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Efficacy of Live Lullaby Singing During Procedural Pain in Preterm and Term Neonates
Örebro University, School of Music, Theatre and Art. Centre for Clinical Research, Värmland County Council, Karlstad, Sweden.ORCID iD: 0000-0002-4436-4258
Department of Music, University of Jyväskylä, Jyväskylä, Finland; Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden .
County Council of Dalarna, Mora Hospital, Mora, Sweden.
County Council of Västernorrland, Sundsvall Hospital, Sundsvall, Sweden.
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2017 (English)In: Music and Medicine, ISSN 1943-8621, Vol. 9, no 2, p. 73-85Article in journal (Refereed) Published
Abstract [en]

This clinical trial tested the pain relieving effect of live lullaby singing on behavioral and physiological pain responses during venepuncture in 38 preterm and full term neonates. Acute and repeated pain, as well as the use of analgesic drugs, may have long-term negative impact on infants’ development and future behaviour. This emphasizes the need for complementary approaches to pain management such as music therapy.

Parent-preferred lullabies were performed live and standard care was provided for all neonates. Behavioral responses with regard to pain were assessed with Premature Infant Pain Profile-Revised (PIPP-R) and Behavioral Indicators of Infant Pain (BIIP). Heart rate, respiratory rate and oxygen saturation were measured each tenth second.

Although the live lullaby singing did not show a statistically significant effect on the infants’ pain score, there was a significantly calmer breathing pattern in the lullaby intervention versus the control condition in the pre-needle stage, showing a non-significant trend towards higher oxygen saturation levels and calmer heart rate in the lullaby intervention versus the control condition in the pre-needle stage. There were non-significant indications of fewer and shorter skin punctures with lullaby singing. More research is needed to explore such positive trends in the data.

Place, publisher, year, edition, pages
PKP Publishing Services , 2017. Vol. 9, no 2, p. 73-85
Keywords [en]
newborn infant, preterm infant, pain, music therapy, lullaby
National Category
Pediatrics
Research subject
Musicology
Identifiers
URN: urn:nbn:se:oru:diva-68308OAI: oai:DiVA.org:oru-68308DiVA, id: diva2:1236054
Available from: 2018-07-31 Created: 2018-07-31 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, AlexandraOlsson, EmmaVolgsten, UlrikEriksson, Mats

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