Arimitsu Takeshi, Ozawa Mio, Gaughwin Kaori
Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Front Pediatr. 2023 Jun 7;11:1174222. doi: 10.3389/fped.2023.1174222. eCollection 2023.
The Japanese Neonatal Pain Guidelines Committee, led by the Japan Academy of Neonatal Nursing, uses the Grading of Recommendations, Assessment, Development, and Evaluation Working Group method to evaluate the quality of evidence and the strength of treatment recommendations. Ratings on the importance of outcomes related to neonatal pain have not been reported. This study aimed to reach a consensus on the importance of outcomes through a guideline panel composed of doctors, nurses, a nurse practitioner, a physical therapist, and families to ensure consistency in systematic reviews of neonatal pain and future revisions to the guidelines.
A total of 26 professionals, including 21 medical personnel from clinical settings and academia and 5 parents from five family associations, participated in 3-stage eDelphi rounds.
The literature review and discussion identified 75 outcomes that were included in round one. The participants proposed three additional outcomes: 78 outcomes were scored in rounds two and three. Round three scores showed different stakeholder groups in terms of priority outcomes. Seventeen outcomes were included in the final core outcome and were considered critical for decision-making.
Core outcomes of the development of neonatal pain guidelines in Japan were identified. The assessment process of importance from this study highlights the difference in the perspectives of medical providers and parents on neonatal pain, thus, involving parents in the assessment and as the spokesperson for the infant admitted to the neonatal intensive care unit is important for a more inclusive evaluation of pain prevention and management.
由日本新生儿护理学会牵头的日本新生儿疼痛指南委员会采用推荐分级、评估、制定与评价工作组方法来评估证据质量和治疗推荐的强度。尚未有关于新生儿疼痛相关结局重要性评级的报道。本研究旨在通过由医生、护士、执业护士、物理治疗师和家长组成的指南小组就结局的重要性达成共识，以确保新生儿疼痛系统评价的一致性以及未来指南的修订。
共有26名专业人员参与了3轮电子德尔菲法调查，其中包括21名来自临床机构和学术界的医务人员以及来自5个家庭协会的5名家长。
文献综述和讨论确定了75个结局纳入第一轮。参与者又提出了3个结局：第二轮和第三轮对78个结局进行了评分。第三轮评分显示不同利益相关者群体在优先结局方面存在差异。最终核心结局纳入了17个结局，这些结局被认为对决策至关重要。
确定了日本新生儿疼痛指南制定的核心结局。本研究的重要性评估过程凸显了医疗服务提供者和家长在新生儿疼痛问题上观点的差异，因此，让家长参与评估并作为新生儿重症监护病房住院婴儿的代言人，对于更全面地评估疼痛预防和管理非常重要。
