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Singing, sharing, soothing: Biopsychosocial rationales for parental infant directed singing in neonatal pain management: A theoretical approach
Örebro University, School of Music, Theatre and Art. Centre for Clinical Research, Värmland County Council, Karlstad, Sweden. (Musiken och Människan, PEARL- Pain in Early Life)ORCID iD: 0000-0002-4436-4258
Örebro University, School of Health Sciences. (PEARL- Pain in Early Life)ORCID iD: 0000-0002-5996-2584
Centre for Clinical Research, Värmland County Council, Karlstad, Sweden.
Örebro University, School of Music, Theatre and Art. (Musiken och Människan)ORCID iD: 0000-0002-5809-3575
2018 (English)In: Music & Science, ISSN 2059-2043, Vol. 1, p. 1-13Article in journal (Refereed) Published
Abstract [en]

Infant-directed singing is a medium for parents and infants to communicate in a mutual relationship. Parental infant-directed singing is a multisensory, biopsychosocial communication that applies to ill and vulnerable hospitalised infants. The primary musical features of infant-directed singing are ideal for emotional coordination and sharing between parent and infant without the risk of over-stimulation. In this article, we suggest that parental infant-directed singing is regarded as a nonpharmacological emotion regulation intervention, which may modify the painful experience for both the infant and the parent before, during and after painful procedures in the neonatal intensive care context. Parents have the biopsychosocial resources to alleviate their infant’s pain through infant-directed singing, if they are empowered to do so and coached in this process. A music therapist specialised in neonatal music therapy methods can mentor parents in how to use entrained and attuned live lullaby singing in connection to painful procedures. Pain and the vast amount of painful procedures early in infancy, combined with early parent–infant separation and lack of parental participation in the care of the infant during neonatal intensive care, place arduous strain on the new family’s attachment process and on the infant’s and parents’ mental health, both from a short and long-term perspective. Therefore, we argue with biopsychosocial rationales, that live parental infant-directed singing should be promoted in neonatal pain care worldwide. Consequently, parents should be welcomed round the clock and invited as prescribed pain management for their infant.

Place, publisher, year, edition, pages
Sage Publications, 2018. Vol. 1, p. 1-13
Keywords [en]
Affect attunement, biopsychosocial, infant, infant-directed singing, music therapy, pain management, parent, vitality affects
National Category
Musicology
Research subject
Health and Medical Care Research
Identifiers
URN: urn:nbn:se:oru:diva-67535DOI: 10.1177/2059204318780841OAI: oai:DiVA.org:oru-67535DiVA, id: diva2:1227969
Available from: 2018-06-27 Created: 2018-06-27 Last updated: 2019-11-19Bibliographically approved
In thesis
1. Singing, sharing, soothing: Family-centred music therapy during painful procedures in neonatal care
Open this publication in new window or tab >>Singing, sharing, soothing: Family-centred music therapy during painful procedures in neonatal care
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

To sing is to communicate. The soothing, comforting and emotional regulating properties of a lullaby are well-known cross-culturally and historically. This doctoral thesis addresses neonatal pain management from a novel and groundbreaking perspective, studying the efficacy of live music therapy on infants’ pain responses during venepuncture. New research is needed to advance the non-pharmacological interventions in neonatal pain care, and neonatal music therapy (NICU MT) offers active methods to involve the parents in pain management. The doctoral thesis includes two empirical and two theoretical articles. In paper I, preterm and term infants (n=38) were subjected to venepuncture with and without live lullaby singing, in a randomised order with a crossover design. Parent-preferred lullabies were performed live by a music therapy student and standard care was provided for all infants. The results did not show any significant pain-alleviating effects, however, the live singing was not stressful for the infants.

In paper II, the microanalysis disclosed that live lullaby singing is a communicative reciprocal intervention that also applies to premature infants during painful procedures. Live lullaby singing is a tool suitable as a means to optimise the homeostatic mechanisms. The results from the theoretical papers III and IV are further developed and synthesised in the thesis into a theoretical strategy; The Nordic NICU MT pain management strategy, featuring the parents and their singing voices as mediators for pain relief. The role of the music therapist in neonatal pain management is as a facilitator and an educator for the parents. Coaching parents to better meet their infant’s attachment needs during a painful procedure may lead to more efficacious interventions. The biopsychosocial parental infant-directed singing is presumably an applicable parent-driven non-pharmacological intervention, which promotes pain relief and attachment formation during painful procedures. Neonatal music therapy is still in its infancy in the Nordic countries, but the societal and healthcare contexts afford important prerequisites to further develop NICU MT as a truly family-centred approach. This doctoral thesis will hopefully contribute to the important interdisciplinary endeavour worldwide of involving and integrating parents in neonatal pain management.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2019. p. 134
Series
Örebro Studies in Musicology ; 4
Keywords
music therapy, pain management, premature infants, family-centred, infant-directed singing, venepuncture, parents, dynamic forms of vitality
National Category
Musicology
Identifiers
urn:nbn:se:oru:diva-77285 (URN)978-91-7529-313-4 (ISBN)
Public defence
2019-12-13, Örebro universitet, Hörsalen, Musikhögskolan, Fakultetsgatan 1, Örebro, 13:00 (English)
Opponent
Supervisors
Available from: 2019-10-14 Created: 2019-10-14 Last updated: 2019-11-20Bibliographically approved

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Ullsten, AlexandraEriksson, MatsVolgsten, Ulrik

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