Why Effective Pain Management Remains a Challenge

Ugwu, Nnenna

doi:10.5772/intechopen.93612

Cited by 3 publications

(4 citation statements)

References 47 publications

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“…Similar findings revealed an extensive knowledge deficit regarding labor pain management among most care providers. 43 These findings are also complemented by a mixed-methods study conducted in the Tigray region of Northern Ethiopia, 44 Taken together, our findings showed that currently available lines of evidence pertaining to labor pain management practices are inconclusive and that more research on labor pain management is needed. Thus, we suggest a systematic review and the integration of findings from qualitative studies (metasynthesis) to form a new interpretation of research into labor pain management.…”

Section: Con Clus Ionssupporting

confidence: 59%

“…Additionally, health care providers who had favorable attitudes toward labor pain management were almost three times more likely to practice labor pain management than health care providers who had unfavorable attitudes toward it. Similar findings revealed an extensive knowledge deficit regarding labor pain management among most care providers 43 . These findings are also complemented by a mixed‐methods study conducted in the Tigray region of Northern Ethiopia, 44 which reported that gaps in health care providers' skills and a lack of essential medicines and supplies can lead to major bottlenecks in the provision of quality obstetric care.…”

Section: Discussionmentioning

confidence: 55%

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Labor pain management practices and associated factors in Ethiopia: A systematic review and meta‐analysis

Azeze,

Asgedom,

Efa

et al. 2023

Intl J Gynecology & Obste

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BackgroundThe pain that women experience during labor and childbirth is the central feature of parturition in humans. Despite improvement in the development of standards for pain assessment and treatment, labor pain is mostly ignored especially in low‐ and middle‐income countries resulting in unmeasured suffering from childbirth for mothers.ObjectivesWe aimed to provide a comprehensive estimation of the pooled magnitude and associated factors of labor pain management practices in Ethiopian public health facilities.Search StrategyA systematic review and meta‐analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analysis statement. Electronic databases including Google Scholar, Web of Science, Excerpta Medica Database (EMBASE), PubMed/MEDLINE, and Scopus were searched from database inception to June 30, 2023.Selection CriteriaThe inclusion criteria were established prior to article review and follows the population, intervention, comparison and outcome criterions.Data Collection and AnalysisWe evaluated publication bias by means of funnel plots and Egger's test. Heterogeneity between studies was assessed using I2 statistics. For each associated factors in meta‐regressions, the pooled odds ratio (OR) and its 95% confidence interval (CI) were extracted. A P value of 0.05 was used to determine the significance of the small study effect.Main ResultsOur search terms yielded 17 studies with 5735 participants. The pooled prevalence of labor pain management practices in Ethiopia was 45.73% (95% CI: 39.13, 52.32; I2 = 96.4). Having adequate knowledge regarding labor pain management (OR: 3.74; 95% CI: 2.74, 5.11; I2 = 53.8%), a favorable attitude toward labor pain management (OR: 2.90; 95% CI: 2.03, 4.14; I2 = 63.8%), availability of labor analgesics (OR: 3.23; 95% CI: 2.18, 4.79; I2 = 46.2%), and clinical experience of 10 or more years (OR: 3.45; 95% CI: 2.06, 5.78; I2 = 19.0%) were factors that were statistically associated with the use of labor pain management practices.ConclusionWe concluded that the routine practices of labor pain management by obstetric health providers in Ethiopia are still low. Therefore, it remains important to call for holistic and inclusive interventions targeting maternity health providers and hospital officials to update their long‐standing practices.RegistrationRegistered in PROSPERO under protocol number CRD42023429140.

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Section: Con Clus Ionssupporting

confidence: 59%

Section: Discussionmentioning

confidence: 55%

Labor pain management practices and associated factors in Ethiopia: A systematic review and meta‐analysis

Azeze,

Asgedom,

Efa

et al. 2023

Intl J Gynecology & Obste

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“…Effective pain management is essential for patient recovery and high‐quality safe care (Ugwu, 2020). However, many studies report poor levels of knowledge with subsequent accompanying negative attitudes about pain assessment and management (Chang et al, 2020; Fitzgerald et al, 2017; Kizza et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Nurses knowledge, attitudes and education needs towards acute pain management in hospital settings: A meta‐analysis

McCabe

Feeney

Basa

et al. 2023

Journal of Clinical Nursing

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Background: Effective pain assessment and management is widely reported as sub optimal due to inadequate knowledge and negative attitudes among nurses. Aim:To determine nurses' attitudes, knowledge and education needs towards acute pain management in acute hospital settings Methods: PRISMA (2021) and guidelines from the University of York, CRD (2009) informed the design and conduct of this review. We included studies with registered nurses involved in direct adult patient care and acute pain management in hospital settings.

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“…Women undoubtedly have the right not to suffer from pain and have a stress-free labor. The adverse effects of moderate-to-severe pain, such as sympatric release, unstable hemodynamic status, and the onset of the inflammation process, are well-known ( 6 ). Supporting painless delivery is an essential step, given the several advantages of NVD compared to CS.…”

Section: Introductionmentioning

confidence: 99%

Maternal Attitude and Knowledge Regarding Painless Labor: A Report from a Referral Hospital in Northern Iran

Hosseinzadeh,

Hamidi Madani,

Shahrokhi Rad

et al. 2023

Anesth Pain Med

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Background: Pregnant women’s knowledge about labor analgesia and the acceptance rate of this method are still undesirable in developing countries. Objectives: This study aimed to examine pregnant women’s knowledge, attitude, and acceptance of painless labor. Methods: The present observational study was conducted in a referral university hospital in Northern Iran from September 2022 to April 2023. Eligible women were interviewed; the data were analyzed in SPSS v. 22 and expressed in numbers and percentages. A P-value < 0.05 was considered significant. Results: The data from 369 eligible women with an average age of 30.39 ± 5.42 years were analyzed. Of these women, 7.6% had minimal information about labor analgesia, and 92.4% declared they were almost aware of the procedure. Only 6 women (1.8%) believed that the anesthesiologists were responsible for performing labor analgesia, while 218 (63.9%) considered it the duty of obstetricians-gynecologists. Besides, 294 women (86.2%) requested this method, and 259 (76%) were ready to pay for it. Moreover, 166(48.7%) had no fear of the procedure. Nonpharmacologic methods were the first choice for 164 (48.1%), while Entonox was the last choice for 26 (7.6%). A significant association was observed between maternal level of education and willingness to pay for painless delivery (P = 0.006), knowledge of who performs it (P = 0.015), requesting a painless delivery (P = 0.0001), options related to the preferred method for painless delivery (P = 0.001), and being ready to pay for a painless delivery service (P = 0.0001). Conclusions: Despite the poor maternal knowledge regarding the process of painless labor, the majority of the women requested the method and were ready to pay for it. These promising findings encourage the application of practical strategies to remove barriers.

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Why Effective Pain Management Remains a Challenge

Cited by 3 publications

References 47 publications

Labor pain management practices and associated factors in Ethiopia: A systematic review and meta‐analysis

Labor pain management practices and associated factors in Ethiopia: A systematic review and meta‐analysis

Nurses knowledge, attitudes and education needs towards acute pain management in hospital settings: A meta‐analysis

Maternal Attitude and Knowledge Regarding Painless Labor: A Report from a Referral Hospital in Northern Iran

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