The relationship between caregiver sensitivity and infant pain behaviors across the first year of life

Abstract

Recent research has begun to examine discrete caregiver pain management behaviors in the infant immunization context. However, there is a dearth of research exploring more global caregiving constructs, such as emotional availability, which can be used to examine the overall sensitivity of caregiver pain management. The aim of the present study was to examine the relationships between caregiver sensitivity (emotional availability) and infant pain behavior (baseline, immediately post-needle, 1 min after needle) over the first year of life. Parents and infants were a part of a Canadian longitudinal cohort (the Opportunities to Understand Childhood Hurt or OUCH cohort) followed up during their 2-, 4-, 6-, and 12-month immunizations (current n=731). Both within-age group analyses and over-age analyses were performed. Results indicated that: (1) over age, previous infant pain behavior predicts future infant pain behavior, but this varied depending on timing of pain response and age of infant; (2) over age, previous caregiver sensitivity strongly predicts future caregiver sensitivity; and (3) the concurrent relationship between caregiver sensitivity and every type of infant pain response is only consistently seen at the 12-month immunization. Caregiver sensitivity to the infant in pain is predicted most reliably from previous caregiver sensitivity, not infant pain behaviour. The significant concurrent relationship between caregiver sensitivity and infant pain behaviours is not seen until 12 months, replicating patterns in the infant development literature regarding the time at which the attachment relationship between parent and child can be reliably measured. Discussion addresses implications for both researchers and clinicians who work with infants in pain.

Infant Clinical Pain Assessment: Core Behavioral Cues

“…This is in line with previous research using the same dataset but the full seven-item version of the scale [26], NFCS scores showed small negative relationships with EAS caregiver sensitivity at 12 months. There was also weak concurrent validity between the 3-item NFCS pain scores and MAISD caregiver behaviours (physical comfort, rocking and verbal reassurance).…”

“…Details of the procedures and materials used for the longitudinal OUCH cohort study have been previously described [26]. Here is a brief summary of the waves relevant to the current analysis.…”

“…The proposed analysis used archival data from a large research study (the OUCH Cohort) [26] in which infant-caregiver dyads were recruited from 3 pediatric clinics in Toronto and observed throughout the infant's first year of life at their 2-, 4-, 6-, and 12-month immunization appointments and again at the child's preschool (i.e., 4-6 years of age) immunization. The data for this longitudinal cohort study was collected between October 2007 and December 2015.…”

Examining Affective-Motivational Dynamics and Behavioral Implications Within The Interpersonal Context of Pain

“…Similarly, efforts to distract a pain sufferer with humour are likely to rely a great deal on what is communicated by the facial expression of the pain observer/caregiver [18,52,71]. A complementary mechanism may be an observer's sensitivity to feedback cues provided by the person in pain [72,73]. For instance, selforiented emotion and avoidance motives may impede observer receptivity or attention to sufferer feedback, potentially contributing to rigid/inflexible caregiving behaviour (e.g., excessive focus on pain control at the expense of non-pain goals [2,8] or, vice versa, excessive focus on non-pain goals at the expense of pain control) and ultimately negative pain outcomes [78].…”

¿Afectan las complicaciones perinatales la respuesta sensible de las madres hacia sus hijos/as de 12 meses?

“…En esta línea, investigaciones posteriores aportan evidencia sobre la relación entre sensibilidad, diferentes patrones de comportamiento de la madre y el estilo de apego desarrollado por el niño/a (Belsky & Fearon, 2008; Kersten-Alvarez, Hosman, Riksen-Walraven, Van Doesum & Hoefnagels, 2011;Meins, Fernyhough, Fradley & Tuckey, 2001). También ha sido asociada al temperamento infantil (Kivijärvi, Räihä, Kaljonen, Tamminen & Piha, 2005), a las conductas del bebé frente al dolor físico (Pillai Riddell et al, 2011), a la cantidad de llanto del infante frente al estrés (Lohaus, Keller, Ball, Voelker & Elben, 2004) y a su desarrollo socioemocional (Page, Wilhelm, Gamble & Card, 2010;Pearson et al, 2011). Estos antecedentes han llevado a proponer que la sensibilidad de la madre en las interacciones tempranas constituye un factor importante para predecir el desarrollo futuro del niño (Kemppinen, Kumpulainen, Raita-Hasu, Moilanen & Ebeling, 2006).…”