The Occurrent Status And Influencing Factors Of Neonatal Procedural Pain In Neonatal Intensive Care Unit

Backgrounds:Repeated pains have short-term and long-term adverse effects on the development of neonates in their early life.Neonatal pain can be caused by many reasons,such as injures,surgeries,diseases and procedures etc.Procedural pain is the greatest impact on the neonates and many researches have proved.Epidemiology,assessment and intervention of neonatal procedural pain are studied in abroad;American Academy of Pediatrics had established guidance even more.Neonatal procedural pain research starts lately in our county,most of articles are reviews of neonatal procedural pain from foreign countries,and some are introduction of neonatal procedural pain assessment scales and non-pharmacological intervention studies.However,there isn’t comprehensive basic research of neonatal procedural pain.In order to do the management of neonatal pain in our country,we should first understand the occurrent status of neonatal procedural pain.This study aimed to investigate the occurrent status of neonatal procedural pain,and to explore the influencing factors in order to provide basic data and reference for neonatal pain management.Objective:1.To describe the current situation of neonatal procedural pain.2.To explore the influencing factors of neonatal procedural pain.Methods:This study is a descriptive study.Convenient sampling was adopted from the neonatal intensive care unit of Peking Union Medical College Hospital.120 neonates were recruited from October 2016 to October 2017.Data on procedural pain associated with medical investigations,treatments and nursing conducted for the purpose of health care was collected.Demographic and disease information questionnaire and occurrent status of procedural pain questionnaire that slef-designed were used to record current situation of neonatal procedural pain.Neonatal Infant Pain Scale(NIPS)was applied to measure pain intensity.Multiple linear regression,and ordered multi-class logistic regression were used to determine the influencing factors of procedural pain frequency and pain intensity.Results:1.Neonates’s median gestational age is 37+,(34+5,39)week,median birth weight is 2813.96 ±695.79g.120 neonates experienced a total of 16840 painful procedures and every neonate was exposed to a median of 66.5(27,154.75)during hospitalization,and 13(11,19)per baby per day.The frequency of the basic nursing was the highest,with a total of 9374(55.66%),and the frequency of the auxiliary examination occurred least,is 119(0.71%).And change diapers(7421,44.07%)is the most on basic nursing,oral or nasal suctioning(2966,17.61%)is the most on respiratory system related procedures,infusion(765,4.54%)is the most on administration,heelsticks(1597,9.48%)is the most on blood-sampling,ultrasound brain(99,0.59%)is the most on auxiliary examination.All procedures are painful,70.37%(19/27)is severe pain even more.ROP screening and PICC puncture are the most painful procedure,but changing diapers is lightest.2.Hospital days(Standardized coefficient β=0.214),age(normalized coefficientβ=0.234),respiratory supporting(normalized coefficient β=0.434)were the influencing factors of peocedural pain frequency that analyzed by multiple linear regression model.Hospital days(p<0.001),sleeping/wake situation(p<0.001)were the influencing factors of peocedural pain intensity that analyzed by ordered multi-class logistic regression model.Conclusions:NICU neonates experienced highly pain frequency and pain intensity during their hospitalization that indicating that neonatal procedural pain is universal,extensive and severe,so health care professionals are urgent to pay attention.Hospital days,respiratory supporting and age are the influencing factors of procedural pain frequency;Hospital days,sleeping/awake situation are the influencing factors of procedural pain intensity.