• Linda A Hatfield, Nancy Murphy, Kelley Karp, and Rosemary C Polomano.
• Family and Community Health, University of Pennsylvania School of Nursing, Pennsylvania Hospital Department of Nursing, Philadelphia, PA, USA. Electronic address: lhat@nursing.upenn.edu.
• J Pediatr Nurs. 2019 Jan 1; 44: 22-30.

ProblemCurrent research suggests behavioral and environmental interventions to prevent neonatal pain prior to an invasive procedure are rarely administered and seldom documented. The aim of this study was to systematically review findings from published randomized controlled trials that tested the effects of behavioral and environmental procedural pain management interventions on behavioral pain response in preterm infants.Eligibility CriteriaRandomized controlled trials examining the effects of behavioral and environmental pain management interventions on behavioral pain response in preterm infants were identified. Articles accepted for inclusion met the following criteria: English language, original, peer refereed, randomized controlled clinical trials published within the past 5 years, study sample: preterm infants, setting: neonatal intensive care units, study intervention behavioral and environmental, outcome pain measurement score from valid and reliable pain scale.SampleFourteen randomized controlled trials from a literature search of PubMed and Medline databases were included in this review.ResultsAcross all age groups, facilitated tucking, oral sucrose, and kangaroo care decreased behavioral and physiologic pain response alone and in combination with other behavioral and environmental interventions.ConclusionAmong preterm infants, facilitated tucking, oral sucrose, and kangaroo care significantly mitigates biobehavioral pain response associated with acutely painful procedures.ImplicationsEvidence suggests that behavioral and environmental interventions can decrease biobehavioral pain response associated with acutely painful procedures in preterm infants. This review highlights the need for rigorous studies to help healthcare providers to build a tailored pain treatment plan for preterm infants.Copyright © 2018 Elsevier Inc. All rights reserved.

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