Systematic Review of the Effectiveness of Involving Parents During Painful Interventions for Their Preterm Infants

Published:October 07, 2021DOI:



      To systematically review the literature related to the effectiveness of parents’ active involvement during painful interventions for their preterm infants.

      Data Sources

      We performed a systematic search of PubMed, EMBASE/Ovid, CINAHL, Livivio, and PsycInfo using the keywords “preterm infants,” “pain,” and “parents.”

      Study Selection

      Articles were eligible for inclusion if they were published between 2000 and 2021 and reported randomized controlled trials (RCTs) in which preterm infants underwent painful interventions, and parents were present and actively involved in pain-reducing measures.

      Data Extraction

      We used the Consolidated Standards of Reporting Trials (CONSORT) checklist for RCTs for data extraction. We assessed methodologic quality using critical appraisal for RCTs according to the Joanna Briggs Institute.

      Data Synthesis

      In total, 22 articles met the inclusion criteria. These articles reported 19 studies focused on kangaroo/skin-to-skin care, one focused on breastfeeding, and two focused on facilitated tucking. The methods used to evaluate pain in the infant varied substantially. Overall, kangaroo/skin-to-skin care and facilitated tucking resulted in clinically and statistically significant decreases in pain. For breastfeeding, effectiveness was linked to a more mature sucking pattern of the preterm infant.


      The current evidence suggests that involving parents in pain-reducing measures during painful interventions for their preterm infants is beneficial. However, more research is needed for the different methods of involving parents in pain-reducing measures.


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      Andrea Barbara Eissler, MSc, RN, is an advanced nurse practitioner, Department of Women’s and Children’s Health, Women’s Clinic Theodor Kocher-house, Bern, Switzerland.


      Sandra Zwakhalen, PhD, RN, is a professor in the Department of Health Services Research, Caphri, Maastricht University, Maastricht, The Netherlands.


      Liliane Stoffel, MSc, is an advanced nurse practitioner, Department of Women’s and Children’s Health, Women’s Clinic Theodor Kocher-house, Bern, Switzerland.


      Sabine Hahn, PhD, RN, is a professor, Department of Health Professionals, Bern University of Applied Science, Bern, Switzerland.