Abstract
Background: The study set out to explore, describe and compare the assessment and management of neonatal procedural pain at two NICUs; one in a LMIC (PGI, Chandigarh, India) and the other in a HIC (OUH, Oslo, Norway). The aim is to gain insight into influence of country, profession, gender, age, professional experience on the pain intensity assessment, and to compare management of painful procedures to international guidelines. Method: A replication of a previous questionnaire was conducted with the aim of assessing painful procedures in neonates at two tertiary level state-owned neonatal intensive care units (NICUs); PGI and OUH. Furthermore, observation and interviews at the NICUs and their pain management for specific neonatal procedures was explored. T-test and linear regressions were performed to analyze the data that was divided into three groups based on the median VAS score. Result: In this study, we have shown that there is a difference in assessment of subjective pain intensity for the highest and moderately perceived painful procedures between health worker from Ullevaal and Nehru. The lowest perceived pain procedures do not show statistically significant difference between the two NICUs. Other factors as age, gender, profession, professional experience and having own children does not vary significantly either. Observations regarding pain management at the two NICUs indicated that clinical practice was not in accordance with guidelines from UpToDate and that there was a discrepancy in management between the two NICUs too. Conclusion: Health workers at the NICU in India rate neonatal procedures as less painful than health workers from Norway. This difference in assessment deserves exploration to identify the reasons and its impact on pain management at the NICUs.