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| 2. |
- Anand, K J S, et al.
(författare)
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Effects of morphine analgesia in ventilated preterm neonates : primary outcomes from the NEOPAIN randomised trial
- 2004
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 363:9422, s. 1673-82
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Opioid analgesia is commonly used during neonatal intensive care. We undertook the Neurologic Outcomes and Pre-emptive Analgesia in Neonates (NEOPAIN) trial to investigate whether pre-emptive morphine analgesia decreases the rate of a composite primary outcome of neonatal death, severe intraventricular haemorrhage (IVH), and periventricular leucomalacia (PVL) in preterm neonates.METHODS: Ventilated preterm neonates (n=898) from 16 centres were randomly assigned masked placebo (n=449) or morphine (n=449) infusions. After a loading dose (100 microg/kg), morphine infusions (23-26 weeks of gestation 10 microg kg(-1) h(-1); 27-29 weeks 20 microg kg(-1) h(-1); 30-32 weeks 30 microg kg(-1) h(-1)) were continued as long as clinically justified (maximum 14 days). Open-label morphine could be given on clinical judgment (placebo group 242/443 [54.6%], morphine group 202/446 [45.3%]). Analyses were by intention to treat.FINDINGS: Baseline variables were similar in the randomised groups. The placebo and morphine groups had similar rates of the composite outcome (105/408 [26%] vs 115/419 [27%]), neonatal death (47/449 [11%] vs 58/449 [13%]), severe IVH (46/429 [11%] vs 55/411 [13%]), and PVL (34/367 [9%] vs 27/367 [7%]). For neonates who were not given open-label morphine, rates of the composite outcome (53/225 [24%] vs 27/179 [15%], p=0.0338) and severe IVH (19/219 [9%] vs 6/189 [3%], p=0.0209) were higher in the morphine group than the placebo group. Placebo-group neonates receiving open-label morphine had worse rates of the composite outcome than those not receiving open-label morphine (78/228 [34%] vs 27/179 [15%], p<0.0001). Morphine-group neonates receiving open-label morphine were more likely to develop severe IVH (36/190 [19%] vs 19/219 [9%], p=0.0024).INTERPRETATION: Pre-emptive morphine infusions did not reduce the frequency of severe IVH, PVL, or death in ventilated preterm neonates, but intermittent boluses of open-label morphine were associated with an increased rate of the composite outcome. The morphine doses used in this study decrease clinical signs of pain but can cause significant adverse effects in ventilated preterm neonates.
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- Andersen Dovland, Randi, et al.
(författare)
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PEARL : Pain in early life. A new network for research and education
- 2016
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Ingår i: Scandinavian Journal of Pain. - : Elsevier. - 1877-8879.
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Konferensbidrag (refereegranskat)abstract
- Aims: To establish a network for research and education and to provide expert knowledge to parents and health care professionals about pain in early life.Methods: In November 2014 a group of Nordic researchers and research students, committed to the field of pain in early life, gathered for an open lecture day and workshop in Örebro, Sweden. Inspired by the work of the Canadian initiative PICH – Pain In Child Health, the network formulated it’s vision: To be a stabile and competent research and training network within the area of pain in early life. A first collaborate project was designed: “Translation, cultural adaptation and validation of the revised version of the Premature Infant Pain Profile (PIPP-R): An effort to improve pain assessment in infants in the Nordic countries”.Results: Fourteen months later, in January 2016, the second PEARL-meeting was held, in Oslo, Norway. The lecture day provided clinically active nurses and physicians from several countries with the latest findings on how to best manage pain in neonatal settings. The network which now consist of 18 researchers from different professions and academic levels presents itself on a five-language website: www.pearl.direct. The PIPP-R project has progressed according to the plan. The PIPP-R is translated into Finnish, Icelandic, Norwegian and Swedish. The cultural adaptation and validation should be finished in fall 2016. The members work on and plan for further collaborate projects. The next two steps are to translate and distribute educational material for parents via Internet and social media, and to establish a research and masters course about pain in early life. The work has been secured by funding from Örebro University and and Örebro University Hospital Research Foundation.Conclusions: PEARL fulfils the need for a collaborative network for pain in early life researchers in the Nordic countries.
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- Anderzén-Carlsson, Agneta, et al.
(författare)
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Hud-mot-hudvård
- 2013. - 1
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Ingår i: Familjecentrerad neonatalvård. - Lund : Studentlitteratur AB. - 9789144074627 ; , s. 97-110
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Anderzén-Carlsson, Agneta, 1966-, et al.
(författare)
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Parental experiences of providing skin-to-skin care to their newborn infant : Part 2: A qualitative meta-synthesis
- 2014
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Järfälla, Sweden : Co-Action Publishing. - 1748-2623 .- 1748-2631. ; 9
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Forskningsöversikt (refereegranskat)abstract
- Aim: To synthesize and interpret qualitative research findings focusing on parental experiences of skin-to-skin care (SSC) for newborn infants.Background: SSC induces many benefits for newborn infants and their parents. Three meta-analyses have been conducted on physiological outcomes, but no previous qualitative meta-synthesis on parental experiences of SSC has been identified.Design: The present meta-synthesis was guided by the methodology described by Paterson and co-workers.Data sources: Four databases were searched, without year or language limitations, up until December 2013. Manual searches were also performed. The searches and subsequent quality appraisal resulted in the inclusion of 29 original qualitative papers from 9 countries, reporting experiences from 401 mothers and 94 fathers.Review methods: The meta-synthesis entails a meta-data analysis, analysis of meta-method, and meta-theory in the included primary studies. Based on the three analyses, the meta-synthesis represents a new interpretation of a phenomenon. The results of the meta-data analysis have been presented as a qualitative systematic review in a separate paper.Results: When synthesizing and interpreting the findings from the included analyses, a theoretical model of Becoming a parent under unfamiliar circumstances emerged. Providing SSC seems to be a restorative as well as an energy-draining experience. A supportive environment has been described as facilitating the restorative experience, whereas obstacles in the environment seem to make the provision of SSC energy-draining for parents. When the process is experienced as positive, it facilitates the growth of parental self-esteem and makes the parents ready to assume full responsibility for their child.Conclusion: The results show that SSC can be interpreted not only as a family-including and important health care intervention but also in terms of actually becoming a parent. The process of becoming a parent in this specific situation is influenced by external factors in three different levels; family and friends, community, and society at large. The descriptions of providing SSC are similar to what has previously been described as the natural process of becoming a mother or a father.
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| 7. |
- Anderzén-Carlsson, Agneta, 1966-, et al.
(författare)
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Parental experiences of providing skin-to-skin care to their newborn infant : Part 1: A qualitative systematic review
- 2014
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Järfälla, Sweden : Co-action Publishing. - 1748-2623 .- 1748-2631. ; 9
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Forskningsöversikt (refereegranskat)abstract
- Aim: To describe parental experiences of providing skin-to-skin care (SSC) to their newborn infants.Background: SSC care for newborn infants has been reported to have positive physiological and psychological benefits to the infants and their parents. No systematic review regarding parental experiences has been identified.Design: In this first part of a meta-study, the findings of a systematic literature review on parental experience of SSC care are presented.Data sources: Four databases were searched, without year or language limitations, up until December 2013. Manual searches were performed in reference lists and in a bibliography of the topic.Review methods: After a quality-appraisal process, data from the original articles were extracted and analysed using qualitative content analysis.Results: The systematic and manual searches led to the inclusion of 29 original qualitative papers from nine countries, reporting experiences from 401 mothers and 94 fathers. Two themes that characterized the provision of SSC emerged: a restoring experience and an energy-draining experience.Conclusion: This review has added scientific and systematic knowledge about parental experiences of providing SSC. Further research about fathers’ experiences is recommended.
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| 8. |
- Anderzen-Carlsson, Agneta, 1966-, et al.
(författare)
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The nursing contribution in facilitating health and well-being in parents and infants in neonatal skin-to-skin care
- 2013
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Konferensbidrag (refereegranskat)abstract
- Background: Qualitative research about parental experiences of skin-to-skin care (SSC) reveals that the provision of SSC is an important part of becoming a parent. It has, from the perspective of the parent been characterised as a restoring experience as well as an energy-draining activity.Aim: The aim of this presentation is to highlight some nursing contributions facilitating a successful SSC.Methods: From the results of a meta-study (1) including 24 qualitative papers from 7 countries, a number of energy-draining experiences were identified, related to factors that can be modified in order to achieve a more restoring and less energy-draining experience. Some of these factors will be discussed and nursing actions will be suggested in order to provide families with better support for SSC.Results: Nursing actions to support parents providing skin-to-skin care should focus on the following factors: - Surveiling a family friendly physical environment of the neonatal unit; provide space and privacy for families and reduce noise and “technology-stress” levels - Nurses should encourage and support parents to provide skin-to-skin care, without inflicting pressure or feelings of guilt. - Fathers need extra support to be confident in providing SSC. - The needs of the whole family, including siblings at home, should be taken into account.Conclusion: It is important for nurses to be aware that SSC can be experienced both as restorative and energy consuming and that nurses’ attitudes can influence the parental experience, and alongside with that the wellbeing of the infant. In order to apply a family centrered perspective nurses must evaluate interventions, such as SSC, from the perspective of the individual infant, as well as from the perspective of the family as a whole.
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| 9. |
- Andreasson, Matilda, et al.
(författare)
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State of the art in parent-delivered pain-relieving interventions in neonatal care
- 2021
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Konferensbidrag (refereegranskat)abstract
- Objectives: Parent’s active involvement during painful procedures is considered a critical first step in improving neonatal pain practices. Of the non-pharmacological approaches in use, the biopsychosocial perspective supports parent-delivered interventions, in which parents themselves mediate pain relief, consistent with modern family-integrated care. Methods: A scoping review was performed to achieve a broad understanding of the current level of evidence and uptake of parent-driven pain- and stress-relieving interventions in neonatal care. Specific objectives of the scoping review were to:1. Explore the breadth and extent of the literature, identify the types of available evidence, map and summarize the evidence, and inform future research on parent-delivered pain- and stress-relieving interventions in neonatal care. 2. Describe parents’ experiences of delivering pain and pain-related stress relief to their newborn infant. 3. Map and summarize recommendations as well as define knowledge gaps in national and international guidelines and in professional organizations or networks.
Results: There is strong evidence for the efficacy of skin-to-skin contact and breastfeeding,
preferably in combination. These parent-delivered interventions are safe, valid, and ready for
prompt introduction in infants’ pain care globally. Research into parents’ motivations for, and
experiences of, alleviating infant pain is scarce. More research on parent-delivered
pain alleviation, including relationship-based interventions such as the parent’s musical
presence, is needed to advance infant pain care. Guidelines need to be updated to include infant pain management, parent-delivered interventions, and the synergistic effects of
combining these interventions and to address parent involvement in low-income and low-tech
settings.
Conclusions: A knowledge-to-practice gap currently remains in parent-delivered pain
management for infants’ procedure-related pain. This scoping review highlights the many advantages of involving parents in pain management for the benefit not only of the infant and
parent, but also of health care.
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| 10. |
- Arenhall, Eva, 1974-, et al.
(författare)
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Decreased sexual function in partners after patients’ first-time myocardial infarction
- 2018
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 17:6, s. 521-526
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Tidskriftsartikel (refereegranskat)abstract
- Background: A myocardial infarction event affects not only patients but also partners, although how it affects the partners’ sexual function is not studied.Aim: The purpose of this study was to describe and compare how partners experienced their sexual function one year before with one year after first-time myocardial infarction of their partner.Methods: A longitudinal and comparative design was used. Self-reported data on Watts Sexual Function Questionnaire was collected retrospectively at two occasions from 123 partners (87 women and 36 men), measuring the year prior to the first-time myocardial infarction and the year after. Data were analysed using descriptive and inferential statistics.Results: The total score for Watts Sexual Function Questionnaire showed a significant decrease over time. In all four subscales a decrease was found, which were statistically significant in three out of the four subscales (sexual desire, 19.39 vs 18.61; p<0.001, orgasm, 14.11 vs 13.64; p=0.027 and satisfaction, 12.61 vs 12.31; p=0.042). Twenty-six partners reported that their intercourse frequencies decreased over time, while six partners reported an increased intercourse frequency.Conclusions: Partners’ sexual function decreased after patients’ first-time myocardial infarction. It is important for health personnel to offer information and discussion about sexual function and concerns with both patients and partners after a first-time myocardial infarction.
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