Knowledge, Attitude, and Practice towards Labor Pain Management and Associated Factors among Skilled Birth Attendants Working at Hospitals Found in Central, West, and North Gondar Zones, Northwest Ethiopia, 2019: A Multicenter Cross-Sectional Study

Abstract

Introduction. Delivery of the infant into the arms of a conscious and pain-free mother is the most exciting and rewarding moment in maternal care services. Physical and mental care of women during delivery requires good knowledge and a positive insight to the needs and rights of the mothers. Little was known regarding skilled birth attendants’ knowledge, attitude, and practice towards labor pain management in the study area. Hence, the current study aimed at assessing knowledge, attitude, and practice, and associated factors towards labor pain management among skilled birth attendants working at hospitals found in central, west, and north Gondar zones, northwest Ethiopia, 2019. Method. A multicenter institution-based cross-sectional study was conducted from June 1 to 30, 2019. A census sampling technique was used to include a total of 336 skill birth attendants. A pretested standardized self-administered questionnaire was used to collect the data. The data were then entered into Epi Info 7.1.2 and exported to SPSS version 25 for analysis. Multivariable logistic regression analyses were undertaken to identify factors associated with outcome variables. The level of significance of the study was declared based on adjusted odds ratio with 95% confidence interval at a p value of ≤0.05. Result. The proportion of skill birth attendants having good knowledge, a favorable attitude, and a good practice on labor pain relief methods was 47%, 41.96%, and 57.14%, respectively. Age of ≤30 years (AOR = 5.43; 95% CI: 1.25, 23.53), educational status of 2nd degree and above (AOR = 3.56; 95% CI: 1.32, 9.60), working at a private primary hospital (AOR: = 6.55; 95% CI: 2.15, 19.93), and working at a referral hospital (AOR = 2.24 : 95% CI: 1.01, 4.93) are factors significantly associated with good knowledge while having good knowledge on labor pain relief methods (AOR = 2.26; 95% CI: 1.42, 3.60) and working at private primary hospitals (AOR = 7.01; 95% CI: 1.92, 25.65) had statistically significant association with favorable attitude and good practice on labor pain relief methods, respectively. Conclusion and Recommendations. Poor knowledge, unfavorable attitude, and poor practice towards labor pain management were found in this study. Strengthening the capacity of public health facilities and providing continuous professional development (CPD) training for the skilled birth attendants would be helpful in improving knowledge, attitude, and practice towards labor pain management.

Obstetrics care providers attitude and utilization of non-pharmacological labor pain management in Harari regional state health facilities, Ethiopia

“…In this study, three hundred five 65.5% [(95% CI (60.9, 69.8)] of the study participants have unfavorable attitudes. This is higher than studies done in Benishangul Gumuz Regional State 53% [ 22 ] and Gondar Ethiopia 58.04% [ 20 ]. This discrepancy may be due to socio-cultural differences among study participants and a higher sample size of the current study than studies done in Gondar [ 20 ] and Benishangul Gumuz Regional State [ 22 ].…”

“…This is higher than studies done in Benishangul Gumuz Regional State 53% [ 22 ] and Gondar Ethiopia 58.04% [ 20 ]. This discrepancy may be due to socio-cultural differences among study participants and a higher sample size of the current study than studies done in Gondar [ 20 ] and Benishangul Gumuz Regional State [ 22 ]. This implied that concerned bodies should work together to improve the attitude of obstetrics care providers through different strategies such as facilitating continuous educational opportunities which have a profound effect on addressing the women’s need of alleviating labor pain.…”

“…The overall utilization of non-pharmacological labor pain relief methods was 59.3% [(95% CI (53.9,63.4)]. The finding is higher than studies done in general hospitals of Tigray 43.3% [ 14 ], East Gojjam zone, Amhara region 30.4% [ 19 ], Gondar 20.72% [ 20 ], Amhara region,40.1 and 46.8% [ 8 , 9 ]. The possible explanation could be variations in the level of knowledge, the higher sample size of the current study, and the availability of labor-management protocols which enhance the utilization of non-pharmacological pain management methods.…”

The relationship between attitude and self-efficacy of labor support with supportive behaviors from the perspective of midwives

“…One's own personal birth experience can also be positively correlated with attitudes about and intent to provide PLS [19], along with age and length of experience [1,12]. Furthermore, good knowledge in relation to pain relief in labor and working at private primary hospitals have also been found to be statistically significant in relation to favorable attitudes and clinical practice [20,21]. Other factors associated with the low levels of supportive behavior provided by midwives for women in labor relate to their workload and shift length [14,18].…”

Knowledge, Practices, and Attitudes of Nurses Regarding Non-Pharmacological Pain Management in the Midwifery Ward

“…This may be due to adequate space, staff, and equipment. It comes along with a study done by [21] in Ethiopia on 336 skilled attendants who, revealed that more than half of the study participants had good practice. This is similar to a crosssectional study carried out by [22] in Ethiopia among 464 healthcare professionals.…”