Pantomimes of pain,distress,repose and lability: the world of the preterm baby

Abstract

■ Little research exists in relation to the world of the preterm baby nursed in moderate- to high-dependency neonatal units

■ A constructivist approach allowed study of the responses of preterm babies to painful stimuli in relation to other patterns of behaviour

■ Heuristic analysis demonstrated four pantomimes: repose, lability, distress and pain

■ Babies used active self-coping strategies to contain pain, distress and lability

■ Babies signalled the need for support with both characteristic hand positions and grosser movements

■ The need for supportive, skilled nursing care and close assessment of behavioural state is indicated

Keywords

Preterm Pantomime Pain Distress Lability Repose Self-coping strategies Hand positions

References

Adler P. , Adler PA (1987). Membership roles in field research. Beverley Hills: Sage Publications.

Anand Kjs , Hickey PR (1992). Comment: Pain and stress responses in neonatal cardiac surgery. New England Journal of Medicine 326: 55-56.

Chamberlain DB (1989). Babies remember pain. Pre-and Peri-Natal Psychology 3: 297-310.

Craig KD , Grunau Rve. (1993). Neonatal pain perception and behavioral measurement . In: Anand KJS , McGrath PJ (Eds). Pain in neonates. Amsterdam: Elsevier Science Publishers: 67-105.

Cunningham Butler N. (1989). Infants, pain and what health care professionals should want to know now - an issue of epistemology and ethics. Bioethics 3: 181-199.

Douglass BG , Moustakas C. (1985). Heuristic inquiry: the internal search to know . Journal of Humanistic Psychology 25: 39-55.

Fitzgerald M. (1993). Development of pain pathways and mechanisms. In: Anand KJS , McGrath PJ (Eds). Pain in neonates. Amsterdam: Elsevier Science Publishers: 19-37.

Fitzgerald M. , McIntosh N. (1989). Pain and analgesia in the newborn. Archives of Disease in Childhood 64: 441-443.

Guba EG ( 1990). The paradigm dialog. Newbury Park : Sage Publications.

10.

Høeg P. ( 1994). Miss Smilla's feeling for snow. London : Flamingo Press.

11.

Horgan M. , Choonara I. , Al-Waidh M. , Sambrooks J. , Ashby D. (1996). Measuring pain in neonates: an objective score . Paediatric Nursing 8: 24-27.

12.

Huberman AM , Miles MB (1994). Data management and analysis methods. In: Denzin NK , Lincoln YS (Eds). Handbook of qualitative research. Thousand Oaks: Sage Publications.

13.

Jorgensen DL (1989). Participant observation. a methodology for human studies. Applied Social Research Methods Series Vol 15. Newbury Park, CA: Sage Publications.

14.

Kirk J. , Miller M. (1986). Reliability and validity in qualitative research. Qualitative Research Methods Series, No 1. London: Sage Publications.

15.

Langercrantz H. , Nilson E. , Redhaml, Hjemdhal P. (1980). Plasma catecholamines following nursing procedures in a neonatal ward. Early Human Development 14: 61-65.

16.

Lofland J. (1971). Analyzing social settings. A guide to qualitative observation and analysis. Belmont: Wadsworth Publications.

17.

Marchette L. , Main R. , Redick E. , Bagg A. , Leatherland J. (1991). Pain reduction interventions during neonatal circumcision . Nursing Research 40: 241-244.

18.

Marshall C. (1990). Goodness criteria, are they objective or judgement calls? In: Guba E (Ed). The paradigm dialog. Newbury Park: Sage Publications.

19.

Mehan H. , Wood H. ( 1975). The reality of ethnomethodology. New York: John Wiley.

20.

Miles MB (1979). Qualitative data as an attractive nuisance: the problem of analysis. Administrative Science Quarterly 24: 590-601.

21.

Moustakas C. (1990). Heuristic research. Design, methodology, and applications Newbury Park: Sage Publications .

22.

Owens ME (1984). Pain in infancy: conceptual and methodological issues. Pain 20: 213.

23.

Silverman D. (1993). Interpreting qualitative data. Methods for analyzing talk, text and interaction London: Sage Publications.

24.

Stevens BJ , Johnston CC , Horton L. (1993). Mutidimensional pain assessment in premature neonataes: a pilot study. Journal of Gynecological and Neonatal Nursing (JOGNN) 22: 531-541.

25.

Volpe JJ (1987). Neurology of the newborn [2nd edn]. WB Saunders: Philadelphia

26.

Woodcock A. , Davis M. (1978). Catastrophe theory. Middlesex : Penguin.