Har barnet ont?- Barnsjuksköterans bedömning av smärta hos barn som vårdas på neonatalavdelning

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Sammanfattning: Introduction: The complexity of the neonates’ way of expressing pain is a difficulttask for the pediatric nurse. The Swedish national guidelines for prevention and treatmentof pain in the newborn infant is suggesting that departments regularly use structuredmethods, such as pain assessment instrument, for the assessment of pain in the neonatalperiod. Previous research shows that pain assessment instruments are only used in abouthalf of all pain assessments in Sweden. Neonate's cannot verbally communicate their pain,and are therefore dependent on the pediatric nurse to acknowledge the pain. Untreatedpain can lead to negative consequences in the child's future. Objective: The aim of thisstudy is to describe how the pediatric nurse assesses pain in neonates. Method: A researchplan for a large-scale study has been designed, and a pilot study was carried out. Semistructuredinterviews were conducted with four nurses in a neonatal unit in westernSweden. The material was processed by using qualitative content analysis. Results: Theresults are presented in three categories; the pediatric nurse uses a strategy of exclusion forindividual assessment of pain, the pediatric nurse uses professional knowledge, andcolleagues and parents’ point of view is involved in pain assessment. Conclusion: Pediatricnurses in neonatal units are assessing neonates’ pain by using clinical experience andprofessional knowledge about the behavior of both healthy and sick children. They use astrategy in their pain assessment, to exclude other causes that can produce the same clinicalpicture as pain. The parents and colleagues are involved in the assessment, when trying tocreate a holistic picture of the neonate's situation.

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