Neonatal pain management practice in the neonatal intensive care unit of public hospitals: a survey of healthcare providers in eastern Ethiopia

BACKGROUND

Newborns experience multiple painful and stressful procedures during their hospitalization in neonatal intensive care units (NICUs). Repeated or untreated pain can have negative consequences for the health and development of newborns. Despite the growing knowledge of pain assessment and intervention, several studies have shown that the practice of neonatal pain management among healthcare providers is poor. Therefore, data regarding neonatal pain management practice and affecting factors are essential for taking appropriate actions. This study assessed neonatal pain management practice and associated factors among healthcare providers working in the NICUs of public hospitals in eastern Ethiopia from 1 January to 28 February 2022.

METHODS

An institution-based cross-sectional study design was used among 372 randomly selected healthcare providers working in the NICUs of public hospitals in eastern Ethiopia. Data were collected using a pre-tested structured self-administered questionnaire and an observation checklist. The collected data were reviewed, coded and entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. Bivariate and multivariable logistic regression were used to identify the associations between outcome and predictor variables at a 95% confidence level and P-values <0.05 were considered statistically significant.

RESULTS

The study found that 185 (53.9%; 95% confidence interval [CI] 48.4 to 59.2) of the 343 respondents had good neonatal pain management practice with a mean of 11.38 (standard deviation 3.64). Receipt of in-service training in neonatal pain management (adjusted odds ratio [AOR] 2.12 [95% CI 1.15 to 3.91]), availability of protocols and guidelines in the NICUs (AOR 2.94 [95% CI 1.74 to 4.91]) and accessibility of analgesics in the NICUs (AOR 4.302 [95% CI 2.46 to 7.53]) were significantly associated with good neonatal pain management practice.

CONCLUSIONS

The overall practice of healthcare providers in neonatal pain management in public hospitals in eastern Ethiopia is relatively high compared with previous studies conducted in Ethiopia. Improving the availability of analgesics as well as neonatal pain management protocols and guidelines in NICUs will aid in the promotion of good neonatal pain management practices. In addition, providing ongoing in-service training on neonatal pain management will allow healthcare providers to better care for newborns in pain.

Level and predictors of nurse caring behaviors among nurses serving in inpatient departments in public hospitals in Harari region, eastern Ethiopia

Background

Nursing practice is centered on caring and nurses’ behaviour has an impact on the quality of patient care and it is predictive of patient satisfaction,however, many nurses, in reality, do not exhibit caring behavior when providing nursing care to clients. This study was aimed to assess the level and predictors of nurse caring behaviors among nurses serving in inpatient departments in public hospitals in Harari Region of Ethiopia from March 10 to April 10, 2021.

Method

A cross-sectional study was conducted among 300 nurses providing inpatient service in public hospitals in the Harari region of eastern Ethiopia. All permanent nurses working in major inpatient services of two public hospitals, namely Jugal General Hospital (JGH) and Hiwot Fana Specialized University Hospital (HFSUH) were included. The English version of the CNPI-Nurse scale was used to determine the level of caring behavior. The association was reported using the crude and adjusted odds ratios along with the 95% confidence interval. The statistical significance of the association was declared at p-value < 0.05.

Result

The caring behavior was classified as high and low based on the median score. According to this study only 51.67% (95% CI:45.97, 57.35%) of nurses had good caring behavior. The odds of having good caring behavior were 2.22 (AOR = 2.22, 95%CI: 1.20, 4.10) times higher among nurses working in good working environment compared to those who work in bad working environment. Nurses who were satisfied with their job had 2.79 (AOR: 2.79, 95%CI: 1.54, 5.08) times higher odds of good caring behavior than those who were not satisfied with their job. Similarly, nurses who had a lower workload had a 3.01 (AOR: 3.01, 95%CI: 1.70, 5.33) times higher probability of having good caring behavior from nurses compared to nurses who reported having a high workload.

Conclusion

The level of nurses caring behavior is not satisfactory and it is influenced by working environment characteristics, job satisfaction and workload. Therefore it necessary to creat conducive working environment, provide adequate time and resources inorder to improve the level of nurses caring behaviour.

Childhood behavioural disorders in Ambo district, western Ethiopia. II. Validation of the RQC

We report here on a study conducted to measure the validity of an Amharic version of the Reporting Questionnaire for Children (RQC), that was used in a survey of childhood behavioural disorders in a predominantly rural district in western Ethiopia. Mothers of 196 children aged 5-15 years, who were initially interviewed by the RQC were re-interviewed by a psychiatrist who was unaware of the RQC status of these children. The re-interview was conducted using a DSM IV checklist. The study showed that a cut-off point of one or more positive responses to any of the 10 questions on the RQC maximized sensitivity (87.5%) and specificity (65%). The discriminatory power of each item was also computed, and the item dealing with wetting/soiling oneself was found to have the highest ability to identify cases from non-cases. The item on abnormal speech was found to have the least discriminating power.

Childhood behavioural disorders in Ambo district, western Ethiopia. I. Prevalence estimates

The study was conducted between September 1994 and May 1995 in Ambo district, western Ethiopia. The prevalence of childhood behavioural disorder in children was found to be 17.7%. Behavioural disorder was found to be more common in boys than in girls. The prevalence increased with age. The most frequent symptoms reported were headache and nervousness. The least prevalent symptom was stealing things from home. As age increased, the risk of behavioural disorder increased. The increase in risk was statistically significant in the 15-year-old group when compared to the age group 5-7 years (adjusted Odds Ratio, OR = 1.89, 95% confidence interval, CI: 1.08-2.85). Childhood mental disorder was statistically significantly associated with parental age and with parental marital status. Children whose parents were < or = 24 years old had a higher risk of having mental disorders (OR: 2.03, 95% CI: 1.30-3.16) compared to those children whose parents were in the 45+ age group. Children whose parents were categorized as unmarried, divorced, separated, or widowed had a higher risk of having behavioural disorders (OR: 2.22, 95% CI: 1.70-2.91) than children whose parents were married. There was a statistically significant association between parental psychoneurosis and children's behavioural disorders; children whose mothers had psychoneuroses were at a higher risk of having behavioural disorders as compared to those whose mothers had no psychoneurosis (OR: 1.78, 95% CI: 1.34-2.35).