Journal of Education and Health Promotion

Four components of pain management in Iranian neonatal Intensive Care Units: The nurses` and physicians` viewpoint

Authors

. Zahra Mohamadamini
. Mahboobeh Namnabati 1
. Maryam Marofi 2
. Behzad Barekatein 3

1 Department of Pediatrics and Neonates, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences

2 Department of Pediatrics and Neonates, Isfahan University of Medical Sciences

3 Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract
BACKGROUND: As an important right and a treatment priority, pain management and alleviation
can prevent harmful consequences and sever effects to the infant. The aim of this study was to
determine the nurses and physicians’ viewpoints about assessment, intervention, and evaluation of
pain in the infants in the neonatal Intensive Care Units (NICUs).
METHODS: The cross-sectional study was performed in census method in the NICUs of educational
hospitals with participation of 157 staff in 2015 in Iran. Data collection tool was a questioner that was
designed to assess the four components of pain management namely assessment, pharmacological
intervention, nonpharmacological intervention, and evaluation. The collected data were analyzed in
a descriptive and inferential statistics by means of the SPSS software, version 16.
RESULTS: The fi ndings of study indicated the total average scores of pain management from nurses
and physicians’ viewpoint 66.7 and 65.5, respectively that were at the moderate level. The average
score of nonpharmacological interventions from nurses’ viewpoint (69.4) was meaningfully higher than
that of the physicians’. A signifi cant relationship was noticed between the respondents’ viewpoint on
the nonpharmacological interventions and their NICU background (r = 0.18, P = 0.03). A meaningful
relation was found between participation in continuing education and scores of pain management.
CONCLUSIONS: The results of this study showed that the nurses and physicians’ viewpoint about
pain management was at a moderate level. The effect of work experience and continuing education
on pain management is proved in the study. Researchers suggest that both experienced staff
employment and education continuation must be incorporated in pain management in NICUs.

Keywords

Infant
Iran
neonatal Intensive Care Unit
pain management
viewpoint
1. De Lima J, Carmo KB. Practical pain management in the neonate.
Best Pract Res Clin Anaesthesiol 2010;24:291-307.
2. Hockenberry E, Wong D. Wong`s Nursing Care of Infants and
Children. Tulsa, USA: Mosby; 2013. p. 303-10.
3. Cong X, McGrath JM, Cusson RM, Zhang D. Pain assessment and
measurement in neonates: An updated review. Adv Neonatal
Care 2013;13:379-95.
4. Namnabati M, Abazari P, Talakoub S. Nurses’ experiences of pain
management in children. Iran J Nurs Res 2008;3:75-86.
5. Sohrabi M, Aghayan M, Zolfaghari M. Study on signs of pain in
neonatals. Knowl Health 2011;6:50-3.
6. Carbajal R, Rousset A, Danan C, Coquery S, Nolent P, Ducrocq S,
et al. Epidemiology and treatment of painful procedures in
neonates in Intensive Care Units. JAMA 2008;300:60-70.
7. Anand KJ, Hickey PR. Pain and its effects in the human neonate
and fetus. N Engl J Med 1987;317:1321-9.
8. Liaw JJ, Yang L, Katherine Wang KW, Chen CM, Chang YC,
Yin T. Non-nutritive sucking and facilitated tucking relieve
preterm infant pain during heel-stick procedures: A prospective,
randomised controlled crossover trial. Int J Nurs Stud
2012;49:300-9.
9. Fitzgerald M, Beggs S. The neurobiology of pain: Developmental
aspects. Neuroscientist 2001;7:246-57.
10. Alvares D, Torsney C, Beland B, Reynolds M, Fitzgerald M.
Modelling the prolonged effects of neonatal pain. Prog Brain Res
2000;129:365-73.
11. Stevens B, McGrath P, Gibbins S, Beyene J, Breau L, Camfi eld C,
et al. Procedural pain in newborns at risk for neurologic
impairment. Pain 2003;105:27-35.
12. Asadi-Noghabi F, Tavassoli-Farahi M, Yousefi H, Sadeghi T.
Neonate pain management: What do nurses really know? Glob J
Health Sci 2014;6:284-93.
13. Kennedy RM, Luhmann J, Zempsky WT. Clinical implications
of unmanaged needle-insertion pain and distress in children.
Pediatrics 2008;122 Suppl 3:S130-3.
14. Namnabati M, Abazari P, Talakoub S. Identifi cation of perceived
barriers of pain management in Iranian children: A qualitative
study. Int J Nurs Pract 2012;18:221-5.
15. Ger LP, Ho ST, Wang JJ. Physicians’ knowledge and attitudes
toward the use of analgesics for cancer pain management: A
survey of two medical centers in Taiwan. J Pain Symptom Manage
2000;20:335-44.
16. P ö l k k i T , K o r h o n e n A , L a u k k a l a H , S a a r e l a T ,
Vehviläinen-Julkunen K, Pietilä AM. Nurses’ attitudes and
perceptions of pain assessment in neonatal intensive care. Scand
J Caring Sci 2010;24:49-55.
17. Niemi-Murola L, Nieminen JT, Kalso E, Pöyhiä R. Medical
undergraduate students’ beliefs and attitudes toward pain: How
do they mature? Eur J Pain 2007;11:700-6.18. Alavi A, Namnabati M, Abdeyzadeh S, Parvin N, Akbari N,
Samipoor V, et al. Pediatric pain management by nurses in
educational hospitals of Shahrekord in 2006. J Shahrekord Univ
Med Sci 2008;10:59-6.
19. Noghabi FA, Soudagar S, Nazari O. Knowledge, attitude
and performance of nurses regarding pain assessment and
measurement. J Hormozgan Univ Med Sci 2012;16:403-13.
20. Manworren RC. Pediatric nurses’ knowledge and attitudes survey
regarding pain. Pediatr Nurs 2000;26:610-4.
21. Zarei KH. The Position of the Body in Pain in Children
Aged 7 to 12. Proceedings of the Fifteenth International
Conference on Children: 2003. Tehran, Iran; 2003. p. 378.
22. Verklan MT, Walden M. Core Curriculum for Neonatal Intensive
Care Nursing. 5th ed. United States: Saunders Elsevier; 2014.
23. Enskär K, Ljusegren G, Berglund G, Eatin N, Harding R,
Mokoena L, et al. Attitudes to and knowledge about pain and
pain management, of nurses working with children with cancer:
A comparative study between UK, South Africa and Sweden.
J Res Nurs 2007;12:501-5.
24. Ozer S, Akyürek B, Başbakkal Z. Investigation of nurses’ pain
related knowledge, attitude and clinical decision making skills.
J Turk Soc Algol 2006;18:36-4.
25. Subhashini L, Vatsa M, Lodha R. Knowledge, attitude and
practices among health care professionals regarding pain. Indian
J Pediatr 2009;76:913-6.
26. Mathew PJ, Mathew JL. Assessment and management of pain in
infants. Postgrad Med J 2003;79:438-43.
27. Akuma A, Jordan S. Pain management in neonates: A survey of
nurses and doctors. J Adv Nurs 2012;68:1288-301.
28. Ozawa M, Yokoo K. Pain management of neonatal Intensive Care
Units in Japan. Acta Paediatr 2013;102:366-72.
29. Mohebbi P, Azimzadeh R. Barrier of implementing
non-pharmacological pain management in children and presented
intereventions by nurses. Inst J Nat Resour 2012;24:40-8.
30. Parvisi F, Alhani F. Studying the rate of nurses’ knowledge of
non-pharmacological pain management in pediatric patients.
Iran J Pediatr 2005;15:245.
31. Esmaeili K, Iranfar SH, Afkary B, Abbasi P. The comparison of
the effect of music and rhythmic breathing techniques on pain
severity of intravenous cannulation during blood transfusion.
Behbood 2008;12:129-39.
32. Layman Young J, Horton FM, Davidhizar R. Nursing attitudes
and beliefs in pain assessment and management. J Adv Nurs
2006;53:412-21.
33. Davis D, Galbraith R; American College of Chest Physicians
Health and Science Policy Committee. Continuing medical
education effect on practice performance: Effectiveness of
continuing medical education: American College of Chest
Physicians evidence-based educational guidelines. Chest
2009;135 3 Suppl: 42S-8S.
34. Karimi R, Parsa-Yekta Z, Mehran A, Nik-Farid L. Perspective of
nurses on effective factors on their decisions to administer PRN
analgesics to children after surgery. Iran J Pediatr 2010;8:245. 
Journal of Education and Health Promotion
Volume 7, Issue 4
July and August 2017
Pages 1-5

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