Ullsten Alexandra, Andreasson Matilda, Eriksson Mats
Center for Clinical Research, Region Värmland, Karlstad, Sweden.
Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
Front Pediatr. 2021 Apr 27;9:651846. doi: 10.3389/fped.2021.651846. eCollection 2021.
Parents' active involvement during painful procedures is considered a critical first step in improving neonatal pain practices. Of the non-pharmacological approaches in use, the biopsychosocial perspective supports parent-delivered interventions, in which parents themselves mediate pain relief, consistent with modern family-integrated care. This scoping review synthesizes the available research to provide an overview of the state of the art in parent-delivered pain-relieving interventions. A scoping review was performed to achieve a broad understanding of the current level of evidence and uptake of parent-driven pain- and stress-relieving interventions in neonatal care. There is a strong evidence for the efficacy of skin-to-skin contact and breastfeeding, preferably in combination. These parent-delivered interventions are safe, valid, and ready for prompt introduction in infants' pain care globally. Research into parents' motivations for, and experiences of, alleviating infant pain is scarce. More research on combined parent-delivered pain alleviation, including relationship-based interventions such as the parent's musical presence, is needed to advance infant pain care. Guidelines need to be updated to include infant pain management, parent-delivered interventions, and the synergistic effects of combining these interventions and to address parent involvement in low-income and low-tech settings. A knowledge-to-practice gap currently remains in parent-delivered pain management for infants' procedure-related pain. This scoping review highlights the many advantages of involving parents in pain management for the benefit not only of the infant and parent but also of health care.
父母在痛苦的医疗程序中积极参与被认为是改善新生儿疼痛处理措施的关键第一步。在现有的非药物治疗方法中，生物心理社会视角支持由父母实施的干预措施，即父母自身介导疼痛缓解，这与现代家庭综合护理理念相一致。本综述性研究综合了现有研究，以概述由父母实施的缓解疼痛干预措施的最新情况。进行本综述性研究是为了全面了解新生儿护理中父母主导的缓解疼痛和压力干预措施的现有证据水平及应用情况。有充分证据表明皮肤接触和母乳喂养（最好两者结合）具有有效性。这些由父母实施的干预措施安全、有效，可立即在全球范围内应用于婴儿疼痛护理。关于父母缓解婴儿疼痛的动机和经历的研究很少。需要开展更多关于父母联合实施疼痛缓解措施的研究，包括基于关系的干预措施，如父母在旁演奏音乐，以推进婴儿疼痛护理。指南需要更新，以纳入婴儿疼痛管理、父母实施的干预措施，以及这些干预措施结合后的协同效应，并解决父母在低收入和低技术环境中的参与问题。目前，在父母实施的针对婴儿与医疗程序相关疼痛的疼痛管理方面，知识与实践之间仍存在差距。本综述性研究强调了让父母参与疼痛管理的诸多益处，这不仅有利于婴儿和父母，也有利于医疗保健。
