Paediatric & neonatal pain最新文献

{"title":"Parents' Perspectives on XR Distraction During Pediatric Needle Procedures.","authors":"Henrik Hjelmgren, Johanna Granhagen Jungner, Cecilia Bartholdson, Klas Kalholm, Anna Stålberg","doi":"10.1002/pne2.70047","DOIUrl":"10.1002/pne2.70047","url":null,"abstract":"<p><p>Parents play a crucial role in supporting their children during pediatric hospital visits, where needle-related procedures are commonly performed. Both children and parents may experience distress related to needles, which can make these procedures more challenging. Adequate distraction, such as extended reality, may help to mitigate these potential difficulties. The aim of this study was to explore parents' perspectives on their child's use of extended reality as a distraction during a needle-related procedure. In this exploratory and prospective mixed-methods study, a total of 30 parents completed a study-specific survey and 26 were interviewed. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using reflexive thematic analysis informed by Braun and Clarke. Parents generally reported positive experiences with XR distraction, with high mean scores for recommending the XR device to other children undergoing a similar procedure (VR 5.00; AR 4.86, scale 1-5). Parent-reported child pain was low in both groups (mean 0.93 for VR and 1.38 for AR, NRS 0-10). Some differences in parents' responses between virtual and augmented reality were observed; however, the study was not designed or powered to detect differences between the two approaches. Nevertheless, parents perceived both approaches as supporting pain and anxiety relief during the needle-related procedure. Five themes were developed through the qualitative analysis: A rewarding addition for the child, Redirection of the child's attention, The importance of the user perspective, Diversified emotional reactions among parents, and Modified roles for nurses and parents. In conclusion, parents viewed extended reality distraction as a valuable tool for supporting children during needle-related procedures. They described its potential to alleviate distress, redirect attention, and provide moments of calm and reassurance for both children and adults. While some concerns were raised, the overall parental perspective was that extended reality can serve as a meaningful resource in clinical care. The findings suggest that future implementation should adopt a flexible, family-centered approach that balances the technological benefits with the preservation of therapeutic relationships.</p>","PeriodicalId":94166,"journal":{"name":"Paediatric & neonatal pain","volume":"8 3","pages":"e70047"},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain Management During Neonatal Blood Sampling: An Overview of Systematic Reviews.","authors":"Libby G Lord, Jane E Harding, Caroline A Crowther, Luling Lin","doi":"10.1002/pne2.70044","DOIUrl":"10.1002/pne2.70044","url":null,"abstract":"<p><p>This overview of systematic reviews aimed to identify effective pain management strategies for neonatal blood sampling. Searches were conducted in four databases from 2014 to April 2026. Eligible studies were systematic reviews including randomized or quasi-randomized controlled trials assessing pain management in neonates during blood sampling. Reviews were required to have searched at least two databases within the past 10 years, reported their search strategy, and conducted a risk-of-bias assessment. The search identified 2463 records; 22 reviews (13 Cochrane and two non-Cochrane pairwise reviews, and seven network meta-analyses) met inclusion criteria. Interventions evaluated included opioids, paracetamol, topical anesthetics, breastfeeding or breastmilk, sucrose, music medicine, acupuncture, and other non-pharmacological methods. Sucrose with or without non-nutritive sucking was effective in reducing pain scores during heel pricks in preterm and term neonates (mean difference -1.74, 95% confidence interval [-2.11, -1.37], moderate-certainty). Skin-to-skin contact also reduced pain scores compared with control (mean difference -3.47 [-5.55, -1.38], moderate-certainty). Recent network meta-analyses generally supported parent-led interventions and oral sweet solutions as the most effective strategies. Breastfeeding, supplemental breastmilk, acupuncture, and light reduction were promising but require further evidence. For other interventions, evidence was insufficient to draw conclusions. Evidence from systematic reviews and network meta-analyses indicates that sucrose and skin-to-skin contact effectively reduce procedural pain in neonates. Parent-led and other non-pharmacological interventions, including breastfeeding, also appear beneficial and should increasingly be considered part of family-centred neonatal pain care where feasible.</p>","PeriodicalId":94166,"journal":{"name":"Paediatric & neonatal pain","volume":"8 3","pages":"e70044"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>\"Google It\":</i> Experiences of Children and Parents During the Assessment and Diagnosis of Complex Regional Pain Syndrome Type I.","authors":"Emma Evans, Lisa Roberts, Rhiannon Joslin","doi":"10.1002/pne2.70045","DOIUrl":"10.1002/pne2.70045","url":null,"abstract":"<p><p>Complex Regional Pain Syndrome Type I (CRPS-I) is a chronic pain disorder that can affect children most commonly in early adolescence. In comparison to adult literature, there is a sparsity of evidence regarding the effect of CRPS-I on children. This evidence gap contributes to diagnostic delays, affecting children and parents physically, psychologically, and socially. The experiences of children and their parents when receiving a CRPS-I diagnosis have yet to be explored. The current study explored the experiences of children and parents during the assessment and diagnosis of CRPS-I. This qualitative study involved secondary analysis of verbatim interviews with children and their parents from a primary study that explored outcomes of chronic musculoskeletal pain treatment in children aged 11-18 years. Timeline drawings were used as a participatory method and, where possible, children and parents were interviewed separately. Seven children who reported they had received a diagnosis of CRPS-I and their parents were included (<i>n</i> = 14). Transcripts were analyzed using reflexive thematic analysis. Data were analyzed inductively to identify key themes that shaped their experiences before, during, and after diagnosis. Four themes were developed that uncovered a complex journey before, during, and after diagnosis. An overarching theme, Navigating Healthcare, developed alongside three sequential themes: Search for Answers, It's CRPS, and What's Next? This study demonstrates that access to health professionals with the knowledge, experience, and skills to provide rehabilitation for pediatric CRPS may be more important than early diagnosis in influencing CRPS-I outcomes. Care pathways must include guidance for health professionals on how to explain CRPS-I so that no family needs to resort to internet searches to explain this complex condition or navigate their child's care.</p>","PeriodicalId":94166,"journal":{"name":"Paediatric & neonatal pain","volume":"8 3","pages":"e70045"},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor.","authors":"Joshua W Pate, Rebecca Fechner, Scott D Tagliaferri, Elan Schneider, Bruno Saragiotto","doi":"10.1002/pne2.70039","DOIUrl":"10.1002/pne2.70039","url":null,"abstract":"","PeriodicalId":94166,"journal":{"name":"Paediatric & neonatal pain","volume":"8 2","pages":"e70039"},"PeriodicalIF":0.0,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral Changes in Children Are Uncommon 4 Weeks After Procedural Sedation and Analgesia With Intranasal Dexmedetomidine and Nitrous Oxide.","authors":"Anna Nikula, Malin Ryd-Rinder, Stefan Lundeberg, Mitja Lääperi, Maaret Castrén, Lisa Kurland","doi":"10.1002/pne2.70038","DOIUrl":"10.1002/pne2.70038","url":null,"abstract":"<p><p>Painful procedures requiring sedation and analgesia are commonly performed in pediatric emergency departments. However, there is little knowledge about the possible delayed effects of procedural sedation and analgesia on children's behavior. The aim of the current study was to examine children's behavioral changes 4 weeks after procedural sedation and analgesia with intranasal dexmedetomidine and nitrous oxide. Parents of the children who participated in a clinical trial comparing intranasal dexmedetomidine and nitrous oxide for procedural sedation and analgesia during painful procedures were interviewed 4 weeks after procedural sedation and analgesia. The Post Hospitalization Behavior Questionnaire was used for the parental interviews by phone to evaluate changes in children's behavior. Behavioral changes were reported in 13 of 128 (10.2%) children, of which eight experienced negative behavioral changes and five positive changes. Young age was associated with negative behavioral changes; median age was 5.7 years in children with negative behavioral changes and 9.4 years in children with no behavioral changes (<i>p</i>-value 0.0062). Children with negative behavioral changes were less likely to accept the same method for procedural sedation and analgesia in the future (<i>p</i>-value 0.049) as were their parents (<i>p</i>-value 0.012). Parents of children with negative behavioral changes were less satisfied with the general management of procedural sedation and analgesia than parents whose children did not experience negative changes (<i>p</i>-value 0.024). No association with higher pain scores during the procedure and negative behavioral changes was seen. Behavioral changes are uncommon 4 weeks after procedural sedation and analgesia with intranasal dexmedetomidine or nitrous oxide for painful procedures such as fracture reduction.</p>","PeriodicalId":94166,"journal":{"name":"Paediatric & neonatal pain","volume":"8 2","pages":"e70038"},"PeriodicalIF":0.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13270210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Factor Analysis of the COMFORTneo Scale: What Are We Measuring?","authors":"Erik Koning, Arend F Bos, Elisabeth M W Kooi, Alexander J de Tempe, Nienke H van Dokkum","doi":"10.1002/pne2.70033","DOIUrl":"10.1002/pne2.70033","url":null,"abstract":"<p><p>Extremely preterm infants (EPT; < 26 weeks) are often exposed to painful and stressful procedures, and in clinical practice it is difficult to distinguish pain from stress. This study investigated whether the COMFORTneo scale can differentiate between these constructs in EPT and older preterm infants (PT; 26-36 weeks' gestational age). We analyzed COMFORTneo scores from 1021 preterm infants admitted to a level IV NICU between 2018 and 2022. Infants were divided into four subgroups: EPT ventilated, EPT non-ventilated, PT ventilated, and PT non-ventilated. Exploratory and confirmatory factor analyses were used to assess the underlying structure of the scale. In addition, a panel of 11 NICU professionals completed a short questionnaire regarding the constructs represented by COMFORTneo items. Exploratory factor analysis indicated a unidimensional structure for EPT infants, whereas two factors emerged in PT infants, with interfactor correlations of <i>r</i> = 0.78 in ventilated infants and <i>r</i> = 0.63 in non-ventilated infants. Confirmatory factor analysis supported these structures, with comparative fit index (CFI) values ≥ 0.96 and root mean square error of approximation (RMSEA) ranging from 0.070 to 0.091. Experts' interpretations of the constructs associated with the identified factors varied across respondents. Overall, the COMFORTneo scale appears to capture a single construct in EPT infants and two related constructs in PT infants. However, NICU professionals did not consistently distinguish between these constructs in practice. These findings highlight the importance of developmentally sensitive interpretation and caution against relying solely on total COMFORTneo scores.</p>","PeriodicalId":94166,"journal":{"name":"Paediatric & neonatal pain","volume":"8 ","pages":"e70033"},"PeriodicalIF":0.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Changes Over 15 Years Within a Pediatric Chronic Pain Service.","authors":"Hadassah Buechner, Cameron Sanderson, Kit Min Chong, Amy Donaghy, Olivia Shand, Iona Lindsay, Mia Findlay, Ewan Wallace","doi":"10.1002/pne2.70025","DOIUrl":"10.1002/pne2.70025","url":null,"abstract":"<p><p>How do we know if a service is working? How has the presentation and management of children with chronic pain changed over the last fifteen years and what demonstrates adherence to changing guidelines? This audit of a large tertiary pediatric chronic pain service assessed relevant multivariate data gathered over the last 15 years to try to give an insight and answer these questions. All patients with electronic patient records (EPR) referred to the chronic pain service in the West of Scotland from 2010 to 2025 were audited. Any patients not seen in clinic at least once were excluded. Patients were grouped into epochs based on their most recent or last pain clinic appointment. 728 patients were included. The audit found that the service is seeing a greater proportion of patients with primary chronic pain diagnoses, accounting for over 40% of patients in the last epoch (<i>p</i> = 0.003). Significantly greater proportions of patients reported being bedbound (<i>p</i> < 0.001), needing walking aids (<i>p</i> = < 0.001) or having their activities of daily living being affected by pain (<i>p</i> = 0.05) in later epochs. The average number of referrals per patient, including referrals for physiotherapy and psychology increased. Although the average number of medications taken by patients increased, the proportion of patients taking gabapentinoids decreased (<i>p</i> = 0.180). This reflects adherence to current recommendations to reduce gabapentinoid prescribing, although the change was not statistically significant. There was a reduction in the percentage of patients discharged due to pain improvement and a greater proportion being transferred to adult services. The results suggest that patients are presenting with more severe complex pain, increasingly with no secondary cause. The service appears to be effective for approximately 30% of patients, who are discharged due to pain improvement. It is unknown how this compares to other services around the country.</p>","PeriodicalId":94166,"journal":{"name":"Paediatric & neonatal pain","volume":"8 2","pages":"e70025"},"PeriodicalIF":0.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Through Parents' Eyes: Reframing Neonatal Pain Assessment Through Lived Experience.","authors":"Linda Ng, Rob Eley, Priya Govindaswamy, Emre Ilhan, Ahmed Moustafa","doi":"10.1002/pne2.70029","DOIUrl":"10.1002/pne2.70029","url":null,"abstract":"","PeriodicalId":94166,"journal":{"name":"Paediatric & neonatal pain","volume":"8 ","pages":"e70029"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus Building on the Content of a Pediatric Pain Educational Program for Healthcare Professionals in a Low-Resource Setting: A Modified e-Delphi Study.","authors":"Abigail Kusi Amponsah, Daniel Ba-Eebu Badengo, Charles Kumi Hammond, Victoria Bam, Joana Kyei-Dompim, Dorothy Wilson, Jerry Armah, Evans Oduro, Faith Nawagi, Snigdha Mukherjee, Anna Axelin","doi":"10.1002/pne2.70031","DOIUrl":"10.1002/pne2.70031","url":null,"abstract":"<p><p>Healthcare professionals (HCPs) play a key role in improving pain outcomes in hospitalized children. Knowledge gaps can significantly hinder the ability of HCPs to provide optimal pain care. Developing targeted educational interventions to address these gaps requires a clear understanding of priority areas for training on essential pain-related topics. Against this background, this study aimed to establish consensus on topics for a pediatric pain educational program (PPEP) for continuing professional education among HCPs. A two-stage modified e-Delphi study was conducted among experts in pediatric care, health education, and pain research. The researchers developed 35 topics by reviewing the Core Content of the Pediatric Pain PRN Curriculum. In the first and second rounds, experts rated the topics and suggested additional topics. Ratings were done on a four-point Likert scale with options ranging from 1 (not important at all) to 4 (very important). The outcomes from both rounds were analyzed based on the level of consensus. Consensus on a topic was set at a threshold of ≥ 70. A response rate of 88% (<i>n</i> = 22/25) and 100% (<i>n</i> = 22/22) was achieved for the first and second rounds, respectively. Experts rated 35 topics and 5 topics (the topic that failed to achieve consensus in the first round and four new ones generated from expert comments) in the first and second rounds, respectively. In the first round, experts agreed on 34 of the 35 topics (72.7%-90.9%) while all five topics achieved consensus (90.9%-100%) in the second round. Thus, 39 topics under the domains of pain theories, pediatric chronic pain, pain assessment, opioid risk evaluation and mitigation strategies (REMS), biobehavioural strategies, procedural pain, acute pain management and reorientation were agreed on for inclusion in the PPEP. A high level of consensus was achieved among a multidisciplinary panel of experts on the content of the PPEP. This can serve as a valuable resource for interprofessional pain continuing education in low-resource settings. The topics can also be integrated into curricula for preregistration healthcare professionals in such settings.</p>","PeriodicalId":94166,"journal":{"name":"Paediatric & neonatal pain","volume":"8 ","pages":"e70031"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulnerability and Pediatric Pain.","authors":"S van Rysewyk, D Harrison, A Harvey, E Ilhan","doi":"10.1002/pne2.70020","DOIUrl":"10.1002/pne2.70020","url":null,"abstract":"<p><p>Healthcare disparities amplify vulnerabilities in infants and children. In the context of pain, vulnerable individuals are those whose pain often goes under-appreciated, -recognized, or -treated. Vulnerability to pain arises due to multiple and interacting sources including inherent vulnerability, situational vulnerability, and pathogenic vulnerability. Some groups are more vulnerable to pain than others, which will be the focus of this article: sick and preterm newborns, and children with intellectual disabilities and complex communication needs, including children with cerebral palsy. In this conceptual review, we highlight vulnerabilities to pain in these vulnerable populations and identify how we have obligations to minimize harm experienced by sick and preterm newborns, and children with developmental disabilities. Although pain is a universal experience, not everyone has equal and fair access to the necessary services for adequate pain management. This is particularly the case for sick and preterm babies who are exposed to large numbers of painful procedures during their hospitalization, and individuals with intellectual disability and complex communication needs, who have limited language and/or speech capacity to self-report pain. Therefore, explicit reflection on vulnerability reinforces a collective responsibility to provide effective assessment and management of pain in particularly vulnerable pediatric populations.</p>","PeriodicalId":94166,"journal":{"name":"Paediatric & neonatal pain","volume":"8 2","pages":"e70020"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}