The Recognition of Facial Expression of Pain in Full-Term Newborns by Parents and Health Professionals

Balda, Rita de Cássia Xavier; Guinsburg, Ruth; Almeida, Maria Fernanda Branco de; Peres, C.; Miyoshi, Milton Harumi; Kopelman, Benjamin Israel

doi:10.1001/archpedi.154.10.1009

Cited by 38 publications

(15 citation statements)

References 37 publications

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“…Low management may be due to nurses' lack of ability to recognize ill infants' subtle expressions of pain (de Rond, de Wit, van Dam, 2001; Reyes, 2003). Researchers have shown that nurses are less adept at recognizing pain expressions in newborns compared with nonhealth professionals (Xavier Balda et al, 2000). This is of considerable concern since children are more likely to have their pain treated in the presence of behavioral indicators (Hamers, Abu‐Saad, Halfens, & Schumacher, 1994; Van Hulle Vincent, 2005).…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Delivery of Evidence-Based Procedural Pain Care in Hospitalized Neonates

Latimer

Johnston

Ritchie

et al. 2009

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Objective-To examine the effects of nurse, infant, and organizational factors on delivery of collaborative and evidence-based pain care by nurses. Design-Cross sectional.Setting-Two Level III neonatal intensive care units in 2 large tertiary care centers in Canada.Participants-A convenience sample of 93 nurses completed survey data on procedures they performed on ill neonates. The 93 nurses performed a total of 170 pain producing procedures on 2 different shifts.Main Outcome-Nurse use of evidence-based protocols to manage procedure related pain using a scorecard of nurses' assessment, management, and documentation.Results-Procedural pain care was more likely to meet evidence-based criteria when nurse participants rated nurse-physician collaboration higher (odds ratio, 1.44; 95% confidence intervals 1.05-1.98), cared for higher care intensity infants (odds ratio, 1.21; 95% confidence intervals, 1.06-1.39), and experienced unexpected increases in work assignments (odds ratio, 1.55; 95% confidence intervals, 1.04-2.30). Nurses' knowledge about the protocols, educational preparation and experience were not significant predictors of evidence-based care for the most common procedures: heel lance and intravenous initiation.Conclusion-Nurse-physician collaboration and nurses' work assignments were more predictive of evidence-based care than infant and nurse factors. Nurses' knowledge regarding evidence-based care was not a predictor of implementation of protocols. In the final statistical modeling, collaboration with physicians, a variable amenable to intervention and further study, emerged as a strong predictor. The results highlight the complex issue of translating knowledge to practice, however, specific

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Section: Discussionmentioning

confidence: 99%

Factors Affecting Delivery of Evidence-Based Procedural Pain Care in Hospitalized Neonates

Latimer

Johnston

Ritchie

et al. 2009

Journal of Obstetric, Gynecologic & Neonatal Nursing

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show abstract

“…Numerous explanations have been advanced for this persistent pattern [161]: 1) the misconception referenced above regarding children's insensitivity to pain; 2) lack of assessment and reassessment of pain; 3) lack of knowledge of pain assessment approaches; 4) lack of knowledge of pain treatment modalities; 5) misperceptions of the time and effort required to assess pediatric pain; and 6) fears of adverse effects of analgesic medications. For these reasons and others, both alone and in combination, it is evident that health care providers consistently underestimate pain in children [162–164]. Moreover, much like older adults, children with cognitive and/or developmental limitations that inhibit communication are especially vulnerable to underassessment and treatment [152,165].…”

Section: Patient Characteristicsmentioning

confidence: 99%

Provider Judgments of Patients in Pain: Seeking Symptom Certainty

2009

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In order to minimize the uncertainty that can characterize symptoms such as chronic pain, practitioners bring information to bear on pain assessment that can lead to misjudgments. While intuitively appealing, much of the information that is considered often has little association with pain severity and/or adjustment. A more rational decision-making process can reduce the judgment errors common to pain assessment and treatment.

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“…Some studies have also reported that medical practitioners are less accurate in identifying painful expressions (Xavier Balda et al, 2000 ; Kappesser and Williams, 2002 ). One previous neuroimaging study examined neurohemodynamic responses in physicians and non-physician controls when they viewed short video clips depicting hands and feet being pricked by a needle (painful situations) or being touched by a Q-tip (non-painful situations; Cheng et al, 2007 ).…”

Section: Introductionmentioning

confidence: 99%

How Situational Context Impacts Empathic Responses and Brain Activation Patterns

Cheng

Chen²,

Decety

2017

Front. Behav. Neurosci.

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Clinical empathy, which is defined as the ability to understand the patient’s experience and feelings from the patient’s perspective, is acknowledged to be an important aspect of quality healthcare. However, how work experience modulates the empathic responses and brain activation patterns in medical professions remains elusive. This fMRI study recruited one hundred female nurses, who varied the length of work experience, and examined how their neural response, functional connectivity, and subjective evaluations of valence and arousal to perceiving another individual in physical pain are modulated by the situational context in which they occur (i.e., in a hospital or at home). Participants with longer hospital terms evaluated pain as less negative in valence and arousal when occurring in a hospital context, but not in a home context. Physical pain perceived in a hospital compared to a home context produced stronger activity in the right temporoparietal junction (rTPJ). The reverse comparison resulted in an increased activity in the insula and anterior midcingulate cortex (aMCC). Mediation analysis indicated that reduced personal accomplishment, a symptom of burnout, breaks down the mediation effect of the putamen on context-dependent valence ratings. Overall, the study demonstrates how situational contexts significantly influence individuals’ empathic processing, and that perceiving reward from patient care protects them from burnout.Highlights Differences in behavior ratings and brain activations between medical practitioners perceiving others’ pain in a hospital and at home.Situational contexts significantly influence individual’s empathic processing.Perceiving rewards from patient care protects medical practitioners from burnout.Empathy is a flexible phenomenon.

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The Recognition of Facial Expression of Pain in Full-Term Newborns by Parents and Health Professionals

Cited by 38 publications

References 37 publications

Factors Affecting Delivery of Evidence-Based Procedural Pain Care in Hospitalized Neonates

Factors Affecting Delivery of Evidence-Based Procedural Pain Care in Hospitalized Neonates

Provider Judgments of Patients in Pain: Seeking Symptom Certainty

How Situational Context Impacts Empathic Responses and Brain Activation Patterns

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