Interprofessional Collaboration and Involvement of Parents in the Management of Painful Procedures in Newborns

Balice-Bourgois, Colette; Zumstein‐Shaha, Maya; Simonetti, Giacomo D.; Newman, Christopher J.

doi:10.3389/fped.2020.00394

Cited by 23 publications

(47 citation statements)

References 60 publications

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“…Guidelines also lack important updates for combined parent-delivered pain management. Research shows that a combination of several nonpharmacological interventions increases the analgesic effect (20). Neonatal pain research suggests that combined parent-delivered interventions, especially multisensory strategies such as SSC and breastfeeding, deliver synergistic effects (30,75).…”

Section: Discussionmentioning

confidence: 99%

“…Parents who are present during painful procedures report lower distress and more satisfaction with care (9) and feel empowered in their caregiving role (14). Parents need and want to participate actively in their infant's pain management, and they should be educated and guided through various means, not just verbal information, to mitigate their infant's pain (15)(16)(17)(18)(19)(20)(21)(22). Coaching parents to better meet their infant's attachment needs during times of pain may lead to more efficacious interventions (23).…”

Section: Introductionmentioning

confidence: 99%

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State of the Art in Parent-Delivered Pain-Relieving Interventions in Neonatal Care: A Scoping Review

2021

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Introduction: Parents' active involvement during painful procedures is considered a critical first step in improving neonatal pain practices. Of the non-pharmacological approaches in use, the biopsychosocial perspective supports parent-delivered interventions, in which parents themselves mediate pain relief, consistent with modern family-integrated care. This scoping review synthesizes the available research to provide an overview of the state of the art in parent-delivered pain-relieving interventions.Methods: A scoping review was performed to achieve a broad understanding of the current level of evidence and uptake of parent-driven pain- and stress-relieving interventions in neonatal care.Results: There is a strong evidence for the efficacy of skin-to-skin contact and breastfeeding, preferably in combination. These parent-delivered interventions are safe, valid, and ready for prompt introduction in infants' pain care globally. Research into parents' motivations for, and experiences of, alleviating infant pain is scarce. More research on combined parent-delivered pain alleviation, including relationship-based interventions such as the parent's musical presence, is needed to advance infant pain care. Guidelines need to be updated to include infant pain management, parent-delivered interventions, and the synergistic effects of combining these interventions and to address parent involvement in low-income and low-tech settings.Conclusions: A knowledge-to-practice gap currently remains in parent-delivered pain management for infants' procedure-related pain. This scoping review highlights the many advantages of involving parents in pain management for the benefit not only of the infant and parent but also of health care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

State of the Art in Parent-Delivered Pain-Relieving Interventions in Neonatal Care: A Scoping Review

2021

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“…On the other hand, negative parental views about parental presence and parental provision of pain care for their infants has also been established in this article (1). Frank et al 3showed the roles parents wanted to play in infant pain management ranged from none (not presence or viewed infant comfort as the role of only the nurse or doctor) to advocating for the infant (believing this was their primary responsibility, in partnership with clinical care team).…”

Section: Negative Parental Views About Parental Participation In Painmentioning

confidence: 80%

“…In addition, this article (1) and other previous (9, 10) studies demonstrated parents' desire for knowledge about infant pain. When parents are educated either verbally or with demonstrations about specific interventions, they have shown they will effectively employ the pain management or reduction interventions during subsequent painful procedures for their infants (1,9,10). Therefore, there is a possibility that parental presence and provision of pain care, or working with health-care providers to advocate for pain management in their infants, will become a mainstream practice in NICUs.…”

Section: Introductionmentioning

confidence: 99%

Commentary: Interprofessional Collaboration and Involvement of Parents in the Management of Painful Procedures in Newborns

Ozawa

2020

Front. Pediatr.

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“…The most common request was the development of national, evidencebased protocols. Moreover, many respondents highlighted the importance of parents' involvement in the care of their neonates, which is also a parental wish as demonstrated by a recent study (47).…”

Section: Sources Of Knowledge Update and Physicians' Suggestions For Further Improving Neonatal Pain Managementmentioning

confidence: 98%

Changes in Physicians' Perceptions and Practices on Neonatal Pain Management Over the Past 20 Years. A Survey Conducted at Two Time-Points

et al. 2021

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Intense research for more than three decades expelled the view that neonates do not experience pain. The aim of this survey was to investigate whether the Greek physicians involved in neonatal intensive care have changed their perceptions regarding neonatal pain, adapting their management practices to the knowledge that have emerged in the past 20-years. This study is a survey conducted at two time-points, 20 years apart. Anonymous questionnaires were distributed to 117 and 145 physicians working in neonatal intensive care units (NICUs) all over Greece in years 2000 and 2019, respectively. The response rate was 90.6 and 80.7% in 2000 and 2019, respectively. All respondents, at both time-points, believed that neonates experience pain, which has serious acute and long-term consequences, while the vast majority considered analgesia-sedation (A-S) during painful interventions as obligatory. Utilization of NICU protocols and pain assessment tools remained low although increased significantly between 2000 and 2019. The use of systemic A-S postoperatively was high at both time-points, while its implementation in infants subjected to prolonged pain, specifically mechanical ventilation, increased significantly by 2019. Systemic or local analgesia for acute procedural pain was used by lower proportions of physicians in 2019, except for the tracheal intubation. In contrast, the use of sweet solutions and non-pharmacological measures prior to or during bedside procedures significantly increased over time. Opioid administration significantly increased, while a shift from morphine to fentanyl was observed. International literature and perinatal–neonatal congresses were stated as the main sources of updating physicians' knowledge and improving management practice on neonatal pain prevention and treatment. In conclusion, Greek NICU-physicians' perceptions that neonates can experience pain with potentially serious acute and long-term consequences remained strong over the past 20 years. Although physicians' practices on neonatal pain management improved, they are still suboptimal, while significant differences exist among centers. Continuing education, globally accepted management protocols, and readily applied pain assessment tools would further improve the management of procedural pain and stress in neonates.

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Interprofessional Collaboration and Involvement of Parents in the Management of Painful Procedures in Newborns

Cited by 23 publications

References 60 publications

State of the Art in Parent-Delivered Pain-Relieving Interventions in Neonatal Care: A Scoping Review

State of the Art in Parent-Delivered Pain-Relieving Interventions in Neonatal Care: A Scoping Review

Commentary: Interprofessional Collaboration and Involvement of Parents in the Management of Painful Procedures in Newborns

Changes in Physicians' Perceptions and Practices on Neonatal Pain Management Over the Past 20 Years. A Survey Conducted at Two Time-Points

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