Neonatal Pain

Evidence shows that verbal communication is just one of the ways patients indicate their wishes. For a sufficiently careful communication, we should also grasp other five unusual though evident languages: (a) body language, (b) the way patients manage their environment, (c) unconscious language, (d) lab-evidenced language, and (e) the way they master technology. So, we have six languages that should be intertwined to understand the real language of the sick. Grasping these languages helps health professionals frame the patient’s mood, their level of suffering or mental growth, and understand what words alone cannot express. Words cannot express completely what a patient senses: for subjection, shyness, because some patients are still non-verbal or because verbal communication is just a useful way of freezing concept but has not the same fluidity and liberty of the other above-described languages. It is mandatory for caregivers to wonder how many of these languages they are actually ...

Background: Reflection is a recent trend in medical and nursing education whether in teaching or treating. Aim: This study was aimed to evaluate the impact of reflective thinking intervention on improving nursing care given by nurses in pediatric critical care units. Materials and Method; The study was conducted at pediatric critical care units (SICU, NICU and ED) in pediatric hospital affiliated to Ain shams university hospitals. The subjects of the study contained 55 nurses and all available children used at the previously mentioned setting regardless their age, sex, level of education and qualification. Three types of tools were used to collect data, an interviewing questionnaire sheet, nursing core competencies clinical evaluation tool &educational supportive material. Results: About (23.6%) had competent level of nursing core competencies through nurses′ reflection at preprogram implementation compared to more than three quarters (78.2%) at post program implementation while ele...

Despite the availability of evidence based clinical guidelines regarding the effectiveness of the nonpharmacological methods of procedural pain relive in hospitalized neonates, the majority of these methods still underused. The aim of this study was to improve nurses' performance towards non pharmacological pain management among neonates in neonatal intensive care unit through the implementation of an educational program. Design: A quasi-experimental design was used in carrying out the study. Setting: The study was conducted at the neonatal intensive care unit affiliated to Mansoura University Children's Hospital. Subjects: A convenience sample of 51 neonatal nurses working in the previously mentioned setting. Tools: Data were collected by using: Predesigned questionnaire sheet to assess nurses' knowledge about neonatal procedural pain and its non-pharmacological management and the observation sheet to assess nurses' application of nonpharmacological pain management methods in the neonatal intensive care unit. Results: There was statistically significant difference regarding nurses' knowledge and practices about neonatal pain and its nonpharmacological management methods pre, immediately post and at follow up of the program implementation. Conclusion: There was a significant positive effect of the educational program in improving nurses' performance towards non-pharmacological pain management in neonatal intensive care unit Recommendations: Conducting more periodical continuing education for neonatal nurses that encouraging more frequent use of non-pharmacological methods in clinical care with necessity of follow up that must be motivated by a multidisciplinary team to be a routine care inside the unit.

La pervietà del dotto arterioso di Botallo (PDA) è la più frequente anomalia cardiaca del neonato prematuro interessando circa il 60% dei neonati di età inferiore alle 28 settimane. Il fenomeno dello shunt sinistro-destro emodinamicamente significativo rappresenta un importante fattore di rischio per lo sviluppo di lesioni cerebrali, insufficienza renale ed enterocolite necrotizzante. Per valutare il danno indotto dall'ipossia e dall'instabilità emodinamica in questi pazienti si sono cercate delle metodiche che consentissero di monitorare in maniera continua ed il più possibile non invasiva i parametri fisiologici vitali. Tecniche come l'ECG, l'EEG, il Doppler e l'ecografia cerebrale, pur di fondamentale importanza, non forniscono informazioni in continuo sull'ossigenazione e sulla perfusione a livello cerebrale e dei vari organi. Il sistema NIRS permette una misurazione quantitativa in continuo sia del flusso sanguigno cerebrale (CBF) che della frazione di e...

Background: The aim of this review of the literature was to find and summarize relevant research evidence available within the scientific sources and gray literature in accordance with the JBI recommendations. Search question: What effect does Basal Stimulation have on the cognitive–behavioral functions or temperament of a preterm or disabled infant? Methods: The following sources were searched: PSYCINFO, MEDLINE, PsycArticles, ERIC, Wiley Online Library, ProQuest Scopus, WOS, JSTOR, Google Scholar, and MedNar. The study contains an analysis of texts that have been published in the English, Czech, and German languages. The search time span was set at 15 years. Results: A total of 15 sources were found for the specified topic. Conclusions: In all cases, there was confirmation about the positive influence of the concept of “Basal Stimulation” on the cognitive–behavioral functions and temperament of premature and disabled children.

Background The symbolic universe of cancer is associated with death, but its treatment has undergone innumerable innovations, which may lead to a new meaning for social representations. The theory of social representations seeks the new, which changes in the knowledge of common sense (Guareschi & Jovchelovitch, 1994). Thus, the objective of this work is to identify the social representations of cancer and breast cancer, identifying their changes and their meanings based on the central nucleus and the peripheral system. Methods Qualitative and descriptive study, based on the structural approach of the theory of social representations. The sample was non-probabilistic and due to accessibility. The collection instrument was a Word Evocation Test with two inducing words, ‘cancer’ and ‘breast cancer’. The subjects were asked to mention three words that came to their mind immediately and spontaneously. The SPSS and IRAMUTEQ software were used. Results 753 subjects participated and 2316 wo...

Background: The aim of this review of the literature was to find and summarize relevant research evidence available within the scientific sources and gray literature in accordance with the JBI recommendations. Search question: What effect does Basal Stimulation have on the cognitive–behavioral functions or temperament of a preterm or disabled infant? Methods: The following sources were searched: PSYCINFO, MEDLINE, PsycArticles, ERIC, Wiley Online Library, ProQuest Scopus, WOS, JSTOR, Google Scholar, and MedNar. The study contains an analysis of texts that have been published in the English, Czech, and German languages. The search time span was set at 15 years. Results: A total of 15 sources were found for the specified topic. Conclusions: In all cases, there was confirmation about the positive influence of the concept of “Basal Stimulation” on the cognitive–behavioral functions and temperament of premature and disabled children.

369 L a nascita pretermine continua ad essere una delle maggiori cause di morbilità e mortalità neonatale, nonostante la progressiva evoluzione delle cure intensive neonatali degli ultimi decenni. I neonati late preterm (LP), nati tra 34+0 e 36+6 settimane di gestazione, rappresentano circa il 10% di tutti i nati e più del 75% del numero totale dei pretermine. Negli anni è stata utilizzata una diversa terminologia per denominare questa categoria eterogenea di neonati (Near Term, Marginally Preterm, Moderately Preterm, Minimally Preterm, Mildly Preterm), spesso considerati al pari dei neonati a termine, in considerazione del peso alla nascita frequentemente al di sopra dei 2500 grammi, soglia di peso dei Low Birth Weight. Soltanto nel 2005 il National Institute of Child Health and Human Development li definì “late preterm” proprio per evidenziare la loro condizione di prematurità, indipendentemente dalle caratteristiche ponderali. La prevalenza dei LP è in costante aumento: da un lat...

Background: Large-scale, centralized data repositories are playing a critical and unprecedented role in fostering innovative health research, leading to new opportunities as well as dilemmas for the medical sciences. Uncovering the reasons as to why citizens do or do not contribute to such repositories, for example, to population-based biobanks, is therefore crucial. We investigated and compared the views of existing participants and non-participants on contributing to large-scale, centralized health research data repositories with those of ex-participants regarding the decision to end their participation. This comparison could yield new insights into motives of participation and non-participation, in particular the behavioural change of withdrawal. Methods: We conducted 36 in-depth interviews with ex-participants, participants, and non-participants of a three-generation, population-based biobank in the Netherlands. The interviews focused on the respondents’ decision-making processe...

At this time no one can deny anymore the ability of the fetus to respond to external physical stimuli. We have previously demonstrated that :1) Fetuses respond to vocal stimulation 2) The reaction is stronger if the stimulus comes from their mother 3) And even more important, if the speech is addressed to them 4) And / or has an emotional content 5) Neonates and fetuses respond in the same way whether mothers address them vocally or "silently". Aim of the study: We tested the individual response of twins in utero to a silent communication specifically addressed to each one. Methods: Eighty seven (87) women participated in the study. They were tested between 28 and 39 weeks of amenorrhea. A total of 349 tests comprise the study. In the experimental group, mothers were instructed to read a text in silence and to communicate silently (without speaking aloud) with one twin and subsequently with the other twin. In the control group, mothers were reading a text in silence during...

The C-tactile (CLTM) peripheral nervous system is involved in social bonding in primates and humans through its capacity to trigger the brain’s endorphin system. Since the mammalian cochlea has an unusually high density of similar neurons (type-II spiral ganglion neurons, SGNs), we hypothesise that their function may have been exploited for social bonding by co-opting head movements in response to music and other rhythmic movements of the head in social contexts. Music provides one of many cultural behavioural mechanisms for ‘virtual grooming’ in that it is used to trigger the endorphin system with many people simultaneously so as to bond both dyadic relationships and large groups. Changes in pain threshold across an activity are a convenient proxy assay for endorphin uptake in the brain, and we use this, in two experiments, to show that pain thresholds are higher when nodding the head than when sitting still.

End-of-life issues involving small babies are particularly challenging for doctors, particularly pediatricians as there are complex issues involved, including long-term disabilities (1) and the parents' wishes (1). Evaluations can be based on statistical risks (2) and case-by-case issues. Some authors (3) suggest that intensive care can be withheld when consciousness is compromised, but that raises questions about what level of consciousness equates to a baby being completely compromised (4). Other authors have questioned whether suspending therapies when the baby is not at their end-of-life is ethically right. Concerns have also been expressed that there is a risk that babies lives are undervalued, in comparison with older patients, because their life support is removed more easily than when adults have a similar prognosis (5). This article is protected by copyright. All rights reserved.