to severe pain. This requires collaboration between the nurse and doctor. This finding was found to be consistent with international pain management standards. The nurses in the study also reported inadequate implementation of non-pharmacological interventions. This method of intervention use can be enhanced with empirical evidence.
The small sample size and composition of respondents are noteworthy limitations, along with the exclusion of record review as part of this study. The main recommendation is to increase research neonatal pain management utilising existing structures in the practice, education and international resources.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/12628
Date05 April 2013
CreatorsKhoza, Sizakele Lucia Thembekile
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Formatapplication/pdf

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