Knowledge, Attitude and Management of Neonatal Pain among Health Care Professional in Neonatal units

Despite a large pool of evidence on neonatal pain, its effects in later life and a variety of pharmacologic and non pharmacologic techniques of pain management, the perception, prevention and management of pain among neonates is still not well established.

To assess the knowledge, attitude and practices of health care professionals on neonatal pain and its management.

A prospective descriptive survey was conducted at two tertiary level neonatal intensive care units (NICU) in south India.

A semi structured questionnaire regarding neonatal pain was administered to Health care professionals (HCP) (nurses and doctors) working in neonatal units of two teaching hospitals. The questionnaire consisted of 37 items of which 10 questions were on knowledge (7MCQ'S &3 open ended) 10 items on attitude (rated on a 5 point likert scale: strongly agree to disagree), 10 items on practices of health care professionals (rated through a 5 point likert scale: always to never) and 7 items (open -ended questions) on practices of health care professionals.

Of the 42 health care professionals who participated in the study 86% of them responded to the questionnaire. Ninety two percent of the respondents were nurses while 8% were physicians. Forty percent of the health care professionals had moderate knowledge on the neonatal pain mechanism and pain transmission, 85% of them identified the pain behavior of neonates as ‘cry’. Sixty nine percentage had an unfavorable attitude towards neonatal pain. Forty seven percent, felt parents should be informed about pain management. With regard to practice 77.7% of the respondents did not permit the mother during procedures, 61% of them never allowed the mother to breastfeed during procedures. 56% of them used lancets for heel prick. 39% of Health care professionals stated they always attempted to minimize the number of procedures and 43% of them stated they did not have a pain management protocol.

From the above survey it is apparent there are inconsistencies in pain management of the neonate; a vulnerable population. Standard protocol in neonatal units regarding various pain management approaches to minimize the pain needs to be implemented.