School of Nursing, Dalhousie University, Halifax, NS, Canada; Faculty of Health, Dalhousie University, Halifax, NS, Canada; MOM-LINC Lab, IWK Health, Halifax, NS, Canada.
MOM-LINC Lab, IWK Health, Halifax, NS, Canada.
Pain Manag Nurs. 2024 Oct;25(5):e327-e335. doi: 10.1016/j.pmn.2024.05.002. Epub 2024 Jul 10.
The purpose of this study was to describe the behaviors of infants who were born preterm, their parents, and clinicians during 2-, 6-, 12-, and 18-month vaccinations.
Vaccination sessions were video recorded for 3-5 minutes. The proportion of 5-second intervals in which distress and soothing behavior by infants, parents, and clinicians was coded using the Measure of Adult and Infant Soothing and Distress. Coding consisted of three phases: baseline/anticipatory (60 seconds prior to first needle), procedure (first needle to removal of final needle), and recovery (up to 180 seconds after removal of final needle).
A total of 64 infants were included. Distress behavior by infants during the baseline phase ranged from 13% (12-month vaccinations) to 29% (2-month). There was limited anticipatory soothing behavior from parents (10% [12-month] to 50% [2-month]) and clinicians (6% [12-month] to 17% [2-month]). Distress behavior in infants during the procedure ranged from 43% (18-month) to 96% (2-month). There was limited soothing behavior during the procedure from parents (10% [12-month] to 81% [12-month]) and clinicians (13% [12-month] to 71% [2-month]). Few infants received additional pain-reducing interventions, including skin-to-skin contact, 24% oral sucrose, and topical anesthetic.
Despite infant distress, there was limited anticipatory behavior from parents and clinicians. Two-month-old infants displayed the most distress across all time points yet received the least amount of treatment and proximal parent and clinician behavior. Additional implementation efforts are required to increase awareness and practice uptake among parents and clinicians to ensure infants receive equitable and effective pain management.
本研究旨在描述早产儿及其父母和临床医生在 2 个月、6 个月、12 个月和 18 个月疫苗接种期间的行为。
对疫苗接种过程进行了 3-5 分钟的视频记录。使用成人和婴儿安抚与痛苦测量量表对婴儿、父母和临床医生在 5 秒间隔内的痛苦和安抚行为的比例进行编码。编码包括三个阶段：基线/预期期（第一针前 60 秒）、程序期（第一针至最后一针拔出）和恢复期（最后一针拔出后最多 180 秒）。
共纳入 64 名婴儿。婴儿在基线期的痛苦行为比例从 13%（12 个月的疫苗接种）到 29%（2 个月的疫苗接种）不等。父母（10%[12 个月]至 50%[2 个月]）和临床医生（6%[12 个月]至 17%[2 个月]）的安抚行为有限。婴儿在程序期的痛苦行为比例从 43%（18 个月）到 96%（2 个月）不等。父母（10%[12 个月]至 81%[12 个月]）和临床医生（13%[12 个月]至 71%[2 个月]）在程序期间的安抚行为有限。很少有婴儿接受额外的止痛干预措施，包括皮肤接触、24%的口服蔗糖和局部麻醉。
尽管婴儿感到痛苦，但父母和临床医生的预期行为有限。两个月大的婴儿在所有时间点都表现出最痛苦，但接受的治疗和父母及临床医生的近端行为最少。需要进一步加强实施力度，提高父母和临床医生的意识和实践接受度，以确保婴儿获得公平有效的疼痛管理。
