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  • 1.
    Angelhoff, Charlotte
    et al.
    Department of Social and Welfare Studies, Division of Nursing Science, Linköping University, Norrköping, Sweden; Department of Clinical and Experimental Medicine, Department of Paediatrics, Linköping University, Linköping, Sweden.
    Blomqvist, Ylva Thernström
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Helmer, Charlotte Sahlén
    Department of Social and Welfare Studies, Division of Nursing Science, Linköping University, Norrköping, Sweden; Department of Clinical and Experimental Medicine, Department of Paediatrics, Linköping University, Linköping, Sweden.
    Olsson, Emma
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Pediatrics.
    Shorey, Shefaly
    Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.
    Frostell, Anneli
    Division of Psychology, Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
    Morelius, Evalotte
    Department of Social and Welfare Studies, Division of Nursing Science, Linköping University, Norrköping, Sweden.
    Effect of skin-to-skin contact on parents' sleep quality, mood, parent-infant interaction and cortisol concentrations in neonatal care units: study protocol of a randomised controlled trial2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 7, article id e021606Article in journal (Refereed)
    Abstract [en]

    Introduction: Separation after preterm birth is a major stressor for infants and parents. Skin-to-skin contact (SSC) is a method of care suitable to use in the neonatal intensive care unit (NICU) to minimise separation between parents and infants. Less separation leads to increased possibilities for parent-infant interaction, provided that the parents' sleep quality is satisfactory. We aimed to evaluate the effect of continuous SSC on sleep quality and mood in parents of preterm infants born <33 weeks of gestation as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge.

    Methods and analysis: A randomised intervention study with two arms-intervention versus standard care. Data will be collected from 50 families. Eligible families will be randomly allocated to intervention or standard care when transferred from the intensive care room to the family-room in the NICU. The intervention consists of continuous SSC for four consecutive days and nights in the family-room. Data will be collected every day during the intervention and again at the time of discharge from the hospital. Outcome measures comprise activity tracker (Actigraph); validated self-rated questionnaires concerning sleep, mood and bonding; observed scorings of parental sensitivity and emotional availability and salivary cortisol. Data will be analysed with pairwise, repeated measures, Mann Whitney U-test will be used to compare groups and analysis of variance will be used to adjust for different hospitals and parents' gender.

    Ethics and dissemination: The study is approved by the Regional Research Ethics Board at an appropriate university (2016/89-31). The results will be published in scientific journals. We will also use conferences and social media to disseminate our findings.

  • 2.
    Eriksson, Mats
    et al.
    Örebro University, School of Health Sciences.
    Ahl, Hanna
    Skåne University Hospital, Lund, Sweden.
    Bengtsson, Kevin
    Lund University, Lund, Sweden.
    Bruschettini, Matteo
    Cochrane, Sweden.
    Norman, Elisabeth
    Lund University, Lund, Sweden.
    Olsson, Emma
    Örebro University, School of Health Sciences.
    Naidu Vejayaram, Dhashin
    Lund University, Lund, Sweden.
    Pain scales in clinical trials in newborn infants – a mapping of the evidence2019Conference paper (Refereed)
    Abstract [en]

    Background: Numerous clinical studies have aimed at finding a strategy to reduce the pain newborn infants are subjected to by their medical conditions and also by medical and caring procedures. Little is however known about whether the outcome measures in these trials are valid for the specific type of pain or group of infants included in the studies. There are today over 40 published scales, consisting of behavioral or physiological signals or a combination of both. The aim of this study was to evaluate the reporting of pain scales assessments that were most commonly used in all the published trials examining interventions related to neonatal pain.

    Methods: A systematic and broad search up to January 2019 was performed in Embase, PubMed, PsycInfo, Cinahl, Cochrane Library, Scopus and Luxid. Randomized and quasi-randomized clinical trials on neonatal pain were included. Title and abstract screening followed by full text screening were performed by two independent researchers using an online tool for the preparation of systematic reviews (Covidence). Disagreements were resolved by a third researcher or in discussions within the group, as recommended in the Cochrane handbook. Data extraction and quality assessment were also performed by two researchers independently. 

    Results: The systematic search retrieved 3715 scientific articles. Following screening, 342 studies with a total of 16210 infants were included, reporting data from the use of at least one neonatal pain assessment scale. Ninety per cent of the studies concerned procedural pain where the most frequently used pain scales were PIPP or PIPP-R (43%), followed by NIPS (17%). For ongoing or post-operative pain there was a more unclear pattern with COMFORT (24%) and NFCS (10%) as the most reported. We observed a wide variation of pain scales (Fig 1) and found numerous studies where pain scales were used that were not validated for the studied population or type of pain. In 11 papers self-constructed study-specific scales were used. The most frequent sources of procedural pain were heel lance (28% of the studies) followed by venipuncture (10%) and ROP-screening (5%).

    Conclusion: This is the first scoping review reporting systematically how neonatal pain scales are used in clinical trials. There are a few validated pain assessment scales used in most clinical studies. It is crucial to choose an appropriate scale, validated for the type of pain and population of infants included in the study. The inappropriate use of pain scales raises serious concerns on ethical conduct of research and waste of resources.

     

  • 3.
    Olsson, Emma
    Örebro University, School of Medical Sciences.
    Promoting health in premature infants: with special focus on skin-to-skin contact and development of valid pain assesment2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Premature infants are at greater risk for both short- and long-term negative outcomes than infants born at full term. Premature infants have an immature nervous system and are not developmentally prepared to process the often excessive stimuli and frequent painful procedures of intensive care. Skin-to-skin contact between the infant and the parent is beneficial for both infant and parents and can also humanize the intense environment of the neonatal intensive care unit. The aim of the thesis, to promote health in premature infants had two parts: (1) to investigate aspects of skin-to-skin contact (SSC) within neonatal care, and (2) to contribute to the development of a valid method for pain assessment in premature infants. In Study I, questionnaires about the implementation of SSC and staff’s attitudes toward the method were sent to all neonatal units in the Nordic countries. SSC was offered in all 87% of the units that responded, but to different extents in different countries. Medical risks and the physical environment were considered barriers to SSC, and the infant’s general development was considered the primary benefit. In Study II, 20 fathers of premature infants were interviewed about their experiences with SSC. The fathers’ overall experiences were positive and SSC made them feel involvedin their infant’s care. They also described the  environment as an obstacle, but the experience as both gratifying and challenging. In Study III, SSC with their mothers was shown to have a pain-relieving effect on premature infants undergoing a blood test. This effect was examined through nearinfrared spectroscopy (NIRS) over the somatosensory cortex. In Study IV the Premature Infant Pain Profile - Revised was translated and culturally adapted into Finnish, Icelandic, Norwegian and Swedish. In summary, SSC was used to various degrees in the Nordic countries, fathers seemed to appreciate the method, which made them feel more involved, and SSC provided pain relief during a blood test.

    List of papers
    1. Skin-to-skin care in neonatal intensive care units in the Nordic countries: a survey of attitudes and practices
    Open this publication in new window or tab >>Skin-to-skin care in neonatal intensive care units in the Nordic countries: a survey of attitudes and practices
    Show others...
    2012 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 10, p. 1140-1146Article in journal (Refereed) Published
    Abstract [en]

    Aim: To investigate the application of skin-to-skin care (SSC) in the Nordic countries, the existence of guidelines for SSC and the attitudes of neonatal staff towards SSC.

    Methods: One questionnaire was distributed at unit level and one at staff level in all Nordic neonatal intensive care units (n = 109).

    Results: The unit questionnaire was answered by 95 (87%) units and the staff questionnaire by 1446 staff members (72%). All units offered SSC to various degrees, but guidelines only existed at 47% of them. Units in Denmark, Norway and Sweden seemed to use SSC earlier, longer and in more medically complicated situations than units in Finland and Iceland. Seventy-seven per cent of the units had private rooms where parents and infants could stay together, still the physical environment of the units limited the use of SSC. Medical risks were considered the main barrier for further implementation of SSC, while general development and early interaction were the most frequently mentioned benefits.

    Conclusion: Skin-to-skin care is implemented in all Nordic neonatal units, but offered to various degrees, to various populations and to varying extents. Danish, Norwegian and Swedish units are offering SSC more extensively than units in Finland and Iceland.

    Place, publisher, year, edition, pages
    Hoboken, USA: Wiley-Blackwell, 2012
    Keywords
    Kangaroo mother care, neonatal care, newborn infant, skin-to-skin care
    National Category
    Nursing
    Research subject
    Medicine; Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-25710 (URN)10.1111/j.1651-2227.2012.02802.x (DOI)000309408200022 ()22849363 (PubMedID)2-s2.0-84867101431 (Scopus ID)
    Available from: 2012-09-04 Created: 2012-09-04 Last updated: 2017-12-07Bibliographically approved
    2. Skin-to-skin contact facilitates a more equal parenthood: a qualitative study from fathers’ perspectives
    Open this publication in new window or tab >>Skin-to-skin contact facilitates a more equal parenthood: a qualitative study from fathers’ perspectives
    (English)Manuscript (preprint) (Other academic)
    National Category
    General Practice
    Identifiers
    urn:nbn:se:oru:diva-56354 (URN)
    Available from: 2017-03-15 Created: 2017-03-15 Last updated: 2018-01-13Bibliographically approved
    3. Skin-to-skin contact reduces near-infrared spectroscopy pain responses in premature infants during blood sampling
    Open this publication in new window or tab >>Skin-to-skin contact reduces near-infrared spectroscopy pain responses in premature infants during blood sampling
    2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 4, p. 376-380Article in journal (Refereed) Published
    Abstract [en]

    Aim: This study investigated if skin-to-skin contact could provide pain relief, measured with near infrared spectroscopy (NIRS), during venepuncture in premature infants.

    Methods: Ten infants born at 26-35 weeks of gestation were examined during a blood sampling procedure with venepuncture under two different conditions: in skin-to-skin contact with their mother or lying in their incubator or crib. A double-channel NIRS device was used and oxygen saturation and heart rate were measured using pulse oximetry. The infant's face and the pulse oximetry values were videotaped throughout the procedures, so that we could carry out a pain assessment using the Premature Infant Pain Profile - Revised (PIPP-R).

    Results: We found a significantly smaller increase in oxygenated haemoglobin on the contralateral side during venepuncture when the infants were in skin-to-skin contact with their mothers, compared to when they were laying in their incubator or crib. When venepuncture was compared with a sham procedure, oxygenated haemoglobin increased significantly more with the infant in the incubator or crib than held skin-to-skin, but no significant differences could be seen in the PIPP-R results between the two groups.

    Conclusion: This study showed that skin-to-skin contact between premature infants and their mothers during venepuncture had a pain-relieving effect.

    Place, publisher, year, edition, pages
    Wiley-Blackwell, 2016
    Keywords
    Near infrared spectroscopy, newborn infant, pain, skin-to-skin contact
    National Category
    Pediatrics
    Research subject
    Pediatrics
    Identifiers
    urn:nbn:se:oru:diva-45724 (URN)10.1111/apa.13180 (DOI)000371892200018 ()26342142 (PubMedID)
    Funder
    Magnus Bergvall Foundation
    Note

    Funding Agencies:

    Örebro University Hospital Research Foundation

    Nils Svenningsens minnesfond

    Stiftelsen Allmana BBs minnesfond

    Research Committee at Region Örebro County 

    Available from: 2015-09-07 Created: 2015-09-07 Last updated: 2018-09-04Bibliographically approved
    4. Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)
    Open this publication in new window or tab >>Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    General Practice
    Identifiers
    urn:nbn:se:oru:diva-56355 (URN)
    Available from: 2017-03-15 Created: 2017-03-15 Last updated: 2018-01-13Bibliographically approved
  • 4.
    Olsson, Emma
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
    Ahlsén, Gunilla
    Department of Neurology, Faculty of Health and Medicine, Örebro University, Örebro, Sweden.
    Eriksson, Mats
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Skin-to-skin contact reduces near-infrared spectroscopy pain responses in premature infants during blood sampling2016In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 4, p. 376-380Article in journal (Refereed)
    Abstract [en]

    Aim: This study investigated if skin-to-skin contact could provide pain relief, measured with near infrared spectroscopy (NIRS), during venepuncture in premature infants.

    Methods: Ten infants born at 26-35 weeks of gestation were examined during a blood sampling procedure with venepuncture under two different conditions: in skin-to-skin contact with their mother or lying in their incubator or crib. A double-channel NIRS device was used and oxygen saturation and heart rate were measured using pulse oximetry. The infant's face and the pulse oximetry values were videotaped throughout the procedures, so that we could carry out a pain assessment using the Premature Infant Pain Profile - Revised (PIPP-R).

    Results: We found a significantly smaller increase in oxygenated haemoglobin on the contralateral side during venepuncture when the infants were in skin-to-skin contact with their mothers, compared to when they were laying in their incubator or crib. When venepuncture was compared with a sham procedure, oxygenated haemoglobin increased significantly more with the infant in the incubator or crib than held skin-to-skin, but no significant differences could be seen in the PIPP-R results between the two groups.

    Conclusion: This study showed that skin-to-skin contact between premature infants and their mothers during venepuncture had a pain-relieving effect.

  • 5.
    Olsson, Emma
    et al.
    Örebro University, School of Medical Sciences.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health Sciences.
    Atladóttir, Sigríður María
    Faculty of Nursing, University of Iceland, Reykjavik, Iceland; Neonatal Intensive Care Unit, Lanspitali University Children’s Hospital, Reykjavik, Iceland .
    Axelin, Anna
    Department of Nursing Science, University of Turku, Turku, Finland.
    Campbell-Yeo, Marsha
    School of Nursing, Faculty of Health Professions and Departments of Pediatrics, Psychology & Neuroscience, Dalhousie University, Halifax, Canada; Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada .
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Kristjánsdóttir, Guðrún
    Faculty of Nursing, University of Iceland, Reykjavik, Iceland; Neonatal Intensive Care Unit, Lanspitali University Children’s Hospital, Reykjavik, Iceland .
    Peltonen, Emilia
    Neonatal Intensive Care Unit, Lanspitali University Children’s Hospital, Reykjavik, Iceland.
    Stevens, Bonnie
    Lawrence S Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Canada; Department of Nursing, The Hospital for Sick Children, Toronto, Canada .
    Vederhus, Bente
    Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
    Dovland Andersen, Randi
    Department of Child and Adolescent Health Services, Telemark Hospital, Skien, Norway; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden .
    Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)Manuscript (preprint) (Other academic)
  • 6.
    Olsson, Emma
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Pediatrics.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Attladottir, Sigríður María
    Faculty of Nursing, University of Iceland, Reykjavik, Iceland; Neonatal Intensive Care Unit, Lanspitali University Children’s Hospital, Reykjavik, Iceland.
    Axelin, Anna
    Department of Nursing Science, University of Turku, Turku, Finland.
    Campbell-Yeo, Marsha
    School of Nursing, Faculty of Health Professions and Departments of Pediatrics, Psychology & Neuroscience, Dalhousie University, Halifax, Canada; Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Kristjánsdóttir, Guðrún
    Faculty of Nursing, University of Iceland, Reykjavik, Iceland; Neonatal Intensive Care Unit, Lanspitali University Children’s Hospital, Reykjavik, Iceland.
    Peltonen, Emilia
    Department of Nursing Science, University of Turku, Turku, Finland.
    Stevens, Bonnie
    Lawrence S Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Canada; Department of Nursing, The Hospital for Sick Children, Toronto, Canada.
    Vederhus, Bente
    Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
    Dovland Andersen, Randi
    Department of Child and Adolescent Health Services, Telemark Hospital, Skien, Norway; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)2018In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 18, article id 349Article in journal (Refereed)
    Abstract [en]

    Background: Preterm infants are especially vulnerable to pain. The intensive treatment often necessary for their survival unfortunately includes many painful interventions and procedures. Untreated pain can lead to both short- and long-term negative effects. The challenge of accurately detecting pain has been cited as a major reason for lack of pain management in these non-verbal patients. The Premature Infant Pain Profile (PIPP) is one of the most extensively validated measures for assessing procedural pain in premature infants. A revised version, PIPP-R, was recently published and is reported to be more user-friendly and precise than the original version. The aims of the study were to develop translated versions of the PIPP-R in Finnish, Icelandic, Norwegian, and Swedish languages, and to establish their content validity through a cultural adaptation process using cognitive interviews.

    Methods: PIPP-R was translated using the recommendations from the International Society for Pharmacoeconomics and Outcomes Research and enhanced with cognitive interviews. The respondent nurse was given a copy of the translated, national version of the measure and used this together with a text describing the infant in the film to assess the pain of an infant in a short film. During the assessment the nurse was asked to verbalize her thought process (thinking aloud) and upon completion the interviewer administered probing questions (verbal probing) from a structured interview guide. The interviews were recorded, transcribed, and analyzed using a structured matrix approach.

    Results: The systematic approach resulted in translated and culturally adapted versions of PIPP-R in the Finnish, Icelandic, Norwegian and Swedish languages. During the cultural adaptation process several problems were discovered regarding how the respondent understood and utilized the measure. The problems were either measure problems or other problems. Measure problems were solved by a change in the translated versions of the measure, while for other problems different solutions such as education or training were suggested.

    Conclusions: This study have resulted in translations of the PIPP-R that have content validity, high degree of clinical utility and displayed beginning equivalence with each other and the original version of the measure.

  • 7.
    Olsson, Emma
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Atladóttir, Sigríður María Atladóttir
    Faculty of Nursing, University of Iceland, Reykjavik, Iceland.
    Axelin, Anna
    Department of Nursing Science, University of Turku, Turku, Finland.
    Campbell-Yeo, Marsha
    School of Nursing, Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax NS, Canada.
    Eriksson, Mats
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Peltonen, Emilia
    Department of Nursing Science, University of Turku, Turku, Finland.
    Stevens, Bonnie
    Faculties of Nursing and Medicine, University of Toronto, Toronto, Canada.
    Yamada, Janet
    The Hospital for Sick Children, Toronto, Canada.
    Andersen-Dovland, Randi
    Department of Child and Adolescent Health Services, Telemark Hospital, Skien, Norway; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Translation, cultural adaptation and validation of the revised version of the Premature Infant Pain Profile: An effort to improve pain assessment in infants in the Nordic countries2015Conference paper (Refereed)
    Abstract [en]

    Background: In order to effectively treat pain in the neonatal period and diminish its negative effects, pain must be recognized and properly assessed.                                       

    Objective: a) Translate the revised version of Premature Infant Pain Profile (PIPP-R) (1, 2) scale into Finnish, Icelandic, Norwegian and Swedish languages. b) Test the content validity of each of the translated versions.                                                                          

    Design: a) translation and cultural adaption following the ISPOR recommendations (3) and b) testing of content validity using cognitive interviews.                                                  Setting: Finland, Iceland, Norway and Sweden, with cognitive debriefing and interviews at selected neonatal units (NU).                                                                                 Participants: In each country 5-10 nurses working in the NU will be included through purposeful sampling.                                                                                       

    Procedures: Phase a): The following steps of the ISPOR protocol will be followed: 1)Preparation, 2) Forward translation, 3) Reconciliation, 4) Back translation, 5) Back translation review, 6) Harmonization, 7) Cognitive debriefing, 8) Review of cognitive debriefing results and finalization, 9) Proofreading, 10) Final report. Phase b): Interviews to gain an understanding concerning the respondents’ understanding of PIPP-R will be performed. Respondents’ first perform a pain assessment with the preliminary version of the scale while verbalizing their thought processes (Think Aloud) followed by an interview based on a semi-structured interview guide (Verbal Probing).                                                              

    Measures: National data will be analyzed in accordance with a predefined problems matrix (4).                                                                                                                     

    Results: None obtained yet. However; members of our research group have previous experience with the original PIPP scale from both research and clinical practice and have tested out the proposed translation methodology in a previous validation study (4).

    Conclusions: Having well validated pain assessment measures available, is a necessary first step for efficient treatment of pain in vulnerable preterm infants. This collaboration among the Nordic countries will help to standardize and develop our pain management practices and contribute to further building the PEARL research network.

  • 8.
    Olsson, Emma
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Baños, Josep-Eladi
    Universitat Pompeu Fabra, Barcelona, Spanien.
    Guardiola, Elena
    Universitat Pompeu Fabra, Barcelona, Spanien.
    Gradin, Maria
    Eriksson, Mats
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Skin-to-skin contact for pain relief: a bibliometric analysis2013Conference paper (Refereed)
    Abstract [en]

    Introduction & Aims

    Skin-to-skin contact originated as a life-saving alternative to conventional neonatal care in low-resource settings. Later research has focused on its advantages for e.g. breastfeeding, mother-infant attachment and also for pain-relief. This study is a part of a larger bibliometric project, analyzing neonatal pain research from 2000 to 2012, as a follow up of a previous investigation (1).

    Methods

    PubMed, PsychInfo, Cochrane, and EBSCO databases were searched using terms relating to pain, neonatal care, infancy, skin-to-skin contact and kangaroo mother care. In addition literature was searched from personal knowledge, reference lists in retrieved articles and from the International Network of Kangaroo Care Bibliography (2). The articles in the final inclusion were analyzed according to publication data and type of  research and also type of pain.

    Results

    A final number of 87 articles were included in the analysis. Publication rate increased from an average of 2.5 articles per year the first 5-year period; 2000-2004, to 8.2 2005-2009 and 12.0 2010-2012. Eighty-eight per-cents were published in English language and the main publishing countries were USA with 34 % and Canada with 24 % of the articles. Randomized controlled trials constituted 33 % of the included articles, followed by 14 % other original research. Twenty per-cents were systematic reviews and 34 % guidelines, position papers or commentaries. The most common topic for the studies were procedural pain (61 %) followed by general pain issues (32 %). Of the first authors,  62 % were nurses and 28 % physicians.

    Discussion & Conclusions

    Research about skin-to-skin contact as pain relieving measure shows an increasing trend over the last decade, both randomized trials and other original research, which is also seen in the increasing number of reviews and guidelines built on the results of this scientific work. The large proportion of nurses performing skin-to-skin contact research shows that skin-to-skin contact is a multi-professional team-based intervention. A next step would be to study compliance with the guidelines and the implementation process of skin-to-skin contact for pain-relief.

    References

    1. Baños, J. E., Ruiz, G., & Guardiola, E. (2001). An analysis of articles on neonatal pain published from 1965 to 1999. Pain Res Manag, 6(1), 45-50.

    2. Ludington-Hoe, S. Kangaroo Care Bibliography. Available at http://www.kangaroocareusa.org/uploads/KCBIB2012_May.pdf

    The authors have no conflict of interest to declare.

  • 9.
    Olsson, Emma
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Paediatrics and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Dovland-Andersen, Randi
    Department of Child and Adolescent Health Services, Telemark Hospital, Skien, Norway.
    Axelin, Anna
    Department of Nursing Science, University of Turku, Turku, Finland.
    Jonsdottir, Rakel B.
    NICU Landspitali University Hospital, Reykjavik, Iceland.
    Maastrup, Ragnhild
    Knowledge Centre for Breastfeeding Infants with Special Needs, Neonatal dept, Rigshospitalet, Copenhagen, Denmark; Department of Health Sciences, Lund University, Lund, Sweden.
    Eriksson, Mats
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Paediatrics and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Skin-to-skin care in neonatal intensive care units in the Nordic countries: a survey of attitudes and practices2012In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 10, p. 1140-1146Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate the application of skin-to-skin care (SSC) in the Nordic countries, the existence of guidelines for SSC and the attitudes of neonatal staff towards SSC.

    Methods: One questionnaire was distributed at unit level and one at staff level in all Nordic neonatal intensive care units (n = 109).

    Results: The unit questionnaire was answered by 95 (87%) units and the staff questionnaire by 1446 staff members (72%). All units offered SSC to various degrees, but guidelines only existed at 47% of them. Units in Denmark, Norway and Sweden seemed to use SSC earlier, longer and in more medically complicated situations than units in Finland and Iceland. Seventy-seven per cent of the units had private rooms where parents and infants could stay together, still the physical environment of the units limited the use of SSC. Medical risks were considered the main barrier for further implementation of SSC, while general development and early interaction were the most frequently mentioned benefits.

    Conclusion: Skin-to-skin care is implemented in all Nordic neonatal units, but offered to various degrees, to various populations and to varying extents. Danish, Norwegian and Swedish units are offering SSC more extensively than units in Finland and Iceland.

  • 10.
    Olsson, Emma
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Eriksson, Mats
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Can skin-to-skin contact work as pain relief in premature infants?2015Conference paper (Refereed)
  • 11.
    Olsson, Emma
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Eriksson, Mats
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Can skin-to-skin contact work as pain relief in premature infants?2014Conference paper (Other academic)
  • 12.
    Olsson, Emma
    et al.
    Örebro University Hospital, Örebro, Sweden.
    Eriksson, Mats
    Örebro University Hospital, Örebro, Sweden.
    Oral glucose for pain relief during eye examinations for retinopathy of prematurity2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 7-8, p. 1054-9Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to determine whether oral glucose could have a pain-relieving effect during the eye examinations that premature neonates undergo in the screening for retinopathy of prematurity.

    Background: Studies have shown that orally administered sweet-tasting solutions reduce signs of pain during painful procedures such as venepuncture and heel sticks on premature and full-term infants. This effect has not yet been proven during the eye examinations for the screening of retinopathy of prematurity. Design.  Randomised, controlled, double-blind study.

    Method: Thirty infants born before 32 weeks of gestation and/or weighing <1500 g at birth were randomised to receive 1 ml of either 30% glucose or sterile water before the eye examination. Examinations were videotaped, and the observer was blinded to the intervention. Pain responses were scored using the premature infant pain profile. Heart rate and crying time were also recorded.

    Results: There were no statistically significant differences between the two groups, neither in premature infant pain profile score, heart rate changes nor crying time.

    Conclusion: This study does not support the pain-relieving effect of orally administered glucose during eye examinations in preterm infants.

    RELEVANCE TO CLINICAL PRACTICE: Oral glucose should not be used as single measure for pain relief during eye examinations of preterm infants. Other comforting and pain-relieving measures should be used.

  • 13.
    Olsson, Emma
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Eriksson, Mats
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Anderzen-Carlsson, Agneta
    Örebro University Hospital. Örebro University, School of Health Sciences. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Skin-to-Skin Contact Facilitates More Equal Parenthood: A Qualitative Study From Fathers' Perspective2017In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 34, no May-Jun 2017, p. e2-e9Article in journal (Refereed)
    Abstract [en]

    Design and Methods: A descriptive design was used where 20 fathers of premature infants were interviewed using a semi-structured interview-guide. The guide contained the following five topics: the fathers' feelings about and experiences of using skin-to-skin contact (SSC), the physical environment at the Neonatal Intensive Care unit, staff attitudes, and whether SSC had any impact on the relationship with their partner and other children in the family. The interviews were analyzed using directed qualitative content analysis and the results compared with those of a qualitative systematic review by Anderzén-Carlsson and colleagues.

    Results: The result shows that the fathers' overall experience of SSC was positive and as in the aforementioned review, they described experiences that were both gratifying and challenging. They felt more included and just as important as the mother because SSC and the demands placed on them by the premature birth helped them to achieve more equal parenthood.

    Conclusion: The fathers' overall experiences of SSC were positive as they felt included in their infants' care and just as important as the mothers. To a great degree the theoretical model tested was supported, although some weaknesses and differences were identified.

    Practical Implications: It is important to include fathers in neonatal care and recognize that they feel equally important as mothers in caring for premature infants.

  • 14.
    Olsson, Emma
    et al.
    Örebro University, School of Health Sciences.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health Sciences. Region Örebro län, Örebro, Sverige.
    Pappors upplevelser av att vårda sitt för tidigt födda barn hud-mot-hud2016Conference paper (Other academic)
    Abstract [sv]

    Bakgrund och syfte: Hud-mot-hudkontakt mellan det för tidigt födda barnet och dennes föräldrar är en vanlig vårdform inom neonatalvården. Metoden har en mängd positiva effekter såsom mer stabil temperaturreglering, färre apnéer och stabilare syresättning. Trots de positiva effekterna är en del föräldrar tveksamma till metoden. Tidigare studier avser huvudsakligen mammors upplevelser. Vårt syfte var därför att beskriva pappors upplevelser av att vårda sitt för tidigt födda barn hud-mot-hud.

    Metod och material: Ett strategiskt urval av 20 pappor till för tidigt födda barn intervjuades med hjälp av en semistrukturerad intervjuguide. Frågorna fokuserade på pappornas känslor och upplevelser vid hud-mot-hudkontakten, den fysiska miljön på avdelningen, inklusive personalens agerande, liksom på hud-mot-hudkontaktens eventuella betydelse för relationen till barnets mamma eller äldre syskon. Svaren transkriberades och analyserades med deduktiv innehållsanalys utifrån en modell av Anderzén-Carlsson m.fl. som bygger på en litteraturreview av 29 originalartiklar om föräldrars (401 mammor och 94 pappor) upplevelser av att vårda hud-mot-hud (2014). Analysmetoden användes för att se om pappors upplevelser skiljer sig från det resultat som huvudsakligen bygger på mammors upplevelser.

    Resultat och konklusion: Analys pågår men preliminära resultat tyder på att det finns likheter mellan pappors och mammors upplevelser, men också områden som skiljer sig åt. Papporna talar till viss del om upplevelser som mammorna inte tog upp, t.ex. en stolthet över att vara den som haft den första hud-mot-hudkontakten med barnet. Många av mammorna i Anderzén-Carlssons studie uttryckte att pappan var viktig som ett stöd, medan pappornas beskrivningar mera pekar på att föräldrarna delar på ansvaret.

     

     

    Referenser

    Anderzén-Carlsson, A, Lamy, ZC & Eriksson, M (2014) Parental experiences of providing skin-to-skin care to their newborn infant – part 1: A qualitative systematic review. Int J Qual Stud Health Well-being. Vol. 13:9; doi: 10.3402/qhw.v9.24906

     

    Anderzén-Carlsson, A, Lamy, ZC, Tingvall, M & Eriksson, M (2014) Parental experiences of providing skin-to-skin care to their newborn infant – part 2: A qualitative meta-synthesis. Int J Qual Stud Health Well-being. Vol. 9; doi: 10.3402/qhw.v9.24907

  • 15.
    Olsson, Emma
    et al.
    Örebro University, School of Medical Sciences.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health Sciences.
    Skin-to-skin contact facilitates a more equal parenthood: a qualitative study from fathers’ perspectivesManuscript (preprint) (Other academic)
  • 16.
    Olsson, Emma
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Pettersson, Miriam
    Örebro University, School of Medical Sciences.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Ohlin, Andreas
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Glukos som smärtlindring vid neonatal höftledsundersökning: En randomiserad kontrollerad studie2018Conference paper (Refereed)
  • 17.
    Olsson, Emma
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Pediatrics.
    Pettersson, Miriam
    Örebro University, School of Medical Sciences. Department of Pediatrics.
    Eriksson, Mats
    Örebro University, School of Health Sciences. Department of Pediatrics.
    Ohlin, Andreas
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Pediatrics.
    Oral sweet solution to prevent pain during neonatal hip examination: a randomized controlled trial2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 4, p. 626-629Article in journal (Refereed)
    Abstract [en]

    Aim: To determine if oral glucose can have a pain relieving effect during routine hip exams in newborn infants.

    Methods: In this randomized controlled study 100 newborn infants undergoing the routine physical examination including the potentially painful hip exam were included between March 2016 and April 2017. 50 infants were randomized to water (control) and 50 to oral glucose (intervention) before their examination. Pain was assessed using crying time, Astrid Lindgren and Lund Children's Hospital Pain and Stress Assessment Scale (ALPS‐Neo) and Visual analogue scale (VAS).

    Results:  Total crying time (p=0.06), crying time during the hip examination (p=0.028), ALPS‐Neo (p=0.004) and VAS (p=0.006) (when assessed by the physician) were all significantly decreased in the group of infants receiving glucose. VAS assessment made by the parents did not reach statistical significance (p=0.127).

    Conclusion:  Oral glucose given before the examination has a pain relieving effect during the hip exam in healthy newborn infants.

  • 18.
    Pettersson, Miriam
    et al.
    Örebro University, School of Medical Sciences. Department of Paediatrics.
    Olsson, Emma
    Örebro University, School of Health Sciences. Department of Paediatrics.
    Ohlin, Andreas
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Paediatrics.
    Eriksson, Mats
    Örebro University, School of Health Sciences. Department of Paediatrics.
    Neurophysiological and behavioral measures of pain during neonatal hip examination2019In: Paediatric and Neonatal Pain, ISSN 2637-3807Article in journal (Refereed)
    Abstract [en]

    Introduction: The aim of this study was to test the hypothesis that neonatal hip ex ‐amination causes pain in newborns. Pain assessment using instruments such as the Premature Infant Pain Profile‐Revised (PIPP‐R) scale is recommended, but recently physiological and neurophysiological measures, for example, near‐infrared spectros‐copy (NIRS) and galvanic skin response (GSR), have been used as well.

    Methods: Heart auscultation and hip examination were performed, and the response of the newborn was registered by NIRS optodes, GSR electrodes, and a pulse oxime‐ter probe attached to the infant. The face of the newborn was filmed. Heart ausculta‐tion was used as a nonpainful reference.

    Results: The pain scores for hip examination were higher than for the heart ausculta‐tion. Near‐infrared spectroscopy showed a significant higher increase from baseline in oxygenated hemoglobin (HbO2) on both sides of the cortex at hip examination compared with at heart auscultation (P = .011 and P= .017). Mean PIPP‐R scores for the hip examination compared with heart auscultation increased from 3.0 to 8.1 (P = .000). The GSR analyses of hip examination compared with heart auscultation showed a significant increase in area under small peaks during the hip examination (P = .016), however, not when measured in peaks per second (P = .104). Interrater reliability was calculated for the NIRS interpretations, with an intraclass correlation coefficient (ICC) range of 0.93‐1.0 (P = .000).

    Discussion: Pain in newborns can have negative consequences, and pain prevention and treatment are therefore important. We conclude that neonatal hip examinations are painful and that the pain should be treated, for example, with oral sweet solution. This is a change from present routines during neonatal hip examination and is hoped to lead to a change in national guidelines.

  • 19.
    Pettersson, Miriam
    et al.
    Örebro University, School of Medical Sciences.
    Olsson, Emma
    Örebro University, School of Health Sciences.
    Ohlin, Andreas
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Neurophysiological and behavioural measures of pain during neonatal hip examination2019Conference paper (Refereed)
    Abstract [en]

    Background

    In Sweden, all newborns are examined before discharge from the maternity ward to rule out innate abnormalities. Parts of this procedure, such as the hip examination, appear to cause pain and discomfort. Pain in newborns can have both short- and long-term negative consequences and preventing and treating this pain is therefore an important part of medical care. There are several ways to recognize and assess pain in newborn infants. Scales such as the Premature Infant Pain Profile-Revised (PIPP-R) are recommended, but recently physiological and neurophysiological measures, e.g. Near-infrared spectroscopy (NIRS) and Galvanic Skin Response (GSR) have been suggested to have pain-assessing properties.

    The aim of the study was to test the hypothesis that neonatal hip examination causes pain in newborns.

    Methods

    The infant was placed on an examination table and a video camera was placed so the face of the newborn was filmed. A pulse oximeter probe, NIRS optodes and GSR electrodes were attached to the infant. Heart auscultation was chosen to be used as a non-painful comparative to hip examination.

    Results

    The results showed higher pain scoring for the hip examination than for the heart auscultation. NIRS, showed a significant difference in HbO2 on both sides of cortex (p=0,011 and p=0,017). Mean PIPP-R went from 3.0 during the heart auscultation to 8.1 during the hip examination (p=0.000). GSR analyses showed significant increase in area under small peaks during the hip examination (p=0.016), however not when measured in peaks per second (p=0.104). Interrater reliability was calculated for the NIRS interpretations, with an ICC-range of 0.93-1.0 (p=0.000).

    Conclusion

    We conclude that neonatal hip examinations are painful and that the pain should be treated, e.g. with oral sweet solution. 

  • 20.
    Pettersson, Miriam
    et al.
    Örebro University, School of Medical Sciences.
    Olsson, Emma
    Örebro University, School of Health Sciences.
    Ohlin, Andreas
    Örebro University Hospital. Örebro University, School of Medical Sciences.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Neurophysiological and behavioural measures of pain during neonatal hip examination2019Conference paper (Refereed)
    Abstract [en]

    Introduction and Purpose: In Sweden, all newborns are examined before discharge from the maternity ward to rule out innate abnormalities. Parts of this procedure, such as the hip examination, appear to cause pain and discomfort. Pain in newborns can have both short- and long-term negative consequences and preventing and treating this pain is therefore an important part of medical care. There are several ways to recognize and assess pain in newborn infants. Scales such as the Premature Infant Pain Profile-Revised (PIPP-R) are recommended, but recently physiological and neurophysiological measures, e.g. Near-in-frared spectroscopy (NIRS) and Galvanic Skin Response (GSR) have been suggested as superior pain measuring methods. The aim of the study was to test the hypothesis that neonatal hip examination causes pain in newborns.

    Methods: The infant was placed on an examination table and a video camera was placed so the face of the newborn was filmed. A pulse oximeter probe, NIRS optodes and GSR electrodes were attached to the infant. Heart auscultation was chosen to be used as a non-painful comparative to hip examination.

    Results: The results showed higher pain scoring for the hip examination than for the heart auscultation. NIRS, showed a significant difference in HbO2 on both sides of cortex (p=0,011 and p=0,017). Mean PIPP-R went from 3.0 during the heart auscultation to 8.1 during the hip examination (p=0.000). GSR analyses showed significant increase in area under small peaks during the hip examination (p=0.016), however not when measured in peaks per second (p=0.104). The interrater reliability for NIRS interpretations had an ICC-range of 0,93-1,0 (p<0,001). 

    Conclusion: We conclude that neonatal hip examinations are painful and that the pain should be treated, e.g. with oral sweet solution.

  • 21.
    Pettersson, Miriam
    et al.
    Örebro University, School of Medical Sciences.
    Olsson, Emma
    Örebro University, School of Health Sciences.
    Ohlin, Andreas
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Neurophysiological and behavioural measures of pain during neonatal hip examination2019Conference paper (Refereed)
    Abstract [en]

    Background: In Sweden, all newborns are examined before discharge from the maternity ward to rule out innate abnormalities. Parts of this procedure, such as the hip examination, appear to cause pain and discomfort. Pain in newborns can have both short- and long-term negative consequences and preventing and treating this pain is therefore an important part of medical care. There are several ways to recognize and assess pain in newborn infants. Scales such as the Premature Infant Pain Profile-Revised (PIPP-R) are recommended, but recently physiological and neurophysiological measures, e.g. Near-infrared spectroscopy (NIRS) and Galvanic Skin Response (GSR) have been suggested to have pain-assessing properties.

    The aim of the study was to test the hypothesis that neonatal hip examination causes pain in newborns. 

    Methods: The infant was placed on an examination table and a video camera was placed so the face of the newborn was filmed. A pulse oximeter probe, NIRS optodes and GSR electrodes were attached to the infant. Heart auscultation was chosen to be used as a non-painful comparative to hip examination. 

    Results: The results showed higher pain scoring for the hip examination than for the heart auscultation. NIRS, showed a significant difference in HbO2 on both sides of cortex (p=0,011 and p=0,017). Mean PIPP-R went from 3.0 during the heart auscultation to 8.1 during the hip examination (p=0.000). GSR analyses showed significant increase in area under small peaks during the hip examination (p=0.016), however not when measured in peaks per second (p=0.104). Interrater reliability was calculated for the NIRS interpretations, with an ICC-range of 0.93-1.0 (p=0.000).

    Conclusion: We conclude that neonatal hip examinations are painful and that the pain should be treated, e.g. with oral sweet solution. 

  • 22.
    Ullsten, Alexandra
    et al.
    Örebro University, School of Music, Theatre and Art. Värmland County Council, Karlstad, Sweden.
    Hugoson, Pernilla
    Department of Music, University of Jyväskylä, Jyväskylä, Finland.
    Forsberg, Malin
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, sweden.
    Forzelius, Lisa
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Klässbo, Maria
    Clinical Research Center, Värmland County Council, Karlstad, Sweden.
    Olsson, Emma
    Örebro University, School of Medical Sciences.
    Volgsten, Ulrik
    Örebro University, School of Music, Theatre and Art.
    Westrup, Björn
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Ådén, Ulrika
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Bergqvist, Lena
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Mats
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Efficacy of Live Lullaby Singing During Procedural Pain in Preterm and Term Neonates2017Conference paper (Refereed)
    Abstract [en]

    Background: Acute and repeated pain has long-term negative impact on infants’ development and future behaviour. The use of analgesic drugs has negative side-effects, which emphasizes the need for complementary approaches to pain management.

    Aim: This study is the first clinical trial measuring if live lullaby singing can influence behavioural and physiological pain responses during venepuncture in preterm and term neonates.

    Method: Preterm and term infants (n=38) were subjected to venepuncture with and without live lullaby singing, in a randomised order with a cross over design. Parent-preferred lullabies were performed live and standard care was provided for all neonates. Behavioural and physiological pain responses were assessed.

    Results: 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. There were non-significant indications of fewer and shorter skin punctures with lullaby singing.

    Conclusions: The additive effect of live lullaby singing has not been shown to alleviate infants’ behavioural pain responses during venepuncture; however nor has it been shown to be harmful. More research is needed to explore the potential benefits of music therapy including the role of the parents.

  • 23.
    Ullsten, Alexandra
    et al.
    Örebro University, School of Music, Theatre and Art. Centre for Clinical Research, Värmland County Council, Karlstad, Sweden.
    Hugosson, Pernilla
    Department of Music, University of Jyväskylä, Jyväskylä, Finland; Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden .
    Forsberg, Malin
    County Council of Dalarna, Mora Hospital, Mora, Sweden.
    Forzelius, Lisa
    County Council of Västernorrland, Sundsvall Hospital, Sundsvall, Sweden.
    Klässbo, Maria
    Centre for Clinical Research, Värmland County Council, Karlstad, Sweden.
    Olsson, Emma
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Volgsten, Ulrik
    Örebro University, School of Music, Theatre and Art.
    Westrup, Björn
    Department of Women’s and Children’s Health, Karolinska Institute, Karolinska University Hospital-Danderyd, Stockholm, Sweden.
    Ådén, Ulrika
    Neonatal Research Unit, Department of Women’s and Children’s Health, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
    Bergqvist, Lena
    Department of Clinical Science, Intervention and Technology, Unit of Pediatrics, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Efficacy of Live Lullaby Singing During Procedural Pain in Preterm and Term Neonates2017In: Music and Medicine, ISSN 1943-8621, Vol. 9, no 2, p. 73-85Article in journal (Refereed)
    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.

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