| 1. |
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| 2. |
- Andersen, Randi Dovland, et al.
(författare)
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Pain assessment practices in Swedish and Norwegian neonatal care units
- 2018
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Ingår i: Scandinavian Journal of Caring Sciences. - : Blackwell Publishing. - 0283-9318 .- 1471-6712. ; 32:3, s. 1074-1082
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The use of measurement scales to assess pain in neonates is considered a prerequisite for effective management of pain, but these scales are still underutilised in clinical practice.AIM: The aim of this study was to describe and compare pain assessment practices including the use of pain measurement scales in Norwegian and Swedish neonatal care units.METHODS: A unit survey investigating practices regarding pain assessment and the use of pain measurement scales was sent to all neonatal units in Sweden and Norway (n = 55). All Norwegian and 92% of Swedish units responded.RESULTS: A majority of the participating units (86.5%) assessed pain. Swedish units assessed and documented pain and used pain measurement scales more frequently than Norwegian units. The most frequently used scales were different versions of Astrid Lindgren's Pain Scale (ALPS) in Sweden and Echelle Douleur Inconfort Noveau-Ne (EDIN), ALPS and Premature Infant Pain Profile (PIPP) in Norway. Norwegian head nurses had more confidence in their pain assessment method and found the use of pain measurement scales more important than their Swedish colleagues.CONCLUSION: The persisting difference between Swedish and Norwegian units in pain assessment and the use of pain measurement scales are not easily explained. However, the reported increased availability and reported use of pain measurement scales in neonatal care units in both countries may be seen as a contribution towards better awareness and recognition of pain, better pain management and potentially less suffering for vulnerable neonates.
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| 3. |
- Axelin, Anna, et al.
(författare)
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Smärta
- 2013. - 1
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Ingår i: Familjecentrerad neonatalvård. - Lund : Studentlitteratur AB. - 9789144074627 ; , s. 111-124
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 4. |
- Baylis, Rebecca, et al.
(författare)
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First-time events between parents and preterm infants are affected by the designs and routines of neonatal intensive care units
- 2014
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 103:10, s. 1045-1052
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Early parental bonding with preterm babies is particularly important, and the aim of our study was to explore when parents experienced what they regarded as important events for the first time while their infant was in the neonatal intensive care unit (NICU).Methods: The study was part of a longitudinal project on Kangaroo Mother Care at two Swedish university hospitals. The parents of 81 infants completed questionnaires during their infants' hospital stay.Results: Most parents saw and touched their infants immediately after birth, but only a few could hold them skin to skin or swaddle them. Other important events identified by parents included the first time they performed care giving activities and did so independently, interaction and closeness with the infant, signs of the infant's recovery and integration into the family. The timing of the events depended on the physical design of the NICU, whether parents' could stay with their infant round-the-clock and when they were allowed to provide care under supervision and on their own.Conclusion: The design and routines of the NICU dictated when parents first interacted with their infants. Clinical guidelines that facilitate early contact with preterm babies can help parents to make the transition to their parental role.
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| 5. |
- Blomqvist, Ylva Thernström, 1974-, et al.
(författare)
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Initiation and extent of skin-to-skin care at two Swedish neonatal intensive care units
- 2013
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 102:1, s. 22-28
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Tidskriftsartikel (refereegranskat)abstract
- Aim To describe initiation and extent of parents application of skin-to-skin care (SSC) with their preterm infants at two Swedish neonatal intensive care units.Methods The duration of SSC was recorded in 104 infants medical charts during their hospital stay, and the parents answered a questionnaire.Results Both parents were involved in the practice of SSC. Three infants experienced SSC directly after birth, 34 within 1 h, 85 within 24 h and the remaining 19 at 2478 h postbirth. SSC commenced earlier (median age of 50 min) in infants whose first SSC was with their father instead of with their mother (median age of 649 min: p < 0.001). The earlier the SSC was initiated, the longer the infant was cared for skin-to-skin per day during his/her hospital stay (p < 0.001). The median daily duration of SSC was 403 min.Conclusion Early initiation of SSC had positive impact on the extent of parents application of SSC. Even though the infants in this study were cared for skin-to-skin to a high extent, there is a potential for extended use of SSC in this type of hospital setting for reducing separation between infants and parents.
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| 6. |
- Eriksson, Mats, 1959-, et al.
(författare)
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Oral glucose and venepuncture reduce blood sampling pain in newborns
- 1999
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Ingår i: Early Human Development. - 0378-3782 .- 1872-6232. ; 55:3, s. 211-218
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to measure pain symptoms in healthy fullterm newborns undergoing routine blood sampling with different methods. The 120 study subjects were randomly allocated to one of four groups with 30 babies in each, namely venepuncture or heel stick, with or without oral glucose administration. Pain was assessed from the duration of crying within the first 3 min, the Premature Infant Pain Profile (PIPP) and changes in heart rate. When the babies received 1 ml 30% glucose prior to skin puncture there was no significant difference between the heel stick and venepuncture group either in mean crying time (12.9 and 11.6 s, respectively) or in PIPP score (3.9 and 3.3). When no glucose was given crying time was 57.3 s in the heel stick group and 26.8 s in the venepuncture group (P=0.0041) and the mean PIPP scores were 8.4 and 6.0, respectively (P=0.0458). This study suggests that if oral glucose is given prior to skin puncture the choice of blood sampling method has no impact on the pain symptoms.
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| 7. |
- Eriksson, Mats, 1959-, et al.
(författare)
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Pain management in Swedish neonatal units : a national survey
- 2008
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 97:7, s. 870-874
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to investigate the degree to which Swedish neonatal units have adopted the national guidelines for prevention and treatment of pain in newborn infants. METHOD: A survey was sent to all units in Sweden that provide neonatal care. For a list of potentially painful procedures, compiled from the national neonatal pain guidelines, the units were asked if they would use pharmacological and/or behavioural interventions, and in each case to specify the treatment. RESULTS: The response rate was 80.4%. Eighty-eight percent of the units had written guidelines for pain management, and 59% of these had been updated within the last 2 years. For almost every presented case, all units reported that they used either pharmacological or behavioural treatment or both. The survey showed a wide variation in morphine and paracetamol dosing and the absence of a paracetamol loading dose in a fourth of the units. CONCLUSIONS: This study suggests that a majority of Swedish neonatal units have adopted pain management guidelines in concordance with the Swedish national guidelines, and kept them up-to-date. For most painful situations a variety of behavioural and pharmacological interventions are used, often in combination.
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| 8. |
- Eriksson, Mats, 1959-, et al.
(författare)
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Söta lösningar och specifikt neonatalt omhändertagande
- 2014
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Ingår i: Information från Läkemedelsverket. - Uppsala : Läkemedelsverket. - 1101-7104. ; 25:3, s. 45-47
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- Barn utsätts för ett antal smärtsamma procedurer i nyföddhetsperioden, som obehandlade kan medföra negativa konsekvenser på kort och lång sikt. Ofta är så kallad beteendestödjande behandling, oral tillförsel av söt lösning samt en optimering av vårdmiljön tillräcklig, men det ska vid behov kompletteras med farmakologisk behandling.De beteendestödjande åtgärder som har visat effekt vid procedursmärta är icke-nutritivt sugande, hud-mot-hudvård, stödjande sammanhållning samt amning/ matning. Med en optimerad vårdmiljö menas dels en dämpning av stressande sinnesintryck och dels att barnet ska vara mätt, torrt och varmt.En liten mängd söt lösning, i Sverige oftast 30 % glukos, som ges i munnen före det smärtsamma ingreppet, dämpar smärtreaktionen vid flertalet procedurer.Enheter som vårdar och behandlar nyfödda barn bör arbeta efter lokala smärtbehandlingsriktlinjer som baseras på de svenska eller internationella riktlinjerna
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| 9. |
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| 10. |
- Gradin, Maria
(författare)
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Effect of oral glucose on the heart rate of healthy newborns
- 2005
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 94:3, s. 324-328
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Increases in heart rate have been widely utilized as pain responses in different studies. In a previous study, we found an increase in heart rate in newborns when they received glucose as pain relief. Other research groups have shown a smaller increase in heart rate on administration of sweet solutions. We therefore investigated the question as to whether or not oral glucose itself can cause an increased heart rate in healthy infants.Method: This was a randomized, controlled, double-blind study comprising 70 healthy newborns. They were randomly allocated to receive 1 ml 30% glucose or 1 ml placebo solution (sterile water) orally without undergoing any painful procedure. The heart rate was recorded during and at different times after this administration.Results: The heart rate was significantly higher in the glucose than in the placebo group (p=0.020). The highest heart rate was noted during treatment, and the heart rate subsequently decreased in both groups (p = 0.002).Conclusion: Oral glucose causes an increase in heart rate in healthy newborns not undergoing any painful intervention.
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| 11. |
- Gradin, Maria, et al.
(författare)
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Feeding and oral glucose : additive effects on pain reduction in newborns
- 2004
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Ingår i: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 77:1-2, s. 57-65
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aims of this study were to compare the pain reducing effect of oral glucose with that of being breast-fed shortly before venipuncture in newborns, and also the pain score and crying time with parents' assessment.Design: Randomised, controlled trial.Subjects: 120 full term newborns undergoing venipuncture randomly assigned to on of four groups: I, Breast-fed and 1-ml placebo; II, Breast-fed and 1-ml 30% glucose; III, Fasting and 1-ml placebo; and IV, Fasting and 1-ml 30% glucose.Outcome measures: Pain during venipuncture was measured with the Premature Infant Pain Profile (PIPP). Crying time was recorded. The parents assessed their babies' pain on a Visual Analogue Scale (VAS).Results: The PIPP score was significantly lower in the infants receiving glucose, than in those not given glucose (p=0.004). There was no significant difference in PIPP score between the infants who were fed and the fasting infants. The PIPP score was lower in group II (median 7) than in group I (md 10). There was a similar difference between group IV (md 9) and group III (md 11). The median crying times during the first 3 min in groups I, II, III, and IV were 63, 18, 142 and 93 s, respectively. There was low agreement between the parents' assessment of pain and the PIPP score and crying time.Conclusion: Breast-feeding shortly before venipuncture has no major impact on the pain score but on crying time. The combination of oral glucose and breast-feeding shows the lowest pain score and significantly shorter duration of crying.
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| 12. |
- Gradin, Maria
(författare)
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Need for a reliable pain evaluation scale in the newborn in Sweden
- 2000
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 44:5, s. 552-554
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Tidskriftsartikel (refereegranskat)abstract
- Background: A major problem in pain treatment in the newborn is the ability to assess the degree of experienced pain. Several different methods for estimating pain in the newborn have been introduced in recent years. The objectives of this study were to see whether pain scoring was used in Swedish neonatal units, and by which method, and furthermore to observe whether any changes had occurred between 1993 and 1998.Method: A questionnaire was distributed to all Swedish neonatal units in 1993 and 1998.Results: In both 1993 and 1998, 86% of all clinics answered the questionnaire. Two-thirds of these clinics used some method for estimating pain in the newborn at both times. Eight clinics used a structured method in the latter period compared to one in the earlier period. A higher proportion of units having full intensive care measured pain compared to other units.Conclusion: The study shows that an unchanging low proportion of neonatal units in Sweden attempt to assess pain. There is a minor increase in the number of departments that use a structured method for pain scoring. Documentation of pain intensity is still inadequate and should be improved.
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| 13. |
- Gradin, Maria, et al.
(författare)
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Neonatal pain assessment in Sweden : a fifteen-year follow up
- 2011
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Ingår i: Acta Paediatrica. - Malden, USA : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 100:2, s. 204-208
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Tidskriftsartikel (refereegranskat)abstract
- Background: It has been proposed that a systematic pain assessment increases the awareness of the need to treat and prevent pain, and most international and national neonatal pain guidelines state that pain assessment should be performed in a systematic way. National surveys show a wide variation in compliance to these guidelines.Methods: A survey to all Swedish neonatal units was performed in 1993, 1998, 2003 and 2008, concerning the use of, and need for, pain assessment tools.Results: The number of units that tried to assess pain increased from 64% in 1993 to 83% in 2008. Forty-four per cent of these used a structured method in 2003, compared to three per cent in 1998. The most common pain indicator was facial actions.Conclusion: The proportion of neonatal units that reported the use of a structured pain assessment tool has increased significantly from 1993 to 2008. There is a need for better evidence for the relation between the implementation of pain guidelines and the actual performance of pain assessment.
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| 14. |
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| 15. |
- Gradin, Maria, 1963-, et al.
(författare)
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Pain reduction at venipuncture in newborns : oral glucose compared with local anesthetic cream
- 2002
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 110:6, s. 1053-1057
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Tidskriftsartikel (refereegranskat)abstract
- Objective. A number of studies have shown that orally administered sweet-tasting solutions reduce signs of pain during painful procedures. The local anesthetic cream EMLA has recently been shown to be safe for use in neonates. This study compared the pain-reducing effect of orally administered glucose with that of EMLA cream during venipuncture in newborns.Methods. Randomized, controlled, double-blind study including 201 newborns undergoing venipuncture for clinical purposes. Ninety-nine of the newborns received EMLA on the skin and orally administered placebo (sterile water), and 102 received glucose 30% orally and placebo (Unguentum Merck) on the skin. Symptoms associated with pain at venipuncture were measured with the Premature Infant Pain Profile (PIPP) scale (also validated for full-term infants). Heart rate and crying time were recorded.Results. There were no differences in background variables between the 2 groups.The results shows that the PIPP scores were significantly lower in the glucose group (mean: 4.6) compared with the EMLA group (mean: 5.7). The duration of crying in the first 3 minutes was significantly lower in the glucose group (median: 1 second) than in the EMLA group (median: 18 seconds). There were significantly fewer patients in the glucose group who were scored having pain (defined as PIPP score above 6); 19.3% compared with 41.7% in the EMLA group. The changes in heart rate were similar in both groups.Conclusions. We found that glucose is effective in reducing symptoms associated with pain from venipuncture in newborns and seems to be better than the local anesthetic cream EMLA.
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| 16. |
- Gradin, Maria, 1963-
(författare)
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Procedural pain reducing methods and pain assessment in newborns
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Our knowledge of pain in neonates has increased significantly during the last fifteen years.We now have an improved understanding of the pain system and of the negative effects of untreated pain. Advances in neonatal care have increased the nwnber of preterm and severely ill infants who are treated in neonatal intensive care units (NICU). These infants are subjected to a variety of painful procedures as part of their management. Sufficient pain relief is needed and for this, valid pain assessment is one prerequisite.The aim of this research was to improve the management of procedural pain and to examine the assessment of neonatal pain in clinical practice.In an earlier study, oral glucose was found to reduce pain during blood sampling. To further evaluate the pain-reducing effect of oral glucose and to compare this effect with different blood sampling techniques, a trial was performed. The pain score was lower and crying time shorter in the venipuncture group than in the heel stick group when no glucose was given. When glucose was administered, the pain score was lower in both glucose groups than in the groups not receiving glucose (paper I).In a randomized, controlled study, the effect of oral glucose was compared with that of a topical local anaesthetic, EMLA, during venipuncture. The pain scores were found to be lower in the glucose group and fewer infants were scored as having pain. Crying time was also shorter in the glucose group (paper II).To compare the pain-reducing effect of oral glucose with that of breast-feeding shortly before venipuncture, a new trial was performed. The pain score was significantly lower in the infants receiving glucose than in those not given glucose. There was no significant difference in pain score between the infants who were fed and the fasting infants (paper III).In a previous study we found an increase in heart rate in newboms when they received glucose as pain relief. We therefore investigated whether oral glucose in itself could cause an increase in heart rate in healthy infants. In a trial, infants were randomized to receive oral glucose or placebo without undergoing any painful procedure. The heart rate was significantly higher in the glucose than in the placebo group (paper IV).Activation of endogenous opioids is suggested as one possible mechanism underlying the pain-reducing effect of oral glucose. We therefore investigated whether administration of an opioid antagonist would reduce the effect of oral glucose at heel stick in full-term newboms. There were no significant differences in pain score or crying between the group receiving an opioid antagonist before oral glucose and the group receiving placebo before oral glucose during heel stick (paper V).To document whether pain is assessed in Swedish neonatal units and by what methods, a questionnaire was distributed to all neonatal wards in Sweden in 1993, and again in 1998. Only a small proportion of neonatal units in Sweden attempted to assess pain. There was a minor increase in the nwnber of wards that used a structured method for pain scoring. Docwnentation of pain is still inadequate and needs to be improved (paper VI). We compared parental assessment during blood sampling with measurement of the pain score with a multidimensional tool and crying. There was low agreement between these variables during the procedure (paper III).In conclusion, we found that oral glucose reduces signs of pain from both heel stick and venipuncture blood sampling. Oral glucose reduces pain better than does EMLA cream and better than if the infant is breast-fed shortly before the procedure. Oral glucose increases the heart rate in infants and the pain-reducing effect of oral glucose in newboms was not diminished by injection of an opioid antagonist. Parental assessment of an infant's pain cannot replace measurement by pain scores. The pain assessment at neonatal units in Sweden needs to be improved.
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| 17. |
- Gradin, Maria, et al.
(författare)
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The role of endogenous opioids in mediating pain reduction by orally administered glucose among newborns
- 2005
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 115:4, s. 1004-1007
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Tidskriftsartikel (refereegranskat)abstract
- Objective. It has been demonstrated clearly that sweet-tasting solutions given before a painful intervention can reduce pain among newborns. There is no fully accepted explanation for this effect, but activation of endogenous opioids has been suggested as a possible mechanism. The aim of this study was to obtain deeper knowledge of the underlying mechanism by investigating whether administration of an opioid antagonist would reduce the effect of orally administered glucose at heel stick among term newborns.Design. A randomized, placebo-controlled, double-blind trial with a validated, neonatal, pain-rating scale.Participants. The trial included 30 term newborns undergoing heel stick, who were assigned randomly to 1 of 2 groups, ie, group I, with naloxone hydrochloride (opioid antagonist) 0.01 mg/kg administered intravenously before oral administration of 1 mL of 30% glucose, or group II, with a corresponding amount of placebo (saline solution) administered intravenously before oral administration of glucose.Outcome Measures. Pain-related behavior during blood sampling was measured with the Premature Infants Pain Profile. Crying time and heart rate were also recorded.Results. The 2 groups did not differ significantly in Premature Infant Pain Profile scores during heel stick. The median crying time during the first 3 minutes was 14 seconds (range: 0–174 seconds) for the naloxone group and 105 seconds (range: 0–175 seconds) for the placebo group. There was no significant difference in heart rate between the 2 groups.Conclusion. Administration of an opioid antagonist did not decrease the analgesic effect of orally administered glucose given before blood sampling.
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| 18. |
- Hellström, Lisbeth Maria, 1969-, et al.
(författare)
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A Study of Fracture processes in Wood Chipping
- 2008
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Ingår i: 6th Fundamental Mechanical Pulp Research Seminar. - Espoo : KCL Oy Keskuslaboratorio - Centrallaboratorium AB.
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Konferensbidrag (refereegranskat)
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| 19. |
- Johansson, Henrik, et al.
(författare)
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Evaluation of the GARD assay in a blind cosmetics Europe study
- 2017
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Ingår i: ALTEX Alternatives To Animal Experimentation. - : ALTEX Edition. - 1868-596X. ; 34:4, s. 515-523
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Tidskriftsartikel (refereegranskat)abstract
- Chemical hypersensitivity is an immunological response towards foreign substances, commonly referred to as sensitizers, which gives rise primarily to the clinical symptoms known as allergic contact dermatitis. For the purpose of mitigating risks associated with consumer products, chemicals are screened for sensitizing effects. Historically, such predictive screenings have been performed using animal models. However, due to industrial and regulatory demand, animal models for the purpose of sensitization assessment are being replaced by non-animal testing methods, a global trend that is spreading across industries and market segments. To meet this demand, the Genomic Allergen Rapid Detection (GARD) assay was developed. GARD is a novel, cell-based assay that utilizes the innate recognition of xenobiotic substances by dendritic cells, as measured by a multivariate readout of genomic biomarkers. Following cellular stimulation, chemicals are classified as sensitizers or non-sensitizers based on induced transcriptional profiles. Recently, a number of non-animal methods were comparatively evaluated by Cosmetics Europe, using a coherent and blinded test panel of reference chemicals with human and local lymph node assay data, comprising a wide range of sensitizers and non-sensitizers. The outcome of the GARD assay is presented in this paper. It was demonstrated that GARD is a highly functional assay with a predictive performance of 83% in this Cosmetics Europe dataset. The average accumulated predictive accuracy of GARD across independent datasets was 86% for skin sensitization hazard.
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| 20. |
- Nygård, Per, et al.
(författare)
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Damage Mechanisms in Paper
- 2006
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Ingår i: 2006 Progress in Paper Physics.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 21. |
- Olsson, Emma, 1980-, et al.
(författare)
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Skin-to-skin contact for pain relief : a bibliometric analysis
- 2013
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Konferensbidrag (refereegranskat)abstract
- 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.References1. 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.pdfThe authors have no conflict of interest to declare.
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| 22. |
- Oras, Paola, 1980-, et al.
(författare)
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Breastfeeding Patterns in Preterm Infants Born at 28-33 Gestational Weeks
- 2015
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Ingår i: Journal of Human Lactation. - : SAGE Publications. - 0890-3344 .- 1552-5732. ; 31:3, s. 377-385
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies of breastfeeding patterns during preterm infants' first year of life are scarce but are important for providing breastfeeding mothers of preterm infants with optimal support.Objective: This study aimed to describe breastfeeding patterns in preterm infants up to 1 year of corrected age.Methods: As part of a larger study on kangaroo mother care in Sweden, a 24-hour breastfeeding diary was sent home after discharge from hospital, and at 2, 6, and 12 months of the infant's corrected age. Eighty-three mothers responded to the follow-up questionnaires, and the number of respondents to the breastfeeding diary was 48 at discharge, 43 at 2 months, 22 at 6 months, and 8 at 12 months. Infants were born at a median (range) gestational age of 32 (28-33) weeks. Breastfeeding patterns were analyzed according to durations, frequencies per 24 hours, and intervals between sessions.Results: In exclusively breastfed infants, the median (range) breastfeeding session frequency was 14 (8-26) times per 24 hours including 4 (1-9) times per night after discharge (n = 24) and 10 (6-25) times per 24 hours including 2 (0-5) times per night at 2 months (n = 23). In partially breastfed infants, the median (range) frequency was 5 (1-14) times per 24 hours including 2 (0-4) times per night at 6 months (n = 20) and 5.5 (1-12) times per 24 hours including 2 (0-3) times per night at 12 months (n = 8).Conclusion: Mothers reported large variations in breastfeeding patterns, with higher median breastfeeding session frequencies than previously described in term infants in affluent settings.
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| 23. |
- Oras, Paola, 1980-, et al.
(författare)
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Skin-to-skin contact is associated with earlier breastfeeding attainment in preterm infants
- 2016
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Ingår i: Acta Paediatrica. - Hoboken, USA : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 105:7, s. 783-789
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study investigated the effects of skin-to-skin contact on breastfeeding attainment, duration and infant growth in preterm infants, as this has not been sufficiently explored.Methods: A prospective longitudinal study on Kangaroo mother care was carried out, comprising 104 infants with a gestational age of 28+0 to 33+6 and followed up to one year of corrected age. Parents and staff recorded the duration of skin-to skin contact during the stay in the neonatal intensive care unit (NICU). Medical data were collected through patient records and follow-up questionnaires were filled in by parents.Results: The 53 infants who attained full breastfeeding in the NICU did so at a median (range) of 35+0 (32+1 to 37+5) weeks of postmenstrual age and skin-to-skin contact was the only factor that influenced earlier attainment in the regression analysis (R(2) 0.215 p<0.001). The daily duration of skin-to-skin contact during the stay in the NICU did not affect the duration of breastfeeding or infant growth after discharge. Furthermore, infant growth was not affected by the feeding strategy of exclusive, partial breastfeeding or no breastfeeding.Conclusion: A longer daily duration of skin-to-skin contact in the NICU was associated with earlier attainment of exclusive breastfeeding.
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| 24. |
- Scherman, Elna, et al.
(författare)
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Procedural pain in neonates : Do nurses follow national guidelines? A survey to Swedish neonatal units
- 2014
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Ingår i: Journal of Neonatal Nursing. - : Elsevier. - 1355-1841 .- 1878-089X. ; 10:1, s. 31-36
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: to investigate if nurses at neonatal units in Sweden have adopted national guidelines when neonates are exposed to intravenous catheter, capillary heel prick, venepuncture and injections, to identify the frequency of documentation of pharmacological and behavioural treatments and to compare the answers from the nurses with results from an earlier national survey completed by the chief neonatologists at the same units.Design and sample: Four nurses at a total of 44 neonatal units in Sweden, received questionnaires. A total number of 116 surveys were analysed (response rate 66 %).Main outcome and results: All units had written guidelines for prevention and treatment of pain. Behavioural treatments were used in every painful procedure in the study, but only1/5 used EMLA® often or always. There was a higher tendency to document the use of drugs than behavioural treatments. The chief neonatologist reported higher use of glucose than did nurses.Conclusions: Swedish national guidelines are not used consistently in some neonatal units. There is a considerably larger cohort of nurses who use behavioral treatments, rather than using drugs when painful procedures are performed. It was also evident that it was more common to document the use of drugs than behavioral treatments.
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- Strand, H., et al.
(författare)
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Kangaroo mother care in the neonatal intensive care unit : staff attitudes and beliefs and opportunities for parents
- 2014
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 103:4, s. 373-378
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To compare attitudes towards Kangaroo mother care (KMC) among staff in two high-tech neonatal intensive care units, which provided parents with different opportunities to get involved in their infants' care.Method: Questionnaires were completed by healthcare staff in Unit A, which provided parents with unrestricted access so that they could provide continuous KMC, and Unit B, where parents could only practice KMC intermittently.Results: Unit A staff were more positive about the benefits and use of KMC, including its use in unstable infants, and rated their knowledge and practical skills more highly than staff in the other unit. Unit B staff also appreciated the method, but expressed more hesitation in using it with unstable infants. In particular, they stressed the need to adapt the physical environment of the NICU to enable parents to stay with their infants and practice the method.Conclusion: Staff working in the NICU that gave parents unrestricted access were more positive about KMC than staff in the NICU that offered limited opportunities for parents to stay with their children. This finding suggests that it is important to eliminate unjustifiable obstacles to the presence of parents in the NICU, so that they can provide KMC.
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