Thursday, July 12, 2007
This presentation is part of : Strategies in Child and Adolescent Health
Factors Decreasing the Effectiveness of Facilitated Tucking by Parents in Preterm Infants Pain Management
Anna Axelin, RN, MNSc and Sanna Salanterä, RN, PhD. Department of Nursing Science, University of Turku, Turku, Finland
Learning Objective #1: 1. The learner will be able to understand how useful it is to reanalyse and pool previously used data.
Learning Objective #2: 2. The learner will be able to notice why parent’s careful education is crucial even in very simple matters.

Background: Preterm infants are subjects to a considerable number of painful procedures at Neonatal Intensive Care Unit. Infants’ pain should be alleviated systematically. Facilitated tucking by parents is one new and effective option for this purpose. In this method parent holds her infant in a side-lying, flexed position. We have used this method successfully but despite its effectiveness tucking has not alleviated pain at all or not enough in 24 % of the studied cases when pain has been assessed by using Neonatal Infant Pain Scale (NIPS, scale 0-7). For further study and use of this new method it is essential to find the factors that diminish its capability to decrease pain.

 Research question: Which background variables might diminish the effectiveness of facilitated tucking by parents?

 Material and methods: Data from two previous studies was pooled (20 + 14, n = 34). This new data was further classified to two groups in terms of the effectiveness of the method: Effective, when NIPS ≤3 and not effective, when NIPS >3. Statistical analysis (chi-square, Wilcoxon test and t-test) was used to test if there were differences between groups in the following background variables: gender, gestational age, postnatal age, birth weight, duration of the painful procedure, amount of previous painful procedures, firmness of the parent’s hold and parent’s talking during tucking.

 Results: Two variables, the firmness of parent’s hold (p=0.079) and the duration of the painful procedure (p=0.127) almost reached the significance level of p ≤ 0.05. The sample size was too small in order to indicate any significant differences between the groups.

 Conclusion: We can hypothesise that parents need very accurate education in how to hold the infant, and potentially focus the use of facilitated tucking by parents towards short duration painful procedures.