O'Brien Kyololo1, Bonnie Stevens2, Denise Gastaldo2, Julia Songok1
1) Kenya 2) Canada
Hospitalized neonates are frequently subjected to painful procedures without adequate analgesia. In high-income countries, sub-optimal pain treatment is a major source of psychological stress for mothers. Adequate pain treatment remains the most important need for mothers of hospitalized neonates. Conversely, maternal perceptions on procedural pain practices in low- and middle-income countries such Kenya, where procedural pain is grossly undertreated, have not been investigated. Therefore, the aim of this study was to explore maternal perceptions on pain and pain treatment practices in neonatal units in Kenya.
A qualitative descriptive study was conducted with 15 mothers of hospitalized newborn infants from 2 neonatal units in Kenya. Individual semi-structured interviews employing the photo-elicitation technique were conducted. Photographs of local mother-neonate dyads during painful procedures formed the interview kit. The interviews were audio-recorded, transcribed verbatim and analyzed using an inductive content analysis approach.
Two main themes emerged; (a) burden of pain and its effects on the mother and neonate dyad and (b) untreatment of pain and feasible pain treatment interventions. Mothers felt that their neonates underwent unexpected and unnecessary pain. The repeated painful experiences were emotionally and psychologically traumatic to mothers and left “permanent scars” on neonates that would serve as a constant reminder of the neonatal experience. Mothers acknowledged that neonates were not given any form of pain treatment during procedures although they felt that interventions such as breastfeeding, kangaroo care and facilitated tucking should be used routinely for procedural pain relief.
Mothers perceived that neonates experienced unexpected pain, repeatedly, without adequate pain relief. Reducing the burden of pain and being involved in pain treatment during procedures would reduce the psychological and emotional trauma associated with untreated pain and improve pain treatment in neonates.
