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Neonatal
CONCEPTUALIZING CHRONIC PAIN IN HOSPITALIZED INFANTS: HEALTH PROFESSIONAL PERSPECTIVES
  1. R R Pillai Riddell1,2,
  2. B J Stevens3,4,
  3. P McKeever3,4,8,
  4. S Gibbins4,5,
  5. L Asztalos5,6,
  6. J Katz1,7,
  7. S Ahola1,
  8. L Din1
  1. 1Department of Psychology, York University, Toronto, ON, Canada
  2. 2Department of Psychiatry Research, Hospital for Sick Children, Toronto, ON, Canada
  3. 3Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
  4. 4Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, ON, Canada
  5. 5Department of Newborn and Developmental Paediatrics, Sunnybrook and Women’s, Toronto, ON, Canada
  6. 6Department of Pediatrics, University of Toronto, Toronto, ON, Canada
  7. 7Toronto General Research Institute, Toronto General Hospital, Toronto, ON, Canada
  8. 8Bloorview Research Institute, Bloorview Children’s Hospital, Toronto, ON, Canada

Abstract

According to anecdotal evidence from health professionals and parents, there are significant numbers of medically comprised infants that are potentially experiencing chronic pain. However, minimal research conceptualizing the phenomenon of chronic pain can be found in the literature. The purpose of this study was to conduct an in-depth qualitative analysis of definitional and assessment parameters for infant chronic pain with experienced health care professionals.

Methods Forty-five health care professionals considered to be expert clinicians (nurses, physicians, respiratory therapists, physiotherapists, occupational therapists, dieticians, pharmacists) with a median of 17 years of clinical experience were recruited from three tertiary level, university-affiliated Neonatal Intensive Care Units and one Pediatric Intensive Care Unit. Using a qualitative descriptive methodology, individual and focus group interviews were conducted with eligible health professionals. All data were transcribed verbatim and analyzed using qualitative and quantitative content analyses methods.

Results There was clear acknowledgement that infants had the capacity to experience chronic pain. Furthermore, although there were inconsistencies as to the exact definition of chronic pain, health care professionals were able to offer preliminary definitional parameters of chronic pain and provide examples of infant chronic pain on their hospital units. They suggested possible indicators for chronic pain that focused on behaviours and physical/physiological responses sustained over time which differ from indicators traditionally used to measure acute pain.

Relevance Articulating preliminary definitional parameters of infant chronic pain and positing potential indicators is the first step to improving pain assessment and management in this vulnerable population.

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