Specific newborn individualized developmental care and assessment program movements are associated with acute pain in preterm infants in the Neonatal Intensive Care Unit.

OBJECTIVE: The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is widely used in neonatal intensive care units and comprises 85 discrete infant behaviors, some of which may communicate infant distress. The objective of this study was to identify developmentally relevant mov...

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Publicado en:Pediatrics Vol. 114; no. 1; pp. 65 - 73
Autores principales: Holsti L, Grunau RE, Oberlander TF, Whitfield MF
Formato: research tables/charts Journal Article
Publicado: American Academy of Pediatrics Jul2004
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2004
      vid: 114
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      pub: American Academy of Pediatrics
      place: Elk Grove Village, Illinois
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        10.1542/peds.114.1.65
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        atl: Specific newborn individualized developmental care and assessment program movements are associated with acute pain in preterm infants in the Neonatal Intensive Care Unit.
      aug:
        au:
          Holsti L
          Grunau RE
          Oberlander TF
          Whitfield MF
        affil: Centre for Community Child Health Research, British Columbia Research Institute for Children's and Women's Health, Vancouver, British Columbia, Canada; lholsti@cw.bc.ca
      sug:
        subj:
          Infant Behavior Classification
          Infant, Premature Physiology
          Pain Measurement Methods
          Pain Diagnosis
          Acute Disease
          Analysis of Variance
          British Columbia
          Clinical Assessment Tools
          Facial Expression
          Female
          Funding Source
          Heart Rate
          Infant Care
          Infant, Newborn
          Infant, Premature Psychosocial Factors
          Intensive Care Units
          Intensive Care Units, Neonatal
          Male
          Movement
          Pearson's Correlation Coefficient
          Post Hoc Analysis
          Repeated Measures
          Sleep
          T-Tests
          Videorecording
          Wakefulness
          Human
          Infant, Newborn: birth-1 month
          Female
          Male
      ab: OBJECTIVE: The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is widely used in neonatal intensive care units and comprises 85 discrete infant behaviors, some of which may communicate infant distress. The objective of this study was to identify developmentally relevant movements indicative of pain in preterm infants. METHODS: Forty-four preterm infants were assessed at 32 weeks' gestational age (GA) during 3 phases (baseline, lance/squeeze, and recovery) of routine blood collection in the neonatal intensive care unit. The NIDCAP and Neonatal Facial Coding System (NFCS) were coded from separate continuous bedside video recordings; mean heart rate (mHR) was derived from digitally sampled continuous electrographic recordings. Analysis of variance (phase x gender) with Bonferroni corrections was used to compare differences in NIDCAP, NFCS, and mHR. Pearson correlations were used to examine relationships between the NIDCAP and infant background characteristics. RESULTS: NFCS and mHR increased significantly to lance/squeeze. Eight NIDCAP behaviors also increased significantly to lance/squeeze. Another 5 NIDCAP behaviors decreased significantly to lance/squeeze. Infants who had lower GA at birth, had been sicker, had experienced more painful procedures, or had greater morphine exposure showed increased hand movements indicative of increased distress. CONCLUSIONS: Of the 85 NIDCAP behaviors, a subset of 8 NIDCAP movements were associated with pain. Particularly for infants who are born at early GAs, addition of these movements to commonly used measures may improve the accuracy of pain assessment.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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