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Eva Cignacco

Publications and source records attributed to Eva Cignacco.

8 recordsLinked to original sources
PubMed2006

The efficacy of non-pharmacological interventions in the management of procedural pain in preterm and term neonates. A systematic literature review.

BACKGROUND: Neonates in a neonatal intensive care unit are exposed to a high number of painful procedures. Since repeated and sustained pain can have consequences for the neurological and behaviour-oriented development of the newborn, the greatest attention needs to be paid to systematic pain management in neonatology. Non-pharmacological treatment methods are being increasingly discussed with regard to pain prevention and relief either alone or in combination with pharmacological treatment. AIMS: To identify effective non-pharmacological interventions with regard to procedural pain in neonates. METHODS: A literature search was conducted via the MedLine, CINAHL, Cochrane Library databases and complemented by a handsearch. The literature search covered the period from 1984 to 2004. Data were extracted according to pre-defined criteria by two independent reviewers and methodological quality was assessed. RESULTS: 13 randomised controlled studies and two meta-analyses were taken into consideration with regard to the question of current nursing practice of non-pharmacological pain management methods. The selected interventions were "non-nutritive sucking", "music", "swaddling", "positioning", "olfactory and multisensorial stimulation", "kangaroo care" and "maternal touch". There is evidence that the methods of "non-nutritive sucking", "swaddling" and "facilitated tucking" do have a pain-alleviating effect on neonates. CONCLUSIONS: Some of the non-pharmacological interventions have an evident favourable effect on pulse rate, respiration and oxygen saturation, on the reduction of motor activity, and on the excitation states after invasive measures. However, unambiguous evidence of this still remains to be presented. Further research should emphasise the use of validated pain assessment instruments for the evaluation of the pain-alleviating effect of non-pharmacological interventions.

Humans↗
PubMed2006

[Ongoing breastfeeding with breast abscess].

Mastitis puerperalis can frequently be complicated by a breast abscess. Immediate diagnosis and treatment are crucial if breastfeeding is to be continued and for the prevention of further complications. Somatic and psychological interventions are of importance for recovery. Specialised nurses and midwives have an important impact on the promotion of well-being of affected mothers.

Breast Cyst↗
PubMed2006

[Needs and expectations of Tamil women attending an antenatal care department at a Swiss university hospital].

It has been noted that immigrant women often initiate prenatal care late in their pregnancy and thus may be inadequately prepared for their birth experience. This leads to poorer maternal outcomes and higher morbidity statistics compared to Swiss women. Tamil women of Sri Lanka represent the largest group of immigrant women being seen at the antenatal care clinic of a Swiss University Hospital. To get a deeper understanding of their needs and expectations relative to their antenatal care, a qualitative study was undertaken. Problem centred interviews were conducted with seven Tamil women before and after delivery. An interpreter was consulting. Data were analyzed using content analysis methods as described by Mayring. Four main themes emerged, demonstrating the need of the women and their resulting expectation: 1) to receive esteem--to show respect and attention; 2) to consult with somebody--to ensure communication; 3) to alleviate worries and fear--to give a sense of security and be in charge; and 4) to make up for lack of experience and knowledge--to pass on experience and knowledge. The quality of the relationships to caregivers is viewed as pivotal and seems to influence Tamil women's satisfaction and their motivation to receive prenatal care.

Emotions↗
PubMed2005

[The efficacy of non-pharmacological interventions in the management of pain in preterm and term neonates. A systematic literature review].

Many diagnostic and therapeutic procedures performed in the neonatal intensive care unit are painful for the preterm or term infant. Pain is therefore a central issue in neonatal intensive care nursing. As significant side effects are associated with analgesics, non-pharmacological methods of pain prevention and relief are being favoured over pharmacological therapy. This development is very important for the nursing profession since non-pharmacological interventions are determined and carried out without an order from a physician. This review of the current literature investigates the efficacy of non-pharmacological nursing interventions in the management of pain in the neonatal intensive care unit. Despite certain methodological problems with some of the studies included in this review, the trend favours non-pharmacological interventions. Modulation of arousal and excitability during and after a painful stimulus as well as an effect on physiological and behavioural parameters have been described following non-pharmacological interventions. The studies reviewed suggest that neonates show fewer signs of pain and stress after non-pharmacological interventions for prevention and relief of pain.

Analgesics↗
PubMed2004

Pain assessment in the neonate using the Bernese Pain Scale for Neonates.

BACKGROUND: Neonates who require treatment in the neonatal intensive care unit (NICU) are subjected to many invasive painful procedures. AIMS: Assessment of pain in preterm and term neonates with or without ventilation on continuous positive airway pressure using the Bernese Pain-Scale for Neonates (BPSN). The validity and the reliability of the BPSN was established. STUDY DESIGN AND SUBJECTS: Pain assessments (n=288) were performed by 6 health care workers in different situations of term and preterm neonates. Each neonate (n=12) was observed in four given situations (after feeding, while a foot was being warmed, while a routine capillary blood sample was taken and 15 min after the blood sample was taken). Pain assessments were made by two nurses at the bedside using the BPSN, the Visual-Analogue Scale (VAS) and the Premature Infant Pain Profile (PIPP). At the same time, a video sequence was made which was shown later to four different nurses to assess pain using the BPSN, the PIPP, and the VAS. RESULTS: The construct validity of the BPSN was very good (F=41.3, p<0.0001). Moreover, concurrent and convergent validity of the BPSN compared to VAS and PIPP was r=0.86, and r=0.91, p<0.0001, respectively. Finally, the study demonstrated high coefficients for interrater (r=0.86-0.97) and intrarater reliability (r=0.98-0.99). CONCLUSION: The BPSN was shown to be a valid and reliable tool for assessing pain in term and preterm neonates with and without ventilation.

Female↗
PubMed2004

[Midwife-led labour in a Swiss hospital].

A midwife-led labour care model was introduced in a Swiss University Hospital. This new model enabled expectant mothers who had a low risk medical history to give birth with the support of only a midwife. The model has been evaluated as part of a pilot project in a comparative study. A quantitative-explorative design was chosen. Labour with only a midwife in comparison with the traditional presence of a doctor and a midwife resulted in fewer invasive procedures, while the outcome parameters were similar in both groups. The post partum hospital stay of the women in the midwife-only group was significantly shorter than in the midwife-and-doctor group. The midwife-only model appealed to a certain group of women and their partners who generally had a higher level of education. Women in both groups were highly satisfied with the midwifery care; the possibility of giving birth in hospital with the presence of a midwife alone was very much appreciated. Under an economic aspect the results of the study provide preliminary indications that delivery by a midwife alone involves lower costs and therefore increased income for the hospital in question.

Female↗
PubMed2002

Between professional duty and ethical confusion: midwives and selective termination of pregnancy.

This qualitative study describes midwives' experiences in relation to termination of pregnancy for fetal abnormalities, and their corresponding professional and ethical position. Thirteen midwives working in a university clinic were interviewed about their problems in this respect. The information gathered was evaluated by using qualitative content analysis. The study focused on the emotional experience of the midwives, their professional position, and ethical conflict. In this situation, midwives are faced with a conflict between the woman's right to self-determination on one hand and the right to life of the child on the other. This conflict causes a high level of emotional stress and, subsequently, professional identity problems. Although questions concerning the child's right to life are generally suppressed, the ethical principle of the woman's right to self-determination is rationalized. Although this process of rationalization seems to present a false ethical decision, it enables midwives to continue with their daily professional duties. As far as orientating midwives to the value of these women's right to self-determination is concerned, it must be assumed that they have made an ethical decision to which they have given insufficient thought. This problem is exacerbated by the fact that midwives are largely excluded from the decision-making process of the parents in question. They cannot therefore help in this process in a valuable and responsible way by providing clear information and proposing objective criteria. In relation to the tasks they are expected to fulfill, these midwives revealed that they were in a state of professional confusion.

Abortion, Therapeutic↗