Care providers' experiences regarding barriers to maternal participation in neonatal pain management

Background Mothers' involvement in the pain management of infants admitted to the intensive care unit can alleviate the infants' pain. Despite International guidelines, maternal involvement in neonatal pain management is low. Hence, investigating the perspectives of care providers (CPs) on barriers to maternal participation can be helpful in developing practice guidelines. Aims The purpose of this study was to investigate the experiences of CPs on barriers to maternal involvement in neonatal pain management in the intensive care unit. Design In this study, a qualitative design based on the content analysis approach was used. Method We included 24 nurses and physicians in the neonatal intensive care unit from February to September 2020. Data were collected through conducting 11 individual interviews and two focus group discussions with eight and five participants, respectively. Results Three main categories and seven sub-categories were found, including maternal barriers (inadequate emotional readiness and unfamiliarity with role), CPs' barriers (time pressure, fear of family-care provider tension, and insufficient knowledge), and organizational barriers (neglected joint decision-making and restricted organizational participative policies). Conclusions The identified barriers could be classified into those related to mothers, care providers, and organizations. The lack of appropriate interaction and cooperation between parents and care-providers can affect the emergence of barriers related to the mothers and staff. Relevance to Clinical Practice There is a lack of knowledge regarding neonatal pain management in the health care team and mothers. Educating mothers and CPs about the benefits and ways of mothers' participation can increase readiness and capabilities. Providing clear guidelines about family-centred care and promoting parent-CPs' interactions can increase the mothers' participation.