| 1. |
- Alm, Fredrik, 1983-, et al.
(författare)
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Establishment of resilience in a challenging recovery at home after pediatric tonsil surgery : Children’s and caregivers’ perspectives
- 2021
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Ingår i: Paediatric and Neonatal Pain. - : John Wiley & Sons. - 2379-5824 .- 2637-3807. ; 3:2, s. 75-86
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to explore children's and caregivers' experiences and management of postoperative recovery at home after tonsil surgery. The study had an explorative qualitative design with an inductive approach. Twenty children (5-12 years of age) undergoing tonsillectomy or tonsillotomy with or without adenoidectomy participated along with their caregivers in semi-structured interviews at a mean time of 28 days after surgery. The interviews were analyzed with content analysis. One main category emerged from the interviews: children and caregivers struggle to establish resilience in a challenging recovery. The families' resilience relied on their situational awareness and capacity to act, which in turn formed a basis for the ability to return to normal daily life. Children and caregivers described the recovery as an evident interruption of daily life which had an impact on the children's physical and psychological well-being. Both children and caregivers described the pain as a central concern. The families used different pharmacological and complementary strategies to manage the pain, which in some cases were complex. Some families said that the analgesics were insufficient in preventing breakthrough pain, and spoke about a lack of support as well as inadequate and contradictory information from healthcare staff. Caregivers also expressed uncertainty, ambivalence, or anxiety about the responsibility associated with their child's recovery. To optimize and support the recovery after tonsil surgery, it is crucial to obtain knowledge of children's and caregivers' perspectives of postoperative recovery at home. The results indicate that the postoperative period included several troublesome experiences for which neither the children nor the caregivers were informed or prepared. The experience of pain was significant, and often complex to manage. To increase families' resilience, the information provided by healthcare professionals needs to be broadened. Multidisciplinary teamwork is necessary to achieve this goal.
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| 2. |
- Andersen, Randi Dovland, et al.
(författare)
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Pain burden in children with cerebral palsy (CPPain) survey : Study protocol
- 2022
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Ingår i: Paediatric and Neonatal Pain. - : John Wiley & Sons. - 2379-5824 .- 2637-3807. ; 4:1, s. 11-21
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Tidskriftsartikel (refereegranskat)abstract
- Pain is a significant health concern for children living with cerebral palsy (CP). There are no population-level or large-scale multi-national datasets using common measures characterizing pain experience and interference (ie, pain burden) and management practices for children with CP. The aim of the CPPain survey is to generate a comprehensive understanding of pain burden and current management of pain to change clinical practice in CP. The CPPain survey is a comprehensive cross-sectional study. Researchers plan to recruit approximately 1400 children with CP (primary participants) across several countries over 6-12 months using multimodal recruitment strategies. Data will be collected from parents or guardians of children with CP (0-17 years) and from children with CP (8-17 years) who are able to self-report. Siblings (12-17 years) will be invited to participate as controls. The CPPain survey consists of previously validated and study-specific questionnaires addressing demographic and diagnostic information, pain experience, pain management, pain interference, pain coping, activity and participation in everyday life, nutritional status, mental health, health-related quality of life, and the effect of the COVID-19 pandemic on pain and access to pain care. The survey will be distributed primarily online. Data will be analyzed using appropriate statistical methods for comparing groups. Stratification will be used to investigate subgroups, and analyses will be adjusted for appropriate sociodemographic variables. The Norwegian Regional Committee for Medical and Health Research Ethics and the Research Ethics Board at the University of Minnesota in USA have approved the study. Ethics approval in Canada, Sweden, and Finland is pending. In addition to dissemination through peer-reviewed journals and conferences, findings will be communicated through the CPPain Web site (www.sthf.no/cppain), Web sites directed toward users or clinicians, social media, special interest groups, stakeholder engagement activities, articles in user organization journals, and presentations in public media.
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| 3. |
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| 4. |
- Carlsen Misic, Martina, 1986-, et al.
(författare)
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Nurses' perception, knowledge, and use of neonatal pain assessment
- 2021
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Ingår i: Paediatric and Neonatal Pain. - : John Wiley & Sons. - 2379-5824 .- 2637-3807. ; 3:2, s. 68-74
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Tidskriftsartikel (refereegranskat)abstract
- Preterm and sick newborn infants undergo several painful procedures during their hospital stay, potentially leading to short‐ and long‐term negative consequences. Pain assessment should be performed regularly to provide optimal pain management. Nurses' knowledge of and attitude toward neonatal pain assessment affect how pain is assessed and managed in the clinical situation. The aim of this study was to explore Swedish nurses' perception, knowledge, and use of neonatal pain assessment. This descriptive, cross‐sectional questionnaire study was conducted across all Swedish neonatal units (n = 38). Respondents were chosen through convenience sampling by the head nurses at each unit. Ten nurses from each unit were asked to complete the survey, which contained both closed and open questions. A majority of the units (30/38; 79%) participated and 232 surveys were returned, a response rate of 61%. Of the nurses, 91% thought that neonatal pain assessment was important. Many nurses mentioned various difficulties with pain assessment and concerns that the scales used might not assess pain correctly. About half of the nurses considered themselves to have enough knowledge of neonatal pain assessment. Those who reported having enough knowledge of pain assessment viewed the pain scales used at their units more positively. Of the nurses, 74% reported using a pain assessment scale several times per work shift. Pain management guidelines were available according to 75% of nurses, but only 53% reported that the guidelines were followed. Although nurses in general expressed a positive attitude toward pain assessment scales, this was not necessarily evident in their clinical practice. Lack of knowledge, available or accessible guidelines, or concerns regarding the validity of available pain scales seemed to limit their use.
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| 5. |
- Castor, C, et al.
(författare)
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Psychometric evaluation of the electronic faces thermometer scale for pain assessment in children 8–17 years old : A study protocol
- 2023
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Ingår i: Paediatric and Neonatal Pain. - : John Wiley & Sons. - 2637-3807 .- 2379-5824. ; 5:4, s. 99-109
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Tidskriftsartikel (refereegranskat)abstract
- It is often a challenge for a child to communicate their pain, and their possibilities to do so should be strengthened in healthcare settings. Digital self-assessment provides a potential solution for person-centered care in pain management and promotes child participation when a child is ill. A child's perception of pain assessment differs when it is assessed using digital or analog formats. As we move into the digital era, there is an urgent need to validate digital pain assessment tools, including the newly developed electronic Faces Thermometer Scale (eFTS). This study protocol describes three studies with the overall aim to evaluate psychometric properties of the eFTS for assessing pain in children 8?17?years of age. A multi-site project design combining quantitative and qualitative methods will be used for three observational studies. Study 1: 100 Swedish-speaking children will report the level of anticipated pain from vignettes describing painful situations in four levels of pain and a think-aloud method will be used for data collection. Data will be analyzed with phenomenography as well as descriptive and comparative statistics. Study 2: 600 children aged 8?17?years at pediatric and dental settings in Sweden, Denmark, Iceland, and USA will be included. Children will assess their pain intensity due to medical or dental procedures, surgery, or acute pain using three different pain Scales for each time point; the eFTS, the Faces Pain Scale Revised, and the Coloured Analogue Scale. Descriptive and comparative statistics will be used, with subanalysis taking cultural context into consideration. Study 3: A subgroup of 20 children out of these 600 children will be purposely included in an interview to describe experiences of grading their own pain using the eFTS. Qualitative data will be analyzed with content analysis. Our pilot studies showed high level of adherence to the study procedure and rendered only a small revision of background questionnaires. Preliminary analysis indicated that the instruments are adequate to be used by children and that the analysis plan is feasible. A digital pain assessment tool contributes to an increase in pain assessment in pediatric care. The Medical Research Council framework for complex interventions in healthcare supports a thorough development of a new scale. By evaluating psychometric properties in several settings by both qualitative and quantitative methods, the eFTS will become a well-validated tool to strengthen the child's voice within healthcare.
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| 6. |
- Castor, C, et al.
(författare)
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Psychometric evaluation of the electronic faces thermometer scale for pain assessment in children 8–17years old: A study protocol
- 2023
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Ingår i: Paediatric and Neonatal Pain. - : Wiley. - 2379-5824 .- 2637-3807. ; 5:4, s. 99-109
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Tidskriftsartikel (refereegranskat)abstract
- It is often a challenge for a child to communicate their pain, and their possibilities to do so should be strengthened in healthcare settings. Digital self-assessment provides a potential solution for person-centered care in pain management and promotes child participation when a child is ill. A child's perception of pain assessment differs when it is assessed using digital or analog formats. As we move into the digital era, there is an urgent need to validate digital pain assessment tools, including the newly developed electronic Faces Thermometer Scale (eFTS). This study protocol describes three studies with the overall aim to evaluate psychometric properties of the eFTS for assessing pain in children 8–17years of age. A multi-site project design combining quantitative and qualitative methods will be used for three observational studies. Study 1: 100 Swedish-speaking children will report the level of anticipated pain from vignettes describing painful situations in four levels of pain and a think-aloud method will be used for data collection. Data will be analyzed with phenomenography as well as descriptive and comparative statistics. Study 2: 600 children aged 8–17years at pediatric and dental settings in Sweden, Denmark, Iceland, and USA will be included. Children will assess their pain intensity due to medical or dental procedures, surgery, or acute pain using three different pain Scales for each time point; the eFTS, the Faces Pain Scale Revised, and the Coloured Analogue Scale. Descriptive and comparative statistics will be used, with subanalysis taking cultural context into consideration. Study 3: A subgroup of 20 children out of these 600 children will be purposely included in an interview to describe experiences of grading their own pain using the eFTS. Qualitative data will be analyzed with content analysis. Our pilot studies showed high level of adherence to the study procedure and rendered only a small revision of background questionnaires. Preliminary analysis indicated that the instruments are adequate to be used by children and that the analysis plan is feasible. A digital pain assessment tool contributes to an increase in pain assessment in pediatric care. The Medical Research Council framework for complex interventions in healthcare supports a thorough development of a new scale. By evaluating psychometric properties in several settings by both qualitative and quantitative methods, the eFTS will become a well-validated tool to strengthen the child's voice within healthcare.
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| 7. |
- Pettersson, Miriam, 1977-, et al.
(författare)
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Neurophysiological and behavioral measures of pain during neonatal hip examination
- 2019
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Ingår i: Paediatric and Neonatal Pain. - : John Wiley & Sons. - 2379-5824 .- 2637-3807. ; 1:1, s. 15-20
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 8. |
- Wallbing, U, et al.
(författare)
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Adolescents' experiences of Help Overcoming Pain Early : A school based person-centred intervention for adolescents with chronic pain
- 2023
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Ingår i: Paediatric & Neonatal Pain. - 2637-3807 .- 2379-5824. ; 5:4, s. 119-126
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Tidskriftsartikel (refereegranskat)abstract
- To illuminate adolescents' experiences of Help Overcoming Pain Early (HOPE), a person-centred intervention delivered in a school setting by school nurses. Twenty-one adolescents with chronic pain recruited from secondary school, who had completed the HOPE intervention, were included in the interview study. The HOPE intervention was built on person-centred ethics and consisted of four meetings between school nurses and adolescents on the subject of stress and pain management. A qualitative method using content analysis with an inductive approach was employed. In the interviews, the adolescents describe how they reclaim their lives with the help of HOPE. They use different strategies and parts of the intervention to move on with their lives. A trustful relationship, as that with the school nurse, was essential to dare to change. The overarching theme summarizes in Becoming myself again and is built up by three sub-themes: Trust a pillar for growth, Making sense of my life with pain, and Putting myself into the world again. A person-centred intervention such as HOPE applied in a school context is promising for promoting confidence in adolescents with chronic pain. A trust-building process emerged, in terms of both the adolescents' trust in the healthcare staff they meet and their confidence in their own ability to handle and influence their situation, which in the long term can promote trust in themselves as a person.
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| 9. |
- Wallbing, Ulrika, 1964, et al.
(författare)
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Adolescents' experiences of Help Overcoming Pain Early—A school based person-centred intervention for adolescents with chronic pain
- 2023
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Ingår i: Paediatric and Neonatal Pain. - 2379-5824 .- 2637-3807. ; 5:4, s. 119-126
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Tidskriftsartikel (refereegranskat)abstract
- To illuminate adolescents' experiences of Help Overcoming Pain Early (HOPE), a person-centred intervention delivered in a school setting by school nurses. Twenty-one adolescents with chronic pain recruited from secondary school, who had completed the HOPE intervention, were included in the interview study. The HOPE intervention was built on person-centred ethics and consisted of four meetings between school nurses and adolescents on the subject of stress and pain management. A qualitative method using content analysis with an inductive approach was employed. In the interviews, the adolescents describe how they reclaim their lives with the help of HOPE. They use different strategies and parts of the intervention to move on with their lives. A trustful relationship, as that with the school nurse, was essential to dare to change. The overarching theme summarizes in Becoming myself again and is built up by three sub-themes: Trust a pillar for growth, Making sense of my life with pain, and Putting myself into the world again. A person-centred intervention such as HOPE applied in a school context is promising for promoting confidence in adolescents with chronic pain. A trust-building process emerged, in terms of both the adolescents' trust in the healthcare staff they meet and their confidence in their own ability to handle and influence their situation, which in the long term can promote trust in themselves as a person.
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| 10. |
- Broman, Johanna, et al.
(författare)
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A descriptive study on the treatment of pediatric CRPS in the Nordic countries and Germany
- 2021
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Ingår i: Paediatric & Neonatal Pain. - : Wiley. - 2637-3807. ; 3:4, s. 163-169
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Tidskriftsartikel (refereegranskat)abstract
- Pediatric complex regional pain syndrome (pCRPS) is a rare, painful state that often occurs as a complication following physical trauma. Diagnosis and treatment require specialist expertise in a multidisciplinary setting. Treatment is focused on pain reduction and improvement in function, which differs from the treatment of adult CRPS. We performed a cross-sectional survey with the aim of identifying pain centers in the Nordic countries and Germany that specialized in treating children with pain, especially pCRPS, and sought to describe their treatment strategies. Centers and health-care professionals working with children experiencing chronic pain were identified using internet search engines, phones, or e-mail. A standardized set of questions and an electronic questionnaire were answered by the participants. A total of 28 participants were identified in 24 centers, which were involved with patients having pCRPS (Germany: 7, Norway: 7, Sweden: 5, Finland: 5, Denmark: 3, and Island: 1). One center in Germany treated more than 20 patients per year. Half of the identified centers (n = 12) treated between 1 and 5 children with pCRPS per year. Guidelines for treating pCRPS were reportedly followed by 9/28 responders (32%), and physiotherapy was reported to be part of the treatment routine in most centers (74%). Interventional anesthesia was rarely used. Psychological therapy: 57% answered that it was always offered, 30% replied that it was proffered in most cases, and 13% responded that it was recommended in only a few patients. Pharmacological treatments were not commonly used. Treatment resources for pCRPS are scarce in the Nordic countries and Germany. Most centers treated very few children with pCRPS and did not have established guidelines. A multidisciplinary approach was used by many centers, most often combining physiotherapy and psychotherapy, and less commonly pharmacological treatment. The difficulties in diagnosing pCRPS and finding official referral units are unfortunate, considering the potentially favorable outcome with adequate treatment.
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| 11. |
- Forsner, Maria, 1954-, et al.
(författare)
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It hurts to get forced : Children's narratives about restraint during medical procedures
- 2023
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Ingår i: Paediatric and Neonatal Pain. - : John Wiley & Sons. - 2637-3807. ; 5:4, s. 110-118
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Tidskriftsartikel (refereegranskat)abstract
- According to the UN Convention on the Rights of the Child (UNCRC), children have the right to be involved in decisions about medical procedures affecting them. However, research has shown that healthcare professionals sometimes find this difficult to achieve and those procedures then are performed against the will of the child. The aim was to illuminate restraint from the perspective of children’s and young people’s experiences of feeling forced during medical procedures. Following the phenomenological hermeneutic method, a secondary qualitative analysis of narrative data from four datasets collected between 2001 and 2020 was performed. Twelve children and young people aged 6-19 years (three male, nine female) from central and northern Sweden narrated their experiences of restraint related to medical procedures in nine narrative interviews and three short written narratives. The analysis revealed that it hurts to get forced, this being illustrated in six themes: bodily misery, emotional rebellion, feeling disregarded, physically limited, desiring escape, and leaving deep traces. From the perspective of children and young people, restraint was interpreted with inspiration from the philosopher Michel Foucault, as being overpowered - not voluntary submission but offering resistance - and according to the theory of caring and uncaring, a relationship in which the healthcare professional is perceived as indifferent to the patient as a person. In conclusion restraint hurts and means powerlessness to the child, leaving deep traces that remain for a long time. The findings call the healthcare profession to take action to support children’s self-determination, participation, and integrity in healthcare. How children experience restraint in healthcare merits further investigation from the children’s own perspective.
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| 12. |
- Kleye, Ida, 1984-, et al.
(författare)
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Positive effects of a child‐centered intervention on children's fear and pain during needle procedures
- 2023
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Ingår i: Paediatric and Neonatal Pain. - : Wiley. - 2637-3807 .- 2637-3807. ; 5:1, s. 23-30
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Tidskriftsartikel (refereegranskat)abstract
- To examine whether children experience less fear or pain using a child-centered intervention and if there were differences between the intervention group and the control group regarding heart rate, time required for the procedure, success rate for the cannula insertion, and patient satisfaction. A controlled single-center case study of observational design, with one control and one intervention group. Child self-reported fear or pain levels did not reveal any differences for those receiving the intervention compared with controls. However, according to a behavioral observation measure with the Procedure Behavior Check List, effects of the intervention were lower distress in relation to fear and pain during the cannula insertion. The time it took to perform the cannula insertion also decreased significantly in the intervention group. More children in the intervention group reported that they were satisfied with the needle procedure compared with the children in the control group. The child-centered intervention provides reduced observed distress related to fear and pain in children undergoing a cannula insertion and reduced total time by more than 50%. This study found that child involvement in care strengthen their ability to manage a needle procedure.
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| 13. |
- Krekmanova, Larisa, et al.
(författare)
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General dental practitioners’ knowledge and attitudes on children’s pain and pain management : A questionnaire survey
- 2021
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Ingår i: Paediatric and Neonatal Pain. - : John Wiley & Sons. - 2637-3807. ; 3:2, s. 87-97
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study general dental practitioners’ knowledge and attitudes on pain and pain management in children and adolescents, using a multidimensional questionnaire.There is little information on dentists’ views on pain in children. The research question was how attitudes and knowledge may correlate to the dentists’ age, sex,years of professional experience, the proportion of working time devoted to treating children and adolescents, as well as being a parent. At the time of the study, 387 general dentists working for the Public Dental Service participated in a web-based, multidimensional validated questionnaire holding the categories (A) views on the care of children in pain, (B) physiology, (C) pain alleviation, (D) medication, (E) sociology/psychology,(F) Pain assessment instruments and methods, (G) non-medication methods of pain alleviation, and (H) documentation of pain management. The age categories were given as; below 25, 25-35, 36-45, 46-55years, and older than 55 years of age.71% of the responders were female. The dentists’ age cohort, as well as the years of professional experience, tended to make a difference as to the pain interventions in children and adolescents (P < 0.03). The female dentists, in comparison to the male dentists, conveyed different pain treatment strategies (P < 0.03). The proportion of working time devoted to treating children and adolescents, as well as being a parent, did not show significant differences regarding pain strategies. Associations were observed between the age of the dentists studied, the number of years as professionals and the knowledge and attitudes that benefit children's pain treatment. Being a parent was not significant. In this studied group, female dentists displayed significantly more care regarding pain management, than did their male colleagues. Furthermore, the study highlighted the need for a short questionnaire, user-friendly yet with retained multidimensionality.
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| 14. |
- Lundqvist, Sara, et al.
(författare)
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Prevalence of chronic pain in children and adolescents with psychiatric conditions.
- 2023
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Ingår i: Paediatric & neonatal pain. - : John Wiley & Sons. - 2637-3807. ; 5:2, s. 50-56
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of pain in children and adolescents with psychiatric conditions is rarely investigated. The aims of the current study were to (a) describe the prevalence of headaches and abdominal pain in children and adolescents with psychiatric conditions, (b) compare the prevalence of pain in children and adolescents with psychiatric conditions with that in the general population, and (c) investigate the associations between pain experience and different types of psychiatric diagnoses. Families with a child aged 6-15 years who had been referred to a child and adolescent psychiatry (CAP) clinic completed the Chronic Pain in Psychiatric Conditions questionnaire. Information about the child/adolescent's psychiatric diagnosis(es) was extracted from the CAP clinic's medical records. The children and adolescents included in the study were divided into diagnostic groups and compared. Their data were also compared with data of control subjects collected during a previous study of the general population. Abdominal pain was more common among girls with a psychiatric diagnosis (85%) than in the matched control population (62%, p = 0.031). Children and adolescents with neurodevelopmental diagnoses had a higher prevalence of abdominal pain than children and adolescents with other psychiatric diagnoses. Pain conditions in children and adolescents with a psychiatric diagnosis are common and must be addressed.
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| 15. |
- Olsson Duse, Beatrice, et al.
(författare)
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Efficacy of topical lidocaine‐prilocaine (EMLA ® ) for management of infant pain during pneumococcal vaccination : A randomized controlled trial
- 2022
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Ingår i: Paediatric and Neonatal Pain. - : Wiley. - 2637-3807.
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have evaluated whether topical anesthetic cream reduces pain during pneumococcal vaccination. This is crucial, since effective pain management should be evidence-based. Previous studies have shown that topical lidocaine-prilocaine (EMLA®) reduces vaccination-related pain, measured using pain-rating instruments and observation of crying time. This intervention study aimed to compare the efficacy of topical lidocaine-prilocaine cream with that of the standard of care on the expression of pain during the first pneumococcal vaccination administered at age 3 months under the Swedish national vaccination program. A randomized controlled trial included 72 infants receiving their first pneumococcal vaccination (Prevenar 13®). The study showed that topical lidocaine-prilocaine before pneumococcal vaccination significantly reduced infants’ expression of pain according to the Face, Legs, Activity, Cry, Consolability (FLACC) score (P = .006) and increased latency to cry (P = .001). There were no statistically significant differences in the total crying time (P = .146) between the groups. Topical lidocaine-prilocaine cream reduced pain expression and increased latency to cry in infants receiving their first pneumococcal vaccine. Systematic efforts are needed to successfully implement the use of topical anesthetic cream and other effective non-pharmacological pain-relieving strategies during infant vaccination procedures.
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| 16. |
- Ullsten, Alexandra, 1967-, et al.
(författare)
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O Parent, Where Art Thou?
- 2019
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Ingår i: Paediatric & Neonatal Pain. - : John Wiley & Sons. - 2637-3807. ; 1:2, s. 53-55
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Tidskriftsartikel (refereegranskat)
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| 17. |
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