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Ullsten A, Campbell-Yeo M, Eriksson M. Parent-led neonatal pain management-a narrative review and update of research and practices. FRONTIERS IN PAIN RESEARCH 2024; 5:1375868. [PMID: 38689885 PMCID: PMC11058235 DOI: 10.3389/fpain.2024.1375868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Research related to parent-led neonatal pain management is increasing, as is the clinical implementation. Skin-to-skin contact, breastfeeding and parents' vocalizations are examples of pain reducing methods that give parents an opportunity to protect their infant from harm while alleviating their anxiety and developing their parenting skills. Methods In this paper we will provide a narrative review and describe the current research about parent-led neonatal pain management. Based on this we will discuss clinical challenges, implementation strategies and implications for future research. Results Parents express great readiness to embrace opportunities to increase their self-efficacy in their ability to address infant pain. Parent-led pain-reducing methods are effective, feasible, cost-effective, culturally sensitive, and can be individualized and tailored to both the parent's and infant's needs. Both barriers and facilitators of parent-led pain care have been studied in research highlighting structural, organizational, educational, and intra- and interpersonal aspects. For example, health care professionals' attitudes and beliefs on parent-led methods, and their concern that parental presence during a procedure increases staff anxiety. On the other hand, the presence of a local pain champion whose duty is to facilitate the adoption of pain control measures and actively promote parent-professional collaboration, is crucial for culture change in neonatal pain management and nurses have a key role in this change. The knowledge-to-practice gap in parent-led management of infants' procedure-related pain highlight the need for broader educational applications and collaborative professional, parental and research initiatives to facilitate practice change. Conclusion Parent-led neonatal pain management is more than simply a humane and compassionate thing to do. The inclusion of parent-led pain care has been scientifically proven to be one of the most effective ways to reduce pain associated with repeated painful procedures in early life and parents report a desire to participate. Focus on enablers across interprofessional, organizational and structural levels and implementation of recommended pediatric pain guidelines can support the provision of optimal evidence-based family-centered neonatal pain management.
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Affiliation(s)
- Alexandra Ullsten
- Center for Clinical Research and Education, Region Värmland, Karlstad, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
- MOM-LINC Lab, IWK Health Halifax, Halifax, NS, Canada
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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Unvar F, Tas Arslan F. Effectiveness of maternal-targeted training on nonpharmacologic pain management on heel stick sampling: A randomized controlled trial. J Pediatr Nurs 2023; 73:e477-e483. [PMID: 37923615 DOI: 10.1016/j.pedn.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Heel stick sampling, which is a common procedure in newborns, causes acute pain, and parents are aware of this. AIM The current study aimed to investigate the effectiveness of maternal-targeted training on newborn pain management, addressing the use of nonpharmacological methods and anxiety. METHODS The study is 2-arm, parallel-group randomized controlled trial. A total of 64 mothers were included in this study. Mothers were randomly allocated to each group; intervention (n:32) and control (n=:32). Training on nonpharmacological pain management in newborns was given to the mothers in the intervention group. Data were collected with an Introductory Information Form, Nonpharmacological Pain Management Use Checklist, and State-Trait Anxiety Inventory. RESULTS Nonpharmacological methods were used for the procedures in the control group and the intervention group, with an absolute difference of 68.8% between groups. The difference was statistically significant (p < 0.001) and had a large effect (d = -79.222; 95% CI, -9.365 to 670.143. There was no significant difference between the groups in terms of anxiety score (p = 0.558). CONCLUSION Demonstrates the clinical relevance and feasibility of training targeting maternal on neonatal pain management during the heel stick sampling procedure. PRACTICE IMPLICATIONS When non-pharmacological methods in pain management of newborns were recommended by the nurse, maternal involvement in pain management increased significantly, suggesting that nurses have a key role in ensuring parental involvement. CLINICAL TRIAL REGISTRATION NCT05173662.
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Affiliation(s)
- Fulya Unvar
- Ministry of Health, Akşehir State Hospital, 42550, Akşehir, Konya, Türkiye
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Hughes Née Richardson B, Benoit B, Rutledge K, Dol J, Martin-Misener R, Latimer M, Smit M, McGrath P, Campbell-Yeo M. Impact of parent-targeted eHealth educational interventions on infant procedural pain management: a systematic review. JBI Evid Synth 2023; 21:669-712. [PMID: 36591975 DOI: 10.11124/jbies-21-00435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The objective of this review was to determine whether electronic health (eHealth) educational interventions about infant procedural pain and pain management impact parental outcomes (eg, mental health, knowledge uptake), eHealth outcomes (eg, acceptance, use), and pain management outcomes (eg, parental involvement, infant pain response). INTRODUCTION Pain in infants is a common concern for parents. Routine postpartum care for infants in early life requires them to endure painful procedures, such as immunizations, yet infants often receive little to no pain management. Parents are an essential component of effective pain management, although they may not be aware of the roles they play. Despite the increased number of eHealth resources available to educate parents about infant pain management, their impact has yet to be synthesized. INCLUSION CRITERIA This review considered studies that evaluated eHealth educational interventions targeted at parents during pregnancy and up to 1 year postpartum. Interventions included, but were not limited to, mobile applications, web-based applications, websites, videos, interactive training, hands-on direct simulation, short message service (SMS), and desktop applications. Primary outcomes included parental outcomes (eg, stress or anxiety, self-efficacy, knowledge, attitudes), eHealth outcomes (eg, acceptance, use), and pain management outcomes (eg, parental involvement, infant pain response). Experimental, quasi-experimental, and observational study designs were included. METHODS MEDLINE, CINAHL, PsycINFO, Embase, Scopus, Web of Science, and SciELO were searched for studies published in English up to June 14, 2021. Citation lists of relevant reviews and included studies were also searched for additional peer-reviewed articles. Two independent reviewers conducted critical appraisal using standardized tools from JBI, and data extraction, using a data extraction form designed by the authors. Statistical pooling of quantitative data was not possible due to heterogeneity; thus, the findings were reported narratively. RESULTS A total of 4163 unique studies were screened, with 11 studies ultimately included for synthesis. Five articles were randomized controlled trials, 5 articles were analytical cross-sectional studies, and 1 article was quasi-experimental. Studies reported on 4 unique eHealth educational interventions, all of which used video format and primarily targeted the postnatal period. The findings for all primary outcomes were mixed but suggested either improvements in outcomes or no impact. The certainty of evidence was determined as low or very low across primary outcomes for reasons related to imprecision, risk of bias, and indirectness. CONCLUSIONS Although heterogeneity of findings limited quantitative synthesis of data, this review suggests that short and engaging educational videos have the potential to positively impact parents' knowledge, confidence, and desire to be involved in procedural pain management for their children. Most of the interventions presented in this review describe evidence-based information about procedural pain management strategies that are known to be effective for infant populations. Thus, it is reasonable to assume that infant pain response should be lower when parents appropriately apply the strategies. However, the findings of this review were not able to confirm this assumption. More research is needed to evaluate the impact of parent-targeted pain management education on infant pain response. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020151569.
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Affiliation(s)
- Brianna Hughes Née Richardson
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
| | - Britney Benoit
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
- Elizabeth and Thomas Rankin School of Nursing, St. Francis Xavier University, NS, Antigonish, Canada
| | - Kallen Rutledge
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Justine Dol
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- The Mothering Transitions Research Lab, St. Michael's Hospital, Toronto, ON, Canada
| | - Ruth Martin-Misener
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
| | - Margot Latimer
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
| | - Michael Smit
- School of Information Management, Dalhousie University, Halifax, NS, Canada
| | - Patrick McGrath
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada
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Be Sweet to Babies: Consumer Evaluation of a Parent-Targeted Video Aimed at Improving Pain Management Strategies in Newborn Infants Undergoing Painful Procedures. Adv Neonatal Care 2023; 23:E2-E13. [PMID: 36170748 DOI: 10.1097/anc.0000000000001031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Evidence for analgesic effects of parent-led pain management strategies during painful procedures in newborn infants exists; however, such strategies are inconsistently used in practice. A publicly available parent-targeted video demonstrates breastfeeding, skin-to-skin care, and sucrose during painful procedures. Australian parents' use and knowledge of this video and these strategies was unknown. PURPOSE To determine parents' use of pain management strategies, and perceived acceptability and usefulness of the parent-targeted video. METHODS A cross-sectional, online, anonymous survey with embedded video. Participants were recruited via social media channels of the Miracle Babies Foundation, an Australian parent support network. Target participants were parents or family members of infants currently or previously hospitalized in neonatal special and/or intensive care nurseries, or high dependency units. RESULTS A total of 162 of 189 respondents provided sufficient data for analysis; all identified as mothers. Only 6 (4%) had previously seen the video; however, nearly all rated it as potentially useful and helpful (n = 124, 82%). Although most reported that sucrose had been used (n = 112, 84%), fewer reported having used skin-to-skin care (n = 50, 37%), or breastfeeding (n = 33, 25%). Most intended to advocate for skin-to-skin care (n = 108, 88%) or breastfeeding (n = 100, 81%) in future procedures. Perceived barriers to utilizing strategies included lack of information-sharing and organizational practices that excluded parent involvement. IMPLICATIONS FOR PRACTICE AND RESEARCH The video may be valuable in supporting mothers to advocate for their involvement during painful procedures in preterm and sick hospitalized infants. Further research is recommended to explore coordinated strategies targeting parents and healthcare professionals to overcome barriers to implementing parent-led infant pain management strategies.
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Hirani SAA, Ratushniak A. Analgesic Role of Breastfeeding: Analysis of Effectiveness, Implementation Barriers, and Strategies to Promote Evidence-Based Practice. CLINICAL LACTATION 2023. [DOI: 10.1891/cl.2022-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Objective:Exposure to painful stimuli serves as toxic stress for infants, increasing their subsequent pain sensitivity and resulting in neurodevelopmental impairments. Besides offering nutritional, psychological, immunological, and economic benefits, breastfeeding is reported as the most effective analgesia for the management of minor procedural pain in infants. Although breastfeeding holds several advantages, implementation of this nonpharmacological intervention is still uncommon in many clinical settings.Methods:This scoping review presents an analysis of 29 clinical trials that compare the effectiveness of breastfeeding with other nonpharmacological methods.Findings:Breastfeeding is an efficacious analgesia compared with sucrose, sweet solutions, and other nonpharmacological methods. When used alone or in combination with other nonpharmacological interventions, breastfeeding reduces infants’ biobehavioral responses to pain and promotes faster physiologic recovery after painful procedures. Breastfeeding is recommended as the first choice whenever feasible. Barriers to the uptake of this effective pain management method in clinical practice include misinformation/inconsistent use of evidence, an infant’s impaired sucking reflex, maternal–child separation, the workload of healthcare professionals, a lack of parental involvement, assumptions of healthcare providers, and a lack of adequate information/guidance for parents. Strategies to promote the uptake of breastfeeding for the management of procedural pain in infants include an effective partnership between healthcare providers and breastfeeding mothers, knowledge mobilization resources in multiple languages, informational support and media campaigns, and experiential learning opportunities for breastfeeding mothers.Conclusions:Successful implementation of baby-friendly hospital initiatives, a patient-centered approach, family-centered care, and the collaborative efforts of healthcare providers in all healthcare settings is recommended to promote the uptake of breastfeeding as analgesia.
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McNair C, Chirinian N, Uleryk E, Stevens B, McAllister M, Franck LS, Taddio A, Shah V. Effectiveness of parental education about pain in the neonatal period on knowledge, attitudes, and practices: A systematic review and meta-analysis. Paediatr Child Health 2022; 27:454-463. [PMID: 36583071 PMCID: PMC9792286 DOI: 10.1093/pch/pxac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 05/20/2022] [Indexed: 01/01/2023] Open
Abstract
Background Despite the availability of effective, safe, and feasible pain management strategies, infant pain remains undertreated. Parents can play a key role in advocating for or delivering pain management strategies if they are educated. To date, a quantitative synthesis of the effectiveness of parental education about pain management in the neonatal period has not been performed. Objective To systematically review the effectiveness of parental education during the neonatal period on pain management in infancy. Methods MEDLINE, EMBASE, PsycInfo, CINAHL, and the Cochrane Library were searched for relevant randomized controlled trials (RCTs) and non-randomized trials (NRTs) that evaluated parental education with respect to pain management during the neonatal period in any setting from inception to February 2021. Screening of article titles and abstracts and data extraction were performed in duplicate. The risk of bias was assessed using the Cochrane Risk Bias Tool 2.0 and the Risk of Bias in Non-randomized Studies of Interventions for RCTs and NRTs, respectively. As per the GRADE methodology, critically important and important outcomes were identified. Critically important outcomes included utilization of pain management strategies and infant pain. Important outcomes included parental knowledge about pain mitigation strategies, parental attitudes, compliance with painful procedures, procedure outcomes, and safety. Data were combined and presented as relative risk (RR) or mean or standardized mean difference (MD or SMD) with 95% confidence interval (CI). Results Of the six studies eligible for inclusion, four studies were RCTs and two studies were NRTs. Written information and/or video were used to deliver parental education during the neonatal period in hospital settings in all studies. Four studies (two RCTs and two NRTs) reported on critically important outcomes. The risk of bias was low for the two RCTs and moderate to serious for the two NRTs. Utilization of pain management strategies was assessed for heel lance in the first 48 hours of life in two studies and for vaccine injection at 2 to 6 months of life in two studies. Higher utilization rate for pain management strategies was reported in the pain education group in three studies (RR 1.15, 95% CI 1.04, 1.26; N=2712). There was no difference in the mean number of pain management strategies used in one NRT tracking utilization tracking utilization as continuous data (MD 0.20, 95% CI -0.01, 0.41; N=178). Parent-reported infant pain scores were lower in the pain education group in one RCT (MD -0.16, 95% CI -0.27, -0.06; N=1615). The quality of evidence for the outcome of utilization of pain management strategies was very low while for the outcome of infant pain the quality of evidence was moderate. Five studies (3 RCTs and 2 NRTs) reported on important outcomes. The risk of bias was low for two RCTs and high for one RCT and moderate to serious for the two NRTs. Parental knowledge about pain management strategies (SMD 0.54, 95% CI 0.26, 0.82), parental confidence in their ability to manage pain (SMD 0.24, 95% CI 0.14, 0.34), parental satisfaction with education (MD 1.18, 95% CI 0.84, 1.52) and parental satisfaction with pain management (RR 1.05. 95% CI 1.01, 1.08) were increased in the pain education group. None of the included studies reported on procedural outcomes. No adverse events with the pain education nor the use of pain management interventions were reported in one study. Conclusions Parental education in the neonatal period was effective in increasing utilization of pain management strategies during painful procedures. Reduction of pain in infants is based on one study of moderate quality. Furthermore, parental education increased parental knowledge about pain management strategies, confidence in their ability to manage infant pain, and satisfaction with the education and pain management. Parental pain education should be incorporated into postnatal care.
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Affiliation(s)
- Carol McNair
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Nevart Chirinian
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
| | | | - Bonnie Stevens
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Mary McAllister
- Nursing Practice, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Linda S Franck
- Department of Family Health Care Nursing, University of California, San Francisco, CA, USA
| | - Anna Taddio
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Vibhuti Shah
- Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
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Zhao J, Harvey G, Vandyk A, Gifford W. Social Media for ImpLementing Evidence (SMILE): Conceptual Framework. JMIR Form Res 2022; 6:e29891. [PMID: 35262488 PMCID: PMC8943555 DOI: 10.2196/29891] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 09/21/2021] [Accepted: 01/07/2022] [Indexed: 12/20/2022] Open
Abstract
Background Social media has become widely used by individual researchers and professional organizations to translate research evidence into health care practice. Despite its increasing popularity, few social media initiatives consider the theoretical perspectives of how social media works as a knowledge translation strategy to affect research use. Objective The purpose of this paper is to propose a conceptual framework to understand how social media works as a knowledge translation strategy for health care providers, policy makers, and patients to inform their health care decision-making. Methods We developed this framework using an integrative approach that first involved reviewing 5 long-standing social media initiatives. We then drafted the initial framework using a deductive approach by referring to 5 theories on social media studies and knowledge translation. A total of 58 empirical studies on factors that influenced the use of social media and its messages and strategies for promoting the use of research evidence via social media were further integrated to substantiate and fine-tune our initial framework. Through an iterative process, we developed the Social Media for ImpLementing Evidence (SMILE) framework. Results The SMILE framework has six key constructs: developers, messages and delivery strategies, recipients, context, triggers, and outcomes. For social media to effectively enable recipients to use research evidence in their decision-making, the framework proposes that social media content developers respond to target recipients’ needs and context and develop relevant messages and appropriate delivery strategies. The recipients’ use of social media messages is influenced by the virtual–technical, individual, organizational, and system contexts and can be activated by three types of triggers: sparks, facilitators, and signals. Conclusions The SMILE framework maps the factors that are hypothesized to influence the use of social media messages by recipients and offers a heuristic device for social media content developers to create interventions for promoting the use of evidence in health care decision-making. Empirical studies are now needed to test the propositions of this framework.
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Affiliation(s)
- Junqiang Zhao
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Gillian Harvey
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Amanda Vandyk
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Wendy Gifford
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
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Benoit B, Cassidy C, van Wijlen J, Correll Q, Campbell-Yeo M, Hendra S, Martin-Misener R, MacDougall J, Cameron A. CO-DEVELOPMENT OF IMPLEMENTATION INTERVENTIONS TO SUPPORT PARENT-LED INFANT PAIN CARE: A QUALITATIVE DESCRIPTIVE STUDY PROTOCOL (Preprint). JMIR Res Protoc 2021; 11:e33770. [PMID: 35930339 PMCID: PMC9391977 DOI: 10.2196/33770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background Untreated pain in infants is associated with adverse health outcomes. Despite strong evidence for accessible, effective, and low-cost parent-led pain-relieving interventions such as breastfeeding or chestfeeding and skin-to-skin contact, these interventions are not routinely used. Objective The objective of this study is to support the implementation of parent-led pain interventions by identifying barriers to and facilitators of parent-led, evidence-informed pain care in infants during acute procedures. In addition, this study aims to develop theory-informed, contextually relevant implementation interventions for supporting the use of parent-led pain care for infants in hospital and community contexts. Methods This study will consist of 2 phases that follow a systematic, theoretically informed approach guided by the Theoretical Domains Framework and Behavior Change Wheel. In phase 1, we will use a qualitative descriptive design to explore barriers and facilitators to using parent-led pain care in infants from the perspectives of hospital and community-based clinicians, clinical leaders, and families. In phase 2, we will use the Behavior Change Wheel to design tailored implementation interventions that have evidence for effectively addressing identified barriers in collaboration with an advisory committee of administrative, clinical, and family leaders. Results Ethics approval for this study was obtained in December 2020. As of May 2022, a total of 15 participants have been enrolled in phase 1. The results from all phases will be reported in 2023. Conclusions Following the completion of this study, we will have co-designed theoretically informed implementation interventions that can be pilot-tested and experimentally applied. The findings will be used to implement parent-led interventions that improve patient safety and health outcomes for diverse families. International Registered Report Identifier (IRRID) DERR1-10.2196/33770
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Affiliation(s)
- Britney Benoit
- Rankin School of Nursing, St Francis Xavier University, Antigonish, NS, Canada
| | | | | | - Quinn Correll
- Rankin School of Nursing, St Francis Xavier University, Antigonish, NS, Canada
| | | | - Sionnach Hendra
- Rankin School of Nursing, St Francis Xavier University, Antigonish, NS, Canada
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Hu J, Xue F, Zhou Y, Liu Y, Li Q, Deng J, Harrison D. Using Social Media to Disseminate Effective Pain Treatments for Newborns During Needle-Related Painful Procedures in China. J Perinat Neonatal Nurs 2021; 35:E50-E57. [PMID: 34726656 DOI: 10.1097/jpn.0000000000000602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Social media has become a powerful approach to disseminating evidence to knowledge users. The BSweet2Babies video was developed in multiple languages showing the effectiveness of sweet solutions, skin-to-skin care, and breastfeeding during newborn painful procedures. This study aimed to disseminate the BSweet2Babies video in Chinese through social media platform of WeChat in China; evaluate the reach, acceptability, and recommendation of the video; and assess viewers' previous knowledge and experience of using the 3 strategies and intention to use these strategies in the future. Multiple dissemination strategies were used to maximize views for a 6-month dissemination period. The video received 19 812 views, 4306 "thumbs," and 671 participants completed surveys. Of the survey respondents, 393 were parents. Most respondents did not know these strategies and did not use or help parents use any of them. More healthcare professionals than parents intended to use or advocate for sweet solutions and breastfeeding. More healthcare professionals rated that the 3 strategies were easy to apply in real-life situations, but more parents evaluated that the length of the video was too long. Social media in China can be a promising approach to disseminating evidence on neonatal procedural pain treatments to healthcare professionals and the public.
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Affiliation(s)
- Jiale Hu
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada (Drs Hu and Harrison and Ms Zhou); Department of Nurse Anesthesia, College of Health Professions, Virginia Commonwealth University, Richmond (Dr Hu); Neonatal Intensive Care Unit, Shanghai Children's Medical Center, Shanghai, China (Mr Xue); School of Nursing, Shanghai University of Medicine & Health Sciences, Shanghai, China (Ms Liu); School of Nursing, Shanghai Jiao Tong University, Shanghai, China (Ms Liu); Nursing Department, Women's Hospital Affiliated to School of Medicine Zhejiang University, Hangzhou City, Zhejiang Province, China (Ms Li); Nursing Department, Peking University First Hospital, Beijing, China (Mr Deng); and Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia (Dr Harrison)
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Ullsten A, Andreasson M, Eriksson M. State of the Art in Parent-Delivered Pain-Relieving Interventions in Neonatal Care: A Scoping Review. Front Pediatr 2021; 9:651846. [PMID: 33987153 PMCID: PMC8112545 DOI: 10.3389/fped.2021.651846] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022] Open
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.
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Affiliation(s)
- Alexandra Ullsten
- Center for Clinical Research, Region Värmland, Karlstad, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Matilda Andreasson
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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Rosen NO, Muise MD, Vannier SA, Chambers CT, Scott H. #postbabyhankypanky: An Empirically Based Knowledge Sharing Initiative About Sex and the Transition to Parenthood. ARCHIVES OF SEXUAL BEHAVIOR 2021; 49:2849-2861. [PMID: 32488647 DOI: 10.1007/s10508-020-01667-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 11/08/2019] [Accepted: 02/25/2020] [Indexed: 05/25/2023]
Abstract
Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new parents and healthcare providers. We convened a multidisciplinary advisory group that also involved community parents who provided feedback at all phases of this project. We developed five brief YouTube videos, each featuring a core research finding. Following an empirically supported strategic knowledge translation plan, we disseminated the videos to our target audiences (i.e., expectant and new parents, healthcare providers, educators, and other stakeholders) using social media from February 2018 to November 2019. Data were collected using YouTube analytics and an online survey (convenience sample: N = 225 parents; N = 161 healthcare providers). From the date of the launch, the videos had a reach of 91,766 views from 14 countries, with viewers watching an average of 90% of a video. Overall, quantitative and qualitative survey results suggested that the videos were acceptable and appropriate, and respondents were more confident and comfortable discussing sexual issues (with their partner/with their patients) and would like more information about postpartum sexuality after watching the videos. YouTube videos are an acceptable and effective way to disseminate evidence aimed at raising awareness of factors affecting sexuality in the transition to parenthood.
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Affiliation(s)
- Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada.
- Department of Obstetrics and Gynecology, IWK Health Centre, Halifax, NS, Canada.
| | - Megan D Muise
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Sarah A Vannier
- Department of Psychology, St. Thomas University, Halifax, NS, Canada
| | - Christine T Chambers
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Heather Scott
- Department of Obstetrics and Gynecology, IWK Health Centre, Halifax, NS, Canada
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Rosen NO, Muise MD, Vannier SA, Chambers CT, Scott H. #postbabyhankypanky: An Empirically Based Knowledge Sharing Initiative About Sex and the Transition to Parenthood. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:45-55. [PMID: 32488647 PMCID: PMC7878212 DOI: 10.1007/s10508-020-01734-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/18/2020] [Accepted: 04/27/2020] [Indexed: 05/17/2023]
Abstract
Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new parents and healthcare providers. We convened a multidisciplinary advisory group that also involved community parents who provided feedback at all phases of this project. We developed five brief YouTube videos, each featuring a core research finding. Following an empirically supported strategic knowledge translation plan, we disseminated the videos to our target audiences (i.e., expectant and new parents, healthcare providers, educators, and other stakeholders) using social media from February 2018 to November 2019. Data were collected using YouTube analytics and an online survey (convenience sample: N = 225 parents; N = 161 healthcare providers). From the date of the launch, the videos had a reach of 91,766 views from 14 countries, with viewers watching an average of 90% of a video. Overall, quantitative and qualitative survey results suggested that the videos were acceptable and appropriate, and respondents were more confident and comfortable discussing sexual issues (with their partner/with their patients) and would like more information about postpartum sexuality after watching the videos. YouTube videos are an acceptable and effective way to disseminate evidence aimed at raising awareness of factors affecting sexuality in the transition to parenthood.
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Affiliation(s)
- Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada.
- Department of Obstetrics and Gynecology, IWK Health Centre, Halifax, NS, Canada.
| | - Megan D Muise
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Sarah A Vannier
- Department of Psychology, St. Thomas University, Halifax, NS, Canada
| | - Christine T Chambers
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Heather Scott
- Department of Obstetrics and Gynecology, IWK Health Centre, Halifax, NS, Canada
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Olsson E, Carlsen Misic M, Dovland Andersen R, Ericson J, Eriksson M, Thernström Blomqvist Y, Ullsten A. Study protocol: parents as pain management in Swedish neonatal care - SWEpap, a multi-center randomized controlled trial. BMC Pediatr 2020; 20:474. [PMID: 33046026 PMCID: PMC7549219 DOI: 10.1186/s12887-020-02356-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/20/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND During the first period of life, critically ill as well as healthy newborn infants experience recurrent painful procedures. Parents are a valuable but often overlooked resource in procedural pain management in newborns. Interventions to improve parents' knowledge and involvement in infants' pain management are essential to implement in the care of the newborn infant. Neonatal pain research has studied a range of non-pharmacological pain alleviating strategies during painful procedures, yet, regarding combined multisensorial parent-driven non-pharmacological pain management, research is still lacking. METHODS/DESIGN A multi-center randomized controlled trial (RCT) with three parallel groups with the allocation ratio 1:1:1 is planned. The RCT "Parents as pain management in Swedish neonatal care - SWEpap", will investigate the efficacy of combined pain management with skin-to-skin contact, breastfeeding and live parental lullaby singing compared with standard pain care initiated by health care professionals, during routine metabolic screening of newborn infants (PKU-test). DISCUSSION Parental involvement in neonatal pain management enables a range of comforting parental interventions such as skin-to-skin contact, breastfeeding, rocking and soothing vocalizations. To date, few studies have been published examining the efficacy of combined multisensorial parent-driven interventions. So far, research shows that the use of combined parent-driven pain management such as skin-to-skin contact and breastfeeding, is more effective in reducing behavioral responses to pain in infants, than using the pain-relieving interventions alone. Combined parental soothing behaviors that provide rhythmic (holding/rocking/vocalizing) or orogustatory/orotactile (feeding/pacifying) stimulation that keep the parent close to the infant, are more effective in a painful context. In the SWEpap study we also include parental live lullaby singing, which is an unexplored but promising biopsychosocial, multimodal and multisensory pain alleviating adjuvant, especially in combination with skin-to-skin contact and breastfeeding. TRIAL REGISTRATION ClinicalTrials.gov ( NCT04341194 ) 10 April 2020.
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Affiliation(s)
- Emma Olsson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-701 82, Örebro, Sweden.
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - Martina Carlsen Misic
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-701 82, Örebro, Sweden
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Randi Dovland Andersen
- Department of Research, Telemark Hospital Trust, Skien, Norway
- Research Center for Habilitation and Rehabilitation Services and Models (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jenny Ericson
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- Department of Pediatrics, Falun Hospital, Falun, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-701 82, Örebro, Sweden
| | - Ylva Thernström Blomqvist
- Neonatal Intensive Care Unit, University Hospital, Uppsala, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Alexandra Ullsten
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-701 82, Örebro, Sweden
- Centre for Clinical Research, Region Värmland, Karlstad, Sweden
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Vieira ACG, Bueno M, Harrison D. "Be sweet to babies": Use of Facebook as a method of knowledge dissemination and data collection in the reduction of neonatal pain. PAEDIATRIC & NEONATAL PAIN 2020; 2:93-100. [PMID: 35547020 PMCID: PMC8975201 DOI: 10.1002/pne2.12022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/05/2020] [Accepted: 04/07/2020] [Indexed: 11/18/2022]
Abstract
The Be Sweet to Babies video demonstrates the analgesic effects of breastfeeding, skin‐to‐skin care, and sweet‐tasting solutions as interventions to reduce pain during blood sampling in newborns. Although effective and safe, these strategies are implemented inconsistently in clinical settings. Given the increasing popularity of social media, there is a potential to disseminate and promote health information through it. The study aim was to evaluate the use of Facebook as a means of disseminating the Be Sweet to Babies video in Portuguese, and to evaluate respondents’ prior knowledge, previous use of the three pain management strategies and intent to use the strategies in the future. We conducted a cross‐sectional study, using the “virtual snowball” sampling method. A Facebook webpage was created, in which the video was posted along with a brief survey. Data analyzed included number of views and visits to the page, number of views of the video, likes, dislikes, and survey responses. One year after posting, the page had 70 753 views and 2199 accesses; there were 1553 “likes”, no dislikes, and 43 positive comments. The survey was completed by 930 respondents (42% response rate based on the page access). Over two thirds of the respondents had previous knowledge about breastfeeding, skin‐to‐skin care, and sweet solutions for pain relief. After watching the video, 87% of the respondents intended to use breastfeeding or skin‐to‐skin care in the future, and 71% intended to use sweet solutions. Almost all viewers rated the video as very useful (n = 917, 99%), easy to understand (n = 926, 99%), and easy to apply in real‐life situations (n = 903, 97%). Using Facebook to deliver and evaluate an intervention is feasible, rapid in obtaining responses, low cost, and it is promising for data collection and knowledge dissemination. Further studies are warranted to evaluate the actual impact of the use of social media in practice change.
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Affiliation(s)
| | | | - Denise Harrison
- Faculty of Medicine, Dentistry and Health Sciences School of Health Sciences Department of Nursing University of Melbourne Melbourne Vic. Australia
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Chambers CT, Dol J, Parker JA, Caes L, Birnie KA, Taddio A, Campbell-Yeo M, Halperin SA, Langille J. Implementation Effectiveness of a Parent-Directed YouTube Video ("It Doesn't Have To Hurt") on Evidence-Based Strategies to Manage Needle Pain: Descriptive Survey Study. JMIR Pediatr Parent 2020; 3:e13552. [PMID: 32130190 PMCID: PMC7081136 DOI: 10.2196/13552] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/07/2019] [Accepted: 09/20/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Despite the availability of high-quality evidence and clinical practice guidelines for the effective management of pediatric pain, this evidence is rarely used in practice for managing children's pain from needle procedures such as vaccinations. Parents are generally unaware of pain management strategies they can use with their children. OBJECTIVE This study aimed to develop, implement, and evaluate the implementation effectiveness of a parent-directed YouTube video on evidence-based strategies to manage needle pain in children. METHODS This was a descriptive study. Analytics were extracted from YouTube to describe video reach. A Web-based survey was used to seek parent and health care professional (HCP) feedback about the video. The 2-minute 18-second video was launched on YouTube on November 4, 2013. In the video, a 4-year-old girl tells parents what they should and should not do to help needles hurt less. The key evidence-based messages shared in the video were distraction, deep breathing, and topical anesthetic creams. A group of parents (n=163) and HCPs (n=278) completed the Web-based survey. Measures of reach included number of unique views, country where the video was viewed, sex of the viewer, and length of watch time. The Web-based survey assessed implementation outcomes of the video, such as acceptability, appropriateness, penetration, and adoption. RESULTS As of November 4, 2018 (5 years after launch), the video had 237,132 unique views from 182 countries, with most viewers watching an average of 55.1% (76/138 seconds) of the video. Overall, both parents and HCPs reported strong acceptance of the video (ie, they liked the video, found it helpful, and felt more confident) and reported significant improvements in plans to use distraction, deep breathing, and topical anesthetic creams. CONCLUSIONS This parent-directed YouTube video was an acceptable and appropriate way to disseminate evidence about the procedure of pain management to a large number of parents.
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Affiliation(s)
- Christine T Chambers
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Justine Dol
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Jennifer A Parker
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Line Caes
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| | - Kathryn A Birnie
- Alberta Children's Hospital, Calgary, AB, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Anna Taddio
- The Hospital for Sick Children, Toronto, ON, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Marsha Campbell-Yeo
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, IWK Health Centre, Halifax, NS, Canada
| | - Scott A Halperin
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, IWK Health Centre, Halifax, NS, Canada
- Canadian Center for Vaccinology, IWK Health Centre, Halifax, NS, Canada
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McNair C, Campbell-Yeo M, Johnston C, Taddio A. Nonpharmacologic Management of Pain During Common Needle Puncture Procedures in Infants: Current Research Evidence and Practical Considerations: An Update. Clin Perinatol 2019; 46:709-730. [PMID: 31653304 DOI: 10.1016/j.clp.2019.08.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Infants undergo painful procedures involving skin puncture as part of routine medical care. Pain from needle puncture procedures is suboptimally managed. Numerous nonpharmacologic interventions are available that may be used for these painful procedures, including swaddling/containment, pacifier/non-nutritive sucking, rocking/holding, breastfeeding and breastmilk, skin-to-skin care, sweet tasting solutions, music therapy, sensorial saturation, and parental presence. Adoption these interventions into routine clinical practice is feasible and should be a standard of care in quality health care for infants. This review summarizes the epidemiology of pain from common needle puncture procedures in infants, the effectiveness of nonpharmacologic interventions, implementation considerations, and unanswered questions.
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Affiliation(s)
- Carol McNair
- Nursing and Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto M5G 1X8, Canada
| | - Marsha Campbell-Yeo
- Department of Pediatrics, IWK Health Centre, School of Nursing, Faculty of Health Professions, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Celeste Johnston
- Ingram School of Nursing, McGill University, Montreal, Canada; IWK Health Centre, 5850/5980 University Avenue, Halifax B3K 6R8, Canada
| | - Anna Taddio
- Clinical, Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, Child Health Evaluative Sciences, The Hospital for Sick Children, 144 College Street, Toronto, Ontario M5S 3M2, Canada.
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Maciel HIA, Costa MF, Costa ACL, Marcatto JDO, Manzo BF, Bueno M. Pharmacological and nonpharmacological measures of pain management and treatment among neonates. Rev Bras Ter Intensiva 2019; 31:21-26. [PMID: 30916233 PMCID: PMC6443311 DOI: 10.5935/0103-507x.20190007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 09/24/2018] [Indexed: 12/29/2022] Open
Abstract
Objective This study sought to describe and quantify the pharmacological and
nonpharmacological strategies used to relieve the pain/stress of neonates
during hospitalization in neonatal intensive care units. Methods This quantitative, longitudinal, and descriptive study examined 50 neonates
from neonatal intensive care unit admission to discharge. Results A total of 9,948 painful/stressful procedures were recorded (mean = 11.25
± 6.3) per day per neonate. A total of 11,722 pain-management and
relief interventions were performed, of which 11,495 (98.1%) were
nonpharmacological strategies, and 227 (1.9%) were pharmacological
interventions. On average, each neonate received 235 pain-management and
treatment interventions during hospitalization, 13 nonpharmacological
interventions per day, and one pharmacological intervention every 2
days. Conclusion Neonates receive few specific measures for pain relief given the high number
of painful and stressful procedures performed during hospitalization. Thus,
it is essential to implement effective pain-relief protocols.
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Affiliation(s)
| | - Marcela Foureaux Costa
- Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | | | | | - Bruna Figueiredo Manzo
- Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Mariana Bueno
- The Hospital for Sick Children - Toronto, ON, Canadá
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Cross A, Rosenbaum P, Grahovac D, Brocklehurst J, Kay D, Baptiste S, Gorter JW. A Web-Based Knowledge Translation Resource for Families and Service Providers (The "F-Words" in Childhood Disability Knowledge Hub): Developmental and Pilot Evaluation Study. JMIR Rehabil Assist Technol 2018; 5:e10439. [PMID: 30578233 PMCID: PMC6331144 DOI: 10.2196/10439] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 05/17/2018] [Accepted: 07/03/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The "F-words in Childhood Disability" (Function, Family, Fitness, Fun, Friends, and Future) are an adaptation and an attempt to operationalize the World Health Organization's (2001) International Classification of Functioning, Disability and Health (ICF) framework. Since the paper was published (November 2011), the "F-words" have attracted global attention (>12,000 downloads, January 2018). Internationally, people have adopted the "F-words" ideas, and many families and service providers have expressed a need for more information, tools, and resources on the "F-words". OBJECTIVE This paper reports on the development and pilot evaluation of a Web-based knowledge translation (KT) resource, the "F-words" Knowledge Hub that was created to inform people about the "F-words" and to provide action-oriented tools to support the use of the "F-words" in practice. METHODS An integrated research team of families and researchers at CanChild Centre for Childhood Disability Research collaborated to develop, implement, and evaluate the Knowledge Hub. A pilot study design was chosen to assess the usability and utility of the Web-based hub before implementing a larger evaluation study. Data were collected using a brief anonymous Web-based survey that included both closed-ended and open-ended questions, with the closed-ended responses being based on a five-point Likert-type scale. We used descriptive statistics and a summary of key themes to report findings. RESULTS From August to November 2017, the Knowledge Hub received >6,800 unique visitors. In 1 month (November 2017), 87 people completed the survey, of whom 63 completed the full survey and 24 completed 1 or 2 sections. The respondents included 42 clinicians and 30 family members or individuals with a disability. The majority of people visited the Knowledge Hub 1-5 times (n=63) and spent up to 45 minutes exploring (n=61) before providing feedback. Overall, 66 people provided information on the perceived usefulness of the Knowledge Hub, of which 92% (61/66) found the Knowledge Hub user-friendly and stated that they enjoyed exploring the hub, and a majority (n=52) reported that the Knowledge Hub would influence what they did when working with others. From the open-ended responses (n=48), the "F-words" videos (n=21) and the "F-words" tools (n=15) were rated as the best features on the Knowledge Hub. CONCLUSIONS The "F-words" Knowledge Hub is an evidence-informed Web-based KT resource that was useful for respondents, most of whom were seen as "early adopters" of the "F-words" concepts. Based on the findings, minor changes are to be made to improve the Knowledge Hub before completing a larger evaluation study on the impact at the family, clinician, and organizational levels with a wider group of users. Our hope is that the "F-words" Knowledge Hub will become a go-to resource for knowledge sharing and exchange for families and service providers.
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Affiliation(s)
- Andrea Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Danijela Grahovac
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Julie Brocklehurst
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Diane Kay
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Sue Baptiste
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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From evidence to influence: dissemination and implementation of scientific knowledge for improved pain research and management. Pain 2018; 159 Suppl 1:S56-S64. [DOI: 10.1097/j.pain.0000000000001327] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Richardson B, Goldberg L, Aston M, Campbell-Yeo M. eHealth versus equity: Using a feminist poststructural framework to explore the influence of perinatal eHealth resources on health equity. J Clin Nurs 2018; 27:4224-4233. [PMID: 29964310 DOI: 10.1111/jocn.14592] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/28/2018] [Accepted: 06/24/2018] [Indexed: 10/28/2022]
Abstract
AIMS AND OBJECTIVES To explore whether and how eHealth resources targeted to families during the perinatal period effectively reach a diverse population or further oppress marginalised groups. BACKGROUND eHealth is often intended to reach a broad population, thus health content must be relatively generalised which limits the ability to tailor health education and interventions to individual needs. Generalisation of health information has historically represented a hegemonic depiction of the health consumer, especially within the perinatal period, often disregarding the diversity that exists in the world and perpetuating heteronormative constructs within healthcare systems as a result. DESIGN A critical review of the literature regarding perinatal eHealth resources was conducted using a feminist poststructuralist approach for analysis. Included literature addresses the development, implementation and/or evaluation of perinatal eHealth resources. DISCUSSION This approach uncovered hegemonic discourses related to the current state of perinatal eHealth resources. Nurses and midwives have the unique advantage of interacting and understanding diverse populations. Thus, nurses and midwives are integral to the development, implementation and evaluation of eHealth resources to reduce social health inequity. RELEVANCE TO CLINICAL PRACTICE This paper acts as an exemplar on how to apply feminist poststructuralism to highlight inequities that exist and identifies strategies for nurses and midwives to become involved in the development of eHealth resources or advocate for greater visibility within current resources.
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Affiliation(s)
- Brianna Richardson
- Dalhousie University School of Nursing, Halifax, NS, Canada.,Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Lisa Goldberg
- Dalhousie University School of Nursing, Halifax, NS, Canada
| | - Megan Aston
- Dalhousie University School of Nursing, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- Dalhousie University School of Nursing, Halifax, NS, Canada.,Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
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Almeida HCCD, Candido LKD, Harrison D, Bueno M. Be Sweet to Babies: evaluation of an instructional video on neonatal pain management by nurses. Rev Esc Enferm USP 2018; 52:e03313. [PMID: 29947704 DOI: 10.1590/s1980-220x2017033903313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/21/2017] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To describe the profile of nurses who work in hospital units that care for newborns; to verify nurses' prior knowledge on breastfeeding, skin-to-skin care and sweet tasting solutions for neonatal procedural pain relief; and to evaluate nurses' perceptions on the feasibility, acceptability and usefulness of the Portuguese version of the "Be Sweet to Babies" video. METHOD A cross-sectional study conducted in four units of a university affiliated hospital in São Paulo. Forty-five (45) nurses who answered the questionnaire and watched the video were included. Thirty-eight (38) nurses subsequently evaluated the video. Descriptive statistics were used to analyze the variables, in addition to content analysis of the open question. RESULTS Forty-five (45) nurses participated in the study; 97.4% were aware of the analgesic strategies, and after watching the video nurses reported that they intend to use or encourage the use of these strategies during painful procedures. All participants would recommend the video to other professionals, and considered the resource as useful, easy to understand and easy to apply in real situations. CONCLUSION Nurses are aware of the analgesic strategies and they considered the video as a feasible, acceptable and useful tool for knowledge translation to health care providers, which can also favor parental involvement in their children's pain management.
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Affiliation(s)
| | - Ligyana Korki de Candido
- Universidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem, São Paulo, SP, Brasil
| | - Denise Harrison
- University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Mariana Bueno
- University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
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Dol J, Richardson B, Boates T, Campbell-Yeo M. Learning to parent from Google? Evaluation of available online health evidence for parents of preterm infants requiring neonatal intensive care. Health Informatics J 2018; 25:1265-1277. [PMID: 29361867 DOI: 10.1177/1460458217752564] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study aim was to identify and evaluate the reliability and quality of online resources for parents of preterm infants seeking health information about their infant using the DISCERN tool and Health on Net code. An Internet search ( www.google.com ) was used to identify websites for parents of preterm infants on their infants' health and health issues. For each search, the top 100 "hits" were downloaded, yielding 1200 websites. After reviewing websites for exclusion criteria and duplicates, 197 websites remained and were analyzed. According to the DISCERN tool, the websites had a moderate reliability score (mean = 29.88, standard deviation = 4.88, range: 18-40), moderate treatment score (mean = 24.15, standard deviation = 5.79, range: 10-35), and moderate overall quality score (mean = 3.41, standard deviation = 0.89, range: 1-5). Only 24 (12.2%) websites had current Health on Net code approval and no other websites met full eligibility for certification. Overall, the reliability and quality of information available online to parents of preterm infants is lacking.
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