Healthcare workers' knowledge, attitudes and practices in the management of pain during acute pain crises in children with sickle cell disease in a county referral hospital in Kenya

Abstract

Background: Acute vaso-occlusive pain accounts for 60–70% of hospitalizations in children with sickle cell disease (SCD). The knowledge, attitudes and practices (KAPs) of healthcare workers (HCWs) in managing acute pain are key in managing pain in these patients.
Methods: We employed a mixed method design to explore these KAPs in HCWs providing care to children with SCD presenting with acute pain in western Kenya. This involved; a semi-structured questionnaire to assess the knowledge and attitudes of the HCWs, focus group discussions (FDGs) and key informant interviews (KIIs) to explore the barriers to proper management and, a retrospective review of clinical records of children with SCD admitted with acute pain to describe the practices of these HCWs.
Results: 50 HCWs completed the questionnaires. A large proportion of participants (92.2% of clinicians and 92.7% of nurses) scored moderately or higher on their knowledge on the assessment of and the pharmacological management of acute pain in children with SCD. Across the 67 files reviewed, the most commonly prescribed analgesic was morphine. None of the files had documentation of pain assessment using a validated tool.
Conclusions: HCWs’ knowledge about pain management was found to be adequate but it did not translate to adequate and proper practice in pain management.