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Higher knowledge of neonatal pain is associated with increased use of standardized assessment toolsFew hospital staff use standard tools to measure newborn pain

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Key Takeaway
Note that higher healthcare provider knowledge is associated with increased use of standardized neonatal pain tools.

This multicenter cross-sectional survey evaluated the knowledge and practices of 530 healthcare professionals regarding postoperative neonatal pain assessment in a resource-limited setting. The study assessed several outcomes, including the recognition of neonatal pain, the use of standardized tools, and the availability of dedicated training.

Key findings indicate that while 86.8% of professionals recognized neonatal pain, only 10.0% reported using a standardized assessment tool. Furthermore, only 15.3% reported performing pain assessments at regular intervals. Notably, 99.8% of the participants reported having no dedicated training in neonatal pain. Regarding knowledge scores, the mean score was 2.16 ± 0.84, with 34.7% of participants achieving a high knowledge score (score ≥3).

Multivariable logistic regression showed that higher knowledge was independently associated with the reported use of a standardized tool (OR 4.90; 95% CI 3.10–7.70; p < 0.001). These results highlight a significant gap in specialized training and standardized practice despite high rates of pain recognition. Because the data are self-reported and based on a cross-sectional survey, the results should be interpreted as an assessment of current practices rather than a measure of clinical outcomes.

When a baby undergoes surgery, managing their pain is a critical part of care. A survey of 530 healthcare professionals in a hospital in the Democratic Republic of the Congo looked at how staff handle neonatal pain. While the vast majority of these professionals (86.8%) recognized that newborns experience pain, the actual tools used to measure that pain were rarely used.

Only 10% of the staff reported using a standardized tool to assess pain, and only about 15% checked for pain at regular intervals. The study also found a significant gap in education, as nearly 100% of the staff reported having no specific training on neonatal pain.

However, there was a clear link between education and practice. Staff with higher knowledge scores were much more likely to use a standardized tool to assess pain. Because this was a survey of self-reported data rather than a clinical trial, these findings highlight a specific need for better training and tools in these settings.

What this means for you:
Most staff recognize newborn pain, but few have the training or tools to measure it consistently.

Common questions

Do hospital staff recognize that newborns feel pain?

Yes, the survey found that 86.8% of the healthcare professionals surveyed recognized that newborns experience pain after surgery.

How often do staff use standard tools to measure pain?

Only 10% of the healthcare professionals reported using a standardized tool to assess neonatal pain, and only 15.3% reported assessing pain at regular intervals.

Is there specific training for managing newborn pain?

The study found that 99.8% of the healthcare professionals reported having no dedicated training for neonatal pain.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
BackgroundNeonatal pain remains inconsistently assessed, particularly in resource-limited settings. We assessed healthcare professionals’ knowledge and reported practices regarding postoperative neonatal pain assessment in Kinshasa, Democratic Republic of the Congo (DRC).MethodsWe conducted a multicenter cross-sectional survey from August 2025 to May 2026 in ten hospitals with pediatric surgical activity. Healthcare professionals completed a 20-item questionnaire developed through expert content review and pretesting. The primary outcome was self-reported use of a standardized neonatal pain-assessment tool. A four-item knowledge score (0–4) was constructed, with ≥3 indicating high knowledge as a pragmatic study-specific threshold. Multivariable logistic regression used hospital-level cluster-robust standard errors.ResultsOf 580 healthcare professionals approached, 536 returned the questionnaire; six were excluded because of >30% missing data, leaving 530 complete questionnaires for analysis. Although 86.8% recognized neonatal pain, only 10.0% reported using a standardized pain-assessment tool, and 15.3% reported postoperative pain assessment at regular intervals. Nearly all participants (99.8%) reported no dedicated neonatal pain training. The mean knowledge score was 2.16 ± 0.84, and 34.7% had high knowledge. Higher knowledge was independently associated with reported standardized tool use (adjusted OR 4.90, 95% CI 3.10–7.70; p 
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