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A Study of Assessment of Neonatal Pain and the Practices in Pain Management amongst Health Care Workers in An NICU of A Tertiary Care Center

Author(s): Manali Shinde, Chhaya Valvi, Isha Deshmukh*, AA Kinikar

Background: Newborn infants experience acute pain during routine medical procedures. Evidence demonstrates that controlling pain in the newborn period can be beneficial, improving physiologic, hormonal and behavioral outcomes. Multiple validated scoring systems exist to assess pain in a neonate; however, there is no standardized or universal approach which can help in managing pain. Healthcare facilities should have a neonatal pain control program. The first step is to minimize the total number of iatrogenic events which can cause pain. If a procedure cannot be avoided, a graded approach to manage pain using non-pharmacological and pharmacological methods is recommended. Despite the recommendations and guidelines based on evidence, contemporary research shows that the problem of pain among patients in NICUs in various centers is still an important and neglected problem. Today we have adequate evidence that shows how repetitive painful procedures have short [1] and long term [2] adverse consequences for the developing neonatal brain. Despite this, adequate pain management is still not observed [3].

Aims and objectives: The aim of this study was to assess the level of knowledge of the medical personnel and their perception of the issue of pain in neonatal patients along with their awareness about evaluation and treatment of pain in a neonatal unit. Also, to assess awareness and use of pharmacological and non-pharmacological methods for pain management.

Methods: A descriptive, cross sectional study was carried out among NICU staff. The questions were inspired by questionnaire used in some studies. [4, 5] Primary data was collected using predesigned questionnaire with open ended questions using Google Forms was circulated using emails. The collected data was retrieved as an excel file. Statistical analysis was done on IBM SPSS STATISTICS VERSION 20. Categorical variables were taken in the form of frequencies and percentages. Distribution was represented by pie charts or bar graphs. Continuous variables were expressed in the descriptive statistics tables as means, standard deviation and range. The Categorical variables in the two groups were compared using cross tabulation design and Chi square T test. The continuous variables were compared by considering mean and standard deviation and using independent sample T test. Correlations between two variables were calculated using Pearson’s correlation coefficient. P value < 0.05 was considered significant and p value < 0.01 was considered highly significant.

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