Pain is a universal experience, but it has been challenging to adequately define. The revised definition of pain recently published by the International Association for the Study of Pain addressed important shortcomings of the previous version; however, it remains narrow in its focus on sensory and emotional features of pain, failing to capture the substantial roles of cognitive and social core components of the experience and their importance to advances in pain management. This paper reviews evidence and theoretical models for the significant role social and cognitive factors play in pain experience and we argue that without explicit recognition of these core components in the definition, significant nuances are lost at a cost to understanding and clinical management of pain. A focus on sensory and emotional features perpetuates biomedical interventions and research, whereas recognition of cognitive and social features supports a multidimensional model of pain, advances in interdisciplinary care, and the benefits of cognitive behavioral therapy and self‐management interventions. We also explore the six Key Notes that accompany the new definition of pain, discuss their application to the understanding of pain in childhood, and, in doing so, further explore social and cognitive implications. Considerations are also described for assessment and treatment of pain in pediatric populations.
{"title":"What is pain: Are cognitive and social features core components?","authors":"K. Craig, Nicole E. MacKenzie","doi":"10.1002/pne2.12046","DOIUrl":"https://doi.org/10.1002/pne2.12046","url":null,"abstract":"Pain is a universal experience, but it has been challenging to adequately define. The revised definition of pain recently published by the International Association for the Study of Pain addressed important shortcomings of the previous version; however, it remains narrow in its focus on sensory and emotional features of pain, failing to capture the substantial roles of cognitive and social core components of the experience and their importance to advances in pain management. This paper reviews evidence and theoretical models for the significant role social and cognitive factors play in pain experience and we argue that without explicit recognition of these core components in the definition, significant nuances are lost at a cost to understanding and clinical management of pain. A focus on sensory and emotional features perpetuates biomedical interventions and research, whereas recognition of cognitive and social features supports a multidimensional model of pain, advances in interdisciplinary care, and the benefits of cognitive behavioral therapy and self‐management interventions. We also explore the six Key Notes that accompany the new definition of pain, discuss their application to the understanding of pain in childhood, and, in doing so, further explore social and cognitive implications. Considerations are also described for assessment and treatment of pain in pediatric populations.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"91 1","pages":"106 - 118"},"PeriodicalIF":0.0,"publicationDate":"2021-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83765416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Walter-Nicolet, L. Marchand-martin, I. Guellec, V. Biran, M. Moktari, E. Zana-Taieb, J. Magny, L. Desfrère, P. Waszak, P. Boileau, G. Chauvin, L. de Saint Blanquat, S. Borrhomée, S. Droutman, Mona Merhi, V. Zupan, Leila Karoui, P. Cimerman, R. Carbajal, X. Durrmeyer
To describe the frequency and nature of premedication practices for neonatal tracheal intubation (TI) in 2011; to identify independent risk factors for the absence of premedication; to compare data with those from 2005 and to confront observed practices with current recommendations. Data concerning TI performed in neonates during the first 14 days of their admission to participating neonatal/pediatric intensive care units were prospectively collected at the bedside. This study was part of the Epidemiology of Procedural Pain in Neonates study (EPIPPAIN 2) conducted in 16 tertiary care units in the region of Paris, France, in 2011. Multivariate analysis was used to identify factors associated with premedication use and multilevel analysis to identify center effect. Results were compared with those of the EPIPPAIN 1 study, conducted in 2005 with a similar design, and to a current guidance for the clinician for this procedure. One hundred and twenty‐one intubations carried out in 121 patients were analyzed. The specific premedication rate was 47% and drugs used included mainly propofol (26%), sufentanil (24%), and ketamine (12%). Three factors were associated with the use of a specific premedication: nonemergent TI (Odds ratio (OR) [95% CI]: 5.3 [1.49‐20.80]), existence of a specific written protocol in the ward (OR [95% CI]:4.80 [2.12‐11.57]), and the absence of a nonspecific concurrent analgesia infusion before TI (OR [95% CI]: 3.41 [1.46‐8.45]). No center effect was observed. The specific premedication rate was lower than the 56% rate observed in 2005. The drugs used were more homogenous and consistent with the current recommendations than in 2005, especially in centers with a specific written protocol. Premedication use prior to neonatal TI was low, even for nonemergent procedures. Scientific consensus, implementation of international or national recommendations, and local written protocols are urgently needed to improve premedication practices for neonatal intubation.
{"title":"Premedication practices for neonatal tracheal intubation: Results from the EPIPPAIN 2 prospective cohort study and comparison with EPIPPAIN 1","authors":"E. Walter-Nicolet, L. Marchand-martin, I. Guellec, V. Biran, M. Moktari, E. Zana-Taieb, J. Magny, L. Desfrère, P. Waszak, P. Boileau, G. Chauvin, L. de Saint Blanquat, S. Borrhomée, S. Droutman, Mona Merhi, V. Zupan, Leila Karoui, P. Cimerman, R. Carbajal, X. Durrmeyer","doi":"10.1002/pne2.12048","DOIUrl":"https://doi.org/10.1002/pne2.12048","url":null,"abstract":"To describe the frequency and nature of premedication practices for neonatal tracheal intubation (TI) in 2011; to identify independent risk factors for the absence of premedication; to compare data with those from 2005 and to confront observed practices with current recommendations. Data concerning TI performed in neonates during the first 14 days of their admission to participating neonatal/pediatric intensive care units were prospectively collected at the bedside. This study was part of the Epidemiology of Procedural Pain in Neonates study (EPIPPAIN 2) conducted in 16 tertiary care units in the region of Paris, France, in 2011. Multivariate analysis was used to identify factors associated with premedication use and multilevel analysis to identify center effect. Results were compared with those of the EPIPPAIN 1 study, conducted in 2005 with a similar design, and to a current guidance for the clinician for this procedure. One hundred and twenty‐one intubations carried out in 121 patients were analyzed. The specific premedication rate was 47% and drugs used included mainly propofol (26%), sufentanil (24%), and ketamine (12%). Three factors were associated with the use of a specific premedication: nonemergent TI (Odds ratio (OR) [95% CI]: 5.3 [1.49‐20.80]), existence of a specific written protocol in the ward (OR [95% CI]:4.80 [2.12‐11.57]), and the absence of a nonspecific concurrent analgesia infusion before TI (OR [95% CI]: 3.41 [1.46‐8.45]). No center effect was observed. The specific premedication rate was lower than the 56% rate observed in 2005. The drugs used were more homogenous and consistent with the current recommendations than in 2005, especially in centers with a specific written protocol. Premedication use prior to neonatal TI was low, even for nonemergent procedures. Scientific consensus, implementation of international or national recommendations, and local written protocols are urgently needed to improve premedication practices for neonatal intubation.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"38 1","pages":"46 - 58"},"PeriodicalIF":0.0,"publicationDate":"2021-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84865280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reassurance in the context of pediatric pain is regarded to promote distress. Typically, spoken reassurance is reported as short, generic statements (“it's ok,” “don't worry”); little research has considered wider reassuring behaviors and actions undertaken by nurses. Most studies focus on unidirectional, dyadic relationships between reassurance and pain (parent‐to‐child, professional‐to‐child) failing to capture the inherent complexities. Adopting an exploratory, interpretative, and qualitative approach, this paper reports on findings from the qualitative interview component of a mixed‐methods study, concerning how nurses actively use reassurance when talking to children and their parents about pain. Eighteen nurses with experience of managing children's pain were recruited on completion of an international online survey (distributed by pain and children's nursing networks and via newsletter, email, and social media). All 18 nurses completed a semi‐structured interview concerning their experiences of managing children's pain working in the UK (n = 14), Canada (n = 3), and Australia (n = 1) in primary, secondary, and tertiary settings with nursing experience ranging from pre‐qualification to >20 years. Thematic analysis generated three themes which reflect the main ways in which nurses focus their reassurance within encounters with children and their parent(s): (a) on child and parent(s), (b) on the child, and (c) on the parent. Nurses generated reassurance using language, gesture, relationship building, individualizing approaches, education, and preparation. The study highlights the diversity of reassurance provided by nurses in relation to children's pain. Our study finds that when nurses reassure children about pain, they focus their reassurance in three distinct directions (child, parents, and children and parents in partnership); this has not been specifically acknowledged by previous research. We highlight the wide range of implicit and explicit reassurance actions undertaken by nurses and propose that reassurance that extends beyond limited vocalizations is part of a complex package of care that can support children's current and future pain experiences.
{"title":"How nurses use reassurance to support the management of acute and chronic pain in children and young people: An exploratory, interpretative qualitative study","authors":"B. Carter, Jane Harris, A. Jordan","doi":"10.1002/pne2.12045","DOIUrl":"https://doi.org/10.1002/pne2.12045","url":null,"abstract":"Reassurance in the context of pediatric pain is regarded to promote distress. Typically, spoken reassurance is reported as short, generic statements (“it's ok,” “don't worry”); little research has considered wider reassuring behaviors and actions undertaken by nurses. Most studies focus on unidirectional, dyadic relationships between reassurance and pain (parent‐to‐child, professional‐to‐child) failing to capture the inherent complexities. Adopting an exploratory, interpretative, and qualitative approach, this paper reports on findings from the qualitative interview component of a mixed‐methods study, concerning how nurses actively use reassurance when talking to children and their parents about pain. Eighteen nurses with experience of managing children's pain were recruited on completion of an international online survey (distributed by pain and children's nursing networks and via newsletter, email, and social media). All 18 nurses completed a semi‐structured interview concerning their experiences of managing children's pain working in the UK (n = 14), Canada (n = 3), and Australia (n = 1) in primary, secondary, and tertiary settings with nursing experience ranging from pre‐qualification to >20 years. Thematic analysis generated three themes which reflect the main ways in which nurses focus their reassurance within encounters with children and their parent(s): (a) on child and parent(s), (b) on the child, and (c) on the parent. Nurses generated reassurance using language, gesture, relationship building, individualizing approaches, education, and preparation. The study highlights the diversity of reassurance provided by nurses in relation to children's pain. Our study finds that when nurses reassure children about pain, they focus their reassurance in three distinct directions (child, parents, and children and parents in partnership); this has not been specifically acknowledged by previous research. We highlight the wide range of implicit and explicit reassurance actions undertaken by nurses and propose that reassurance that extends beyond limited vocalizations is part of a complex package of care that can support children's current and future pain experiences.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"4 1","pages":"36 - 44"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88517263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael Höck, A. Posod, M. Waltner-Romen, U. Kiechl-Kohlendorfer, E. Griesmaier
LISA is a promising method in improving preterm outcome. The aim of this study was to assess whether the INSURE (intubation‐surfactant extubation) technique or LISA (less invasive surfactant administration) procedure for surfactant administration is associated with more pain‐relieving interventions after the intervention in preterm infants.
{"title":"Less invasive surfactant administration is associated with a higher need for nonpharmacological pain‐relieving interventions compared to the intubation‐surfactant extubation technique in preterm infants","authors":"Michael Höck, A. Posod, M. Waltner-Romen, U. Kiechl-Kohlendorfer, E. Griesmaier","doi":"10.1002/pne2.12042","DOIUrl":"https://doi.org/10.1002/pne2.12042","url":null,"abstract":"LISA is a promising method in improving preterm outcome. The aim of this study was to assess whether the INSURE (intubation‐surfactant extubation) technique or LISA (less invasive surfactant administration) procedure for surfactant administration is associated with more pain‐relieving interventions after the intervention in preterm infants.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"110 1","pages":"29 - 35"},"PeriodicalIF":0.0,"publicationDate":"2020-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80538000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There are continued challenges in achieving effective pain management for children and young people (CYP). Research has found several barriers to effective CYP pain management, which include, but are not limited to, deficiencies in knowledge among nurses and other healthcare professionals. Calls for improvements in and an increase in pain education ensue, in the expectation that an increase in knowledge will lead to an improved pain care for patients. Educational initiatives, as reported in the literature, have tended to focus on increasing empirical knowledge which has not resulted in the anticipated improvements in practice. An exploration of Carper's and Chinn & Kramer's five ways of knowing helps demonstrate why an over‐reliance on empirics fails to equip nurses for the realities of clinical practice and does not facilitate knowledge mobilization or improvements in pain care for CYP. In this paper, we explore these ways of knowing to produce a model for knowledge mobilization in (pain) education. Our model puts forward a multifaceted approach to education using the active learning principles which supports and equip nurses to become effective pain practitioners.
{"title":"Using ways of knowing in nursing to develop educational strategies that support knowledge mobilization","authors":"A. Swift, A. Twycross","doi":"10.1002/pne2.12037","DOIUrl":"https://doi.org/10.1002/pne2.12037","url":null,"abstract":"There are continued challenges in achieving effective pain management for children and young people (CYP). Research has found several barriers to effective CYP pain management, which include, but are not limited to, deficiencies in knowledge among nurses and other healthcare professionals. Calls for improvements in and an increase in pain education ensue, in the expectation that an increase in knowledge will lead to an improved pain care for patients. Educational initiatives, as reported in the literature, have tended to focus on increasing empirical knowledge which has not resulted in the anticipated improvements in practice. An exploration of Carper's and Chinn & Kramer's five ways of knowing helps demonstrate why an over‐reliance on empirics fails to equip nurses for the realities of clinical practice and does not facilitate knowledge mobilization or improvements in pain care for CYP. In this paper, we explore these ways of knowing to produce a model for knowledge mobilization in (pain) education. Our model puts forward a multifaceted approach to education using the active learning principles which supports and equip nurses to become effective pain practitioners.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"27 1","pages":"139 - 147"},"PeriodicalIF":0.0,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77704548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Incredible knowledge about neonatal and infant pain has been generated since the field's inception1; however, much of that research is not being put into practice or making it into the hands of people who need it the most, including healthcare providers, patients, and families.2 This means that while effective treatments exist for neonatal pain, suffering continues for premature, sick and healthy infants, and their families due to undertreated and preventable pain.3,4 Knowledge mobilization is about making evidence "usable," by making knowledge accessible, understandable, meaningful, and useful for knowledge users.5 Knowledge mobilization bridges research, policies, and practices to improve outcomes in partnership with families, health professionals, researchers, educators, organizations, and policymakers, in this case, to ultimately improve pain for neonates, children, and their families.3 Solutions for Kids in Pain (SKIP; www.kidsi npain.ca) is a knowledge mobilization network whose mission is to improve children's pain management by mobilizing evidence-based solutions through coordination and collaboration. SKIP is pleased to partner with pediatric and neonatal pain to introduce this first of two special issues focused on knowledge mobilization. These special issues highlight initiatives aimed to move knowledge in pediatric and neonatal pain into practice. This first special issue focuses on knowledge mobilization in neonatal pain (Part 1), with forthcoming issue focused on knowledge mobilization in pediatric pain (Part 2). Showcased is the incredibly diverse knowledge mobilization work being down in the field around the world. This includes efforts to engage and benefit varied knowledge user audiences, including health professionals, parents, children, and decision makers, addressing acute, procedural, and chronic pain in populations from infancy to later adolescence, and led by interdisciplinary teams. The four papers in this special neonatal edition (Part 1) highlight how evidence about effective neonatal pain management can be mobilized via interprofessional interventions and social media.69 Firstly, Balice-Bourgois and her team report on the processes of developing a theoretically informed interprofessional intervention aimed at improving procedural pain management in a NICU in Switzerland.6 The content of the proposed intervention was then evaluated and approved by a panel of experts, healthcare providers, and parents. Secondly, Korki de Candido and her team report on an evaluation of the Portuguese version of the “Be Sweet to Babies” video in a postnatal setting in Brazil.8 The brief video, produced in 9 languages, is a knowledge translation tool, co-produced with parents and targeted at parents, and demonstrates the use of breastfeeding, skin-to-skin contact and sucrose during painful procedures. In this case, the video was evaluated using a pragmatic pilot randomized controlled trial, on use of the pain management strategies during ne
自该领域成立以来，已经产生了关于新生儿和婴儿疼痛的令人难以置信的知识。然而，许多研究并没有付诸实践，也没有将其交到最需要它的人手中，包括医疗保健提供者、患者和家庭这意味着，尽管存在针对新生儿疼痛的有效治疗方法，但由于治疗不足和可预防的疼痛，早产儿、患病和健康婴儿及其家庭继续遭受痛苦。3,4知识动员是通过使知识易于获取、可理解、有意义和对知识使用者有用，从而使证据“可用”知识动员将研究、政策和实践联系起来，与家庭、卫生专业人员、研究人员、教育工作者、组织和政策制定者合作，改善结果，最终改善新生儿、儿童及其家庭的疼痛儿童痛苦解决方案(SKIP;www.kidsi npain.ca)是一个知识动员网络，其使命是通过协调和合作，动员以证据为基础的解决方案，改善儿童疼痛管理。SKIP很高兴与儿科和新生儿疼痛合作，介绍两个特别问题中的第一个，重点是知识动员。这些特殊问题突出了旨在将儿科和新生儿疼痛知识付诸实践的举措。第一期特刊关注的是新生儿疼痛的知识动员(第1部分)，即将出版的一期关注的是儿科疼痛的知识动员(第2部分)。展示的是世界各地正在进行的令人难以置信的多样化的知识动员工作。这包括努力吸引各种知识用户受众，包括卫生专业人员、父母、儿童和决策者，并使其受益，解决从婴儿期到青春期后期人群的急性、程序性和慢性疼痛问题，并由跨学科团队领导。这篇新生儿特别版(第一部分)的四篇论文强调了如何通过跨专业干预和社交媒体动员有效的新生儿疼痛管理证据首先，Balice-Bourgois和她的团队报告了开发一种理论上知情的跨专业干预措施的过程，旨在改善瑞士新生儿重症监护室的程序疼痛管理。6然后，建议的干预措施的内容由专家小组、医疗保健提供者和家长进行评估和批准。其次，Korki de Candido和她的团队报告了在巴西产后环境下对葡萄牙语版“对婴儿甜蜜”视频的评估。8这个简短的视频用9种语言制作，是一个知识翻译工具，与父母共同制作，针对父母，并展示了在痛苦的过程中使用母乳喂养，皮肤接触和蔗糖。在这种情况下，视频使用实用的试点随机对照试验进行评估，在健康新生儿筛查期间使用疼痛管理策略。在本特刊的第三篇论文中，使用相同的视频，维埃拉和她的团队利用社交媒体的力量，评估使用Facebook作为在整个巴西传播视频的手段，并评估受访者的先验知识，以前使用母乳喂养，皮肤对皮肤接触和蔗糖，并打算在未来使用这些策略该小组报告了大量的观点，并完成了930项调查，突出了使用非传统研究方法进行知识动员研究的巨大潜力。最后，Bueno, Stevens和大型ImPaC(实施婴儿疼痛实践改变)团队的论文报告了在线资源的可用性，可接受性和可行性测试，针对临床医生，在加拿大的新生儿重症监护病房中。该资源现在被用作包括加拿大18个新生儿重症监护病房在内的全国性集群随机试验的干预措施。这四篇论文报告了多样化和创新的研究方法和干预措施，在世界不同地区以三种不同的语言(瑞士意大利语，葡萄牙语和英语)进行，但具有相同的重点;将新生儿疼痛治疗的知识付诸实践，目的是改善新生儿及其家庭的预后。我们对这第一个特别的知识动员问题感到兴奋，重点关注新生儿疼痛，希望我们的读者分享这种兴奋。我们还对以儿童和青少年为重点的《知识动员》特刊的第二部分感到兴奋。
{"title":"Special issue on knowledge mobilization: Neonatal pain","authors":"D. Harrison, K. Birnie","doi":"10.1002/pne2.12039","DOIUrl":"https://doi.org/10.1002/pne2.12039","url":null,"abstract":"Incredible knowledge about neonatal and infant pain has been generated since the field's inception1; however, much of that research is not being put into practice or making it into the hands of people who need it the most, including healthcare providers, patients, and families.2 This means that while effective treatments exist for neonatal pain, suffering continues for premature, sick and healthy infants, and their families due to undertreated and preventable pain.3,4 Knowledge mobilization is about making evidence \"usable,\" by making knowledge accessible, understandable, meaningful, and useful for knowledge users.5 Knowledge mobilization bridges research, policies, and practices to improve outcomes in partnership with families, health professionals, researchers, educators, organizations, and policymakers, in this case, to ultimately improve pain for neonates, children, and their families.3 Solutions for Kids in Pain (SKIP; www.kidsi npain.ca) is a knowledge mobilization network whose mission is to improve children's pain management by mobilizing evidence-based solutions through coordination and collaboration. SKIP is pleased to partner with pediatric and neonatal pain to introduce this first of two special issues focused on knowledge mobilization. These special issues highlight initiatives aimed to move knowledge in pediatric and neonatal pain into practice. This first special issue focuses on knowledge mobilization in neonatal pain (Part 1), with forthcoming issue focused on knowledge mobilization in pediatric pain (Part 2). Showcased is the incredibly diverse knowledge mobilization work being down in the field around the world. This includes efforts to engage and benefit varied knowledge user audiences, including health professionals, parents, children, and decision makers, addressing acute, procedural, and chronic pain in populations from infancy to later adolescence, and led by interdisciplinary teams. The four papers in this special neonatal edition (Part 1) highlight how evidence about effective neonatal pain management can be mobilized via interprofessional interventions and social media.69 Firstly, Balice-Bourgois and her team report on the processes of developing a theoretically informed interprofessional intervention aimed at improving procedural pain management in a NICU in Switzerland.6 The content of the proposed intervention was then evaluated and approved by a panel of experts, healthcare providers, and parents. Secondly, Korki de Candido and her team report on an evaluation of the Portuguese version of the “Be Sweet to Babies” video in a postnatal setting in Brazil.8 The brief video, produced in 9 languages, is a knowledge translation tool, co-produced with parents and targeted at parents, and demonstrates the use of breastfeeding, skin-to-skin contact and sucrose during painful procedures. In this case, the video was evaluated using a pragmatic pilot randomized controlled trial, on use of the pain management strategies during ne","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"37 1","pages":"61 - 62"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88601552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children commonly undergo painful needle procedures. Unmanaged procedural pain can have short‐ and long‐term consequences, including longer procedure times, greater distress at future procedures, and vaccine hesitancy. While parent behaviors are one of the strongest predictors of children's response to acute pain, pediatric procedural pain management interventions focus almost exclusively on the child. Further, existing parent‐involved pediatric pain management interventions typically fail to improve child self‐reported pain during painful procedures. The current protocol offers the first randomized controlled trial involving a mindfulness intervention for pediatric acute pain that includes children and their parents. This study aims to conduct a single‐site, two‐arm, parallel‐group RCT to examine the effects of a mindfulness intervention for parents and children before child venipuncture compared to a control group on primary (child self‐report of pain and fear), secondary (parent self‐report and child report of parent distress), and tertiary outcomes (parent report of child pain and fear). Parent‐child dyads (n = 150) will be recruited from the McMaster Children's Hospital outpatient blood laboratory. Dyads will be randomly assigned to either a mindfulness group guided through a mindfulness intervention or control group guided through an unfocused attention task. Parents will accompany their child for their venipuncture. Postvenipuncture measures will be collected (eg, child pain‐related outcomes as reported by parents and children). The first enrollment occurred in October 2019. We offer a novel intervention that aims to facilitate both parent and child coping during child venipuncture.
{"title":"Study protocol for a randomized controlled trial of a child and parent mindfulness intervention for pediatric venipuncture","authors":"Rachel L. Moline, C. Chambers, C. McMurtry","doi":"10.1002/pne2.12038","DOIUrl":"https://doi.org/10.1002/pne2.12038","url":null,"abstract":"Children commonly undergo painful needle procedures. Unmanaged procedural pain can have short‐ and long‐term consequences, including longer procedure times, greater distress at future procedures, and vaccine hesitancy. While parent behaviors are one of the strongest predictors of children's response to acute pain, pediatric procedural pain management interventions focus almost exclusively on the child. Further, existing parent‐involved pediatric pain management interventions typically fail to improve child self‐reported pain during painful procedures. The current protocol offers the first randomized controlled trial involving a mindfulness intervention for pediatric acute pain that includes children and their parents. This study aims to conduct a single‐site, two‐arm, parallel‐group RCT to examine the effects of a mindfulness intervention for parents and children before child venipuncture compared to a control group on primary (child self‐report of pain and fear), secondary (parent self‐report and child report of parent distress), and tertiary outcomes (parent report of child pain and fear). Parent‐child dyads (n = 150) will be recruited from the McMaster Children's Hospital outpatient blood laboratory. Dyads will be randomly assigned to either a mindfulness group guided through a mindfulness intervention or control group guided through an unfocused attention task. Parents will accompany their child for their venipuncture. Postvenipuncture measures will be collected (eg, child pain‐related outcomes as reported by parents and children). The first enrollment occurred in October 2019. We offer a novel intervention that aims to facilitate both parent and child coping during child venipuncture.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"30 1","pages":"20 - 28"},"PeriodicalIF":0.0,"publicationDate":"2020-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86593194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Recent years have seen the increasing use of noninvasive respiratory support in preterm infants with the aim of minimizing the risk of mechanical ventilation and subsequent bronchopulmonary dysplasia. Respiratory distress syndrome is the most common respiratory diagnosis in preterm infants, and is best treated by administration of surfactant. Until recently, this has been performed via an endotracheal tube using premedication, which has often included opiate analgesia; subsequently, the infant has been ventilated. Avoidance of mechanical ventilation, however, does not negate the need for surfactant therapy. Less invasive surfactant administration (LISA) in spontaneously breathing infants is increasing in popularity, and appears to have beneficial effects. However, laryngoscopy is necessary, which carries adverse effects and is painful for the infant. Conventional methods of premedication for intubation tend to reduce respiratory drive, which increases the likelihood of ventilation being required. This has led to intense debate about the best strategy for providing appropriate treatment, taking into account both the respiratory needs of the infant and the need to alleviate procedural pain. Currently, clinical practice varies considerably and there is no consensus with respect to optimal management. This review seeks to summarize the benefits, risks, and challenges associated with this new approach.
{"title":"New techniques, new challenges—The dilemma of pain management for less invasive surfactant administration?","authors":"A. Balakrishnan, Ranveer Sanghera, E. Boyle","doi":"10.1002/pne2.12033","DOIUrl":"https://doi.org/10.1002/pne2.12033","url":null,"abstract":"Recent years have seen the increasing use of noninvasive respiratory support in preterm infants with the aim of minimizing the risk of mechanical ventilation and subsequent bronchopulmonary dysplasia. Respiratory distress syndrome is the most common respiratory diagnosis in preterm infants, and is best treated by administration of surfactant. Until recently, this has been performed via an endotracheal tube using premedication, which has often included opiate analgesia; subsequently, the infant has been ventilated. Avoidance of mechanical ventilation, however, does not negate the need for surfactant therapy. Less invasive surfactant administration (LISA) in spontaneously breathing infants is increasing in popularity, and appears to have beneficial effects. However, laryngoscopy is necessary, which carries adverse effects and is painful for the infant. Conventional methods of premedication for intubation tend to reduce respiratory drive, which increases the likelihood of ventilation being required. This has led to intense debate about the best strategy for providing appropriate treatment, taking into account both the respiratory needs of the infant and the need to alleviate procedural pain. Currently, clinical practice varies considerably and there is no consensus with respect to optimal management. This review seeks to summarize the benefits, risks, and challenges associated with this new approach.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"58 1","pages":"2 - 8"},"PeriodicalIF":0.0,"publicationDate":"2020-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87496238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over the past 20 years, our knowledge regarding evidence‐based psychological interventions for pediatric chronic pain has dramatically increased. Unfortunately, access to evidence‐based pain management interventions remains a challenge for many children and adolescents who suffer with persistent pain. Reducing patient burden and system‐level barriers to care are a central target of clinical innovations in pain treatment intervention. Psychological interventions are also increasingly focused on reducing biomedical biases that may inhibit attainment of services. While there are many new psychological interventions across an array of delivery platforms, few interventions have been systematically disseminated. This paper will highlight the translational research procedures that have informed the development and dissemination of the Comfort Ability Program (CAP), an interactive group‐based intervention teaching adolescents and their parents evidence‐based strategies to manage chronic or persistent pain. Now in its fifth year of dissemination, CAP has a demonstrated record of success with cross‐institutional implementation and sustainability at 18 hospitals across three countries. This paper reviews six dynamic and iterative phases of development, based on the Graham et al knowledge‐to‐action cycle (2006), that have guided the implementation and dissemination research for this program. The phases of CAP development include the following: (a) identifying knowledge and clinical gaps in care, (b) generating knowledge assets and implementation procedures, (c) evaluating clinical outcomes and system‐level processes, (d) developing and testing dissemination procedures, (e) expanding partnerships and monitoring knowledge use, and (f) sustaining knowledge use and continued innovation. This paper targets primarily health professionals and administrators and secondarily caregivers and the public at large.
{"title":"Mobilizing the psychology evidence base for the treatment of pediatric chronic pain: The development, implementation, and impact of the Comfort Ability Program","authors":"Rachael Coakley, Simona Bujoreanu","doi":"10.1002/pne2.12019","DOIUrl":"https://doi.org/10.1002/pne2.12019","url":null,"abstract":"Over the past 20 years, our knowledge regarding evidence‐based psychological interventions for pediatric chronic pain has dramatically increased. Unfortunately, access to evidence‐based pain management interventions remains a challenge for many children and adolescents who suffer with persistent pain. Reducing patient burden and system‐level barriers to care are a central target of clinical innovations in pain treatment intervention. Psychological interventions are also increasingly focused on reducing biomedical biases that may inhibit attainment of services. While there are many new psychological interventions across an array of delivery platforms, few interventions have been systematically disseminated. This paper will highlight the translational research procedures that have informed the development and dissemination of the Comfort Ability Program (CAP), an interactive group‐based intervention teaching adolescents and their parents evidence‐based strategies to manage chronic or persistent pain. Now in its fifth year of dissemination, CAP has a demonstrated record of success with cross‐institutional implementation and sustainability at 18 hospitals across three countries. This paper reviews six dynamic and iterative phases of development, based on the Graham et al knowledge‐to‐action cycle (2006), that have guided the implementation and dissemination research for this program. The phases of CAP development include the following: (a) identifying knowledge and clinical gaps in care, (b) generating knowledge assets and implementation procedures, (c) evaluating clinical outcomes and system‐level processes, (d) developing and testing dissemination procedures, (e) expanding partnerships and monitoring knowledge use, and (f) sustaining knowledge use and continued innovation. This paper targets primarily health professionals and administrators and secondarily caregivers and the public at large.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"123 50","pages":"148 - 159"},"PeriodicalIF":0.0,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91407293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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