Background: Effective neonatal pain management is reliant upon the expert care of nurses and midwives working in neonatal intensive care units (NICUs). Previous research has explored barriers, facilitators, and some aspects of nurse competence in managing neonatal pain; however, this research has been predominantly performed in Western countries. To date, little is known about the barriers, facilitators, and perceived competence of Thai nurses and midwives in relation to neonatal pain management in NICUs. Exploring Thai nurses' and midwives' perceptions in these areas is crucial for understanding the contextual nuances of neonatal pain management, which can guide the provision of care for these high-risk neonates.

Purpose: To investigate nurses' and midwives' perceptions of barriers, facilitators, and competence regarding effective neonatal pain management in Thai NICUs.

Methods: Data were collected using virtual one-to-one, semistructured interviews with 12 neonatal nurses and midwives between July and August 2021 in 3 units of 2 tertiary hospitals in Southern Thailand. Inductive thematic analysis was used to examine interview data.

Results: These data revealed following 3 major themes: (a) barriers to effective neonatal pain management, (b) facilitators of effective neonatal pain management, and (c) perceptions of competence.

Implications for Practice: Assisting nurses and midwives in overcoming barriers and strengthening facilitators while enhancing their competence may result in better neonatal pain management.

Implications for Research: Further research should be designed to achieve change at individual, unit, and organizational levels, particularly implementing parent-friendly visitation and ongoing professional development in neonatal pain management.