Parents as Pain Management in Swedish Neonatal Care

Summary

Parents are a valuable but underused resource in neonatal pain management. In the Nordic countries, family-centred neonatal care has come a long way in welcoming and including parents in the everyday care of their infant. Nonseparation of parents and infants is a protective measure in decreasing stress in both parents and infants and should also be applicable during painful procedures. Sick newborn infants and infants that are born premature are cared for in neonatal intensive care units (NICUs). Because of the intense nature of the care the infants are subjected to an extensive amount of painful procedures and treatments needed for survival. Research shows that infants cared for in the NICU, experience on average between 7 and 17 painful procedures per day, and far from all infants receive adequate pharmacological or non-pharmacological analgesia during the procedures. The parents' role in the pain experience of older children has received considerable attention in research, but parents' participation in infant pain management has quite recently become a focus for research in nursing pain science with currently a handful studies. Research shows for example that when parents are present, the documentation of nursing pain assessment increases as well as the use of non-pharmacological pain-relieving methods, and parental presence can reduce the child's pain intensity and behavioural distress. There is no previous research within Swedish health care context that has investigated the parents' attitudes towards being involved in their infant's pain management, nor any research that previously has assessed the efficacy of combined parent-driven pain management such as skin-to-skin contact or breastfeeding including parental live lullaby singing. The objectives for the study are to investigate parents' and health professional's attitudes, experiences and perspectives on non-pharmacological parent-driven pain management and also to test the efficacy of combined parent-driven pain management such as skin-to-skin contact, breastfeeding and parental live lullaby singing.

Conditions

• Infant Pain Management
• Parent-driven Pain Management

Interventions

BEHAVIORAL

Parent-driven pain management with skin-to-skin contact

The infant is placed naked (except for a diaper and possibly a hat) on the parents' bare chest.

BEHAVIORAL

Parent-driven pain management with skin-to-skin contact/breastfeeding/parental singing

Live parental infant-directed lullaby singing is an individually tailored, non-verbal, multisensory, multimodal and affective tool to regulate the infant before, during and after venipuncture. Direct breast-feeding has demonstrated efficacy that is equal to, or greater than, sweet taste interventions in reducing behavioral and physiological responses to pain in full-term infants undergoing venipuncture with no demonstrated adverse outcomes. Direct breast-feeding should be considered the preferred first-line analgesic intervention for painful procedures performed on full-term infants.

Sponsors & Collaborators

• Region Örebro County

  collaborator OTHER

• Uppsala County Council, Sweden

  collaborator OTHER_GOV

• Dalarna County Council, Sweden

  collaborator OTHER

• Sykehuset Telemark

  collaborator OTHER_GOV

• Örebro University, Sweden

  collaborator OTHER

• Värmland County Council, Sweden

  lead OTHER_GOV

Principal Investigators

• Alexandra Ullsten, PhD · Värmland County Council, Sweden

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2021-03-01

Primary Completion

2023-09-15

Completion

2023-09-15

Countries

• Sweden

Study Locations