Variability in pain response to a non‐pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study
Identifieur interne : 001249 ( Istex/Corpus ); précédent : 001248; suivant : 001250Variability in pain response to a non‐pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study
Auteurs : E. Cignacco ; K. Denhaerynck ; M. Nelle ; C. Bührer ; S. EngbergSource :
- Acta Pædiatrica [ 0803-5253 ] ; 2009-05.
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Abstract
Aim: To explore the variability in pain response in preterm infants across time who received sucrose during routine heel stick. Method: Single group, exploratory repeated measures design. Setting: Two tertiary level neonatal intensive care units (NICU) in Switzerland. Subjects: Nine preterm infants born between 28 2/7 and 31 4/7 weeks of gestation during their first 14 days of life. Measurements: Pain was assessed by the Bernese Pain Scale for Neonates (BPSN), the Premature Infant Pain Profile (PIPP) and the Visual Analogue Scale (VAS). Salivary cortisol was analysed. Results: 72–94% of the variability was within‐subject variability, indicating inconsistency of pain responses across the 5 heel sticks. Interrater agreement was highest during heel sticks 1–3 and decreased during heel stick 4 and 5, indicating a possible alteration of pain patterns. No significant differences in the amount of cortisol could be detected before and after the heel sticks (p = 0.55), indicating no stress‐induced peak after the painful intervention. However, a general gradual decrease of cortisol levels across time could be detected. Conclusion: A high variability in pain response among preterm neonates across time could be described. Consistency of cortisol levels before and after the heel sticks could indicate the effectiveness of sucrose across time.
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DOI: 10.1111/j.1651-2227.2008.01203.x
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ISTEX:169273DAE97782FC275F75B33DACB555BEF0434DLe document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Variability in pain response to a non‐pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study</title><author><name sortKey="Cignacco, E" sort="Cignacco, E" uniqKey="Cignacco E" first="E" last="Cignacco">E. Cignacco</name><affiliation><mods:affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Denhaerynck, K" sort="Denhaerynck, K" uniqKey="Denhaerynck K" first="K" last="Denhaerynck">K. Denhaerynck</name><affiliation><mods:affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Nelle, M" sort="Nelle, M" uniqKey="Nelle M" first="M" last="Nelle">M. Nelle</name><affiliation><mods:affiliation>Division of Neonatology, Children's Hospital, University Hospital Bern, Bern, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Buhrer, C" sort="Buhrer, C" uniqKey="Buhrer C" first="C" last="Bührer">C. Bührer</name><affiliation><mods:affiliation>Basel University Children's Hospital, Division of Neonatology, Basel, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Engberg, S" sort="Engberg, S" uniqKey="Engberg S" first="S" last="Engberg">S. Engberg</name><affiliation><mods:affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</mods:affiliation></affiliation><affiliation><mods:affiliation>School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:169273DAE97782FC275F75B33DACB555BEF0434D</idno><date when="2009" year="2009">2009</date><idno type="doi">10.1111/j.1651-2227.2008.01203.x</idno><idno type="url">https://api.istex.fr/document/169273DAE97782FC275F75B33DACB555BEF0434D/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001249</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001249</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Variability in pain response to a non‐pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study</title><author><name sortKey="Cignacco, E" sort="Cignacco, E" uniqKey="Cignacco E" first="E" last="Cignacco">E. Cignacco</name><affiliation><mods:affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Denhaerynck, K" sort="Denhaerynck, K" uniqKey="Denhaerynck K" first="K" last="Denhaerynck">K. Denhaerynck</name><affiliation><mods:affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Nelle, M" sort="Nelle, M" uniqKey="Nelle M" first="M" last="Nelle">M. Nelle</name><affiliation><mods:affiliation>Division of Neonatology, Children's Hospital, University Hospital Bern, Bern, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Buhrer, C" sort="Buhrer, C" uniqKey="Buhrer C" first="C" last="Bührer">C. Bührer</name><affiliation><mods:affiliation>Basel University Children's Hospital, Division of Neonatology, Basel, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Engberg, S" sort="Engberg, S" uniqKey="Engberg S" first="S" last="Engberg">S. Engberg</name><affiliation><mods:affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</mods:affiliation></affiliation><affiliation><mods:affiliation>School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Acta Pædiatrica</title><idno type="ISSN">0803-5253</idno><idno type="eISSN">1651-2227</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2009-05">2009-05</date><biblScope unit="volume">98</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="842">842</biblScope><biblScope unit="page" to="846">846</biblScope></imprint><idno type="ISSN">0803-5253</idno></series><idno type="istex">169273DAE97782FC275F75B33DACB555BEF0434D</idno><idno type="DOI">10.1111/j.1651-2227.2008.01203.x</idno><idno type="ArticleID">APA1203</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0803-5253</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Pain management</term><term>Premature infant</term><term>Saliva cortisol</term><term>Sucrose</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Aim: To explore the variability in pain response in preterm infants across time who received sucrose during routine heel stick. Method: Single group, exploratory repeated measures design. Setting: Two tertiary level neonatal intensive care units (NICU) in Switzerland. Subjects: Nine preterm infants born between 28 2/7 and 31 4/7 weeks of gestation during their first 14 days of life. Measurements: Pain was assessed by the Bernese Pain Scale for Neonates (BPSN), the Premature Infant Pain Profile (PIPP) and the Visual Analogue Scale (VAS). Salivary cortisol was analysed. Results: 72–94% of the variability was within‐subject variability, indicating inconsistency of pain responses across the 5 heel sticks. Interrater agreement was highest during heel sticks 1–3 and decreased during heel stick 4 and 5, indicating a possible alteration of pain patterns. No significant differences in the amount of cortisol could be detected before and after the heel sticks (p = 0.55), indicating no stress‐induced peak after the painful intervention. However, a general gradual decrease of cortisol levels across time could be detected. Conclusion: A high variability in pain response among preterm neonates across time could be described. Consistency of cortisol levels before and after the heel sticks could indicate the effectiveness of sucrose across time.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>E Cignacco</name><affiliations><json:string>Institute of Nursing Science, University of Basel, Basel, Switzerland</json:string></affiliations></json:item><json:item><name>K Denhaerynck</name><affiliations><json:string>Institute of Nursing Science, University of Basel, Basel, Switzerland</json:string></affiliations></json:item><json:item><name>M Nelle</name><affiliations><json:string>Division of Neonatology, Children's Hospital, University Hospital Bern, Bern, Switzerland</json:string></affiliations></json:item><json:item><name>C Bührer</name><affiliations><json:string>Basel University Children's Hospital, Division of Neonatology, Basel, Switzerland</json:string></affiliations></json:item><json:item><name>S Engberg</name><affiliations><json:string>Institute of Nursing Science, University of Basel, Basel, Switzerland</json:string><json:string>School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Pain management</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Premature infant</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Saliva cortisol</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Sucrose</value></json:item></subject><articleId><json:string>APA1203</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Aim: To explore the variability in pain response in preterm infants across time who received sucrose during routine heel stick. Method: Single group, exploratory repeated measures design. Setting: Two tertiary level neonatal intensive care units (NICU) in Switzerland. Subjects: Nine preterm infants born between 28 2/7 and 31 4/7 weeks of gestation during their first 14 days of life. Measurements: Pain was assessed by the Bernese Pain Scale for Neonates (BPSN), the Premature Infant Pain Profile (PIPP) and the Visual Analogue Scale (VAS). Salivary cortisol was analysed. Results: 72–94% of the variability was within‐subject variability, indicating inconsistency of pain responses across the 5 heel sticks. Interrater agreement was highest during heel sticks 1–3 and decreased during heel stick 4 and 5, indicating a possible alteration of pain patterns. No significant differences in the amount of cortisol could be detected before and after the heel sticks (p = 0.55), indicating no stress‐induced peak after the painful intervention. However, a general gradual decrease of cortisol levels across time could be detected. Conclusion: A high variability in pain response among preterm neonates across time could be described. Consistency of cortisol levels before and after the heel sticks could indicate the effectiveness of sucrose across time.</abstract><qualityIndicators><score>6.3</score><pdfVersion>1.4</pdfVersion><pdfPageSize>595.274 x 782.286 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1350</abstractCharCount><pdfWordCount>3376</pdfWordCount><pdfCharCount>20985</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>202</abstractWordCount></qualityIndicators><title>Variability in pain response to a non‐pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study</title><refBibs><json:item><author><json:item><name>KJ Anand</name></json:item><json:item><name>BA Barton</name></json:item><json:item><name>N McIntosh</name></json:item><json:item><name>H Lagercrantz</name></json:item><json:item><name>E Pelausa</name></json:item><json:item><name>TE Young</name></json:item></author><host><volume>153</volume><pages><last>8</last><first>331</first></pages><author></author><title>Arch Pediatr Adolesc Med</title></host><title>Analgesia and sedation in preterm neonates who require ventilatory support: results from the NOPAIN trial. 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medicine</json:string><json:string>pediatrics</json:string></scienceMetrix></categories><publicationDate>2009</publicationDate><copyrightDate>2009</copyrightDate><doi><json:string>10.1111/j.1651-2227.2008.01203.x</json:string></doi><id>169273DAE97782FC275F75B33DACB555BEF0434D</id><score>0.027857095</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/169273DAE97782FC275F75B33DACB555BEF0434D/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/169273DAE97782FC275F75B33DACB555BEF0434D/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/169273DAE97782FC275F75B33DACB555BEF0434D/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Variability in pain response to a non‐pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><availability><p>©2009 The Author(s)/Journal Compilation ©2009 Foundation Acta Pædiatrica/Acta Pædiatrica</p></availability><date>2009</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Variability in pain response to a non‐pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study</title><author xml:id="author-1"><persName><forename type="first">E</forename><surname>Cignacco</surname></persName><affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</affiliation></author><author xml:id="author-2"><persName><forename type="first">K</forename><surname>Denhaerynck</surname></persName><affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</affiliation></author><author xml:id="author-3"><persName><forename type="first">M</forename><surname>Nelle</surname></persName><affiliation>Division of Neonatology, Children's Hospital, University Hospital Bern, Bern, Switzerland</affiliation></author><author xml:id="author-4"><persName><forename type="first">C</forename><surname>Bührer</surname></persName><affiliation>Basel University Children's Hospital, Division of Neonatology, Basel, Switzerland</affiliation></author><author xml:id="author-5"><persName><forename type="first">S</forename><surname>Engberg</surname></persName><affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</affiliation><affiliation>School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA</affiliation></author></analytic><monogr><title level="j">Acta Pædiatrica</title><idno type="pISSN">0803-5253</idno><idno type="eISSN">1651-2227</idno><idno type="DOI">10.1111/(ISSN)1651-2227</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2009-05"></date><biblScope unit="volume">98</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="842">842</biblScope><biblScope unit="page" to="846">846</biblScope></imprint></monogr><idno type="istex">169273DAE97782FC275F75B33DACB555BEF0434D</idno><idno type="DOI">10.1111/j.1651-2227.2008.01203.x</idno><idno type="ArticleID">APA1203</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2009</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Aim: To explore the variability in pain response in preterm infants across time who received sucrose during routine heel stick. Method: Single group, exploratory repeated measures design. Setting: Two tertiary level neonatal intensive care units (NICU) in Switzerland. Subjects: Nine preterm infants born between 28 2/7 and 31 4/7 weeks of gestation during their first 14 days of life. Measurements: Pain was assessed by the Bernese Pain Scale for Neonates (BPSN), the Premature Infant Pain Profile (PIPP) and the Visual Analogue Scale (VAS). Salivary cortisol was analysed. Results: 72–94% of the variability was within‐subject variability, indicating inconsistency of pain responses across the 5 heel sticks. Interrater agreement was highest during heel sticks 1–3 and decreased during heel stick 4 and 5, indicating a possible alteration of pain patterns. No significant differences in the amount of cortisol could be detected before and after the heel sticks (p = 0.55), indicating no stress‐induced peak after the painful intervention. However, a general gradual decrease of cortisol levels across time could be detected. Conclusion: A high variability in pain response among preterm neonates across time could be described. Consistency of cortisol levels before and after the heel sticks could indicate the effectiveness of sucrose across time.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>keywords</head><item><term>Pain management</term></item><item><term>Premature infant</term></item><item><term>Saliva cortisol</term></item><item><term>Sucrose</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-05">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/169273DAE97782FC275F75B33DACB555BEF0434D/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1651-2227</doi><issn type="print">0803-5253</issn><issn type="electronic">1651-2227</issn><idGroup><id type="product" value="APA"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="ACTA PAEDIATRICA">Acta Pædiatrica</title></titleGroup></publicationMeta><publicationMeta level="part" position="05005"><doi origin="wiley">10.1111/apa.2009.98.issue-5</doi><numberingGroup><numbering type="journalVolume" number="98">98</numbering><numbering type="journalIssue" number="5">5</numbering></numberingGroup><coverDate startDate="2009-05">May 2009</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="18" status="forIssue"><doi origin="wiley">10.1111/j.1651-2227.2008.01203.x</doi><idGroup><id type="unit" value="APA1203"></id></idGroup><countGroup><count type="pageTotal" number="5"></count></countGroup><titleGroup><title type="tocHeading1">REGULAR ARTICLES</title><title type="tocHeading2">Pain</title></titleGroup><copyright>©2009 The Author(s)/Journal Compilation ©2009 Foundation Acta Pædiatrica/<i>Acta Pædiatrica</i></copyright><eventGroup><event type="firstOnline" date="2009-01-13"></event><event type="publishedOnlineFinalForm" date="2009-04-03"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-15"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:4.0.1" date="2014-03-15"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-14"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="842">842</numbering><numbering type="pageLast" number="846">846</numbering></numberingGroup><correspondenceTo><b>Correspondence</b>
E Cignacco, Institute of Nursing Science, University of Basel, Bernoullistr. 28, 4056 Basel, Switzerland.
Tel: +41 61 267 09 12 |
Fax: +41 61 267 09 55 |
Email: <email>eva.cignacco@unibas.ch</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:APA.APA1203.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory><b>Received</b> 26 August 2008; revised 8 December 2008; accepted 10 December 2008.</unparsedEditorialHistory><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="1"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="29"></count><count type="linksCrossRef" number="38"></count></countGroup><titleGroup><title type="main">Variability in pain response to a non‐pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study</title><title type="shortAuthors">Cignacco et al.</title><title type="short"><i>Variability in pain response in premature infants</i></title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>E</givenNames><familyName>Cignacco</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>K</givenNames><familyName>Denhaerynck</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a2"><personName><givenNames>M</givenNames><familyName>Nelle</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a3"><personName><givenNames>C</givenNames><familyName>Bührer</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1 #a4"><personName><givenNames>S</givenNames><familyName>Engberg</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="CH"><unparsedAffiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="CH"><unparsedAffiliation>Division of Neonatology, Children's Hospital, University Hospital Bern, Bern, Switzerland</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="CH"><unparsedAffiliation>Basel University Children's Hospital, Division of Neonatology, Basel, Switzerland</unparsedAffiliation></affiliation><affiliation xml:id="a4" countryCode="US"><unparsedAffiliation>School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">Pain management</keyword><keyword xml:id="k2">Premature infant</keyword><keyword xml:id="k3">Saliva cortisol</keyword><keyword xml:id="k4">Sucrose</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Aim: To explore the variability in pain response in preterm infants across time who received sucrose during routine heel stick.</p><p>Method: Single group, exploratory repeated measures design.</p><p>Setting: Two tertiary level neonatal intensive care units (NICU) in Switzerland.</p><p>Subjects: Nine preterm infants born between 28 2/7 and 31 4/7 weeks of gestation during their first 14 days of life.</p><p>Measurements: Pain was assessed by the Bernese Pain Scale for Neonates (BPSN), the Premature Infant Pain Profile (PIPP) and the Visual Analogue Scale (VAS). Salivary cortisol was analysed.</p><p>Results: 72–94% of the variability was within‐subject variability, indicating inconsistency of pain responses across the 5 heel sticks. Interrater agreement was highest during heel sticks 1–3 and decreased during heel stick 4 and 5, indicating a possible alteration of pain patterns. No significant differences in the amount of cortisol could be detected before and after the heel sticks (p = 0.55), indicating no stress‐induced peak after the painful intervention. However, a general gradual decrease of cortisol levels across time could be detected.</p><p>Conclusion: A high variability in pain response among preterm neonates across time could be described. Consistency of cortisol levels before and after the heel sticks could indicate the effectiveness of sucrose across time.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Variability in pain response to a non‐pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Variability in pain response in premature infants</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Variability in pain response to a non‐pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study</title></titleInfo><name type="personal"><namePart type="given">E</namePart><namePart type="family">Cignacco</namePart><affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K</namePart><namePart type="family">Denhaerynck</namePart><affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Nelle</namePart><affiliation>Division of Neonatology, Children's Hospital, University Hospital Bern, Bern, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C</namePart><namePart type="family">Bührer</namePart><affiliation>Basel University Children's Hospital, Division of Neonatology, Basel, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S</namePart><namePart type="family">Engberg</namePart><affiliation>Institute of Nursing Science, University of Basel, Basel, Switzerland</affiliation><affiliation>School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2009-05</dateIssued><edition>Received 26 August 2008; revised 8 December 2008; accepted 10 December 2008.</edition><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">1</extent><extent unit="references">29</extent></physicalDescription><abstract lang="en">Aim: To explore the variability in pain response in preterm infants across time who received sucrose during routine heel stick. Method: Single group, exploratory repeated measures design. Setting: Two tertiary level neonatal intensive care units (NICU) in Switzerland. Subjects: Nine preterm infants born between 28 2/7 and 31 4/7 weeks of gestation during their first 14 days of life. Measurements: Pain was assessed by the Bernese Pain Scale for Neonates (BPSN), the Premature Infant Pain Profile (PIPP) and the Visual Analogue Scale (VAS). Salivary cortisol was analysed. Results: 72–94% of the variability was within‐subject variability, indicating inconsistency of pain responses across the 5 heel sticks. Interrater agreement was highest during heel sticks 1–3 and decreased during heel stick 4 and 5, indicating a possible alteration of pain patterns. No significant differences in the amount of cortisol could be detected before and after the heel sticks (p = 0.55), indicating no stress‐induced peak after the painful intervention. However, a general gradual decrease of cortisol levels across time could be detected. Conclusion: A high variability in pain response among preterm neonates across time could be described. Consistency of cortisol levels before and after the heel sticks could indicate the effectiveness of sucrose across time.</abstract><subject lang="en"><genre>keywords</genre><topic>Pain management</topic><topic>Premature infant</topic><topic>Saliva cortisol</topic><topic>Sucrose</topic></subject><relatedItem type="host"><titleInfo><title>Acta Pædiatrica</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0803-5253</identifier><identifier type="eISSN">1651-2227</identifier><identifier type="DOI">10.1111/(ISSN)1651-2227</identifier><identifier type="PublisherID">APA</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>98</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>842</start><end>846</end><total>5</total></extent></part></relatedItem><identifier type="istex">169273DAE97782FC275F75B33DACB555BEF0434D</identifier><identifier type="DOI">10.1111/j.1651-2227.2008.01203.x</identifier><identifier type="ArticleID">APA1203</identifier><accessCondition type="use and reproduction" contentType="copyright">©2009 The Author(s)/Journal Compilation ©2009 Foundation Acta Pædiatrica/Acta Pædiatrica</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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