Peer-reviewed article
Knowledge and practices regarding postoperative neonatal pain assessment among healthcare professionals in Kinshasa: a multicenter cross-sectional survey
Eriksson Landu, Joseph Nsiala, Arriel Makembi Bunkete, Wilfrid Mbombo, Stéphane Mutombo et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This survey asked 530 healthcare professionals in ten hospitals in Kinshasa, Democratic Republic of the Congo, about how they assess pain in newborns after surgery. Most (86.8%) recognised that newborns feel pain, but only 10.0% said they used a standardized pain-assessment tool. Only 15.3% said they assessed postoperative pain at regular intervals, and almost none had received dedicated neonatal pain training. Professionals with higher knowledge scores were more likely to report using a standardized tool.
Key points
- 86.8% of respondents recognized neonatal pain.
- Only 10.0% reported using a standardized pain-assessment tool.
- Only 15.3% reported assessing postoperative pain at regular intervals.
- 99.8% reported no dedicated neonatal pain training.
- Higher knowledge was associated with reported tool use (adjusted OR 4.90, 95% CI 3.10–7.70); the association was weaker (adjusted OR 1.93) when scale recognition was removed from the knowledge score.
Limitations
The data are self-reported and come from a cross-sectional design, so the study cannot show that knowledge causes tool use or what staff actually do at the bedside. The knowledge threshold was a study-specific choice, and the results are limited to ten hospitals in Kinshasa.
Abstract
Background Neonatal pain remains inconsistently assessed, particularly in resource-limited settings. We assessed healthcare professionals’ knowledge and reported practices regarding postoperative neonatal pain assessment in Kinshasa, Democratic Republic of the Congo (DRC). Methods We conducted a multicenter cross-sectional survey from August 2025 to May 2026 in ten hospitals with pediatric surgical activity. Healthcare professionals completed a 20-item questionnaire developed through expert content review and pretesting. The primary outcome was self-reported use of a standardized neonatal pain-assessment tool. A four-item knowledge score (0–4) was constructed, with ≥3 indicating high knowledge as a pragmatic study-specific threshold. Multivariable logistic regression used hospital-level cluster-robust standard errors. Results Of 580 healthcare professionals approached, 536 returned the questionnaire; six were excluded because of >30% missing data, leaving 530 complete questionnaires for analysis. Although 86.8% recognized neonatal pain, only 10.0% reported using a standardized pain-assessment tool, and 15.3% reported postoperative pain assessment at regular intervals. Nearly all participants (99.8%) reported no dedicated neonatal pain training. The mean knowledge score was 2.16 ± 0.84, and 34.7% had high knowledge. Higher knowledge was independently associated with reported standardized tool use (adjusted OR 4.90, 95% CI 3.10–7.70; p < 0.001). In the prespecified sensitivity analysis using the reduced three-item knowledge score, the association remained significant but was attenuated (adjusted OR 1.93, 95% CI 1.23–3.03; p = 0.004). Conclusion Reported use of standardized neonatal pain-assessment tools and regular postoperative pain assessment were low despite widespread recognition of neonatal pain. Higher knowledge was associated with reported tool use, although the association was attenuated after excluding scale recognition from the knowledge score. These findings highlight gaps in neonatal pain assessment and training, while the cross-sectional design precludes causal interpretation.