Paediatric & Neonatal Pain最新文献

{"title":"Using collaborative logic analysis evaluation to test the program theory of an intensive interdisciplinary pain treatment for youth with pain‐related disability","authors":"Karen Hurtubise, A. Brousselle, C. Camden","doi":"10.1002/pne2.12018","DOIUrl":"https://doi.org/10.1002/pne2.12018","url":null,"abstract":"Intensive interdisciplinary pain treatment (IIPT) involves multiple stakeholders. Mapping the program components to its anticipated outcomes (ie, its theory) can be difficult and requires stakeholder engagement. Evidence is lacking, however, on how best to engage them. Logic analysis, a theory‐based evaluation, that tests the coherence of a program theory using scientific evidence and experiential knowledge may hold some promise. Its use is rare in pediatric pain interventions, and few methodological details are available. This article provides a description of a collaborative logic analysis methodology used to test the theoretical plausibility of an IIPT designed for youth with pain‐related disability. A 3‐step direct logic analysis process was used. A 13‐member expert panel, composed of clinicians, teachers, managers, youth with pain‐related disability, and their parents, were engaged in each step. First, a logic model was constructed through document analysis, expert panel surveys, and focus‐group discussions. Then, a scoping review, focused on pediatric self‐management, building self‐efficacy, and fostering participation, helped create a conceptual framework. An examination of the logic model against the conceptual framework by the expert panel followed, and recommendations were formulated. Overall, the collaborative logic analysis process helped raiseawareness of clinicians’ assumptions about the program causal mechanisms, identified program components most valued by youth and their parents, recognized the program features supported by scientific and experiential knowledge, detected gaps, and highlighted emerging trends. In addition to providing a consumer‐focused program evaluation option, collaborative logic analysis methodology holds promise as a strategy to engage stakeholders and to translate pediatric pain rehabilitation evaluation research knowledge to key stakeholders.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"25 1","pages":"113 - 130"},"PeriodicalIF":0.0,"publicationDate":"2020-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78222017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study protocol for a multi‐centre parallel two‐group randomized controlled trial evaluating the effectiveness and impact of a pain assessment and management program for respite workers supporting children with disabilities","authors":"Lara M. Genik, C. McMurtry, P. Barata, C. Barney, Stephen P. Lewis","doi":"10.1002/pne2.12014","DOIUrl":"https://doi.org/10.1002/pne2.12014","url":null,"abstract":"Pain is common and complex for children with intellectual and developmental disabilities (I/DD). Secondary caregivers such as respite workers are lacking important pain‐related information which can impact care. Here, we outline a randomized controlled trial (RCT) protocol testing the effectiveness of a pain training for respite workers supporting children with I/DD.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"38 1","pages":"7 - 13"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85871902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Tribute to Gopi Menon","authors":"E. Boyle","doi":"10.1002/pne2.12016","DOIUrl":"https://doi.org/10.1002/pne2.12016","url":null,"abstract":"","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"5 1","pages":"14 - 15"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88834535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of virtual reality for epidural placement in an adolescent with ischemic priapism","authors":"Zvonimir Bebic, J. Thomas","doi":"10.1002/pne2.12021","DOIUrl":"https://doi.org/10.1002/pne2.12021","url":null,"abstract":"In children with chronic pain conditions, the acute pain and anxiety induced by routine procedures such as dressing changes, phlebotomy, and lumbar punctures may be amplified compared to that experienced by healthy children. However, sedatives and opiates may be contraindicated if respiratory depression is a concern. In this case report, we describe a 17‐year‐old male with ischemic priapism secondary to sickle cell disease in whom we used virtual reality immersion as a distraction method during epidural catheter placement. No sedation or analgesia was needed, and the patient reported no pain or distress.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"1 1","pages":"16 - 17"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76626927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A chewable pediatric preparation of ibuprofen is palatable and acceptable to children","authors":"S. Barnett, A. Bhatt","doi":"10.1002/pne2.12013","DOIUrl":"https://doi.org/10.1002/pne2.12013","url":null,"abstract":"The development of palatable and acceptable analgesics for children is a major challenge. Given the majority of medications are administered orally, and children are more sensitive to and less tolerant of bitterness, novel “child‐friendly” preparations need to be developed and tested specifically in this patient population. This study investigated the palatability and acceptability of a therapeutic dose of ibuprofen in the form of soft chewable capsules in 100 healthy children aged 7‐12 years of age and the acceptability of this novel preparation to their caregivers. About 97% of children adhered to a full therapeutic age‐related dose, with 72% of these participants rating the preparation as acceptable on a hedonic facial scale. Despite 22% of children noting a “hot, spicy, or burning” sensation, consistent with known chemesthetic effects of ibuprofen, 83% of children confirmed they would take the medication in future, which rose to 87% in the context of future illness. In addition, after observing their children ingesting the medication, 92% of parents/guardians confirmed that they would be happy to administer this preparation of ibuprofen to their child if they were unwell. In conclusion, ibuprofen administered in the form of soft chewable capsules was palatable and acceptable to the majority of children and their parents/guardians and may provide a convenient and easy to dose preparation to reduce fever and relieve pain in children.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"14 1","pages":"2 - 6"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73503602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A complex interprofessional intervention to improve the management of painful procedures in neonates","authors":"Colette Balice-Bourgois, C. Newman, G. Simonetti, M. Zumstein-Shaha","doi":"10.1002/pne2.12012","DOIUrl":"https://doi.org/10.1002/pne2.12012","url":null,"abstract":"During hospitalization, neonates are exposed to a stressful environment and a high number of painful procedures. If pain is not treated adequately, short‐ and long‐term complications may develop. Despite evidence about neonatal pain and available guidelines, procedural pain remains undertreated. This gap between research and practice is mostly due to limited implementation of evidence‐based knowledge and time constraints. This study describes in detail the development process of a complex interprofessional intervention to improve the management of procedural pain in neonates called NEODOL© (NEOnato DOLore). The framework of the Medical Research Council (MRC) for the development and evaluation of complex interventions was used as a methodological guide for the design of the NEODOL© intervention. The development of the intervention is based on several steps and multiple methods. To report this process, we used the Criteria for Reporting the Development of Complex Interventions in Healthcare (CReDECI 2). Additionally, we evaluated the content of the intervention using a Delphi method to obtain consensus from experts, stakeholders, and parents. The complex interprofessional intervention, NEODOL©, is developed and designed for three groups: healthcare professionals, parents, and neonates for a level IIb neonatal unit at a regional hospital in southern Switzerland. A total of 16 panelists participated in the Delphi process. At the end of the Delphi process, the panelists endorsed the NEODOL© intervention as important and feasible. Following the MRC guidelines, a multimethod process was used to develop a complex interprofessional intervention to improve the management of painful procedures in newborns. Complex interprofessional interventions need theoretical bases, careful development, and integration of stakeholders to provide a comprehensive approach. The NEODOL intervention consists of promising components and has the potential to improve the management of painful procedures and should facilitate the knowledge translation into practice.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"229 1","pages":"63 - 73"},"PeriodicalIF":0.0,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72668579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O Parent, Where Art Thou?","authors":"Alexandra Ullsten, M. Eriksson, A. Axelin","doi":"10.1002/pne2.12010","DOIUrl":"https://doi.org/10.1002/pne2.12010","url":null,"abstract":"Neonatal pain researchers in British Columbia, Canada, have designed a “robot” to help babies delivered preterm to cope with painful procedures by mimicking skin-to-skin contact with a parent.1 A picture of this device with an infant in prone position resting on this appliance was displayed in one of the many cutting-edge lectures at the excellent and well-organized 12th International Symposium on Pediatric Pain in Basel in June. This “substitute parent-device,” shaped like a rectangular platform, fits inside an incubator and is programmed with information on the parent's heartbeat and breathing motions, simulating skin-to-skin contact with a parent who may not be available during around-the-clock procedures in a neonatal intensive care unit. In Florida, USA, to assist preterm born infants requiring care in the neonatal intensive care unit (NICU) to eat more efficiently and increase weight gain, music medicine researchers have invented a device to enhance suck effectiveness.2 The device is a pacifier that can detect whether a baby is sucking on it, and in turn, the baby gets to hear a lullaby as an auditory input in direct response to effective sucking. The music is prerecorded and consists of instrumental lullabies or songs sung by the parent. Devices such as the ones identified have good intentions and promising results in research studies.1-3 These substitutes are also said to save millions of dollars in staffing costs and shorten hospital stays.4 However, devices like these fail to acknowledge the needs of the whole family. Given the high incidence of maternal depression, family stress, and elevated incidence of post-traumatic stress in NICU parents, the benefits and cost-effectiveness derived with active parental participation in care are overlooked with these approaches.5,6 The hospitalized infant has an innate need for experiencing contingent and reciprocal interactions with a loving and affectionate parent. Similarly, parents have a need to fulfill their protective role. Separation and ruptures in the processes and functions linked to attachment, for example, related to painful procedures, may have long-term negative effects.7 The researchers in Canada emphasize in their study that parents should always be the first choice.1 Why then, develop devices that we know will deprive the infant of optimal and efficacious pain alleviation and development,5 including threatening parents’ mental well-being? What if the hospital boards find these devices more convenient and less expensive in the neonatal care than trying to change societal structures in the healthcare system and rebuild hospitals to welcome parents around the clock? More and more research emphasizes the importance of parents as mediators for pain relief.8-11 Parents are an underused resource in pain management, but they are highly motivated to participate in their infant's pain care.12 Pain management should be considered a reciprocal continuation where both parent and infant can lea","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"41 1","pages":"53 - 55"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74269525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous intravenous to oral morphine switch in very premature ventilated infants: A retrospective study on efficacy, efficiency, and tolerability","authors":"P. Duong, M. Tauzin, F. Decobert, L. Marchand, L. Caeymaex, X. Durrmeyer","doi":"10.1002/pne2.12011","DOIUrl":"https://doi.org/10.1002/pne2.12011","url":null,"abstract":"Continuous intravenous (IV) morphine is commonly used in ventilated neonates. Oral route is theoretically feasible but data on oral morphine in ventilated premature infants are lacking.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"8 1","pages":"45 - 52"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85335386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buprenorphine pharmacotherapy for the management of neonatal abstinence syndrome in methadone‐exposed neonates","authors":"Afshin A Taleghani, B. Isemann, Ward Rice, Laura P Ward, K. Wedig, H. Akinbi","doi":"10.1002/pne2.12008","DOIUrl":"https://doi.org/10.1002/pne2.12008","url":null,"abstract":"We aimed to compare the outcomes of pharmacotherapy with either buprenorphine or methadone in infants treated for neonatal abstinence syndrome (NAS) secondary to intrauterine exposure to methadone. This is a multi‐center, retrospective cohort study to assess length of treatment (LOT), hospital length of stay (LOS), and cumulative opioid exposure between infants treated with either methadone or buprenorphine for NAS secondary to in utero exposure to methadone. Infants delivered at a gestational age ≥35 weeks and a maternal history of opioid‐use disorder and/or urine drug screen positive for methadone, and postnatal pharmacotherapy for NAS with either buprenorphine or methadone as first‐line opioid replacement therapy, were eligible. Median LOT, LOS, and cumulative opioid exposure were compared between buprenorphine‐ and methadone‐treated infants. A total of 156 infants (48 treated with buprenorphine and 108 with methadone) were identified. The median LOT and LOS for buprenorphine‐treated infants was 8 and 13 days compared with 15 and 20 days for methadone‐treated infants, respectively, P < .001 for both outcomes. Median cumulative opioid dose in morphine equivalents was 0.6 mg/kg for buprenorphine‐treated infants vs 1.05 mg/kg for methadone‐treated infants, P < .001. No adverse effects were noted among either group. Of infants treated with buprenorphine, 34 (71%) required the addition of adjunctive pharmacotherapy during the NICU stay, compared with 31 (32%) in the methadone‐treated group, P = .0008. However, significantly fewer infants treated with buprenorphine required continuation of therapy beyond discharge as compared with those treated with methadone. The difference is most likely a reflection of the protocols used by the sites. In infants that required pharmacotherapy for NAS secondary to intrauterine exposure to methadone, treatment with buprenorphine, compared with methadone therapy, was associated with better outcomes. If confirmed with prospective data, buprenorphine could be considered first‐line therapy for the two medication‐assisted treatment regimens recommended by the American College of Obstetricians and Gynecologists.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"83 1","pages":"33 - 38"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82141916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of vein‐viewing device to assist intravenous cannulation decreases the time and number of attempts for successful cannulation in pediatric patients","authors":"Alka Sara Saju, Lilly Prasad, Menaka Reghuraman, Immanuel Karl Sampath","doi":"10.1002/pne2.12009","DOIUrl":"https://doi.org/10.1002/pne2.12009","url":null,"abstract":"Every child who contacts a healthcare setting has a potential for intravenous cannulation (IV) procedure and related pain, fear, and distress. Many of the healthcare professionals recognize that there is a lack of intervention to prevent multiple cannulation attempts and to reduce pain and distress inflicted to children during IV cannulation. A quasi‐experimental study was undertaken in pediatric patients to study the effect of a vein‐viewing device (VTorch) on IV cannulation procedure. The number of cannulation attempts and time taken for successful cannulation were assessed with the use of this device (experimental group, n = 159) and compared it with the standard procedure (control group, n = 159). The effect of this device in cannulation associated pain, fear, and behavioral distress were also evaluated among these children. Using Vein‐viewing device as an aid for IV cannulation significantly reduced the time taken for cannulation (P = .003) and the number of cannulation attempts (P = .03). In addition, there was a significant increase in the first‐attempt cannulation success rate with the use of this device (P = .04). The use of vein‐viewing device did not have any direct effect on cannulation associated pain, fear, or behavioral distress among the study participants. The results of this study may aid in improving the quality of intravenous access procedure in pediatric patients.","PeriodicalId":19634,"journal":{"name":"Paediatric & Neonatal Pain","volume":"9 1","pages":"39 - 44"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86959114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}