Faculty of Nursing, Université de Montréal, Canada; Research Centre, CHU Sainte-Justine, Canada.
Université du Québec en Abitibi-Témiscamingue, Canada.
Int J Nurs Stud. 2024 Jul;155:104773. doi: 10.1016/j.ijnurstu.2024.104773. Epub 2024 Apr 17.
Exposure to repetitive pain during the neonatal period has been shown to have important short and long-term effects on the neurodevelopment of the premature neonate and can contribute to experienced prolonged pain. A uniform taxonomy of neonatal prolonged pain is still lacking to this day which contributes to suboptimal prolonged pain management in neonatal intensive care units. Accordingly, a scoping review exploring the state of knowledge about prolonged pain in preterm neonates hospitalised in the neonatal intensive care unit will contribute to the developing field of neonatal prolonged pain and provide recommendations for clinical prolonged pain management.
To determine the scope, extent, and nature of the available literature on prolonged pain in premature neonates hospitalised in neonatal intensive care units.
Scoping review.
An electronic search was conducted from inception to November 2023 in the databases of CINAHL, PubMed, Medline, Web of Science, GeryLit.org and Grey Source Index. Included studies discussed concepts related to neonatal prolonged pain such as definitions of prolonged pain, indicators of prolonged pain, contexts that result in prolonged pain, prolonged pain evaluation tools, consequences of prolonged pain and interventions for prolonged pain management.
Key concepts of neonatal prolonged pain were identified in the 86 included articles of this scoping review such as definitions (n = 26), indicators (n = 39), contexts (n = 49), scales (n = 56), consequences of prolonged pain (n = 30) and possible interventions for prolonged pain management (n = 22). Whilst a consensus on a definition has yet to be achieved, no proximate event was shown to cause prolonged pain and a time criterion was identified by authors as being relevant in defining prolonged pain. Interestingly, the context of hospitalisation was identified as being the most indicative of prolonged pain in premature neonates and should guide its evaluation and management, whilst only limited pain management interventions and consequences were discussed.
The findings of this scoping review contribute to the foundation of growing knowledge in neonatal prolonged pain and shed light on the ambiguity that currently exists on this topic in the scientific literature. This review summarises knowledge of key concepts necessary for a better understanding of prolonged pain and stresses the importance of considering contexts of hospitalisation for prolonged pain evaluation and management in neonatal intensive care units, with the objective of improving developmental outcomes of premature neonates.
A scoping review reveals that the contexts of prolonged pain in premature neonates hospitalised in the neonatal intensive care unit are essential in guiding its evaluation and management.
研究表明，新生儿期反复疼痛暴露对早产儿的神经发育有重要的短期和长期影响，并可能导致经历长期疼痛。至今仍缺乏新生儿长期疼痛的统一分类学，这导致新生儿重症监护病房的长期疼痛管理不理想。因此，一项探索早产儿在新生儿重症监护病房住院期间长期疼痛知识状态的范围综述将有助于发展新生儿长期疼痛领域，并为临床长期疼痛管理提供建议。
确定关于新生儿重症监护病房住院早产儿长期疼痛的可用文献的范围、程度和性质。
范围综述。
从开始到 2023 年 11 月，在 CINAHL、PubMed、Medline、Web of Science、GeryLit.org 和 Grey Source Index 数据库中进行电子检索。纳入的研究讨论了与新生儿长期疼痛相关的概念，如长期疼痛的定义、长期疼痛的指标、导致长期疼痛的情况、长期疼痛评估工具、长期疼痛的后果和长期疼痛管理干预措施。
在这项范围综述的 86 篇文章中确定了新生儿长期疼痛的关键概念，如定义（n=26）、指标（n=39）、情况（n=49）、量表（n=56）、长期疼痛的后果（n=30）和长期疼痛管理的可能干预措施（n=22）。虽然尚未就定义达成共识，但没有近端事件被证明会导致长期疼痛，作者认为时间标准与定义长期疼痛有关。有趣的是，住院环境被确定为早产儿长期疼痛最具指示性的因素，应指导其评估和管理，而只有有限的疼痛管理干预措施和后果被讨论。
这项范围综述的结果为新生儿长期疼痛日益增长的知识基础做出了贡献，并揭示了目前科学文献中这一主题存在的模糊性。该综述总结了理解长期疼痛所需的关键概念的知识，并强调了在新生儿重症监护病房中考虑住院环境对长期疼痛评估和管理的重要性，目的是改善早产儿的发育结果。
范围综述表明，新生儿重症监护病房住院早产儿长期疼痛的情况对于指导其评估和管理至关重要。
