Metasynthesis of Factors That Influence Parents' Participation in Pain Management for Their Infants in the NICU
Parents/psychology; Newborn Infant; Professional-Patient Relations; Patient Satisfaction; Qualitative Research; Nicu; Quality of Health Care/standards; qualitative research; pain management; Neonatal Intensive Care Unit Standards; Patient Participation/methods/psychology; parents’ participation; Pain Management/methods/standards/trends; Parenting/psychology/trends
OBJECTIVE: To metasynthesize the results of qualitative studies on the factors that affect parents' participation in pain management for their infants during procedures in the NICU. DATA SOURCES: We conducted a literature search for articles published from 1976 through November 2019 using MeSH terminology in the following databases: MEDLINE, CINAHL Plus, EMBASE, PubMed, PsycINFO, Cochrane, Scopus, and Web of Science. All qualitative studies in which researchers explored parental participation and education in the NICU were included. STUDY SELECTION: A total of 29,937 articles were returned. Once we removed duplicates and limited results to qualitative studies, 48 articles remained. We excluded 41 articles because the studies reported were not conducted in NICUs, involved neonatal palliative care, or were review or opinion articles. We included seven articles for review. DATA EXTRACTION: Two authors reviewed all articles using the Critical Appraisal Skills Programme tool to assess study quality and independently scored each study. We reviewed and extracted authors, publication date, type of study, sample size, results, themes, and quotes and included these data elements in the analysis. DATA SYNTHESIS: We used a thematic synthesis technique to review the qualitative data, entered codes into NVivo software, and compared codes to create descriptive themes. From these descriptive themes, we generated four analytic themes: Learning to Parent a Hospitalized Infant, Stress and Anxiety, Health Care Providers as Gatekeepers, and NICU Environment. CONCLUSION: The four themes identified in this qualitative metasynthesis represent the factors that affect parents' abilities to participate in their infants' pain management. Further research is recommended to develop interventions that address these factors to optimize parents' participation in pain management for their infants during procedures in the NICU.
McNair C; Chinian N; Shah V; McAllister M; Franck LS; Stevens B; Burry L; Taddio A
Journal of Obstetric, Gynecologic, & Neonatal Nursing
2020
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jogn.2020.02.007" target="_blank" rel="noreferrer noopener">10.1016/j.jogn.2020.02.007</a>
Analgesia and local anesthesia during invasive procedures in the neonate
PedPal Lit
2005
Anand KJ; Johnston CC; Oberlander T; Taddio A; Lehr VT; Walco GA
Clinical Therapeutics
2005
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/j.clinthera.2005.06.018" target="_blank" rel="noreferrer">10.1016/j.clinthera.2005.06.018</a>
Summary proceedings from the neonatal pain-control group
Humans; infant; United States; Pain; Pain Measurement; Respiration; Analgesia; Research Support; U.S. Gov't; Newborn; Pain/drug therapy/etiology; Government Regulation; Anesthesia; N.I.H.; Postoperative/drug therapy; Non-P.H.S.; Extramural; General; Outcome Assessment (Health Care)/methods; Artificial/adverse effects; Clinical Trials/ethics/legislation & jurisprudence
Recent advances in neurobiology and clinical medicine have established that the fetus and newborn may experience acute, established, and chronic pain. They respond to such noxious stimuli by a series of complex biochemical, physiologic, and behavioral alterations. Studies have concluded that controlling pain experience is beneficial with respect to short-term and perhaps long-term outcomes. Yet, pain-control measures are adopted infrequently because of unresolved scientific issues and lack of appreciation for the need for control of pain and its long-term sequelae during the critical phases of neurologic maturation in the preterm and term newborn. The neonatal pain-control group, as part of the Newborn Drug Development Initiative (NDDI) Workshop I, addressed these concerns. The specific issues addressed were (1) management of pain associated with invasive procedures, (2) provision of sedation and analgesia during mechanical ventilation, and (3) mitigation of pain and stress responses during and after surgery in the newborn infant. The cross-cutting themes addressed within each category included (1) clinical-trial designs, (2) drug prioritization, (3) ethical constraints, (4) gaps in our knowledge, and (5) future research needs. This article provides a summary of the discussions and deliberations. Full-length articles on procedural pain, sedation and analgesia for ventilated infants, perioperative pain, and study designs for neonatal pain research were published in Clinical Therapeutics (June 2005).
2006
Anand KJ; Aranda JV; Berde CB; Buckman S; Capparelli EV; Carlo W; Hummel P; Johnston CC; Lantos J; Tutag-Lehr V; Lynn AM; Maxwell LG; Oberlander T; Raju TN; Soriano SG; Taddio A; Walco GA
Pediatrics
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1542/peds.2005-0620C" target="_blank" rel="noreferrer">10.1542/peds.2005-0620C</a>
Beta-endorphin concentration after administration of sucrose in preterm infants
Female; Humans; infant; Male; Pain Measurement; Prospective Studies; Intensive Care; Administration; beta-Endorphin/blood; Biomarkers of Pain; Newborn; Oral; Pain/drug therapy/etiology; Premature; Sucrose/administration & dosage
BACKGROUND: Sucrose is an effective analgesic for procedural pain in preterm infants. It has been hypothesized that its analgesic effects are mediated by the release of endogenous opioid neurotransmitters such as beta-endorphin. OBJECTIVE: To determine whether intraoral administration of sucrose was associated with an increase in serum beta-endorphin concentrations in preterm infants with a gestation period less than 29 weeks who were not exposed to a painful stimulus. METHODS: We performed a prospective open-label study in preterm infants admitted to 2 tertiary neonatal intensive care units. Each infant received a single dose of 30% sucrose intraorally during a 1- to 2-minute period. A blood sample was obtained using an indwelling arterial catheter to determine beta-endorphin concentration immediately before and 2 to 5 minutes after the commencement of sucrose administration. RESULTS: We enrolled 11 preterm infants with a mean +/- SD gestational age of 27.2 +/- 0.9 weeks and a mean +/- SD birth weight of 1018 +/- 238 g (1.02 +/- 0.24 kg) at a mean +/- SD postnatal age of 3.0 +/- 2.5 days. The mean +/- SD beta-endorphin concentration before and after sucrose administration was 60.4 +/- 30.5 pg/mL and 57.4 +/- 22.4 pg/mL, respectively (P =.45). No adverse events were observed during the study procedures. CONCLUSION: Intraoral administration of sucrose in preterm infants did not lead to an increase in serum beta-endorphin concentrations at a point in time when the analgesic effects of sucrose were presumed to be present.
2003
Taddio A; Shah V; Shah P; Katz J
Archives Of Pediatrics & Adolescent Medicine
2003
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1001/archpedi.157.11.1071" target="_blank" rel="noreferrer">10.1001/archpedi.157.11.1071</a>