• Anna-Kaija Palomaa, Anne Korhonen, and Tarja Pölkki.
• Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland. Electronic address: annakaija.palomaa@gmail.com.
• J Pediatr Nurs. 2016 Sep 1; 31 (5): 519-27.

PurposeNeonates are likely to experience numerous painful procedures in neonatal intensive care units (NICUs). Parents have expressed a wish to be more involved in their infants' pain alleviation. The purpose of this study was to describe parents' perceptions concerning the factors that influence parental participation in pain alleviation in an NICU.Design And MethodsThe qualitative study was conducted in level II and III NICUs (7 units) of Finland's four university hospitals. Data were collected through open-ended questionnaires and analyzed using inductive content analysis.ResultsFactors that promoted parental participation consisted of five main categories: parental counseling by staff, parents' awareness of their own role, parents' motivation to participate in pain relief, family-friendly facilities and good communication. Factors hindering parental participation consisted of eight categories, including restrictive environment, lack of knowledge, everyday life requirements, underestimation of parents, the nature of the medical procedures, procedure- and pain-related emotions, deteriorated health status of the child and mother and (8) uncertainty of parenting.ConclusionsThis study revealed a number of factors that are important to take into account when improving parental involvement in neonatal pain alleviation. Especially, parental participation can be promoted by providing sufficient counseling based on the parents' needs and creating facilities that support parents' participation.Practice ImplicationParents should be engaged as partners in caregiving and decision making, and they should be given space to assume the role of parents during their child's hospitalization.Copyright © 2016 Elsevier Inc. All rights reserved.

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