Assessment of knowledge, practice, and barriers regarding neonatal pain care among pediatrics and pediatric surgical residents at a Tertiary Hospital, Addis Ababa, Ethiopia

Abstract

Background: The growing knowledge in medicine has shown newborns can feel pain and that treating pain has benefits for the  neonates in the short- and long-term. Despite the presence of expert consensus on neonatal pain scoring methods, neonatal pain  remains unnoticed and under treated. Among others, effective pain management requires that the physicians caring for neonates be well  informed, keen-eyed and amenable to ensure that neonatal pain care is multi-tiered and multifaceted.

Objective: To assess the knowledge, practice and barriers regarding neonatal pain management among pediatric and pediatric surgical  residents at Tikur Anbesa Specialized Hospital.

Methods: Institution based cross sectional study using a self-administered questionnaire was employed from June 01- July 15, 2020  among all pediatrics and pediatric surgical residents. Data was analyzed using SPSS version 26.0 software. One way ANOVA was used to  determine differences in means. Statistical, significance was set at p≤0.05.

Results: Response rate was 96 % (104 out of 108 participants).  The maximum and minimum score for the knowledge questions were 10 and 4 out of 10 respectively. The mean (SD) knowledge score was 8.5 (±1.4). Only 15.8% of residents reported using neonatal pain assessment tools on daily practice. The frequency of analgesia and  non-pharmacologic measures for common neonatal procedures were sub-optimal and varied with the procedure. One-way ANOVA found  no significant difference in neonatal pain care by specialty, knowledge status, experience, and residency year (P>0.05). Most residents cited inadequate staff training (88.4%), absence of local neonatal pain guidelines (87.4%), and lack of pain assessment (63.2%)  as barriers to optimal neonatal pain care. 

Conclusion: Despite the high knowledge score achieved by most of the residents, the use of  analgesia and comfort measures for common neonatal procedures were not optimal, indicating a need for supervised practical  application.