Healthcare professionals' perceptions of pain in infants at risk for neurological impairment

BMC Pediatr. 2004 Nov 12;4(1):23. doi: 10.1186/1471-2431-4-23.

Abstract

Background: To determine whether healthcare professionals perceive the pain of infants differently due to their understanding of that infant's level of risk for neurological impairment.

Method: Neonatal Intensive Care Units (NICU's) at two tertiary pediatric centers. Ninety-five healthcare professionals who practice in the NICU (50 nurses, 19 physicians, 17 respiratory therapists, 9 other) participated. They rated the pain (0-10 scale and 0-6 Faces Pain Scale), distress (0-10), effectiveness of cuddling to relieve pain (0-10) and time to calm without intervention (seconds) for nine video clips of neonates receiving a heel stick. Prior to each rating, they were provided with descriptions that suggested the infant had mild, moderate or severe risk for neurological impairment. Ratings were examined as a function of the level of risk described.

Results: Professionals' ratings of pain, distress, and time to calm did not vary significantly with level of risk, but ratings of the effectiveness of cuddling were significantly lower as risk increased [F (2,93) = 4.4, p = .02]. No differences in ratings were found due to participants' age, gender or site of study. Physicians' ratings were significantly lower than nurses' across ratings.

Conclusion: Professionals provided with visual information regarding an infants' pain during a procedure did not display the belief that infants' level of risk for neurological impairment affected their pain experience. Professionals' estimates of the effectiveness of a nonpharmacological intervention did differ due to level of risk.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Attitude of Health Personnel*
  • Canada
  • Empathy
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Infant Care / methods*
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Judgment
  • Male
  • Middle Aged
  • Nervous System Diseases / complications*
  • Pain / etiology*
  • Pain / rehabilitation*
  • Pain Measurement*
  • Personnel, Hospital
  • Risk Assessment
  • Workforce