Parents’ perceptions of their child’s pain assessment in hospital care:a cross-sectional study

Abstract Purpose: A prerequisite for successful pain management is identifying the pain and assessing its intensity. The aim of this study was to describe parents’ perceptions of their child’s pain assessment in hospital care. Design and methods: This study was a descriptive cross-sectional study. A questionnaire was completed by parents (n = 261) whose child was hospitalized in one of the pediatric units (n = 6) of the University Hospital in Finland. Quantitative data were analyzed using statistical methods; open-ended data were analyzed using inductive content analysis. Results: Parents reported that their children experienced moderate (36%) to severe pain (42%) during hospitalization. The most intense pain experienced by the children was associated with needle-related procedures (41%). A large proportion of parents (83%) were involved in their child’s pain assessment. Parents were satisfied with their child’s pain assessment but perceived some shortcomings. Parents hoped that a variety of methods would be used to assess their child’s pain and that the parents’ and child’s views on pain would be taken into account. Conclusions: Most children experience moderate to severe pain during hospitalization. Parents are often involved in pain assessment but are rarely instructed to use pain scales. Practice implications: Child’s pain should be assessed regularly and frequently enough. It is important that the child and parents are involved in shared decision-making about pain assessment and treatment, and they have opportunities to ask questions. Guidance should be offered to parents about the use of pain assessment scales

Hoitotyöntekijöiden käsityksiä vauvojen kivunarvioinnista, lääkkeettömästä kivunhoidosta ja moniammatillisesta yhteistyöstä lastenosastoilla

Tiivistelmä Tutkimuksen tarkoitus: Tutkimuksen tarkoituksena oli kuvata hoitotyöntekijöiden käsityksiä vauvojen kivunarvioinnista ja lääkkeettömästä kivunhoidosta sekä siihen liittyvästä moniammatillisesta yhteistyöstä lastenosastoilla. Aineisto ja menetelmät: Aineisto kerättiin vuonna 2018 kokonaisotantana kyselylomakkeella hoitotyöntekijöiltä (N=268), jotka työskentelivät sairaanhoitajina, kätilöinä, lastenhoitajina tai lähi- ja perushoitajina erään suomalaisen yliopistosairaalan lastenosastoilla. Analyysi tehtiin kuvailevilla menetelmillä. Tutkimuksen tulokset: Osallistujien mielestä kipumittarit olivat tarpeellisia apuvälineitä, ja vauvan vanhemmat oli tärkeä ottaa mukaan kivunarviointiin. Kivunarvioinnin ajateltiin vaikuttavan toteutettavaan kivunhoitoon. Kipumittareiden käyttö vauvojen kivunarvioinnissa oli kuitenkin vähäistä. Lääkkeettömiä kivunlievitysmenetelmien käyttö ja ohjaus ei ollut kaikilta osin riittävää ja niiden välillä oli tilastollisesti merkitsevä yhteys. Moniammatillista yhteistyötä arvioitiin kriittisesti, ja siihen esitettiin parannusehdotuksia. Päätelmät: Tutkimuksesta saatuja tuloksia voidaan hyödyntää moniammatilliseen yhteistyöhön perustuvien toimintamallien kehittämisessä sekä vauvojen kivunarvioinnin ja -hoidon yhtenäistämisessä. Moniammatillista yhteistyötä kivunhoidossa tulisi kehittää koulutuksellisilla interventioilla.Abstract Nursing staff’s perceptions about infants’ pain assessment and non-pharmacological pain alleviation related to interprofessional collaboration at pediatric wards Aim: The aim of this study was to describe nursing staff’s perceptions about infants’ pain assessment and nonpharmacological pain alleviation as well as interprofessional collaboration related to it at pediatric wards. Data and methods: The data were collected in 2018 on a total sample basis through a questionnaire from the nursing staff (N=268) who worked as nurses, midwives or practical nurses at pediatric wards in a Finnish university hospital. The data were analysed using descriptive statistical methods. Results: Participants considered both pain assessment scales and parental involvement in pain assessment important. Although pain assessment was thought to influence the performed treatment, only a few participants regularly used pain assessment scales. The use and counselling of nonpharmacological pain relieving methods were not adequate in all aspects and there was a statistically significant association between them. Interprofessional collaboration with own and other professional groups was critically evaluated and some improvements were proposed. Conclusions: The results of the study can be used to develop interprofessional collaboration approaches and to integrate pain assessment and management among infants. Interprofessional collaboration in pain management should be further developed by educational interventions

Vanhempien käsityksiä lapsensa lääkkeettömän kivunhoidon ohjauksesta sairaalassa

Tiivistelmä Tutkimuksen tarkoitus: Tarkoituksena oli kuvata vanhempien käsityksiä lapsensa lääkkeettömän kivunhoidon ohjauksesta sairaalassa ja selvittää taustekijöiden yhteyttä ohjaukseen. Aineisto ja menetelmät: Kuvailevan poikkileikkaustutkimuksen aineisto kerättiin kyselylomakkeella 1–15-vuotiaiden lasten vanhemmilta (n=210) erään suomalaisen yliopistollisen sairaalan lastenosastoilla. Aineisto analysoitiin kuvailevin tilastollisin menetelmin. Tulokset: Vanhemmille eniten ohjattuja lääkkeettömiä kivunlievitysmenetelmiä lapsen kivunhoidossa olivat emotionaalisen tuen menetelmät, asentohoito sekä ajatusten suuntaaminen pois kivusta. Sen sijaan vähiten ohjattuja menetelmiä olivat musiikki ja hieronta. Ohjauksessa käytettiin harvoin kirjallista materiaalia, videoita tai Internet-sivustoja. Lapsen yksilölliset ominaisuudet huomioitiin hyvin ohjauksessa. Lapsen iällä ja kivun voimakkuudella oli tilastollisesti merkitsevä yhteys ohjattuihin menetelmiin. Vanhempien saama ohjaus eri menetelmien käytössä lisäsi heidän tyytyväisyyttään lääkkeettömän kivunhoidon ohjaukseen kokonaisuudessaan. Päätelmät: Vanhempia osallistava ohjaaminen lapsensa lääkkeettömässä kivunhoidossa on tärkeää. Vanhemmille tarjottuun ohjaukseen sekä monipuolisiin ohjausmenetelmiin tulee kiinnittää huomiota lastenhoitotyössä huomioiden myös lapsen yksilölliset ominaisuudet. Tuloksia voidaan hyödyntää lasten kivunhoidon kehittämisessä.Abstract Aim: The aim of the study was to describe parents’ perceptions of received guidance in non-pharmacological pain management during their children’s hospitalization and to find out the association between the background factors and counselling. Data and methods: The data of this cross-sectional study were collected through a questionnaire from the parents of children aged 1–15 years (n=210) at pediatric wards in a Finnish university hospital. Data were analyzed using descriptive statistical methods. Results: Parents received the most guidance in their child’s pain management on emotional support methods, positioning and distraction, while the least guided methods were music and massage. Written instructions, educational videos or websites were rarely used in the guidance. The individual characteristics of the child were well taken into account. Child’s age and intensity of pain were statistically significantly associated with the guided methods. Guidance in different methods increased parents’ satisfaction in the overall guidance in non-pharmacological pain management. Conclusions: The guidance of parents to take part in their children’s non-pharmacological pain treatment is important. Attention should be paid to the guidance and its methods offered to parents in pediatric nursing, and this should be done taking into account the child’s individual characteristics. The results of this study can be utilized in the development of children’s pain treatment

The competence of neonatal intensive care nurses:a systematic review

Abstract Objective: The objective was to conduct a systematic review describing the competencies required from nurses working in neonatal intensive care settings. Design: Systematic review. Data sources: A total of eight databases, including PubMed, Scopus, CINAHL, MEDLINE, Mednar, Web of Science, ProQuest and Medic, were screened for relevant literature during February and September 2022. Review methods: The systematic review process followed Joanna Briggs Institute guidelines. The inclusion criteria were: 1) (P = population) registered nurses; 2) (C = concept) the competence; 3) (C = context) nursing in neonatal intensive care units; and 4) cross-sectional study as study method. A critical appraisal tool for cross-sectional studies from Joanna Briggs Institute was used by two independent reviewers. After data extraction, thematic analysis was performed. Results: The database searches yielded a total of 8887 studies and after two independent evaluations, a total of 50 eligible studies were identified comprising of 7536 registered nurses working in neonatal intensive care units across 19 countries. The studies described four main competence themes: 1) neonatal care interventions; 2) caring for a dying infant; 3) family-centered care; and 4) neonatal intensive care interventions. Conclusion: Previous research has focused on evaluating specific competencies that are necessary in the neonatal intensive care setting. There is a need for research concerning the overall competence of nurses working in neonatal intensive care units. There was a lot of variety within the quality of the eligible studies and within the used instruments. Protocol registration: This systematic review was registered in Prospero (PROSPERO 2022 CRD42022308028)

Effectiveness of technology-based interventions compared with other non-pharmacological interventions for relieving procedural pain in hospitalized neonates:a systematic review protocol

Abstract Objectives: The objective of this review is to evaluate the effectiveness of technology-based interventions in relieving procedural pain in hospitalized neonates compared with other non-pharmacological interventions. Introduction: Neonates requiring hospital care often experience acute pain during medical procedures. The current best practice for relieving pain in neonates is the use of non-pharmacological interventions, such as oral solutions or intervention-based human touch. Technological solutions (such as games, eHealth applications, and mechanical vibrators) have become more commonplace in pediatric pain management over recent years. However, there is a knowledge gap about how effective technology-based interventions are at relieving pain in neonates. Inclusion criteria: This review will consider experimental trials that include technology-based non-pharmacological interventions for relieving procedural pain in hospitalized neonates. Primary outcomes of interest include pain response to a procedure measured by a validated pain assessment scale for neonates, behavioral indicators, and/or changes in physiological indicators. Methods: MEDLINE (Ovid), CINAHL (EBSCO), Scopus (Elsevier), Cochrane Central Register of Controlled Trials, and the MEDIC databases will be searched for studies published in English, Finnish, and Swedish. Critical appraisal and data extraction will be conducted by two independent researchers following JBI methodology. Quantitative data will be pooled in statistical meta-analyses. If statistical analysis is not possible, the findings will be reported narratively. Systematic review registration: PROSPERO CRD4202125421

Association of TERC and OBFC1 Haplotypes with Mean Leukocyte Telomere Length and Risk for Coronary Heart Disease

Objective: To replicate the associations of leukocyte telomere length (LTL) with variants at four loci and to investigate their associations with coronary heart disease (CHD) and type II diabetes (T2D), in order to examine possible causal effects of telomere maintenance machinery on disease aetiology. Methods: Four SNPs at three loci BICD1 (rs2630578 G??C), 18q12.2 (rs2162440 G??T), and OBFC1 (rs10786775 C??G, rs11591710 A??C) were genotyped in four studies comprised of 2353 subjects out of which 1148 had CHD and 566 T2D. Three SNPs (rs12696304 C??G, rs10936601G>T and rs16847897 G??C) at the TERC locus were genotyped in these four studies, in addition to an offspring study of 765 healthy students. For all samples, LTL had been measured using a real-time PCR-based method. Results: Only one SNP was associated with a significant effect on LTL, with the minor allele G of OBFC1 rs10786775 SNP being associated with longer LTL (??=0.029, P=0.04). No SNPs were significantly associated with CHD or T2D. For OBFC1 the haplotype carrying both rare alleles (rs10786775G and rs11591710C, haplotype frequency 0.089) was associated with lower CHD prevalence (OR: 0.77; 95% CI: 0.61-0.97; P= 0.03). The TERC haplotype GTC (rs12696304G, rs10936601T and rs16847897C, haplotype frequency 0.210) was associated with lower risk for both CHD (OR: 0.86; 95% CI: 0.75-0.99; P=0.04) and T2D (OR: 0.74; 95% CI: 0.61-0.91; P= 0.004), with no effect on LTL. Only the last association remained after adjusting for multiple testing. Conclusion: Of reported associations, only that between the OBFC1 rs10786775 SNP and LTL was confirmed, although our study has a limited power to detect modest effects. A 2-SNP OBFC1 haplotype was associated with higher risk of CHD, and a 3-SNP TERC haplotype was associated with both higher risk of CHD and T2D. Further work is required to confirm these results and explore the mechanisms of these effects