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

Abstract

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.

Efficacy and safety of non-pharmacological interventions for neonatal pain: an overview of systematic reviews

“… 45 Studies have shown that KC can not only reduce pain and stabilise the physiological and behavioural responses of the neonates, but it also strengthens the mother–infant bonding. 56 57 Furthermore, no significant difference in pain scores was found between the mother and other providers (father and another woman). 45 If mothers could not participate in KC, fathers or other women can serve as alternatives.…”

Elaboration and Validation of a Terminology Subset for Newborns With Central Venous Catheters

“…Painful manifestations are frequent in Neonatal Intensive Care 10 . In an international study conducted with 101 newborns, with gestational ages between 24 and 40 weeks, occurrence of nearly eight painful procedures per day was found, a reality verified at the national level, where a study with 150 newborns pointed out 6.6 invasive procedures per day 21 .…”

“…Pain expression can be characterized by behavioral changes and facial expressions, such as: crying, excessive limb movement, increased heart rate, and decreased oxygen saturation 22 . The long-term consequences are delayed growth and neurological development, as well as cognitive and motor deficits 10 .…”

“…Comparative studies of the use of X-ray or ultrasound as the most effective technique for recognizing the ideal positioning of the catheter tip were also found in the databases, as well as research studies about the benefits or disadvantages of early catheter removal when compared to an expectant approach. All these productions aim at improving and supporting the techniques performed by nurses to guarantee safe assistance to the neonate [7][8][9][10][11][12][13][14] . Thus, a gap was observed in the literature about the development and validation of a terminology subset of the ICNP ® for this clientele, guided by a Nursing theory, thus justifying conduction of this research.…”

What About Parental Involvement in Infants' Pain Management? A Commentary on Erkut, Mutlu, and Çakıcı (2021)

“…Parents' advocacy for adequate neonatal pain management, closely related to the family-centered care philosophy, has significantly contributed to advancing research and clinical care practice in the past decades. As reported by systematic and scoping reviews, 12,17,18 parent-nurse collaboration can optimize the use of effective and safe analgesic strategies in neonatal intensive care units.…”