Mats Eriksson

Protecting infants’ vulnerable brain during repeated painful procedures like blood-sampling and immunizations in early life is a top priority in neonatal health care. Use of parent-delivered pain management may safeguard the infant brain but at the brain level, it is still unclear what drives the analgesic effect of parent-led interventions such as skin-to-skin contact, breastfeeding, and the parent’s live singing. The objective of this study is to advance our understanding of the neural mechanisms behind parent-led pain management in newborn pain care. Twenty mother-infant dyads will be studied during a planned blood sampling venepuncture, with skin-to-skin contact, breastfeeding, and the mother’s live singing. The potential interbrain synchronous cerebral activation in cortical regions of interest will be registered using functional Near-Infrared Spectroscopy (fNIRS) hyperscanning. Secondly, registration of skin conductance, heart rate variability, and the mother’s gaze will be registered. Social and musical interactions will be studied using microanalysis, as will pain using the Behavioral Indicators of Infant Pain (BIIP). The Swedish Research Ethical Review Authority has approved the study (Dnr 2025-02283-01).

To maintain sufficient vaccination rates for human papillomavirus (HPV), it is important to understand the experiences of the target group. Boys were included in the Swedish National Immunization program for HPV more recently, in 2020, than girls, so boys’ experiences of the program are relatively underexplored. This study therefore aimed to explore schoolboys’ experiences of information and communication regarding HPV vaccination. The study had a qualitative explorative design. Individual semi-structured interviews were conducted with 11-year-old schoolboys (n = 13) and analysed using interpretive description. Three themes were identified: information and communication about HPV vaccination in school, schoolboys’ knowledge about HPV and the vaccination, and lack of family involvement in the HPV vaccination. Boys lacked knowledge about HPV vaccination, and parents only partly involved the boys in the vaccination process. There is a need for school nurses to be given clear guidelines for informing boys and parents about HPV, and for the teachers to be provided with health education regarding HPV vaccination.

To examine the inter-rater agreement between parent- and child-reported measures of somatic distress, gastrointestinal symptoms, mental health, and general health in girls aged 9–13 years with functional abdominal pain disorders (FAPDs). This secondary analysis used data from the Just in TIME randomized controlled trial, including girls aged 9–13 years with FAPDs. Both girls and their parents completed the Children’s Somatic Symptoms Inventory (gastrointestinal distress (CSSI-GI) and somatic distress (CSSI-nonGI) subscales) and answered questions about general health and mental health symptoms, measures at baseline and after 8 months. Agreement was assessed using intra-class correlation (ICC) and linear-weighted Cohen’s kappa. Data from 121 girls (mean age 10.6 years) and their parents were analysed. For CSSI-GI, mean scores were similar at baseline (girls 6.98, parents 7.27; ICC 0.84, p < .001) and follow-up (girls 4.25, parents 4.16; ICC 0.91, p < .001). For CSSI-nonGI, girls reported higher mean scores than parents at baseline (8.75 vs. 6.79; ICC 0.75, p < .001) and follow-up (7.14 vs. 5.43; ICC 0.78, p < .001). Agreement for general health was fair (kappa 0.31 at baseline, 0.41 at follow-up, both p < .001). For mental health symptoms, agreement ranged from slight to moderate (kappa 0.20–0.52 at baseline; 0.11–0.46 at follow-up, all significant). Conclusion : Findings indicated good parent– and child agreement for gastrointestinal and general somatic symptoms, but lower agreement for mental health and general health. Clinical trial registration: ClinicalTrials.gov, ID: NCT02920268, Name: Just in TIME–Intervention with Dance and Yoga for Girls with Recurrent Abdominal Pain, registered 29 September 2016. What is Known: • Parent reports are commonly used in paediatric assessment, but it is recommended that children’s perspectives should be integrated in clinical practice and research. • Discrepancies between child and parent reports are frequent and may influence assessment accuracy and treatment planning. What is New: • Parent–child agreement was higher for observable somatic symptoms, particularly gastrointestinal complaints, but lower for subjective experiences such as emotional states and perceived well-being. • Agreement for some items was higher at follow-up, suggesting potential gains in parental awareness or child–parent communication over time.

Necrotizing enterocolitis (NEC) is probably the most painful intestinal disease affecting infants born preterm. NEC is known to cause highly severe and prolonged pain that has been associated with adverse short- and long-term effects. However, research on pain management in infants with NEC is scarce. This is likely due to its low incidence and very acute occurrence. As a result, the optimal pain management for these vulnerable infants remains unknown, and analgesic therapy practices are highly variable. Therefore, we aimed to establish expert-based consensus recommendations on pain management for NEC. Experts of the European Society for Paediatric Research (ESPR) Special Interest Groups on Neonatal pain and NEC were invited to participate in two consensus meetings. Prior to the first hybrid consensus meeting, an online survey provided input for potential recommendations. During the consensus meetings, experts shared clinical expertise and voted on recommendations. An expert consensus statement, comprising nine recommendations on optimal pain assessment and pain treatment in infants with NEC, was developed. Expert recommendations included regular pain assessments with a neonatal pain scale with additional assessments on indication and pre-emptive administration of analgesic therapy (e.g., paracetamol and an opioid) in infants with NEC stage ≥ II. Conclusion: This expert consensus statement provides clinical recommendations essential for any healthcare professional caring for premature infants with NEC. The recommended guidance this statement provides on pain management strategies is key to preventing and reducing pain in this vulnerable population. What is Known: •  Necrotizing enterocolitis (NEC) is a very painful disease, making effective pain management essential.• Current pain management practices for infants with NEC are highly variable. What is New: •  This expert consensus statement provides recommendations on optimal pain assessment and pain treatment in infants with NEC.• These clinical recommendations may help better prevent pain in these vulnerable infants.

Objectives Medical adhesives provide securement of medical devices, facilitate skin protection and allow non-invasive monitoring. Application and removal of medical adhesives can result in pain, dermatitis, trauma or other skin lesions. Understanding patients’ experiences when subjected to medical adhesives will contribute to the improvement of clinical routines and the development and improvement of new adhesive technologies. A qualitative systematic review was conducted to identify patients’ experiences with the application of medical adhesives to the skin. Design Qualitative systematic review. Data sources CINAHL, EMBASE, MEDLINE and PsycINFO were systematically searched for records published between January 2012 and March 2024. Reference lists of systematic reviews and included articles were reviewed. Eligibility criteria Studies published in Danish, Dutch, English, German, Norwegian and Swedish that collected qualitative data on the experience of patients with the application of medical adhesives to the skin were considered. There were no restrictions regarding age, gender or setting. Data extraction and synthesis Study selection, data extraction and quality appraisal were independently conducted by two reviewers. The methodological quality of the studies under consideration was assessed using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research. The extracted data were synthesised using meta-aggregation. Results Nine studies describing patients’ experiences were included. The included studies only reflected experiences with wound dressings. Meta-aggregation of the extracted findings resulted in seven categories that were further synthesised into two synthesised findings: ‘strategies to alleviate pain during dressing changes’ and ‘dressing construction and characteristics’. The synthesised findings illustrate that patients experience pain during dressing change and removal and employ various strategies to alleviate this pain. Conclusions Patients experience pain and discomfort when dressings are changed or removed. Future research should focus on enhancing both routines and technologies, with a particular emphasis on advancing skin-friendly adhesives to reduce unwanted side effects. PROSPERO registration number CRD42023457711.

The aim of this study was to investigate Swedish children’s and parents’ attitudes and knowledge about human papillomavirus (HPV) vaccination a year after gender-neutral HPV vaccination was introduced in Sweden’s national immunization program (NIP). Additional information about HPV and vaccine was provided in the extended immunazation program. In total, 276 parents and 206 children from 22 School Health Services responded to a web-based survey. Results showed that half of the children and about a third of the parents received additional Public Health Agency information about HPV vaccination, and a majority were satisfied. Parents considered HPV vaccination being important for their children’s health, and both children and parents considered it important to vaccinate all genders against HPV. Both children and parents rated school nurses as most reliable source of HPV vaccination information. Teachers were also a common source of HPV and HPV vaccination information for children. Further research among teachers in Sweden is needed to explore their knowledge and abilities to inform students and parents about HPV and vaccination.

Background: While parent-delivered pain management has been demonstrated to effectively reduce neonatal procedural pain responses, little is known about to what extent it is utilized. Our aim was to explore the utilization of parents in neonatal pain management and investigate whether local guidelines promote parent-delivered interventions. Methods: A web-based survey was distributed to neonatal units worldwide. Results: The majority of the 303 responding neonatal intensive care units (NICUs) from 44 countries were situated in high-income countries from Europe and Central Asia. Of the responding units, 67% had local guidelines about neonatal pain management, and of these, 40% answered that parental involvement was recommended, 27% answered that the role of parents in pain management was mentioned as optional, and 32% responded that it was not mentioned in the guidelines. According to the free-text responses, parent-delivered interventions of skin-to-skin contact, breastfeeding, and parental live singing were the most frequently performed in the NICUs. Of the responding units, 65% answered that parents performed some form of pain management regularly or always. Conclusions: There appears to be some practice uptake of parent-delivered pain management to reduce neonatal pain in high-income countries. Additional incorporation of these interventions into NICU pain guidelines is needed, as well as a better understanding of the use of parent-delivered pain management in low- and middle-income countries.

Objective: To describe factors associated with quality of couple relationships among parents of infants cared for in neonatal intensive care units (NICUs) 1 year after birth and examine the trajectory of the relationship quality compared to parents from maternity units (MUs). Study design: Longitudinally comparative cohort design. Parents answered surveys during the first year after discharge about the couple relationship, social support, and depressive symptoms. Results: Better social support and a hospital stay of 7–14 days were positively associated with the couple relationship in NICU mothers, whereas not having slept together with the partner and infant during hospitalization were negatively associated. Depressive symptoms were negatively associated with the relationship among NICU fathers. There were no differences in trajectory of the relationship quality between NICU and MU parents. Conclusion: To strengthen couple relationships, it could be important to improve social support, facilitate space and time for support, and enable togetherness during hospitalization.