Facilitators and barriers to parental involvement in neonatal pain management in the NICU: a scoping review.

Abstract

Objectives: Neonatal pain prevention is not only a humanistic but also an ethical imperative. Fitting with the principles of family-centred care, parental involvement in neonatal pain management plays an active role in infant development and parental well-being. However, the process of parental involvement faces constant challenges. To help structure and implement a family engagement programme in neonatal pain management in the neonatal intensive care unit (NICU), we conducted a scoping review to identify facilitators and barriers to parental involvement in neonatal pain management.

Methods: We conducted the scoping review using the Arksey and O'Malley framework. PubMed, Cochrane Library, Web of Science, CINAHL, Scopus, Wanfang database (Chinese), CNKI (Chinese), VIP database(Chinese) and SinoMed (Chinese) were searched systematically for relevant studies published in English and Chinese from inception up to October 2023. We categorised the facilitators and barriers based on the socioecological model and analysed the results thematically in each category.

Results: Ten English qualitative studies were included in the final analysis. The 34 facilitators and 41 barriers extracted were grouped into 4 domains of the socioecological model framework. Of the 10 facilitator themes, the most critical theme was informational and emotional support. Of the 10 barrier themes, the most frequently reported theme was restricted policies and resources.

Conclusions: Our review highlights the essential roles of intrapersonal and interpersonal factors in parental involvement in pain management while suggesting the interconnectedness of factors in various domains within the context of the socioecological model. It implies that most interventions require development and administration at both intrapersonal and interpersonal levels. Regarding the macrolevel, a broad programme with clear regulatory approaches and targeted guidelines could be developed in the future to drive innovations in NICU pain management mode.