scholarly journals Singing, sharing, soothing – biopsychosocial rationales for parental infant-directed singing in neonatal pain management

2018 ◽  
Vol 1 ◽  
pp. 205920431878084 ◽  
Author(s):  
Alexandra Ullsten ◽  
Mats Eriksson ◽  
Maria Klässbo ◽  
Ulrik Volgsten
Keyword(s):  
Intensive Care ◽  
Pain Management ◽  
Neonatal Intensive Care ◽  
Parental Participation ◽  
Music Therapist ◽  
Neonatal Pain ◽  
Short And Long Term ◽  
Early Parent ◽  
Pain Care

Infant-directed singing is a medium for parents and infants to communicate in a mutual relationship. Parental infant-directed singing is a multisensory, biopsychosocial communication that applies to ill and vulnerable hospitalised infants. The primary musical features of infant-directed singing are ideal for emotional coordination and sharing between parent and infant without the risk of over-stimulation. In this article, we suggest that parental infant-directed singing is regarded as a nonpharmacological emotion regulation intervention, which may modify the painful experience for both the infant and the parent before, during and after painful procedures in the neonatal intensive care context. Parents have the biopsychosocial resources to alleviate their infant’s pain through infant-directed singing, if they are empowered to do so and coached in this process. A music therapist specialised in neonatal music therapy methods can mentor parents in how to use entrained and attuned live lullaby singing in connection to painful procedures. Pain and the vast amount of painful procedures early in infancy, combined with early parent–infant separation and lack of parental participation in the care of the infant during neonatal intensive care, place arduous strain on the new family’s attachment process and on the infant’s and parents’ mental health, both from a short and long-term perspective. Therefore, we argue with biopsychosocial rationales, that live parental infant-directed singing should be promoted in neonatal pain care worldwide. Consequently, parents should be welcomed round the clock and invited as prescribed pain management for their infant.

scholarly journals Changes in Physicians' Perceptions and Practices on Neonatal Pain Management Over the Past 20 Years. A Survey Conducted at Two Time-Points

2021 ◽  
Vol 9 ◽  
Author(s):  
Eleni Agakidou ◽  
Konstantia Tsoni ◽  
Theodora Stathopoulou ◽  
Agathi Thomaidou ◽  
Maria Farini ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Assessment Tools ◽  
Procedural Pain ◽  
Time Points ◽  
Neonatal Pain ◽  
The Past ◽  
Long Term Consequences ◽  
Experience Pain

Intense research for more than three decades expelled the view that neonates do not experience pain. The aim of this survey was to investigate whether the Greek physicians involved in neonatal intensive care have changed their perceptions regarding neonatal pain, adapting their management practices to the knowledge that have emerged in the past 20-years. This study is a survey conducted at two time-points, 20 years apart. Anonymous questionnaires were distributed to 117 and 145 physicians working in neonatal intensive care units (NICUs) all over Greece in years 2000 and 2019, respectively. The response rate was 90.6 and 80.7% in 2000 and 2019, respectively. All respondents, at both time-points, believed that neonates experience pain, which has serious acute and long-term consequences, while the vast majority considered analgesia-sedation (A-S) during painful interventions as obligatory. Utilization of NICU protocols and pain assessment tools remained low although increased significantly between 2000 and 2019. The use of systemic A-S postoperatively was high at both time-points, while its implementation in infants subjected to prolonged pain, specifically mechanical ventilation, increased significantly by 2019. Systemic or local analgesia for acute procedural pain was used by lower proportions of physicians in 2019, except for the tracheal intubation. In contrast, the use of sweet solutions and non-pharmacological measures prior to or during bedside procedures significantly increased over time. Opioid administration significantly increased, while a shift from morphine to fentanyl was observed. International literature and perinatal–neonatal congresses were stated as the main sources of updating physicians' knowledge and improving management practice on neonatal pain prevention and treatment. In conclusion, Greek NICU-physicians' perceptions that neonates can experience pain with potentially serious acute and long-term consequences remained strong over the past 20 years. Although physicians' practices on neonatal pain management improved, they are still suboptimal, while significant differences exist among centers. Continuing education, globally accepted management protocols, and readily applied pain assessment tools would further improve the management of procedural pain and stress in neonates.

Neonatal Intensive Care Nursesʼ Perceptions of Parental Participation in Infant Pain Management

2015 ◽  
Vol 29 (4) ◽  
pp. 363-374 ◽  
Author(s):  
Anna Axelin ◽  
Agneta Anderzén-Carlsson ◽  
Mats Eriksson ◽  
Tarja Pölkki ◽  
Anne Korhonen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pain Management ◽  
Neonatal Intensive Care ◽  
Parental Participation ◽  
Infant Pain

scholarly journals Assistance flowchart for pain management in a Neonatal Intensive Care Unit

2018 ◽  
Vol 71 (suppl 3) ◽  
pp. 1281-1289 ◽  
Author(s):  
Danielle Lemos Querido ◽  
Marialda Moreira Christoffel ◽  
Viviane Saraiva de Almeida ◽  
Ana Paula Vieira dos Santos Esteves ◽  
Marilda Andrade ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pain Management ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Scientific Evidence ◽  
Methodological Framework ◽  
Health Team ◽  
Neonatal Pain ◽  
Key Points

ABSTRACT Objective: To describe and discuss the process of developing a flowchart collectively constructed by the health team of a Neonatal Intensive Care Unit for the management of neonatal pain. Method: This is a descriptive and an exploratory study with a qualitative approach that used Problem-Based Learning as a theoretical-methodological framework in the process of developing the assistance flowchart for the management of neonatal pain. Results: Based on this methodology, there was training in service and the discussion of key points of pain management by the health team, which served as input for the construction of the flowchart. Final considerations: The assistance flowchart for pain management, based on scientific evidence, provided means to facilitate the decision-making of the health team regarding the pain of the newborn. It is suggested to use the flowchart frequently to promote the permanent education of the team and identify possible points to be adjusted.

The Impact of Implementing a “Pain, Agitation, and Delirium Bundle” in a Pediatric Intensive Care Unit: Improved Delirium Diagnosis

2021 ◽  
Author(s):  
Lise D. Cloedt ◽  
Kenza Benbouzid ◽  
Annie Lavoie ◽  
Marie-Élaine Metras ◽  
Marie-Christine Lavoie ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Post Intervention ◽  
Number Of Patients ◽  
Implementation Period ◽  
Short And Long Term ◽  
The Impact

AbstractDelirium is associated with significant negative outcomes, yet it remains underdiagnosed in children. We describe the impact of implementing a pain, agitation, and delirium (PAD) bundle on the rate of delirium detection in a pediatric intensive care unit (PICU). This represents a single-center, pre-/post-intervention retrospective and prospective cohort study. The study was conducted at a PICU in a quaternary university-affiliated pediatric hospital. All patients consecutively admitted to the PICU in October and November 2017 and 2018. Purpose of the study was describe the impact of the implementation of a PAD bundle. The rate of delirium detection and the utilization of sedative and analgesics in the pre- and post-implementation phases were measured. A total of 176 and 138 patients were admitted during the pre- and post-implementation phases, respectively. Of them, 7 (4%) and 44 (31.9%) were diagnosed with delirium (p < 0.001). Delirium was diagnosed in the first 48 hours of PICU admission and lasted for a median of 2 days (interquartile range [IQR]: 2–4). Delirium diagnosis was higher in patients receiving invasive ventilation (p < 0.001). Compliance with the PAD bundle scoring was 79% for the delirium scale. Score results were discussed during medical rounds for 68% of the patients in the post-implementation period. The number of patients who received opioids and benzodiazepines and the cumulative doses were not statistically different between the two cohorts. More patients received dexmedetomidine and the cumulative daily dose was higher in the post-implementation period (p < 0.001). The implementation of a PAD bundle in a PICU was associated with an increased recognition of delirium diagnosis. Further studies are needed to evaluate the impact of this increased diagnostic rate on short- and long-term outcomes.

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