Impact of prenatal education on maternal utilization of analgesic interventions at future infant vaccinations: a cluster randomized trial.
Analgesic interventions are not routinely used during vaccine injections in infants. Parents report a desire to mitigate injection pain, but lack the knowledge about how to do so. The objective of this cluster-randomized trial was to evaluate the effect of a parent-directed prenatal education teaching module about vaccination pain management on analgesic utilization at future infant vaccinations. Expectant mothers enrolled in prenatal classes at Mount Sinai Hospital in Toronto were randomized to a 20-30minute interactive presentation about vaccination pain management (experimental group) or general vaccination information (control group). Both presentations included a PowerPoint (Microsoft Corporation, Redmond, WA, USA) and video presentation, take-home pamphlet, and "Question and Answer" period. The primary outcome was self-reported utilization of breastfeeding, sugar water, or topical anaesthetics at routine 2-month infant vaccinations. Between October 2012 and July 2013, 197 expectant mothers from 28 prenatal classes participated; follow-up was obtained in 174 (88%). Maternal characteristics did not differ (P>0.05) between groups. Utilization of one or more prespecified pain interventions occurred in 34% of participants in the experimental group, compared to 17% in the control group (P=0.01). Inclusion of a pain management module in prenatal classes led to increased utilization of evidence-based pain management interventions by parents at the 2-month infant vaccination appointment. Educating parents offers a novel and effective way of improving the quality of pain care delivered to infants during vaccination. Additional research is needed to determine if utilization can be bolstered further using techniques such as postnatal hospital reinforcement, reminder cards, and clinician education.
Clinical, Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada Women's and Infant's Ambulatory Health Programs, Mount Sinai Hospital, Toronto, ON, Canada Maternal-Infant Care (MiCare) Research Centre, Mount Sinai Hospital, Toronto, ON, Canada Department of Psychology, York University, Toronto, ON, Canada Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada Department of Pediatrics, The Hospital for Sick Children, Halifax, NS, Canada.
Anna
A
Taddio
Sarah
S
Smart
Matthuschka
M
Sheedy
Eugene W
EW
Yoon
Charmy
C
Vyas
Chaitya
C
Parikh
Rebecca
R
Pillai Riddell
Vibhuti
V
Shah
D000279:Administration, Cutaneous; D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use*; D001942:Breast Feeding; D005260:Female; D006801:Humans; D007223:Infant; D007267:Injections / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000193:education*; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D059408:Pain Management / Q000706:statistics & numerical data*; D064186:Prenatal Education / Q000379:methods*; D013549:Sweetening Agents / Q000627:therapeutic use*; D014611:Vaccination
D000779:Anesthetics, Local; D013549:Sweetening Agents
Infant; Pain management; Parent education; Parental knowledge; Randomized controlled trial; Vaccination