Paediatric Pain Management Experiences of Parents of Children in Botswana Referral Hospitals.

Aim: To describe the experience and understanding of paediatric acute pain management practices by parents/guardians' of hospitalised children in Botswana.

Design: Descriptive qualitative study.

Methods: Face-to-face semistructured interviews were conducted in two public hospitals. Data were transcribed verbatim and analysed using thematic analysis.

Results: A convenience sample of 19 parents/guardians, two fathers, one grandmother and 16 mothers who were recruited in 2019. Six major themes were identified with several subthemes. The themes were as follows: 'soldiering on with hope'-representing the parents/guardians overall general positive outlook; 'facing adversity'-highlighting parents/guardians responses to acute pain management; 'acceptance to nonacceptance of the reality of care'-parents/guardians view on the quality of pain care they received measured against their expectations; 'smiles to unending nightmares'-parents/guardians visualisation of the pain treatment outcomes; 'perceptions of child pain'-parents/guardians' knowledge of pain assessment and treatment strategies that they used or were being used by healthcare providers to their children and 'guarded empathy'-highlighting the intricacies of each child's response to pain. Parents/guardians in Botswana have both positive and negative experiences regarding child pain management in referral hospitals and recognise the need to adequately manage paediatric pain.

Patient or public contribution: The results show that parents/guardians in LMIC equally understand the children's pain management and should be involved in decision-making regarding pain management as equal partners. It further highlights the challenges faced by parents due to poorly and inadequately treated acute paediatric pain in hospital units and pushes for hospital policies that ensure that pain is adequately managed for all children.