title: Perceptions of health professionals on pain in extremely low gestational age infants.
abstract: Extremely low gestational age infants (<28 weeks at birth) experience significant pain from repeated therapeutic procedures while hospitalized in the neonatal intensive care unit. As part of a program of research examining pain in preterm infants, we conducted a qualitatively driven mixed-methods design, supplemented with a qualitative and quantitative component, to understand how health care professionals (HCPs) assess and manage procedural pain for tiny and underdeveloped preterm infants. Fifty-nine HCPs from different disciplines across four tertiary-level neonatal units in Canada participated in individual or focus group interviews and completed a brief questionnaire. Four themes from the content analysis were (a) subtlety and unpredictability of pain indicators, (b) infant and caregiver attributes and contextual factors that influence pain response and practices, (c) the complex nature of pain assessment, and (d) uncertainty in the management of pain. The information gleaned from this study can assist in identifying gaps in knowledge and informing unit-based and organizational knowledge translation strategies for this vulnerable population.
authors: Trillium Health Partners, Mississauga, Ontario, Canada Sharyn.gibbins@trilliumhealthpartners.ca.
authors: Sharyn
authors: S
authors: Gibbins
authors: Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Bonnie
authors: B
authors: Stevens
authors: Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Kim
authors: K
authors: Dionne
authors: Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Janet
authors: J
authors: Yamada
authors: York University, Toronto, Ontario, Canada.
authors: Rebecca
authors: R
authors: Pillai Riddell
authors: Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Patrick
authors: P
authors: McGrath
authors: Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Elizabeth
authors: E
authors: Asztalos
authors: Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Karel
authors: K
authors: O'Brien
authors: McMaster University, Hamilton, Ontario, Canada.
authors: Joseph
authors: J
authors: Beyene
authors: Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Patrick
authors: P
authors: McNamara
authors: McGill University, Montreal, Quebec, Canada.
authors: Celeste
authors: C
authors: Johnston
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D005069:Evaluation Studies as Topic; D055318:Evidence-Based Nursing / Q000379:methods; D005865:Gestational Age; D006302:Health Services Research / Q000706:statistics & numerical data*; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000523:psychology*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D059408:Pain Management / Q000379:methods / Q000451:nursing; D010147:Pain Measurement / Q000451:nursing* / Q000523:psychology*; D036301:Qualitative Research; D012107:Research Design; D062606:Tertiary Care Centers; D057170:Translational Research, Biomedical / Q000706:statistics & numerical data
keywords: content analysis; decision making; descriptive methods; evidence-based practice; health care professionals; health care, interprofessional; health care, teamwork; health care, work environment; infants, high-risk; intensive care unit (ICU); interviews, semi-structured; nursing; pain; pediatrics; research, qualitative