Parents in Neonatal Pain Management—An International Survey of Parent-Delivered Interventions and Parental Pain Assessment
Abstract
:1. Introduction
2. Materials and Methods
2.1. The Construction of the Survey
2.2. Distribution
2.3. Statistical Analysis
2.4. Quantitative Content Analysis
3. Results
3.1. The Responding Units
3.2. Parent-Delivered Interventions in the Guidelines and Protocols
“Some of these parent-led methods are commonly practiced, but they are not mentioned in our written guidelines”.
“Live singing is encouraged but not in the written recommendations”.
3.3. Parent-Delivered Interventions Performed
3.4. Pain Assessment Performed by Parents
“Parents are not instructed on how to assess pain formally using a validated pain scale. We do tell them how to recognize signs of pain and encourage parents to voice their concerns about pain levels but not using a pain score based on a validated pain scale”.
“I think a pain scale should first be validated for use by parents”.
“We use the ALPS for parents to help them to read their babies signals. Mostly used for parents to premature babies. Even when ALPS is not used, we encourage parents to tell us if they see signs of pain or discomfort”.
3.5. Health Care Professionals’ Attitudes towards Parent-Delivered Interventions
“Still, many nurses prefer that parents stay away during pain maneuvers; I mean invasive ones; while all of them are very positive for parents’ participation in pain relief during simple procedures such as heel puncture”.
“Especially young doctors with less experience feel uncomfortable being watched doing blood withdrawals and venous punctures”.
“We know it is a subject that needs to be discussed, but it always becomes second to other subjects for example ventilation, infection, etc.”.
“Nurses believe that parents in some way disturb the nursing care routine and can transmit infections”.
“Even if I would like to have parents in NICU all day, the hospital Director doesn’t agree”.
“Parents could take part more in pain relief if they were present more with the baby in the neonatal intensive care unit. Only a few parents are on the unit around the clock”.
“Culturally, parents and staff are not comfortable with each other during procedures. I mean staff are not comfortable doing procedures in the presence of parents and parents also don’t want to be around when procedures are being done on baby”.
3.6. Parents’ Attitudes towards Parent-Delivered Pain Management
“In the beginning the parents are worried about their ability to care for the baby; after a couple of days, they are much more confident, and they feel ready to care”.
“The reaction of the parents depends on their education and socioeconomic level”.
3.7. Information Given to Parents
“We have a “Parents guide to the NICU” with information in all family rooms that include information about parent-delivered-relieving interventions”.
“QR code at the unit’s entrance to download Linda Frank’s French version of Comforting Your Baby in the NICU”.
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Level of Neonatal Care According to AAP 1 Guidelines | |
---|---|
I—well newborn nursery, n (%) | 4 (1.3) |
II—special care nursery, n (%) | 38 (12.5) |
III—neonatal intensive care unit, n (%) | 151 (49.8) |
IV—regional neonatal intensive care unit, n (%) | 105 (34.7) |
Unit design | |
Single rooms, n (%) | 60 (19.8) |
Open bay, n (%) | 102 (33.7) |
Mixed design, n (%) | 139 (45.9) |
Number of beds, median (q1–q3) | 10 (6–20) |
Number of beds in which a parent can stay, median (q1–q3) | 5 (1–13.5) |
World Bank income classification of the country | |
Low-income, n (%) | 1 (0.3) |
Lower–middle-income, n (%) | 15 (5.0) |
Upper–middle-income, n (%) | 40 (13.2) |
High-income, n (%) | 247 (81.5) |
Sociodemographic index | |
Low SDI, n (%) | - |
Low–middle SDI, n (%) | 13 (4.3) |
Middle SDI, n (%) | 15 (6.3) |
High SDI, n (%) | 147 (48.5) |
Level of Parental Participation in Pain Management | Low (26.4%) | Moderate (49.8%) | High (23.8%) |
---|---|---|---|
World Bank income classification of the country | |||
Low or lower–middle | 43.8% | 37.5% | 18.8% |
Middle–high or high | 25.4% | 50.5% | 24.0% |
World Bank region classification | |||
East Asia and Pacific | 60.0% | 20.0% | 20.0% |
Europe and Central Asia | 24.2% | 50.4% | 25.4% |
South Asia | 50.0% | 50.0% | - |
Latin America and the Caribbean | 18.3% | 50.0% | 31.3% |
North America | 42.9% | 47.6% | 9.5% |
Middle East and North Africa | 16.7% | 83.3% | - |
Sub-Saharan Africa | 38.5% | 38.5% | 23.1% |
Level of neonatal care according to AAP 1 guidelines | |||
I—well newborn nursery | - | 50.0% | 50.0% |
II—special care nursery | 23.7% | 65.8% | 10.5% |
III—neonatal intensive care unit | 25.8% | 48.3% | 25.8% |
IV—regional neonatal intensive care unit | 28.6% | 47.6% | 23.5% |
Unit design | |||
Single rooms | 20.0% | 56.7% | 23.3% |
Open bay | 32.4% | 47.1% | 20.6% |
Mixed design | 23.7% | 49.6% | 26.6% |
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Ullsten, A.; Beken, S.; Campbell-Yeo, M.; Cavallaro, G.; Decembrino, N.; Durrmeyer, X.; Garrido, F.; Kristjánsdóttir, G.; Amponsah, A.K.; Lago, P.; et al. Parents in Neonatal Pain Management—An International Survey of Parent-Delivered Interventions and Parental Pain Assessment. Children 2024, 11, 1105. https://doi.org/10.3390/children11091105
Ullsten A, Beken S, Campbell-Yeo M, Cavallaro G, Decembrino N, Durrmeyer X, Garrido F, Kristjánsdóttir G, Amponsah AK, Lago P, et al. Parents in Neonatal Pain Management—An International Survey of Parent-Delivered Interventions and Parental Pain Assessment. Children. 2024; 11(9):1105. https://doi.org/10.3390/children11091105
Chicago/Turabian StyleUllsten, Alexandra, Serdar Beken, Marsha Campbell-Yeo, Giacomo Cavallaro, Nunzia Decembrino, Xavier Durrmeyer, Felipe Garrido, Guðrún Kristjánsdóttir, Abigail Kusi Amponsah, Paola Lago, and et al. 2024. "Parents in Neonatal Pain Management—An International Survey of Parent-Delivered Interventions and Parental Pain Assessment" Children 11, no. 9: 1105. https://doi.org/10.3390/children11091105