Knowledge, attitudes and practices of neonatal professionals regarding pain management.

Pain management is an important issue which impacts the prognosis of neonates in neonatal intensive care units. Evidence has shown that professionals' knowledge and attitudes regarding pain management can impact the quality of their practice. The purpose of this study was to evaluate the knowledge, attitudes, and practices of neonatal professionals regarding neonatal pain management. A cross-sectional study was performed involving neonatal physicians and nurses, using a research questionnaire to investigate the knowledge and attitudes of professionals as well as to assess their practice of pain management. Research found an apparent discrepancy between the knowledge levels of neonatologists and nurses regarding pain assessment and management, with nurses displaying weaker professional knowledge and more negative attitudes toward pain management than did neonatologists. Additionally, research revealed a lack of knowledge and negative attitudes among participants regarding the provision of sufficient opioid analgesics to sick infants during invasive procedures and even for dying neonates. There is an urgent need for continuing education regarding neonatal pain management with the goal of empowering neonatal professionals; further research is needed into the question of how to translate education into more reliable practice.Conclusion: This research provides useful information regarding the knowledge, attitudes, and clinical practice of neonatal pain management among neonatologists and nurses and points out some differences in the knowledge levels of these two groups. What is Known: •Neonates can perceive and respond to pain stimuli by showing their biological signals similarly to children and adults. •Untreated or insufficient pain management for high-risk neonates has short-term. negative effects and may also induce long-term negative effects. What is New: •The level of knowledge, the attitudes, and the practices regarding neonatal pain in intensive care are different among neonatal professionals. •There is an urgent need to provide interdisciplinary continuing education to improve the knowledge of neonatal professionals and encourage them to more highly prioritize neonatal pain management.

Cultural practices relating to menarche and menstruation among adolescent girls in Taiwan--qualitative investigation.

STUDY OBJECTIVE: The aim of this study was to qualitatively record the cultural attitudes and practices associated with menarche and menstruation in Taiwanese girls, particularly with respect to coping mechanisms. PARTICIPANTS: Forty-eight adolescent girls participated. INTERVENTION: Adolescent girls were individually interviewed to investigate the effects of their cultural practices, coping mechanisms, and physiological symptoms during menarche and menstruation. MAIN OUTCOME MEASURE(S): The qualitative investigation revealed mixed reactions to menstruation, such as eating chocolate, using sanitary napkins, and feeling irritable or embarrassed. Cluster construction suggested that adolescents were prepared for menarche but required emotional support; in addition, the new generation employed the Internet to learn how to cope. RESULTS: A phenomenological approach showed that menarche and menstrual attitudes among Taiwanese adolescents were comprised in 4 dimensions: self-perception, information, and cultural practices with regard to menarche; physiological symptoms and psychological reactions during menstruation; coping mechanisms during menarche and menstruation; and methods for coping and cultural practices for menstruation. Cultural beliefs and the Internet have changed cross-cultural contacts. CONCLUSIONS: Educators and health professionals should seek to understand this generation of girls, who perceive the world as more flexible and available and have more creativity and new eating behaviors and hobbies.

[Effects of light intensity on the physiological parameters of the premature infant].

This study attempts to find out the effects of light intensity on premature infants' physiological parameters. The research method adopted utilized a quasiexperimental repeated measures design. Thirty-five premature infants born in no more than thirty seven gestation weeks and with birth weight less than 2500g were targeted. The first step was to examine the original arrangement of the blankets over the incubators, the second step was to investigate the effect of placing blankets on the top of the incubator and draped down the top 1/3 of the sides. The third step was conducted without blankets. Factors including light intensity and volume in the incubator and heart rate, respiration rate, and blood oxygen saturation of the premature infants were recorded in all three steps. During the experimental period, no nursing treatment or interventions were allowed. Instruments used in the study included a photometer, a phonometer, a V8 camera, a heart rate monitor, a respiration monitor, and a blood oxygen saturation monitor. The study was conducted in the NICUs in three district hospitals in northern Taiwan. To analyze the data, descriptive statistics and the General Estimation Equation (GEE) were applied. The study shows: (1) Light intensity had a significant statistical relationship with the premature infants' physiological parameters (p = .00). (2) The heart rate and respiration rate increased and the blood oxygen saturation decreased as the intensity of light went up. (3) Placing a blanket over the top and sides of the incubator effectively reduces light levels inside (p = .00). The results of this study suggest a treatment principle for premature infants and provide a basis further research.

[Continuous infusion of morphine in use of pain relief after upper abdominal surgery].

This study was designed as a prospective randomized comparative trial of continuous infusion of morphine (CIM) controlled by a micro-electric pump and traditional intermitted intramuscle injection of pethidine (IMP) to relieve pain after surgery. 40 patients submitted from upper abdominal surgery were divided into two groups, 20 patient receiving CIM and others using IMP. The amount of morphine used during the 24 hours was 0.5 mg/kg in CIM group. In IMP group, 20 patients were given standard intramuscular dosages of 1.5 mg/kg of pethidine, then, every 4-6 hours repeatedly within 24 hours after operation. An analgesic scale was observed by WHO's pain score from I to IV degree. The result showed that all patients of CIM group had good analgesic effect (I and II degree), however, 10% of the patients in IMP group had only analgesic effect of I and II degree during the first 24 hours after operation. Their respiratory frequency, heart rate, BP and SpO2 had no significant difference in two groups. It woule appear that CIM is an efficacious and safe method for providing postoperative pain relief.