Nurses' Perceived Barriers and Strategies to Promote Parental Involvement in Newborn Pain Management

Area of Science:

• Neonatal care
• Pediatric nursing
• Pain management

Background:

• Newborns in NICUs experience numerous painful procedures impacting neurodevelopment.
• Parental involvement in pain management (PM) is crucial for infant well-being when parents receive adequate preparation and guidance.
• Nurses are pivotal in facilitating and supporting parental engagement in neonatal pain management.

Purpose of the Study:

• To explore neonatal intensive care unit (NICU) nurses' perspectives on strategies for parental involvement in newborns' pain management (PM).
• To identify barriers hindering effective parental participation in neonatal pain management.
• To understand nurses' views on facilitating family-centered pain management in the NICU.

Main Methods:

• Exploratory, qualitative, and descriptive research design.
• Online focus group interviews conducted with 24 nurses across three Portuguese NICUs.
• Inductive content analysis employed, adhering to COREQ guidelines for transparent reporting.

Main Results:

• Nurses utilize strategies such as education, progressive involvement, nonpharmacological methods, and communication to engage parents in PM.
• Facilitators include nurse expertise, strong nurse-parent relationships, teamwork, and a comfortable environment.
• Barriers encompass excessive workload, poor nurse-to-baby ratios, limited space, and parental emotional distress or avoidance.

Conclusions:

• Parental involvement and nonpharmacological methods enhance family-centered PM but are limited by organizational barriers and parental emotional distress.
• Systemic and relational strategies are essential to support parental engagement in neonatal pain management.
• Recommendations include acknowledging parental willingness, addressing nurse workload, and fostering collaborative organizational policies.