Labour pain management practices and associated factors among health workers in labor wards in selected hospitals in Transnzoia County, Kenya

Abstract

Pain experienced during childbirth is a complex, multidimensional and subjective phenomenon. Mothers having a pain free is one of the most exciting and rewarding moments both healthcare workers and the mother. However, in developing countries, women still go through painful labour despite the availability and presence of various methods of labour pain management. Transnzoia is not exceptional because a gap in labour pain management practices among health workers exists. The research aimed to determine the labour pain management practices and associated factors among healthcare workers in labour wards in selected hospitals in Transnzoia, County Kenya. The objectives that guided the study; to determine the health care workers factors that influence labour pain management, in selected hospitals in Trans-Nzoia County. Comfort Theory as stated by Katherine Kolcaba was adopted as the theoretical frame work. Analytical cross-sectional design using mixed methods for data collection was used to collect data from 144 (sample)health workers in labour ward, from selected hospitals with functional labour wards in Transnzoia County for 12 weeks. Purposive sampling techniques was used to selected hospitals with functional labour wards; the random sampling was used to selected health workers. Key informants were identified purposively. Structured questionnaires and KII (key informant interviews) were for in charges, were used for data collection. Descriptive statistics was used to analyze data. Results on respondents’ level of knowledge revealed that 21.4% had poor knowledge, 38.6% fair, and 40% had a good knowledge. The majority, 73.6%, were registered nurse-midwives (RN/RM) and 96.6% used labour pain relief. However, there were significant associations between respondents’ educational (p=0.018 < 0.05), level training (p=0.002 < 0.05), and knowledge (p=0.003 < 0.05) of health workers (p<0.05). The results revealed a positive attitude of offering labour pain relief, among health workers. 121(86.4%) of respondents that strongly agreed women need labour pain relief compared to10 (7.1%) strongly agreed thus showed a negative attitude and thought pain of labour as a natural process where endurance is encouraged. Results further showed that 111(79.3%) of respondents strongly agreed that they were willing to offer any labour pain relief, whereas 6(4.3%) saw no value for non-pharmacological labour pain relief methods to mothers in labour. The role of health workers in labour pain management was acknowledged by 134 (95.7%) of respondents and 134(95.7%) of health workers desired to benefit from additional training in labour pain management.  Health care workers factors play a crucial role in labour pain management practice. Level of education, training and knowledge were significant factors to practice of labour pain management. Therefore, improving knowledge and attitude of healthcare workers will improve practice of labour pain management. The study recommends, County government and ministry of health to: avail trainings for health workers on use of different methods of labour pain management, improving knowledge thus improving their practices on labour pain management.