Parental Involvement in Pain Reducing Measures

NCT ID: NCT05656677

Last Updated: 2022-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-01

Study Completion Date

2022-11-01

Brief Summary

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This pilot study was conceptualised to determine the feasibility of involving parents via facilitated tucking or observing during painful procedures and to measure change in parental stress and infant pain. An additional purpose of this pilot study was to determine the size of the cohort of preterm infants needed for a larger trial, the time, and resources required for recruitment and data collection.

Detailed Description

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Objectives

In this pilot study, the aims were to determine the feasibility of whether pain behaviour in extremely and very preterm infants and perceived parental stress change when parents are involved in pain reducing measures, either actively, performing facilitated tucking or passively, observing the intervention, in comparison to the involvement of nurses only. In addition, the infant's pain reactivity and parental stress over three time points of measurement was of interest.

Methods

Extremely and very preterm infants in need of subcutaneous erythropoietin were randomly assigned to the two intervention groups. The intervention encompassed that one parent of each infant was involved during the painful procedure: Either parents executed facilitated tucking themselves or stood by, observing the procedure. Usual care involved that nurse executed facilitated tucking. All infants received 0.5ml of 30% oral glucose solution via cotton swab before the painful procedure. Infant pain was observed with the Bernese Pain Scale for Neonates (BPSN) and measured with the skin conductance algesimeter (SCA) before, during, and after the procedure. Parents' stress levels were measured before and after the painful procedure on the infant, using the Current Strain Short Questionnaire (CSSQ).

Feasibility of a subsequent trial was determined by assessing recruitment, measurement and active parental involvement. Quantitative data collection methods (i.e., questionnaires, algesimeter) were employed to determine the number of participants for a larger trial and measurement adequacy. Qualitative data (interviews) was employed to determine parents' perspectives of their involvement.

Conditions

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Procedural Pain Preterm Infants Parents

Keywords

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pain stress preterm infants parents

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A three-arm pilot study using mixed methods of data collection (questionnaires, SCA, interviews) was designed to test the feasibility of the intervention encompassing parents' active and passive involvement in procedural pain management of extremely and preterm infants hospitalised at a neonatal intensive care unit (NICU).
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators
The six NICU nurses involved were blinded to the purpose of the study, whereas the clinical nurse specialist (CNS) was not. Always three members of this research team conducted the pain assessment during the facilitated tucking or the observing by the parents. The other three members of the research team focused on the nurses' group.

The CNS or the neonatologist provided information about the study to the parents, without stating its specific aim, instead referring in principle to the increased involvement of parents in pain management.

Study Groups

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Two nurses executing facilitated tucking (FT)

Usual care

Group Type NO_INTERVENTION

No interventions assigned to this group

One parent watching passively

One parent watching passively the 2 nurses executing FT

Group Type ACTIVE_COMPARATOR

Passive parental involvement

Intervention Type BEHAVIORAL

One parent watching a procedural painful intervention, two nurses executing facilitated tucking

One parent actively involved

One parent actively executing FT

Group Type ACTIVE_COMPARATOR

Active parental involvement

Intervention Type RADIATION

One parent watching a procedural painful intervention and at the same time executing facilitated tucking

Interventions

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Passive parental involvement

One parent watching a procedural painful intervention, two nurses executing facilitated tucking

Intervention Type BEHAVIORAL

Active parental involvement

One parent watching a procedural painful intervention and at the same time executing facilitated tucking

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Premature infants born at the NICU concerned
* Born between 24 0/7- 32 0/7 weeks of gestation, birthweight (bw) \<1250g
* Infant in need of s.c. erythropoietin
* Parents fluently speaking and writing in German
* Written informed consent by parents

Exclusion Criteria

* Premature infant with an umbilical artery pH measurement \<7.00 or asphyxia
* Premature infant with life threatening malformations of the central nervous system
* Premature infant with intracranial haemorrhage (even if not present at the start of the study)
* Premature infant with any surgical intervention
* Parents with substance abuse (i.e., methadone, heroin, etc.), as mentioned in the electronic patient documentation (EPD)
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Insel Gruppe AG, University Hospital Bern

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sandra Zwakhalen, Prof. Dr.

Role: STUDY_CHAIR

Fac. Health, Medicine and Life Sciences, Health Services Research CAPHRI - University of Maastricht

Locations

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Inselspital

Bern, , Switzerland

Site Status

Countries

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Switzerland

Other Identifiers

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079/13

Identifier Type: -

Identifier Source: org_study_id