85 research outputs found
Parental judgments of infant pain: Importance of perceived cognitive abilities, behavioural cues and contextual cues.
BACKGROUND: Despite blatant indications, such as behavioural
and contextual cues, infant pain is often undermanaged by adult caretakers.
The belief that infants are limited in their abilities to comprehend
the meaning of an experience or recall that experience has been
used to minimize or deny the need for intervention in this vulnerable
population.
OBJECTIVES: This investigation explored parental beliefs regarding
the impact of infant cognitive capabilities, behavioural cues and
contextual cues to their pain judgments. Particular interest was
focused on their beliefs regarding the general cognitive capabilities of
infants of different ages.
METHODS: Forty-nine parents viewed videotapes of healthy
infants, aged two, four, six, 12 and 18 months, receiving routine
immunization injections and provided judgements of the severity of
pain on a 100 mm Visual Analogue Scale. Upon completion of their
pain judgements for each of the five age groups (two infants per age
group; 10 infants total), parents completed questionnaires regarding
their beliefs about the capabilities of infants in that age group and
then reported the importance of the various cues utilized to formulate
their pain judgements.
RESULTS: Parents attributed substantial pain to infants in all age
groups, almost twice the amount they hypothesized an adult undergoing
a similar injection would experience. The cues rated as most
important for judgements were similar for infants of varying ages.
Overall, facial expressions, sounds and body movements were consistently
reported to be most important. Parents acknowledged the
development of memory and understanding of pain throughout
infancy. However, these beliefs were not deemed by parents as important
to their pain ratings, nor were their importance ratings directly
related to the pain ratings.
CONCLUSION: Parents judged that infants undergoing a routine
immunization were experiencing clinically significant levels of pain.
However, despite generally acknowledging a developing trajectory for
memory and understanding across the five age groups, parents did not
indicate that a child’s ability to remember and understand pain were
essential features of their pain judgements. The results indicated
that memory and understanding did not influence parental judgements
of infant pain demonstrating the validity of the parents’ selfassessments
Фигуры мысли в анонимной римской «Риторике для Геренния» (86-82 гг. До н.э.) и их соответствия или аналоги в современном гуманитарном знании : аннотация к магистерской диссертации / Куприянова Анастасия Александровна, Филологический факультет, Кафедра теоретического и славянского языкознания; научный руководитель Мечковская Нина Борисовна
Premature infants hospitalized after birth are exposed to repeated painful procedures as part of their routine medical care. Early neonatal exposure to unmanaged pain has been linked to numerous negative long-term outcomes, such as the development of pain hypersensitivity, detrimental psychological symptomology, and altered neurodevelopment. These findings emphasize the crucial role of pain management in neonatal care. The aim of this article is to give an overview of evidence-based non-pharmacological pain management techniques for hospitalized neonates. Research supporting the effectiveness of various proximal, distal, and procedural pain management methods in neonates will be presented. Additionally, understanding the larger biopsychosocial context of the infant that underpins the mechanisms of these pain management methods is essential. Therefore, two important models that inform non-pharmacological approaches to infant pain management (DIAPR-R [The Development of Infant Acute Pain Responding-Revised], Attachment Theory) will be discussed
Developing a Measure of Distress-Promoting Parent Behaviours During Infant Vaccination: Assessing Reliability and Validity
Background: Infants rely on their parents’ sensitive and contingent soothing to support their regulation from pain-related distress. However, despite being of potentially equal or greater import, there has been little focus on how to measure distress-promoting parent behaviors.
Aims: The goal of this article was to develop and validate a measure of distress-promoting parent behaviors for acute painful procedures (e.g., vaccinations) that could be used by researchers and clinicians.
Methods: Following initial generation of measure items, focused group discussions were held with vaccinating clinicians to understand the measure’s face, content, and ecological validity. Archival video footage (n = 537 videos of infant-caregiver dyads during vaccination) was then coded using the measure of distress-promoting behaviors for 3 minutes post vaccine injection. Validity and reliability were examined using correlational analyses. Construct validity was assessed by convergent relationships with infant pain-related distress and divergent relationships were assessed with parent sensitivity and soothing-promoting behaviors.
Results: The measure demonstrated both moderate to excellent interrater and test-retest reliability and convergent and divergent validity (absolute magnitude of r’s = 0.30 to 0.46).
Conclusions: By demonstrating strong reliability and validity, this measure represents a promising new way to understand how caregivers interact with infants during painful procedures. Through focusing on distress promotion and using a format that may be coded both from video or in vivo, it is a feasible way to operationalize the impact of the caregiver on the infant’s pain experience in both research and clinical settings
Convergence of behavioral and cardiac indicators of distress in toddlerhood: A systematic review and narrative synthesis
The objective of the current study was to systematically review the available literature on the relation between behavioral and cardiac indicators used to measure distress in toddlerhood. After ascertaining the eligibility of 2,424 articles through a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PROSPERO (International Prospective Register of Systematic Reviews) guided search process, 22 articles (N = 2,504) that investigated associations between behavioral and cardiac indicators of distress in toddlerhood were identified. The narrative synthesis described the overall relation (direction [positive, negative], strength [Cohen’s D]) between behavioral and cardiac indicators and was organized by cardiac indicator (i.e., heart rate [HR], heart period, respiratory sinus arrhythmia, pre-ejection period) and type of behavior measured (i.e., coding for expressed emotion behaviors vs. emotion regulation behaviors). Methodological characteristics (i.e., timing of measurement for behavioral and cardiac indicators [concurrent, predictive], length of measurement epochs, inclusion of covariates and moderators) were also described. HR was consistently positively (D = .05 to .54) related to expressed emotion behaviors. No other cardiac and behavioral indicators were consistently related. Methodological differences related to behavioral and cardiac indicators utilized, timing of measurement, and length of measurement epochs may be responsible for heterogeneity in findings. The findings suggest that researchers might get divergent results depending on whether distress is measured with cardiac or behavioral indicators of distress in toddlerhood. Suggestions for future psychophysiological research with young children are offered
Parental Report of Self and Child Worry During Acute Pain: A Critical Factor in Determining Parental Pain Judgment
Objective: The objective of this study was to determine which variables predict parental postvaccination pain ratings. It was hypothesized that after child behavior, parental sensitivity, and parental reports of worry would be the strongest predictors. Methods: Data for 215 parent-child dyads were analyzed from a longitudinal cohort at the preschool (4 to 5 y of age) vaccination. Preschoolers' pain behaviors 15 seconds, 1 minute 15 seconds, and 2 minutes 15 seconds after the painful immunization were observed and rated. Parental sensitivity, as well as parental own worry and their assessment of their child's worry, were assessed before and after the needle. Three regression models were used to determine the impact of these variables on parental pain assessment. Results: Preschoolers' pain behaviors moderately accounted for variance in parental pain judgment (R=0.23 to 0.28). Parental sensitivity was not a significant unique predictor of parental pain rating at the preschool age. Parental assessment of their own worry and worry about their preschoolers after the needle were critical contributors to parental pain judgment. Post hoc analyses suggest that parents who report low child worry, are more congruent with their child during regulatory phases postvaccination. However, both parents with high and low self-worry had more congruent pain ratings with child pain behavior scores during the reactivity phase. Discussion: The study suggests that the majority of variance in parent pain ratings was not predominantly based on preschoolers' pain behaviors. Parental worry levels and their assessment of their child's worry were also significant predictors. Clinical implications are discussed
A longitudinal analysis of the development of infant facial expressions in responses to acute pain: Immediate and regulatory expressions
Facial expressions during infancy are important to examine as infants do not have the
language skills to describe their experiences. This is particularly vital in the context of pain where
infants depend solely on their caregivers for relief. The objective of the current study was to
investigate the development of negative infant facial expressions in response to immunization pain
over the first year of life. Infant facial expressions were examined longitudinally using a subsample of
100 infants that were each videotaped during their 2-, 4-, 6-, and 12-month routine immunization
appointments. Infant facial expressions were coded using BabyFACS for the first minute after a painful
needle prick. Facial expressions were examined with a catalogue of the most commonly occurring
facial expressions. Results demonstrated that clear differences were seen over ages. Infants display a
variety of facial expressions with some of the components of adult pain expressions immediately after
the needle and abate shortly after. However, infants did not display adult expressions of discrete
negative emotions. Instead, infants display a variety of generalized pain and distress faces aimed at
gaining caregiver aid. The development of non-verbal communication in infants, particular facial
expressions, remains an important area of inquiry. Further study into accurately measuring infant
negative emotions, pain, and distress is warranted
The role of infant pain behaviour in predicting parent pain ratings
BACKGROUND: Research investigating how observers empathize or
form estimations of an individual experiencing pain suggests that both
characteristics of the observer (‘top down’) and characteristics of the individual
in pain (‘bottom up’) are influential. However, experts have opined
that infant behaviour should serve as a crucial determinant of infant pain
judgment due to their inability to self-report.
OBJECTIVE: To predict parents’ immunization pain ratings using archival
data. It was hypothesized that infant behaviour (‘bottom up’) and
parental emotional availability (‘top down’) would directly predict the
most variance in parent pain ratings.
METHODS: Healthy infants were naturalistically observed during their
two-, four-, six- and/or 12-month immunization appointments. Crosssectional
latent growth curve models in a structural equation model context
were conducted at each age (n=469 to n=579) to examine direct and
indirect predictors of parental ratings of their infant’s pain.
RESULTS: At each age, each model suggested that moderate amounts of
variance in parent pain report were accounted for by models that included
infant pain behaviours (R2=0.18 to 0.36). Moreover, notable differences
were found for older versus younger infants with regard to parental emotional
availability, infant sex, caregiver age and amount of variance
explained by infant variables.
CONCLUSIONS: The results of the present study suggest that parent
pain ratings are not predominantly predicted by infant behaviours, especially
before four months of age. Current results suggest that recognizing
infant pain behaviours during painful events may be an important area of
parent education, especially for parents of very young infants. Further work
is needed to determine other factors that predict parent judgments of
infant pain
Does exposure to university researchers improve undergraduate perceptions of research?: A quasi cluster-randomized controlled trial
This study explores the impact of talks by university researchers in different formats on students’ perceptions of research. Undergraduate students (N = 222) were randomly assigned to watch research talks via video recording (n = 78), research talks presented live (n = 67), or a control group (n = 77). Students completed pre-intervention (Time 1) and post-intervention (Time 2) questionnaires on their perceptions of 1) university-specific research, 2) psychology-specific research, and 3) general research. Analysis of Variance (ANOVA) testing revealed that at Time 2, the video intervention group had significantly more positive perceptions about research compared to the control group. Several barriers to research involvement were noted, including competitiveness, lack of interest, lack of knowledge, and time constraints. Enhancing the undergraduate curriculum by integrating university researchers into the classroom is a potentially innovative way to introduce and promote research interests in students
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