Background: Despite scientific advances on pain measurement and intervention, pain management for infants has remained a challenge for health teams. This is because infants are not able to talk and defend themselves when they are in pain. Prevention of pain is important, not only because it is an ethical expectation, but also because repeated painful exposures can have harmful consequences. The aim of this study was to explore factors influencing neonatal pain management from the perspectives of nurses and physicians in a neonatal intensive care unit (NICU). Methods: A qualitative content analysis study was carried out. The participants were the nurses and physicians working in the NICU of Alavi medical training center in Ardabil, Iran. Twenty-five nurses took part in focus group discussions and five physicians attended private interviews. Four focus group discussions and five interviews were carried out until data saturation was ensured. Data analysis was performed using conventional content analysis. All the participants were provided with information about the purpose and the nature of the study, and provided informed consent. Results: Data analyses indicated two effective themes about barriers of implementation of infant pain management, namely "Individual Factors" and "Organizational Factors". The first theme consisted of the categories "knowledge of the personnel" and "commitment of the personnel". The second theme included three categories namely "pain control policy", "work environment condition" and "management issues". Conclusions: Our findings indicated that lack of educational courses, absence of an infant pain management policy, and management issues were the main obstacles in the way of implementation of infant pain management by nurses and physicians at the NICU. Therefore, strategies are required to reduce or remove these barriers.
Background: Pain management is especially important for neonates who are not able to verbally express their pain. Non-pharmacological pain management method as an alternative to pharmacological pain medication has increased nowadays. Objectives: The purpose of this study was to test the effect of leg massage and non-nutritive sucking (NNS) on reducing the pain that neonates experience when undergoing the heel stick procedure for blood testing. Methods: This investigation was a random controlled clinical trial study on ninety neonates who were selected randomly among admitted neonates to NICU in Alavi hospital at Ardabil. The subjects were randomly classified in two case and one control groups. The neonates received leg massage (n=30), NNS (n=30), and no intervention (n=30) respectively. Measurements of HR and SaO2 were taken twice: once before and then again after intervention. Pain response was measured by the PIPP scale. Results:The study showed that the HR of the three groups significantly increased after heel stick compared to before heel stick. The change of SaO2 levels in NNS groups was lower than the control and massage groups. The change of PIPP scores in massage and NNS groups was lower than that of the control group; however, there was not statistically significant differences between NNS & massage groups(p=0.91) Conclusion: pain management and pain relief in the infant is an important issue in neonatal health care. It is suggested that the single or combined use of massage and a pacifier is effective in reducing pain responses in neonates undergoing heel stick.
Background and Aims: Diabetic foot ulcers require special attention due to their complex and chronic nature and special care and the Nurse-led approach has emerged in the current situation in response to the increasing need for health care as a way to treat chronic patients and provide them with ongoing care. Providing this specialized duty in nursing can be promoted and enhanced the professional independence of nurses and presents challenges. This study has been conducted to make an understanding of the nurses’ experiences about their participation in a nurse-led multidisciplinary team to providing care for patients with Diabetic Foot Ulcer. Methods: This was a qualitative, phenomenological research, carried out with the participation of 8 nurses of Shariaty Hospital of Tehran. Data collection was done through in-depth and semi structured interview. Dieklemann method was used for data analysis. Results: 2 themes and 4 categories emerged during data analysis: antecedents (background and nursing skills) and manifestation of multidisciplinary function (from despair to tranquility, professional worthiness, promotion of self-confidence, preference of multidisciplinary approach). Conclusion: The findings of this study, which were the lived experiences of the participants, indicated that most of them had experienced positive effect of nurse-led multidisciplinary team care, training and development, appropriate skill mix, quality and outcome of care. Therefore, despite working on a multidisciplinary team is complex and demanding, management attributions and communication strategies is well situated to meet the challenge.
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