title: Factors Influencing Parental Participation in Neonatal Pain Alleviation.
abstract: OBJECTIVE
  Neonates are likely to experience numerous painful procedures in neonatal intensive care units (NICUs). Parents have expressed a wish to be more involved in their infants' pain alleviation. The purpose of this study was to describe parents' perceptions concerning the factors that influence parental participation in pain alleviation in an NICU.
  
  
  METHODS
  The qualitative study was conducted in level II and III NICUs (7 units) of Finland's four university hospitals. Data were collected through open-ended questionnaires and analyzed using inductive content analysis.
  
  
  RESULTS
  Factors that promoted parental participation consisted of five main categories: parental counseling by staff, parents' awareness of their own role, parents' motivation to participate in pain relief, family-friendly facilities and good communication. Factors hindering parental participation consisted of eight categories, including restrictive environment, lack of knowledge, everyday life requirements, underestimation of parents, the nature of the medical procedures, procedure- and pain-related emotions, deteriorated health status of the child and mother and (8) uncertainty of parenting.
  
  
  CONCLUSIONS
  This study revealed a number of factors that are important to take into account when improving parental involvement in neonatal pain alleviation. Especially, parental participation can be promoted by providing sufficient counseling based on the parents' needs and creating facilities that support parents' participation.
  
  
  CONCLUSIONS
  Parents should be engaged as partners in caregiving and decision making, and they should be given space to assume the role of parents during their child's hospitalization.
authors.affiliation: Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland. Electronic address: annakaija.palomaa@gmail.com.
authors.forename: Anna-Kaija
authors.initials: AK
authors.lastname: Palomaa
authors.affiliation: Clinical Nursing Science, Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Korhonen
authors.affiliation: Institute of Health Sciences, University of Oulu, 90014 University of Oulu, Oulu, Finland.
authors.forename: Tarja
authors.initials: T
authors.lastname: Pölkki
mesh_terms: D022143:Family Nursing / Q000458:organization & administration*; D005260:Female; D005387:Finland; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration; D015931:Intensive Care, Neonatal / Q000458:organization & administration*; D008297:Male; D020380:Needs Assessment; D010146:Pain / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010287:Parent-Child Relations; D010290:Parents / Q000193:education*; D036301:Qualitative Research; D016896:Treatment Outcome
keywords: Infant; Neonatal intensive care unit; Pain management; Parent