School of Nursing, University of California, San Francisco, California 94143, USA.
Pediatrics. 2011 Sep;128(3):510-8. doi: 10.1542/peds.2011-0272. Epub 2011 Aug 22.
To demonstrate feasibility and estimate the effect of an intervention to increase parental involvement in infant pain management in the NICU on parents' stress and postdischarge parenting competence and confidence.
The study involved a randomized controlled trial. Parents recruited from 4 NICUs were randomly assigned by site to receive (1) a pain information booklet and instruction on infant comforting techniques (n = 84 intervention) in addition to a generic NICU care booklet or (2) the generic NICU care booklet alone (n = 85 control). The primary outcome was postintervention Parent Stressor Scale: NICU (PSS:NICU) scores. Secondary outcomes included parent attitudes about infant pain, nursing pain assessment, and parenting competence and role attainment after discharge.
No differences were found between groups in PSS:NICU scores. Significant differences favoring the intervention group were found for satisfaction with pain information, parents shown infant pain cues and comforting techniques, nursing pain assessment, and parent preference for involvement during painful procedures. Role attainment after discharge was higher for the intervention group than for the control group. Both the intervention and control groups highly valued attention to infant pain and wanted information and involvement.
These results provide no evidence of a reduction in NICU-related stress for parents who receive an intervention to increase their understanding and involvement in infant pain management. However, parents in the intervention group were better prepared to take an active role in infant pain care and had more positive views about their role attainment in the postdischarge period.
展示一项干预措施增加 NICU 中父母参与婴儿疼痛管理的可行性，并评估其对父母压力和出院后育儿能力和信心的影响。
本研究采用随机对照试验。从 4 家 NICU 招募的父母按地点随机分配，接受（1）疼痛信息手册和婴儿安抚技术指导（干预组，n=84），外加通用 NICU 护理手册，或（2）仅接受通用 NICU 护理手册（对照组，n=85）。主要结局为干预后新生儿重症监护病房父母压力量表（PSS：NICU）评分。次要结局包括父母对婴儿疼痛的态度、护理疼痛评估以及出院后育儿能力和角色实现。
两组间 PSS：NICU 评分无差异。干预组在对疼痛信息的满意度、向父母展示婴儿疼痛线索和安抚技术、护理疼痛评估以及父母对参与疼痛处理过程的偏好方面存在显著差异，这些差异均有利于干预组。出院后，干预组的角色实现高于对照组。干预组和对照组都高度重视对婴儿疼痛的关注，并希望获得信息和参与。
这些结果表明，接受增加其对婴儿疼痛管理理解和参与的干预措施并不能减轻父母在 NICU 相关的压力。然而，干预组的父母在婴儿疼痛护理方面更有准备，对出院后的角色实现有更积极的看法。
