Appraising Evidence for Practice Assignment Sample

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Introduction to Appraising Evidence for Practice Assignment

This paper will review the study “The Role of Mothers During Painful Procedures on Neonates: A Focused Ethnography.” It will also include the aims and objectives of the chosen study, the methodology that was used, the results that were obtained, and then a discussion in terms of implications for children’s nursing and evidence-based practice. The significance of research has been broadly emphasized in the Chamber of Health and Social Care since it offers the best working practices with favourable outcomes of the patient’s care. Interventions in the care of neonates have benefits for both parents and infants. Ethnography is a statistical method of studying cultural phenomena, while family-centred care presupposes the close involvement of the parents in the management of the patient. This essay will focus on the analysis of the study and the related prospects in neonatal pain, both for strengths and weaknesses and for integration into practice, while also supporting academic needs through Online Assignment Help UK when required.

Main Body

Title

“The role of mothers during painful procedures on neonates: A focused ethnography”

Abstract

This critical analysis aims to analyse the objectives, methods, and conclusions of the study titled The Role of Mothers During Painful Procedures on Neonates: A Focused Ethnography. This paper aims to focus on the level of maternal participation in neonatal pain management and its advantages and disadvantages. Studying children’s nurses is important for strengthening paediatric care in general and neonatal care in particular due to the impact of parents’ presence on the babies. This discussion evaluates the strengths as well as the limitations of the study, mainly for the provision of family-centred care. Therefore, the accomplishments identified in the course of the appraisal suggest that parental support issues should be incorporated into the NICU to improve the situation for infants and families.

Research problem/purpose significance of study

The research question of the focused ethnography, The Role of Mothers During Painful Procedures on Neonates, is the lack of knowledge of how maternal presence affects neonatal pain in the NICU. It is a concern to observe pain in neonates and their parents’ role in easing the same, which has not been researched much in the Iranian healthcare system. Family-centred care (FCC) encourages parents’ involvement; however, cultural and organization factors and constraints can restrict a mother’s presence during procedures that cause children pain. The current work aims to understand the views of the mothers and the nurses about their presence in neonatal painful treatments. Therefore, to shed light on the number of benefits and disadvantages of maternal involvement the research is to apply the focused ethnographic study concerning neonates and healthcare professionals. It is important hence to focus on the importance of this study in providing meaningful information for neonatal nursing practice. Thus, a proper understanding of the nature of the role of mothers can contribute to the formation of recommendations guiding the development of FCC policies that adequately take into consideration the needs and concerns of both parents and healthcare workers. The administration of this study affirms parental participation in newborn pain relief to enhance the child's development and their mothers (Hassankhani et al., 2020). It also underlines the necessity of the training of the nurse in parents’ encouragement and education regarding their possible involvement in the care of the neonate.

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Literature review

The study The Role of Mothers During Painful Procedures on Neonates: A Focused Ethnography expands the current findings and discussions of the FCC and neonatal pain relief. Concerning parental involvement, the FCC takes it as important since the parents should be involved in decision-making and care of the child, In preventing the feeling of being left out, the FCC reasons that the company that acquires the patent should take adequate measures to involve the parents in any medical procedures involving the infant since the presence of the parents assist in reducing stress in both the infants and the caregivers (Craig et al., 2015). Ullsten, Campbell-Yeo and Eriksson (2024) have found that parental involvement helps to increase the mother’s confidence and also minimizes the stress in a newborn baby. Neonates’ pain is an essential concern since newborns feel pain when undergoing procedures such as venipuncture, intubation, and injections (Feng et al., 2025) Research has shown that both touching and comforting the infant, in this case by parents, can reduce neonatal pain (Bearden et al., 2012). Still, the state of research presents the challenges that affect parents’ attendance. Therefore, according to Van Der Vaart et al. (2024) study, some nurses feel that the presence of parents consoles and disrupts the patients as well. Similarly, Franck and her partners noted in a study conducted in 2012, that they pointed out how healthcare sectors should educate parents. In this regard, this work shares some similarities with another Iranian research conducted by Valizadeh et al. (2018) where they discovered that FCC is not commonly implemented in neonatal units in Iran because of cultural and organizational constraints. This paper advances the literature by detailing how these factors influence maternity roles in neonatal pain management. Besides, the analysis of the results pointed out differences in nurses’ expectations and mothers’ engagement, which is completely absent in the current body of knowledge. This is a call for welcoming and implementing the FCC principles within neonatal pain management based on prior studies. This article recommends the need for raising awareness among nurses and formulation of policies for maternal engagement. Thus, the literature review suggests directions for further inquiry and education to increase the role of parents in neonatal care.

Study design/methods/philosophical underpinnings/theoretical framework/Aim/Hypothesis

The study The Role of Mothers During Painful Procedures on Neonates: A Focused Ethnography expands the current findings and discussions of the FCC and neonatal pain relief. Concerning parental involvement, the FCC takes it as important since the parents should be involved in decision-making and care of the child, in preventing the feeling of being left out, the FCC reasons that the company that acquires the patent should take adequate measures to involve the parents in any medical procedures involving the infant, since the presence of the parents assists in reducing stress in both the infants and the caregivers (Ullsten, Andreasson and Eriksson, 2021). Ullsten et al., (2024) have found that parental involvement helps to increase the mother’s confidence and also minimizes the stress in a newborn baby. Neonates’ pain is an essential concern since newborns feel pain when undergoing procedures such as venipuncture, intubation, and injections (Ullsten, Andreasson and Eriksson, 2021). Research has shown that both touching and comforting the infant, in this case by parents, can reduce neonatal pain (Bearden et al., 2012). Still, the state of research presents the challenges that affect parents’ attendance. Therefore, according to Simons et al. (2001) study, some nurses feel that the presence of parents consoles and disrupts the patients as well. Similarly, Franck and her partners noted in a study conducted in 2012, that they pointed out how healthcare sectors should educate parents. In this regard, this work shares some similarities with another Iranian research conducted by Valizadeh et al. (2018) where they discovered that FCC is not commonly implemented in neonatal units in Iran because of cultural and organizational constraints. This paper advances the literature by detailing how these factors influence maternity roles in neonatal pain management. Besides, the analysis of the results pointed out differences in nurses’ expectations and mothers’ engagement, which is completely absent in the current body of knowledge. Through a review of the key literature, this paper highlights how the need to incorporate the FCC in neonatal pain control. This article recommends the need for raising awareness among nurses and formulation of policies for maternal engagement. Thus, the literature review suggests directions for further inquiry and education to increase the role of parents in neonatal care.

Sampling

The study adopted purposive sampling which is a non-probability sampling technique that is frequently used in qualitative research, it is used to choose participants who are knowledgeable concerning the phenomenon under study. The total subjects selected for the present study were 15 nurses and 18 mothers attending NICU in the western province of Iran. Participants were recruited purposively from the NICU, and the inclusion criterion was that the nurses must have at least six months of actual practice in the NICU. Inclusion criteria for the mothers were that their neonate should have been admitted to the NICU, they had to have spent at least one week in the unit to have adequate exposure to the different procedures being carried out in the NICU. The participants were selected purposively and included a total of thirty-five female nurses 24- 43 years old and with a mixture of years of experience. The mothers were between the ages of 14 and 33 years of age, had various levels of education, and provided different levels of care for their child or children(Toivonen et al., 2020). The study took place at a Level II NICU in a large children’s hospital that specialized in admitting term and near-term stable newborns. Convenience sampling was used with patients recruited till the point of no new emerging themes in observational and interview data. To increase the participants’ variability, the researchers recruited only the mothers of the full-term neonates and the pre-term neonates. Lowndes has also pointed out that such a sampling approach facilitated a high level of coverage of how the aspect of maternal presence when undergoing painful procedures was perceived and received by both nurses and mothers.

Ethical considerations

To maintain high ethical standards to safeguard the rights of the participants, the study followed certain measures like anonymity and informed consent. The permission and consent to participate were taken from the Ethics Committee of Tabriz University of Medical Sciences (IR.TBZMED.REC.2016.789). The participants, the mothers, and the nurses were all informed and willingly consented to participate in the study as explained to them the purpose and procedures of the study. All participants were informed that their withdrawal from the study at any point without any reason would be respected. Their identifying information was blurred in the transcription process while all collected data were kept secure and anonymous. The study also considered possible sources of emotional fatigue for the subjects such as painful neonatal procedures by providing the subject mothers the choice to withdraw or take a break from the study. Since the patients involved were neonates in the hospital, ethical issues also embraced the side effects of engaging the mothers for their involvement in the study(Urbina et al., 2024). The focus of the study involved beneficence, respect, and non-maleficence while ensuring the participants’ welfare as well as the accuracy of neonatal care techniques.

Data collection

The method of data collection comprised participant observation, informal conversations, and long, individual interviews and face-to-face interviews for 7 months in an Iranian NICU. The observations were carried out by the PI over 200 hours of interaction between 15 nurses and 18 mothers through painful neonatal procedures. The observations involved various procedures like venipuncture, arterial puncture, and intubation in seventy instances. Verbal interview, thus, was institutionalized in an attempt to usher in a better understanding of the observed behaviours among the participants. Apart from that, semi-structured interviews were conducted with all participants and each interview lasted 30 to 60 minutes. Though few healthcare professionals were approached, it was easier to interview the nurses in a quiet room close to the NICU, and the mothers were interviewed at their child’s bedside or as per their preference. Recruitment also went on until data depletion was deemed sufficient to capture the various manners in which maternity and nursing were experienced(Filippa et al., 2019). The use of multiple data collection techniques proved to be effective in offering insight into the physical participation of mothers in neonatal pain reduction while making the study more accurate and comprehensive.

Data analysis

Data analysis used Roper and Shapira's (2000) method of ethnography analysis, which is divided into five general steps which include code for labels, identifying patterns, recognizing outliers, generality of construct, and memo note. As such, five main themes were identified from the data collected from the observations, casual conversation, and semi-structured interviews of 15 nurses and 18 mothers. These interviews were tape-recorded and later transcribed by the PI with exact text codes assigned to the interviews out of the identified reoccurring themes and ideas. These codes were then classified into subthemes and further debated with the research team members to have similarities that would make credibility high. These emerging themes included the role of the mother during procedures, the detrimental effects of maternal interference, and the beneficial effects of maternal benefits on newborn care. It was ensured that data analysis was concurrent with data collection to improve its rigor and validity through the refinement of themes. This approach allowed the identification of the state of the art for maternal and nursing knowledge on neonate pain management as well as the implementation of effective guidance for family-centred neonatal care.

Findings

The study revealed that three areas of interest concern maternal presence during neonatal painful procedures, these are; Degree of Maternal Presence, Negative Elements, and Positive Aspects.

1. Determining Maternal Presence:

Nurses first evaluated the woman’s condition from an egg-sacrificing point of view when they decided whether to let her be present in the next painful procedures. Some of the nurses introduced barriers to maternal engagement due to concerns of aggravating maternal anxiety or interference with care. The following subthemes were deemed influential in the decision and experience of the mothers involved: Voluntary resignation hence leaving due to emotional discomfort; Staying on for the baby for support.

1. Negative Impacts of Maternal Involvement:

Nurses stated that some of the mothers remained distressed, cried, or tried to interfere with exercises that were stressful to staff. When they were excluded, mothers experienced Helplessness, which increased Anxiety as an outcome(Filippa et al., 2019).

1. Positive Impacts of Maternal Involvement:

Territorial destructive mothers in turn coaxed their babies using their hands or their voices. A few nurses supported the idea of maternal presence provided that mothers engaged themselves with the process of comforting their child.

The results of this study indicate the lack of good nurse-parent relationships as well as poor programs in training to enhance a family-integrated approach to managing neonatal pain effectively and with care for the mother.

Conclusion

This research established that the involvement of mothers during the painful procedures of neonates can be beneficial or detrimental dependent on the emotional state of the mother and nurses. Whereas some of the nurses see the involvement of the mother as a disturbance, others appreciate the role that it plays in settling the neonates. However, they do not offer guidelines for specific and comprehensive inclusion of the parents in neonatal pain management.

Application to Practice & Recommendations:

Maternal & Parental Involvement: Prepare the nurses to help in identifying the readiness of the mother and also engaging the parents appropriately.

Parental Support Programs: help the mothers to know how to console their infants in the course of invasive procedures.

Policy Proposal: Set standards at the hospital in addressing the incorporation of family-centred care into neonatal pain management.

Communication Strategies: Frequent and mutual communication between the nurses and parents to demystify their fears, as well as improve cooperation.

References

• Feng, L. et al. (2025) ;Facilitators and barriers to parental involvement in neonatal pain management in the NICU: a scoping review,; BMJ Open, 15(1), p. e085881. https://doi.org/10.1136/bmjopen-2024-085881.
• Filippa, M. et al. (2019) ;Pain, parental involvement, and oxytocin in the neonatal Intensive care unit,; Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.00715.
• Hassankhani, H. et al. (2020) ;The role of mothers during painful procedures on neonates: A focused ethnography,; Journal of Neonatal Nursing, 26(6), pp. 340–343. https://doi.org/10.1016/j.jnn.2020.03.002.
• Toivonen, M. et al. (2020) ;Close Collaboration with Parents intervention improves family-centered care in different neonatal unit contexts: a pre–post study,; Pediatric Research, 88(3), pp. 421–428. https://doi.org/10.1038/s41390-020-0934-2.
• Ullsten, A. et al. (2024) ;Parents in Neonatal Pain Management—An International survey of Parent-Delivered Interventions and Parental Pain assessment,; Children, 11(9), p. 1105. https://doi.org/10.3390/children11091105.
• Ullsten, A., Andreasson, M. and Eriksson, M. (2021) ;State of the Art in Parent-Delivered Pain-Relieving Interventions in Neonatal Care: A scoping review,; Frontiers in Pediatrics, 9. https://doi.org/10.3389/fped.2021.651846.
• Ullsten, A., Campbell-Yeo, M. and Eriksson, M. (2024) ;Parent-led neonatal pain management—a narrative review and update of research and practices,; Frontiers in Pain Research, 5. https://doi.org/10.3389/fpain.2024.1375868.
• Urbina, T. et al. (2024) ;The why and how of Family-Centered care,; NeoReviews, 25(7), pp. e393–e400. https://doi.org/10.1542/neo.25-7-e393.
• Van Der Vaart, M. et al. (2024) ;Parental experience of neonatal pain research while participating in the Parental touch trial (Petal),; Pain, 165(8), pp. 1727–1734. https://doi.org/10.1097/j.pain.0000000000003177.