Pain in premature infants: Approaches to its recognition and treatment by nurses and doctors in NICUs

2.50
Hdl Handle:
http://hdl.handle.net/10755/154895
Type:
Presentation
Title:
Pain in premature infants: Approaches to its recognition and treatment by nurses and doctors in NICUs
Abstract:
Pain in premature infants: Approaches to its recognition and treatment by nurses and doctors in NICUs
Conference Sponsor:Sigma Theta Tau International
Conference Year:1992
Conference Date:May 19 - 22, 1992
Author:Dick, Margaret, PhD
P.I. Institution Name:University North Carolina at GreensboroSchool of Nursing
Title:Assistant Professor
In the past, it was commonly assumed that infants, especially

premature infants did not experience pain. Within the past few

years the assumption of no or little pain has been challenged in

the literature. It is not clear to what extent changes have taken

place in the practice area. This ethnographic study identified

current beliefs and practices about pain in premature infants and

its treatment among doctors and nurses. Open-ended interviews were

used to explore beliefs about the occurrence of pain, its

assessment, and its treatment. The subjects were neonatologists

and nurses at two regional referral neonatal intensive care units

in the southeast. Eight nurses and three neonatologists at one

hospital were interviewed. To insure that responses from these

subjects were not characteristic of just this one hospital, two

neonatologists and three nurses from another hospital were

interviewed. In the latter stage of interviewing, responses

provided were redundant of information provided in earlier

interviews. Interviews took from 20 to 40 minutes to complete.

Interviews were transcribed and analyzed using the Ethnograph

program. Findings indicate that all of the subjects interviewed

believe that premature infants experience pain. Commonalities were

found in the way subjects identified pain. They look for physical

expressions (crying, grimacing, a worried expression, pulling away,

or splinting) and for describe changes in heart and respiratory

rates and decreasing oxygenation. Several subjects emphasized that

these changes indicate pain when other causes have been ruled out.

Nurses emphasized the importance of working with the same infant,

in order to more quickly identify behavioral changes and institute

comfort measures. Nurses and doctors responded differently when

asked what measures were used to treat pain. Nurses described a

series of comfort measures which included such things as stroking,

positioning, and cuddling. If these were not deemed to be effective

and the pain was of long duration, nurses then approached the

doctor for pain medication. Doctors immediately described the

types of medications which could be used, expecting that all

comfort measures had been tried first. Both indicated that a local

should be used for procedures such as chest tube insertion and

anything involving cutting of the skin. However, nurses indicated

that it was sometimes necessary to hand the anesthetic to the

doctor. All of the subjects expressed feeling some frustration in

trying to treat the pain. There was agreement between doctors and

nurses that the responsibility for identification and initiation of

care lies with the nurse. Findings do indicate support for primary

nursing assignments, and for doctors and nurses to discuss

practices relative to pain in premature infants.



Repository Posting Date:
26-Oct-2011
Date of Publication:
19-May-1992
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePain in premature infants: Approaches to its recognition and treatment by nurses and doctors in NICUsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154895-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Pain in premature infants: Approaches to its recognition and treatment by nurses and doctors in NICUs</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1992</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">May 19 - 22, 1992</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Dick, Margaret, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University North Carolina at GreensboroSchool of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr><td colspan="2" class="item-abstract">In the past, it was commonly assumed that infants, especially<br/><br/>premature infants did not experience pain. Within the past few<br/><br/>years the assumption of no or little pain has been challenged in<br/><br/>the literature. It is not clear to what extent changes have taken<br/><br/>place in the practice area. This ethnographic study identified<br/><br/>current beliefs and practices about pain in premature infants and<br/><br/>its treatment among doctors and nurses. Open-ended interviews were<br/><br/>used to explore beliefs about the occurrence of pain, its<br/><br/>assessment, and its treatment. The subjects were neonatologists<br/><br/>and nurses at two regional referral neonatal intensive care units<br/><br/>in the southeast. Eight nurses and three neonatologists at one<br/><br/>hospital were interviewed. To insure that responses from these<br/><br/>subjects were not characteristic of just this one hospital, two<br/><br/>neonatologists and three nurses from another hospital were<br/><br/>interviewed. In the latter stage of interviewing, responses<br/><br/>provided were redundant of information provided in earlier<br/><br/>interviews. Interviews took from 20 to 40 minutes to complete.<br/><br/>Interviews were transcribed and analyzed using the Ethnograph<br/><br/>program. Findings indicate that all of the subjects interviewed<br/><br/>believe that premature infants experience pain. Commonalities were<br/><br/>found in the way subjects identified pain. They look for physical<br/><br/>expressions (crying, grimacing, a worried expression, pulling away,<br/><br/>or splinting) and for describe changes in heart and respiratory<br/><br/>rates and decreasing oxygenation. Several subjects emphasized that<br/><br/>these changes indicate pain when other causes have been ruled out.<br/><br/>Nurses emphasized the importance of working with the same infant,<br/><br/>in order to more quickly identify behavioral changes and institute<br/><br/>comfort measures. Nurses and doctors responded differently when<br/><br/>asked what measures were used to treat pain. Nurses described a<br/><br/>series of comfort measures which included such things as stroking,<br/><br/>positioning, and cuddling. If these were not deemed to be effective<br/><br/>and the pain was of long duration, nurses then approached the<br/><br/>doctor for pain medication. Doctors immediately described the<br/><br/>types of medications which could be used, expecting that all<br/><br/>comfort measures had been tried first. Both indicated that a local<br/><br/>should be used for procedures such as chest tube insertion and<br/><br/>anything involving cutting of the skin. However, nurses indicated<br/><br/>that it was sometimes necessary to hand the anesthetic to the<br/><br/>doctor. All of the subjects expressed feeling some frustration in<br/><br/>trying to treat the pain. There was agreement between doctors and<br/><br/>nurses that the responsibility for identification and initiation of<br/><br/>care lies with the nurse. Findings do indicate support for primary<br/><br/>nursing assignments, and for doctors and nurses to discuss<br/><br/>practices relative to pain in premature infants.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T13:21:58Z-
dc.date.issued1992-05-19en_GB
dc.date.accessioned2011-10-26T13:21:58Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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