Neonatal pain perception, management and review of practices among medical workers in Nigeria newborn units

Abstract

Background: Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. The perception of pain is variable and knowledge may not match practise. Aims: To ascertain the knowledge, attitude and practice of neonatal pain management (NPM) among HCW in newborn units across Nigeria. Methods: The validated questionnaire administered to consenting doctors and nurses working in various newborn units in Nigeria was utilised. Results: There were 256 respondents from tertiary institutions 228 (89.1%) located in 31 states of Nigeria. There were 91% doctors and 8.6% nurses’. The perception of newborn pain was high (≥95%) among doctors and nurses . Up to 67.1% of the doctors and 57.1% of nurses were aware of NPM. One third (37.3%) of doctor respondents knew of NPM from friends and colleagues while half of the nurses knew from course textbooks. Pain definition was in most by sensation (94%), 50% by emotion. Most nurses were aware of the subjective report of potential tissue damage and knew the facial expressions of pain compared to doctors. Crying was equally recognised as an expression of pain. Perception of non-pharmacologic methods of NPM was highest for massaging and KMC; the knowledge of Sucrose analgesia was low. Procedural pain perception was poor and analgesia was for few procedures. Conclusions: Perception of pain was high but did not match knowledge and practice of NPM. Formal education on NPM was lacking in the training of HCW. Keywords: Neonatal pain management; Nigerian newborns; health care workers.