Abstract

Purpose: The purpose of this study was to describe newborns’ procedural pain assessment and alleviation with non-pharmacological pain alleviation methods based on nurses’ perceptions in neonatal and neonatal intensive care units.

Design and methods: A descriptive cross-sectional survey carried out among all nurses (n =149) who were working in neonatal and infant departments or neonatal intensive care units (NICUs) in Estonian hospitals. Altogether, 128 questionnaires were returned and 111 respondents were eligible (75% response rate). The data was analysed using statistical methods.

Results: More than half of the nurses agreed that the systematic documentation of the measurement of pain is necessary in nursing care and affects newborns ́ pain alleviation. Half of the respondents (51%) confirmed that pain scales are important in the measurement of neonate pain and 58% of the respondents stated that they could measure pain in a reliable way. Nurses also reported that most of the pain scales were unfamiliar for them and were not routinely used in everyday practice. The most useful non-pharmacological pain alleviation methods were touching (83%) and positioning infants (78%) and the most rarely used were music (17%) and encouraging mothers to breastfeed (34%). The majority of respondents (79%) reported that they don’t know or don’t have written instructions on pain assessment in their workplace and only a few nurses (10%) reported that they have participated in pain management courses during the last year.

Conclusions: The study results were controversial. There are problems with using pain scale and pain documentation in every day practice. The use of scales in pain assessment was valued by quite few nurses. The biggest problem seems to be the lack of information on such methods. Even though nurses are using non-pharmacological pain alleviation methods and counselling parents to use them, the results show that there is a need to increase awareness and offer pain alleviation training courses to nurses.

Practice implication: Nurses need pain management guidlines for everyday work and in addition to nurses, it’s needed to create written guidlines for parents.