The Experiences of Professionals Regarding Involvement of Parents in Neonatal Pain Management.

Objective
To explore the experiences of health care professionals related to parent involvement during painful procedures carried out on their infants and to describe contextual facilitators and barriers that influence parent involvement during evidence-based, nonpharmacologic pain relief.

Design
Qualitative study with focus group interviews.

Setting
Two Level III NICUs and one Level II NICU in the German-speaking part of Switzerland.

Participants
Convenience sample of 17 NICU nurses and six neonatologists.

Methods
Three interprofessional focus group interviews were conducted. Data were analyzed by thematic analysis.

Results
Contextual factors among professionals, such as know-how and communication skills regarding neonatal pain management; reflective and collaborative practice; and an attitude of partnership with parents and organizational resources, such as time and staffing, promoted a working atmosphere in which it was possible to talk about neonatal pain with parents. Within this context, parents could be successfully involved in their infant's pain management. In contrast, lack of the aforementioned contextual factors, including an attitude of paternalism toward parents, resulted in a working atmosphere in which professionals “kept silent about pain” and hindered parent involvement during painful procedures.

Conclusion
The work culture and organizational features of a NICU facilitate or hinder parent involvement in neonatal pain management. Facilitators and barriers should be identified from the individual, team, and system perspectives. Facilitation of parent-centered pain management in infants should be promoted by the organization.