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Developmental care decreases physiologic and behavioral pain expression in preterm neonates.

Examined the effects of developmental care on pain expression during routine nursing intervention in preterm neonates (NNs). 19 preterm NNs (aged 6-36 days) experienced 2 diaper changes, with and without developmental support. Physiologic responses during baseline, diaper change, and recovery period were assessed, including heart rate, oxygen saturation, hypoxic events with SaO-sub-2 less than 80%, and bradycardia <80 beats per min. Pain expression was evaluated with 2 pain scales: chronic pain with Echelle Douleur et Inconfort (EDIN) or Pain and discomfort scale for newborns at time B60 min, 0, +30 min, and +60 min, and procedural pain with the Preterm Infant Pain Profile (PIPP) at time 0. Results show that PIPP, EDIN 0, EDIN +30 min, and EDIN +60 min scores were significantly decreased with developmental care. Hypoxic events rate was decreased with developmental care during baseline and diaper change periods. The lowest oxygen saturation observed during the PIPP measure was significantly higher with developmental care. Developmental care significantly decreased the PIPP and EDIN pain scores and hypoxic events during a routine nursing intervention. Findings suggest that pain expression in the NN is affected by gestational and postconceptional age, states, and painful experiences. (PsycINFO Database Record (c) 2007 APA, all rights reserved)