Parental involvement in neonatal pain management: an empirical and conceptual update

Abstract

Background: New findings are emerging about parental perceptions and desires for involvement in infant pain management in the neonatal intensive care unit (NICU) setting, and the importance of building greater knowledge about this aspect of the patient care is beginning to be appreciated.

Objectives: The study had two aims: (a) to describe perceptions and feelings of parents who participated in a randomized controlled trial of an intervention to increase parent knowledge and involvement in infant pain management; and (b) to further refine the conceptual representation of the parental experience of involvement in infant pain management (or lack thereof) and the influencing factors.

Methods: Thematic analysis was used to explore the content of parents' written comments and to integrate the present and previous research findings.

Results: Parents expressed strong preferences for more information about all aspects of infant pain care, improved timing of information giving, and involvement opportunities. They further desired increased sensitivity and consistency in infant care giving and increased use of specific pain-relieving interventions by NICU staff. Contextual factors such as parents' emotional state and the communication and support from NICU staff influenced parents' ability to achieve their desired level of involvement.

Discussion: The role of parents in infant pain management is a relatively new area of research. The discussion of conceptual models to guide research and practice is an important milestone representing new opportunity for further scientific developments with important clinical implications for the nursing care of critically ill infants and their families.

Clinical relevance: New data continue to emerge about parental perceptions and desires for involvement in infant pain management. A new empirically based model may be useful to nurses in providing optimal pain management for NICU infants in partnership with parents.