Neonatal pain management practices by health care professionals at Nyangabgwe and Princess Marina hospitals, Francistown and Gaborone, Botswana.
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Date
2025
Authors
Difsele, Barulaganye
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
Neonatal pain management remains a global challenge, particularly in low- and middle-income countries such as Botswana, due to inadequate resources, training, and evidence-based practice. Despite all neonates experiencing pain, with preterm babies being especially vulnerable, pain assessment and management are often overlooked, potentially leading to adverse short- and long-term outcomes. The main objective of this study was to assess neonatal pain management practices among healthcare professionals in the Neonatal Intensive Care Units of Nyangabgwe Referral Hospital (NRH) and Princess Marina Hospital (PMH) in Gaborone and Francistown towns of Botswana. This study used a descriptive cross-sectional design. The study included 110 healthcare professionals, all of whom were enrolled into the study by census method. The data were collected using an online questionnaire with validated items of the Likert scale. The collected data was exported into Excel 2013 for cleaning. The data was further imported into Stata version 18 for analysis using descriptive and inferential statistics. Chi-square, Fisher’s exact and binary logistic regression tests were used to statistically analyse the data. A confidence interval of 95% with a significance level of 5% was set. The results showed that 87 (79%) of
the participants demonstrated good neonatal knowledge of pain management practices. The final analysis using binary logistic regression identified key predictors of good practice. Participants categorized as knowledgeable had 6 times odds of practicing good neonatal pain management practices compared to those not knowledgeable (AOR = 6.34; 95% CI: 0.10-22.7, p < .001). Participants with formal training in neonatal pain management had about 4 times odds of having good neonatal pain management practices compared to those who did not receive training (AOR= 3.974, 95%, CI: 0.37-1.82, p = .046) . Those who reported the presence of protocols in the Neonatal Intensive Care Units (NICUs) also had more than 1 times odds of having good neonatal pain management practices (AOR= 1.132; 95% CI: 0.12-1.02, p = .012). Non-Christian participants had 23% odds of having good neonatal pain management practices, while Christians had 76.9% odds of having good neonatal pain management practices (AOR= 0.231, 95%,
CI:0.98-1.25, p = .002). Non-pharmacological interventions also mattered with respondents using non-pharmacological interventions to manage pain in neonates having better practices than those not using them (AOR= 6.863, 95%, CI: 0.001-63.2, p = .27). These results suggest that knowledge, training and adherence to protocols are crucial for improving neonatal pain management. The study highlights critical gaps in neonatal pain management practices in Botswana. The study recommends revising curricula, enhancing interdisciplinary training, and advocating for updated policies and protocols to improve assessment, documentation, and overall neonatal pain management practices.
Keywords: Infant, newborn, Botswana, pain management, hospitals, Health care professionals.
Description
Thesis of Master of Science in Neonatal Nursing.