Dataset Information

Nurses and midwives' experiences of using non-pharmacological interventions for labour pain management: a qualitative study in Ghana.

ABSTRACT:

Background

Non-pharmacological interventions hold promise in reducing labour pain, with minimal or no harm to the mother, foetus and the progress of labour and are simple and cost-effective. Yet their use has not been adequately explored in clinical settings, especially in sub-Saharan Africa.

Methods

This was a descriptive phenomenological study. Fifteen (15) nurses and midwives working in labour wards of two hospitals in Ghana were interviewed. Data analysis was guided by the principles of coding by Bailey and the constant comparative approach to generate themes. Ethics approval was obtained from the 37 Military Teaching Hospital Institutional Review Board in Ghana.

Results

Three major themes were identified that described the experiences of nurses and midwives regarding their use of non-pharmacological interventions in managing labour pain. These were familiarity with non-pharmacological interventions, perceived benefits of non-pharmacological interventions, and barriers to the use of non-pharmacological interventions in the management of labour pain.

Conclusions

While some non-pharmacological pain management interventions were known and used by the nurses and midwives, they were not familiar with a good number of these interventions. Nurses and midwives perceived these interventions to be beneficial yet a number of barriers prevented easy utilisation.

SUBMITTER: Boateng EA

PROVIDER: S-EPMC6518741 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Publications

Nurses and midwives' experiences of using non-pharmacological interventions for labour pain management: a qualitative study in Ghana.

Boateng Edward Appiah EA Kumi Linda Osaebea LO Diji Abigail Kusi-Amponsah AK

BMC pregnancy and childbirth 20190514 1

<h4>Background</h4>Non-pharmacological interventions hold promise in reducing labour pain, with minimal or no harm to the mother, foetus and the progress of labour and are simple and cost-effective. Yet their use has not been adequately explored in clinical settings, especially in sub-Saharan Africa.<h4>Methods</h4>This was a descriptive phenomenological study. Fifteen (15) nurses and midwives working in labour wards of two hospitals in Ghana were interviewed. Data analysis was guided by the pri ...[more]

PMID: 31088408

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Project description:BackgroundWomen of childbearing age feel great about giving birth, but the pain could be excruciating depending on their pain tolerances. Midwives requires obstetrical knowledge and skills such as pain management during labour and safety. We explored midwives' perspectives on the utilisation of pharmacological pain alleviation interventions during labour in selected hospitals in Matjhabeng Municipality, Free State province, South Africa. A qualitative study was undertaken, involving a sample of ten midwives, using a semi-structured interview guide. The interviews were audio-recorded and transcribed verbatim. Tesch's open coding data analysis method was applied to analyse the data. The midwives were restricted to use Pethidine and Phenergan prescribed by doctors for labour pain relief, which disrupted labour pain management and obliged them either to wait for a physician or follow telephone instructions. According to the midwives, women taking Pethidine and Phenergan encountered adverse effects and discomfort. Midwives identified high workload, inadequate personnel, lack of skill and knowledge, lack of medication availability, and lack of infrastructure as the primary challenges of administering pharmacological methods to women in labour. The lack of standing orders, which delays the administration of medications pending a physician's prescription, constituted an additional difficulty. In the instance that Pethidine and Phenergan were unavailable or ineffective for some women, the midwives recommended that women be administered alternative pharmacological pain relievers. They also advocated for institutionalization of pharmacological guidelines allowing them to use their discretion when treating labour pain. Midwives can only utilise a few standardised and regulated pharmacological medications for labour pain management. The midwives' ability to administer pharmacological pain relief during labour was hampered by a high workload burden, insufficient staff, lack of skill and understanding, drug unavailability, and inadequate infrastructure. Midwives advocated for supported guidelines that would allow them to treat labour pain at their discretion. Intersectoral stakeholders are required to improve midwife skills and attitudes. Health facilities need to train and supply analgesics to midwives. Midwives ought to be familiar with pharmacological pain relievers.

Project description:IntroductionDecent working time in the health sector is critical to providing quality care, and balancing health workers' well-being with the requirements of 24/7 healthcare provision. Nursing and midwifery staff, comprising the largest group in the health workforce, play a crucial role. Understanding their experiences and challenges related to duty rosters is essential for improving work conditions, job satisfaction, and ultimately, the quality of care.ObjectiveThis study aims to explore the experiences of nurses and midwives with the hospital duty roster at selected health facilities in Ho, the Volta Region of Ghana.MethodA qualitative research method with a phenomenological approach was employed to capture the nuanced experiences of nurses and midwives regarding the hospital duty roster. A semistructured interview guide facilitated data collection, ensuring a comprehensive exploration of participants' experiences. Three selected health facilities in Ho, the Volta Region of Ghana, served as the study's location. The study recruited 20 participants (nurses and midwives) to reach data saturation. The collected data were transcribed verbatim and analyzed through thematic content analysis, using a deductive approach. Researchers reviewed the raw data, generating initial codes to capture new concepts of interest.ResultsThe duty roster often demonstrated organizational flaws negatively impacting the health, well-being, and job performance of nurses and midwives, consequently affecting patient care quality. The study identified that these healthcare professionals faced significant risks of work-related stress, burnout, and mental health problems due to ineffective coping strategies toward the hospital duty roster. Findings from the study also demonstrated that nurses and midwives prefer day shift because of its short time and the availability of all groups of professionals to help manage cases as compared to a night shift.ConclusionsThe findings underscore factors influencing nurses' choice of shift patterns, emphasizing the need for further research to explore the extent to which nurses' preferences are considered when designing hospital duty rosters. Such insights can contribute to improving both the working conditions of healthcare professionals and the overall quality of patient care.

Project description:BackgroundChronic pain constitutes a significant burden for the individuals affected, and is a frequent reason why patients seek health care services. While in-person psychosocial interventions can be of support to people living with chronic pain, such interventions are not always accessible. eHealth interventions may provide greater accessibility, but the evidence and use of digital self-management solutions for chronic pain are still limited and the lack of health care provider input in the development process of such solutions a concern. Therefore, the aim of the current study was to investigate health care providers' experiences of treating patients with chronic pain, their attitudes towards, and use of, digital solutions in pain management, and their suggestions for content and design elements for a potential digital pain self-management intervention.MethodsTwelve health care providers representing a variety of health care disciplines participated in semi-structured interviews. The interviews were analyzed using thematic analysis.ResultsThe material was analyzed into three main themes: [1] Patients with chronic pain and their current use of the health care services, [2] Health care providers' own motivation and impression of patient prerequisites for use of digital self-management interventions, and [3] Suggestions for content and design elements in a digital self-management intervention for people living with chronic pain. The challenges faced by patients living with chronic pain were described as numerous. Despite interest and positive attitudes, few of the health care providers had used or recommended eHealth solutions to their patients. A range of potential content and functionality elements were identified, including aspects of motivation and engagement and providers also emphasized the importance of easy access and positive, personal content to support existing treatment.ConclusionsThis study offers insights into health care providers' considerations for the potential of digital self-management interventions supporting patients living with chronic pain. Findings indicate the need for change and a more comprehensive treatment approach to pain management. eHealth solutions may contribute to such change, and providers pointed to a need for health care provider involvement, timely support and follow-up as important factors for integrating digital pain self-management interventions into clinical care.Trial registrationClinicalTrials.gov : NCT03705104.

Project description:ObjectiveSchizophrenia is a chronic condition, of which the diagnosis and management require comprehensive care. The role mental health nurses play in this management cannot be overemphasised. In an effort to give their best, several challenges confront them which need to be sought and addressed. This study aimed to explore the factors that influence the management of schizophrenia by mental health nurses in the Upper East Region.Design and participantsA descriptive phenomenology design was used in this study. Individual in-depth interviews were conducted among 18 purposively sampled mental health nurses using a semistructured interview guide. Audio-recorded interviews were transcribed verbatim and analysed thematically using Colaizzi's approach.SettingThe study was conducted in five primary and secondary-level health facilities in the Upper East Region of Ghana.FindingsFive themes were deduced from the theoretical framework, which were as follows: individual factors, interpersonal factors, organisational factors, community-level factors, and policy-level factors. At the individual level, factors such as the condition of the patient at presentation, medication side effects, inadequate knowledge, and poor adherence were identified. Interpersonal factors identified were poor communication, lack of mutual respect, and poor communication, while organisational factors such as inadequate staff, inadequate infrastructure and logistics, and unavailability of antipsychotics were reported. Moreover, the study identified community-level factors such as stigma and cultural beliefs, while policy-level factors such as laws regarding suicide, patient rights, and non-inclusion of mental health services into the National Health Insurance Scheme were reported as factors influencing the management of schizophrenia by mental health nurses.ConclusionsAddressing these factors is essential to ensure sustainable improvements and the effective management of schizophrenia. It is imperative to consider these factors when designing interventions and policies to optimise the management of schizophrenia by mental health nurses in Ghana.

Project description:ObjectivesTo explore women's experiences of remifentanil or pethidine for labour pain and infant feeding behaviours at 6weeks post partum.DesignQualitative postnatal sub-study to the randomised controlled trial of remifentanil intravenous patient controlled analgesia (PCA) versus intramuscular pethidine for pain relief in labour (RESPITE). Semistructured telephone interviews were conducted at 6 weeks post partum, and thematic analysis was undertaken.SettingWomen recruited to the RESPITE trial from seven UK hospitals.ParticipantsEighty women consented and 49 (30 remifentanil group and 19 pethidine group) completed the interview.ResultsEight themes emerged which encompassed women's antenatal plans for pain management (Birth Expectations) through to their future preferences for pain relief (Reflections for Future Choices). Many women who used remifentanil felt it provided effective pain relief (Effectiveness of Pain Relief), whereas women in the pethidine group expressed more mixed views. Both groups described side effects, with women using pethidine frequently reporting nausea (Negative Physiological Responses) and women using remifentanil describing more cognitive effects (Cognitive Effects). Some women who used remifentanil reported restricted movements due to technical aspects of drug administration and fear of analgesia running out (Issues with Drug Administration). Women described how remifentanil enabled them to maintain their ability to stay focused during the birth (Enabling a Sense of Control). There was little difference in reported breastfeeding initiation and continuation between pethidine and remifentanil groups (Impact on Infant Behaviour and Breastfeeding).ConclusionsQualitative insights from a follow-up study to a trial which explored experiences of intravenous remifentanil PCA with intramuscular pethidine injection found that remifentanil appeared to provide effective pain relief while allowing women to remain alert and focused during labour, although as with pethidine, some side effects were noted. Overall, there was little difference in reported breastfeeding initiation and duration between the two groups.Trial registration numberISRCTN29654603.

Dataset Information

Nurses and midwives' experiences of using non-pharmacological interventions for labour pain management: a qualitative study in Ghana.

Background

Methods

Results

Conclusions

Publications

Nurses and midwives' experiences of using non-pharmacological interventions for labour pain management: a qualitative study in Ghana.

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