The experiences of families in family-integrated approaches to neonatal and infant pain management in the neonatal intensive care unit: a systematic review

Neonates and infants undergo various painful procedures in the neonatal intensive care unit (NICU). Family-integrated approaches, although commonly employed for infant pain management, often fail to involve parents, leading to feelings of stress and an inability to fulfill parental roles. The aim of this systematic review was to explore the experiences of families in family-integrated approaches to neonatal and infant pain management in the NICU. A systematic review of qualitative studies was conducted to synthesize and appraise the literature surrounding this topic. The search was performed in November 2023 across three databases (Medline, Embase, and CINAHL) yielding 362 studies, eight of which were included in this review. These were appraised using the Joanna Briggs Institute Critical Appraisal Tool. Inductive meta-thematic analysis was used to synthesize the data. The findings of this review revealed three meta-themes: (1) The experience of lack of parental knowledge surrounding family-integrated approaches to infant pain management in the NICU, (2) The experience of how the NICU culture and environment affect parental participation in family-integrated approaches to infant pain management, and (3) The experience of families and their desired level of involvement in family-integrated approaches to infant pain management in the NICU. There are several challenges and opportunities parents experience that shape their involvement in family-integrated approaches to infant pain management in the NICU. Future clinical practice in the NICU should emphasize parental education and foster a supportive, collaborative, and inclusive environment for parental involvement in family-integrated approaches to infant pain management. Further research is warranted to explore the experiences of healthcare workers and fathers. PROSPERO Registration: CRD42023492701.