Midwives’ experiences of assessing and managing neonatal pain

Abstract

The assessment and management of pain in neonates cared for at the Neonatal and Paediatric Intensive Care Unit (NPICU) are very crucial aspects of care provided on a daily basis in order to safeguard their wellbeing. The aim of this study was to explore midwives’ experiences of assessing and managing neonatal pain at the local NPICU. The objectives were to explore how midwives identify and assess neonatal pain and to explore how midwives manage neonatal pain. The study adopted a qualitative research approach. Data was collected via a one-time, face-to-face, semi-structured interview using a self-designed interview schedule. Participants were selected by purposive sampling from a target population of qualified midwives who have a minimum of two years working experience at the NPICU. Seven midwives who satisfied the inclusion criteria participated in this small-scale study. Data collected was transcribed verbatim and analysed by means of thematic analysis. Findings revealed that midwives assess behavioural and physiological indicators of neonatal pain. However, neonates’ inability to self-report their pain, time and work constraints, and the lack of use of established neonatal pain assessment tools seem to hinder midwives from carrying out a thorough pain assessment. Most midwives agreed that their assessment would improve by using objective guidelines. While participants reported using both non-pharmacological and pharmacological pain management strategies, some barriers are also encountered, such as parents’ fears, Covid-19 restrictions, neonates requiring intensive care and the desensitization to pain. In conclusion, midwives agreed that their neonatal pain assessment and management practices can be improved. Therefore, the implementation of educational and practice interventions, together with the introduction of pain assessment guidelines are being recommended.