School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia.
Adv Neonatal Care. 2022 Apr 1;22(2):E34-E42. doi: 10.1097/ANC.0000000000000911. Epub 2021 Jul 1.
Neonates in need of intensive care are often subjected to numerous painful procedures. Despite the growing scientific research, hospitalized neonates continue to experience unrelieved pain. Enhancing the competence of neonatal intensive care nurses is an integral component of effective pain management.
The purpose of this article is to identify and synthesize the existing evidence on nurses' and midwives' competence regarding neonatal pain management internationally.
METHODS/SEARCH STRATEGY: The review was guided by Whittemore and Knafl's 5-stage framework, with 8 databases searched in June 2020 including PubMed, CINAHL Complete (via EBSCOhost), MEDLINE (via EBSCOhost), PsycINFO (via Ovid), EMBASE, Scopus, Cochrane Library, and Google Scholar. Reference lists of selected articles were also hand-searched. Studies were reviewed independently for methodology and inclusion and exclusion criteria. The initial search yielded 3037 articles; 19 met the inclusion criteria and were included for analysis: qualitative (n = 5) and quantitative (n = 14).
FINDINGS/RESULTS: Nurses' and midwives' competence regarding neonatal pain management in the neonatal intensive care unit is discussed in relation to knowledge, attitudes, behaviors, and perceptions of competence by most studies. The barriers to effective neonatal pain management were found to relate to nurses' and midwives' factors, underutilized pain assessment tools, and organizational factors. Potential facilitators to effective neonatal pain management included clear evidence-based guidelines/protocols, adequate training, and the use of appropriate and accurate pain assessment tools. Parent involvement and a team approach to neonatal pain management were also identified.
These findings suggest that further research is necessary to address the barriers and promote facilitators to improve neonatal pain management.
需要重症监护的新生儿经常要接受许多有创的操作，尽管有越来越多的科学研究，但住院的新生儿仍持续经历未缓解的疼痛。提高新生儿重症监护护士的能力是有效疼痛管理的一个组成部分。
本文旨在确定并综合国际上有关护士和助产士在新生儿疼痛管理方面的能力的现有证据。
方法/搜索策略：本综述以 Whittemore 和 Knafl 的 5 阶段框架为指导，于 2020 年 6 月在 8 个数据库中进行了搜索，包括 PubMed、CINAHL Complete（通过 EBSCOhost）、MEDLINE（通过 EBSCOhost）、PsycINFO（通过 Ovid）、EMBASE、Scopus、Cochrane Library 和 Google Scholar。还对手动检索选定文章的参考文献列表。对研究方法和纳入与排除标准进行了独立审查。最初的搜索产生了 3037 篇文章；其中 19 篇符合纳入标准并纳入分析：定性研究（n = 5）和定量研究（n = 14）。
结果/发现：大多数研究都讨论了新生儿重症监护病房护士和助产士在新生儿疼痛管理方面的知识、态度、行为和对能力的感知。有效新生儿疼痛管理的障碍被发现与护士和助产士的因素、未充分利用的疼痛评估工具以及组织因素有关。有效新生儿疼痛管理的潜在促进因素包括明确的循证指南/方案、充分的培训以及使用适当和准确的疼痛评估工具。家长参与和团队方法在新生儿疼痛管理中也得到了确定。
这些发现表明，需要进一步研究以解决障碍并促进促进因素，以改善新生儿疼痛管理。
