Knowledge and practice of pediatric pain management and associated factors among nurses in Ethiopia: a systematic review and meta-analysis.

Abstract

Background: The knowledge and practices of nurses are determinant factors of pediatric pain management, but there are no pooled results concerning prevalence and associated factors. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of good knowledge, good practices, and associated factors for pediatric pain management in Ethiopia.

Methods: PubMed, Cochrane, Scopus, CINAHL, Google Scholar, and university repositories in Ethiopia were searched. It was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and Newcastle-Ottawa Scale was used to assess the quality. Cross-sectional studies conducted any time were included. STATA 17 was used to analyze the data after extraction. Heterogeneity was assessed via I² statistics, Galbraith plot and meta-regression. A random effects model was used in the presence of heterogeneity. Funnel plots and Egger's regression were used to assess publication bias. Subgroup analyses were conducted by the study period and sample size. Sensitivity analysis was also performed.

Results: Nine studies with a total of 2355 nurses were included. The pooled prevalence of good knowledge and practices for pediatric pain management among nurses was 60% and 42%, respectively. The percentages were higher from 2015-2021 than from 2022-2024. Education, training, pain management protocols, and tools were the main variables analyzed. Hence, pre-service training (OR: 3.1, CI: 2.21-4.36), in-service training (OR: 3.04, CI: 1.78-5.18), and pain management protocol (OR: 2.53, CI: 1.59-4.03) were associated with good knowledge. MSc degrees (OR: 7.45, CI: 2.74-20.21), pre-service training (OR: 2.26, CI: 1.53-3.34), in-service training (OR: 3.27, CI: 1.72-6.25), presence of protocol (OR: 2.68, CI: 1.79-3.99), presence of tool (OR: 2.74, CI: 1.96-3.83), presence of policy (OR: 6.2, CI: 2.98, 12.91), knowledge of nurses (OR: 4.47, CI: 3.24, 6.18) and child cooperativeness (OR: 1.98, CI: 1.46, 2.67) were associated with good practices of pediatric pain management.

Conclusion: The pooled prevalence of good knowledge and good practices was low. Education, training, and the availability of pain management protocols were the most important factors. Therefore, education and training provisions should focus on nurses working in pediatric wards.

Trial registration: PROSPERO registration number: CRD42024572462.