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Celeste Johnston

Celeste Johnston
McGill University; IWK Health Centre · Ingram School of Nursing; Newborn Medicine

RN, DEd

About

190
Publications
35,536
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11,682
Citations
Citations since 2016
15 Research Items
4248 Citations
20162017201820192020202120220200400600
20162017201820192020202120220200400600
20162017201820192020202120220200400600
20162017201820192020202120220200400600

Publications

Publications (190)
Article
Full-text available
Background Strong evidence suggests that maternal-infant skin-to-skin contact (SSC) is effective in reducing behavioural responses to pain. Given the multi-sensory benefits of SSC, it is highly likely that SSC provided during pain in early life may reduce pain-induced brain activity. The aim of this study is to examine the effect of SSC compared to...
Article
Full-text available
Objectives To define and validate types of pain in critically ill neonates and infants by researchers and clinicians working in the neonatal intensive care unit (NICU) and high dependency unit (HDU). Design A qualitative descriptive mixed-methods design. Procedure/s Each stage of the study was built on and confirmed the previous stages. Stage 1 w...
Chapter
A major role of mothers is to protect their infant from harm, including pain. The aim of this chapter is to review the evidence on the effectiveness of maternal strategies that are efficacious in managing procedural pain. These strategies are naturally occurring and have been used for millenia by mothers, but only recently have been systematically...
Article
Full-text available
From 1980 into present day, 2020, the evolution of neonatal pain research is told as a journey by one researcher, Celeste Johnston. At the beginning of her work, there was essentially no interest or work in the area. She was fortunate to be led into the area by a clinical problem: how to determine the amount of pain babies in the NICU were experien...
Article
Preterm neonates hospitalized in the neonatal intensive care unit undergo frequent painful procedures daily, often without pain treatment, with associated long-term adverse effects. Maternal-infant skin-to-skin contact, or kangaroo care (KC), and sweet-tasting solutions such as sucrose are effective strategies to reduce pain during a single procedu...
Article
Full-text available
Background: The 2018 Global Year for Excellence in Pain Education, an initiative of the International Association for the Study of Pain, brought worldwide attention to the need for education that crosses narrow disciplinary boundaries, addresses up-to-date research methods and findings, and encourages teamwork among trainees and mentors at differen...
Article
Full-text available
This study aimed to examine the validity of the regional cerebral oxygenation using the near infrared spectroscopy technique for pain assessment in postoperative cardiac surgery adults in the intensive care unit. The near infrared spectroscopy for the assessment of pain has been studied in pediatric population, but its use in adult population espec...
Chapter
Background: Skin-to-skin care (SSC), often referred to as 'kangaroo care' (KC) due to its similarity with marsupial behaviour of ventral maternal-infant contact, is one non-pharmacological intervention for pain control in infants. Objectives: The primary objectives were to determine the effect of SSC alone on pain from medical or nursing procedu...
Article
Background: Preterm infants generally spend weeks in the neonatal intensive care unit where light intensity can fluctuate as well as be high, leading to physiological instability and increased motor activity in these infants. To date, 2 lighting control methods have been studied: cycled lighting and continuous near darkness. The most appropriate m...
Article
Aims: To assess the acceptability of methods that increase trial inclusion in meta-analyses, and the level of evidence for skin-to-skin contact for procedural pain in infants. Background: The current Cochrane review of skin-to-skin contact for pain in newborns found it to be an effective intervention, but identified several methodological limita...
Article
Background: Skin-to-skin contact between mother and infant, commonly referred to as Kangaroo Care (KC), has demonstrated efficacy as a pain-relieving strategy for infants, yet, it remains underutilized in clinical practice. Purpose: To evaluate changes in neonatal intensive care unit staff nurse beliefs, utilization, and challenges related to pr...
Chapter
Evidence indicates that the experience of pain begins in the second trimester, well before the third and last trimester of human gestation: thus preterm babies can perceive pain. When babies are born preterm, they undergo painful experiences as a necessary component of their care. These experiences can result in important short-term stress response...
Chapter
Pain in infants was essentially ignored up until the 1980s. The few reports that did exist were small observational studies. In 1987, the first randomized trial on pain in neonates was published in the Lancet, in which it was reported that the standard for anesthesia for neonates undergoing repair of patent ductus arteriosus was inadequate and that...
Article
Full-text available
Conclusion: Despite international guidelines, neonates included in control groups during painful procedures do not receive analgesia in the majority of cases. Several historical reasons can explain this, but in the light of present knowledge, this should not continue. Ethical committees are thereof invited since now to not permit clinical trials t...
Article
The purpose of this study was to evaluate the pain response of 28-32 weeks gestational age preterm infants during a heel lance following a 4-h period where they had worn eye shields and earmuffs as a light and noise reduction intervention. A randomized controlled trial was conducted on 44 preterm infants recruited from four level III NICU. Heart ra...
Article
Extremely low gestational age infants (<28 weeks at birth) experience significant pain from repeated therapeutic procedures while hospitalized in the neonatal intensive care unit. As part of a program of research examining pain in preterm infants, we conducted a qualitatively driven mixed-methods design, supplemented with a qualitative and quantita...
Article
Full-text available
Marsha L Campbell-Yeo,1–4 Timothy C Disher,1 Britney L Benoit,1 C Celeste Johnston,2,4,5 1School of Nursing, Dalhousie University, 2Department of Pediatrics, IWK Health Centre, 3Department of Psychology and Neuroscience, Dalhousie University, 4Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, 5Ingram School of Nursing, McGill Univ...
Article
Objective To evaluate the efficacy of cobedding on twin coregulation and twin safety.DesignRandomized controlled trial (RCT).SettingTwo university affiliated Level III neonatal intensive care units (NICUs).ParticipantsOne hundred and seventeen sets (N = 234) of stable preterm twins (<37 weeks gestational age at birth) admitted to the NICU.Methods S...
Article
A large number of patients who are in pain upon arriving at the emergency department are still in pain when they are discharged. It is suggested that nurses' personal traits and their level of empathy can explain in part this issue in pain management. The purpose of this study was to better understand the shortfalls in pain management provided by e...
Article
Full-text available
Background and objectives: Pain in Child Health (PICH) is a transdisciplinary, international research training consortium. PICH has been funded since 2002 as a Strategic Training Initiative in Health Research of the Canadian Institutes of Health Research, with contributions from other funding partners and the founding participation of five Canadia...
Article
Full-text available
Objective: This study reports on the preferences for psychological treatment after abortion among college students who experienced psychological distress and desired mental health services, and provides validation of the Post Abortion Questionnaire (PAQ) as a measure of abortion intervention preferences. Background: The current study is part of a l...
Article
Objectives To examine the construct validity, inter-rater reliability, and feasibility of the Premature Infant Pain Profile-Revised in infants of varying gestational ages, diagnoses, and procedures. Methods A prospective cross-over study with infants in three gestational age groups (26–31, 32–36, and ≥ 37 weeks) at three university-affiliated Neon...
Article
To describe revisions to the Premature Infant Pain Profile (PIPP) and initial construct validation and feasibility of the Premature Infant Pain Profile-Revised (PIPP-R). The PIPP was revised to enhance validity and feasibility. To validate the PIPP-R, data from 2 randomized cross-over studies were utilized to: (1) calculate and compare PIPP and PIP...
Article
Skin-to-skin care (SSC), otherwise known as Kangaroo Care (KC) due to its similarity with marsupial behaviour of ventral maternal-infant contact, is one non-pharmacological intervention for pain control in infants. The primary objectives were to determine the effect of SSC alone on pain from medical or nursing procedures in neonates undergoing pain...
Article
Full-text available
To examine the effect of co-bedding between preterm twins on stress response following heel lance. Using a multisite randomized controlled trial design, stable preterm twins (67 sets, N=134 infants) between 28 and 36 completed week's gestational age, stratified by gestational age (less than or equal to and greater than 32 weeks) and site, were rand...
Article
Full-text available
Skin-to-skin contact (SSC) between mother and infant, commonly referred to as Kangaroo Mother Care (KMC), is recommended as an intervention for procedural pain. Evidence demonstrates its consistent efficacy in reducing pain for a single painful procedure. The purpose of this study is to examine the sustained efficacy of KMC, provided during all rou...
Chapter
A major role of maternal care is to protect their infant from harm, including pain. The aim of this chapter is to review the evidence on the effectiveness of maternal strategies that are efficacious in managing procedural pain including breastfeeding, kangaroo mother care, and facsimiles of maternal presence such as voice recordings, odour, and oth...
Article
Hospitalized children frequently receive inadequate pain assessment and management despite substantial evidence to support effective pediatric pain practices. The objective was to determine the effect of a multidimensional knowledge translation intervention, Evidence-based Practice for Improving Quality (EPIQ), on procedural pain practices and clin...
Article
Full-text available
All infants undergo painful procedures involving skin puncture as part of routine medical care. Pain from needle puncture procedures is suboptimally managed. Numerous nonpharmacologic interventions are available for these painful procedures, including swaddling, holding, skin-to-skin care, pacifier, sweet-tasting solutions, and breast-feeding. Adop...
Chapter
Pain in infants was essentially ignored up until the 1980s. The few reports that did exist were small observational studies. In 1987, the first randomized trial on pain in neonates was published in the Lancet, in which it was reported that the standard for anesthesia for neonates undergoing repair of patent ductus arteriosus was inadequate and that...
Article
Full-text available
Controversy over abortion inhibits recognition and treatment for women who experience psychological distress after abortion (PAD). This study identified the characteristics, severity, and treatment preferences of university students who experienced PAD. Of 151 females, 89 experienced an abortion. Psychological outcomes were compared among those who...
Article
Preterm neonates below 30 weeks' gestational age undergo numerous painful procedures. Many management approaches are not appropriate for this population. Therapeutic Touch, an alternative approach based on the theory of energy medicine, has been shown to promote physiological stability in preterm neonates and reduce pain in some adult studies. The...
Article
Objectives: Inferring the pain level of a critically ill infant is complex. The ability to accurately extract the appropriate pain cues from observations is often jeopardized when heavy sedation and muscular blocking agents are administered. Near-infrared spectroscopy is a noninvasive method that may provide the bridge between behavioral observatio...
Article
Neonatal intensive care unit (NICU) light and noise may be stressful to preterm infants. This research evaluated the physiological stability of 54 infants born at 28- to 32-weeks' gestational age while wearing eye goggles and earmuffs for a 4-hour period in the NICU. Infants were recruited from four NICUs of university-affiliated hospitals and rand...
Article
Full-text available
Aim: To determine the feasibility and effect size of kangaroo care (KC) for pain from heel lance in preterm neonates provided by either the infant's mother (MKC) or an unrelated alternate female (AFKC). Methods: Using a randomized crossover design, preterm neonates (n = 18) between 28 and 37 weeks gestational age within 10 days of life from two...
Article
Cobedding of preterm twin infants provides tactile, olfactory, and auditory stimulation and may affect pain reactivity. We carried out a randomized trial to assess the effect of cobedding on pain reactivity and recovery in preterm twin neonates. Stable preterm twins (n = 67 sets) between 28 and 36 weeks of gestational age were randomly assigned to...
Article
Full-text available
Intrauterine growth restriction is associated with increased risk for adult metabolic syndrome and cardiovascular disease, which seems to be related to altered food preferences in these individuals later in life. In this study, we sought to understand whether intrauterine growth leads to fetal programming of the hedonic responses to sweet. Sixteen...
Article
Analgesic trials pose unique scientific, ethical, and practical challenges in pediatrics. Participants in a scientific workshop sponsored by the US Food and Drug Administration developed consensus on aspects of pediatric analgesic clinical trial design. The standard parallel-placebo analgesic trial design commonly used for adults has ethical and pr...
Chapter
Neonates who are born preterm spend weeks in the neonatal intensive care unit (NICU) and undergo numerous painful procedures as part of their routine care [1]. In spite of evidence of negative effects and published guidelines on pain control, about one third of procedures remain unmanaged [2].
Article
Celeste Johnston is an Emeritus Professor at McGill University School of Nursing, Montreal and a scientist at IWK Health Center, Halifax. Her research, funded by Canadian Institutes of Health Research, Quebec Research Fund, SickKids Foundation, Nova Scotia Health Research Foundation and the Mayday Fund, has, over the past three decades, focused on...
Article
This is the second of a 2-part series to provide an overview of our current level of knowledge related to nonpharmacological strategies to diminish the pain associated with commonly performed procedures in the NICU. In our first article we discussed the prevalence of repeated pain exposure in the NICU and the importance of nonpharmacological strate...
Article
Full-text available
To test paternal vs maternal kangaroo care (KC) to reduce pain from heel lance. Randomized crossover design. Three university-affiliated level III neonatal intensive care units. Sixty-two preterm neonates at 28 to 36 weeks' gestational age who were expected to stay in the neonatal intensive care unit for at least 2 blood sampling procedures, withou...
Article
Full-text available
Due to the subtlety or absence of predictable, objective signs of pain in critically ill infants, health care professionals must often rely on observations of behavioural or nonspecific physiological signals. Although parameters such as heart rate or blood pressure could be regarded as relatively more objective or quantifiable measures than behavio...
Article
Neonates who are born preterm and are admitted to neonatal intensive care units endure frequent procedures that may be painful. Nonpharmacological interventions that have been studied to relieve their pain may be categorized in 2 main groups according to their nature: interventions that focus on creating a favorable environment and offering pleasan...
Article
Full-text available
Background: Research reporting effective pain care strategies exists, yet it is not translated to care. Little is known about how repeated pain exposure has affected nurses' ability to be empathetic and use their knowledge to provide evidence-based care. Concerns have been raised regarding the validity of self-report empathy instruments; therefore...
Article
Full-text available
Parents consistently express a desire to support their child and retain a care-giving role in the paediatric intensive care unit (PICU). Qualitative data gathered as part of a PICU intervention study were analysed to explore mothers' experiences using a Touch and Talk intervention to comfort their children during invasive procedures. To describe ho...
Article
Critically ill children are at risk for psychological sequelae following pediatric intensive care unit hospitalization. This article reports on the psychometric testing of the first self-report measure of psychological distress for 6-12-yr-old children post-pediatric intensive care unit hospitalization: The Children's Critical Illness Impact Scale....
Article
To determine the incidence of and factors predicting management strategies used for procedural pain in Canadian neonatal intensive care units and to determine whether the incidence of procedures and their management has changed since our 1997 study. Five hundred eighty-two neonates who were hospitalized in any of the participating study centers wer...
Article
This pilot study examined the discriminant validity and criterion validity of regional cerebral oxygenation measurement (rSO₂), using the near-infrared spectroscopy (NIRS) technique (INVOS-4100 system, Somanetics, Troy, MI) for measuring pain during nociceptive procedures in adults undergoing cardiac surgery. A repeated-measures, within-subjects de...
Article
To review the (1) reliability, validation, feasibility, and clinical utility and (2) the use of the Premature Infant Pain Profile (PIPP) from 1996 to 2009 to determine the effectiveness of pain management strategies. Data sources included MEDLINE, CINAHL, EMBASE, PsycINFO, and the Web of Science. Published studies evaluating the measurement propert...
Article
This paper is a report of the efficacy of a parental educational intervention on children's pain intensity and experience of pain-related unpleasantness at 24 hours post-discharge from the emergency department, and on parents' beliefs about pain. Parents' misbeliefs about pain management may inhibit them from managing their child's pain appropriate...
Article
Pain processing and management in neonates, especially preterm neonates, differs from older populations. In this review, a brief background on pain processing in neonatal life, pain exposure in Neonatal Intensive Care Units (NICU), the consequences of untreated pain, and the difficulties in treating procedural pain pharmacologically will be present...
Article
To describe how (i) risk of neurological impairment (NI) and (ii) procedure invasiveness influence health professionals' assessment and management of procedural pain in neonates in the Neonatal Intensive Care Unit (NICU). Prospective observational study. Three tertiary level NICUs in Canada. 114 neonates, 25-40 weeks gestational age (GA) undergoing...
Article
Nurses are involved in many of the painful procedures performed on hospitalized children. In collaboration with physicians, nurses have an exceptional responsibility to have knowledge to manage the pain; however, the evidence indicates this is not being done. Issues may be twofold: (a) opportunities to improve knowledge of better pain care practice...
Conference Paper
BACKGROUND: Skin-to-skin contact, often referred to as Kangaroo Care (KC), by mothers has been reported to reduce pain response and more rapid recovery in preterm neonates undergoing heel lance for clinical purposes. Studies to date have exclusively examined mothers as the provider of SSC for painful procedures. Although fathers have participated i...
Article
Full-text available
Background Co-bedding, a developmental care strategy, is the practice of caring for diaper clad twins in one incubator (versus separating and caring for each infant in separate incubators), thus creating the opportunity for skin-to-skin contact and touch between the twins. In studies of mothers and their infants, maternal skin-to-skin contact has b...
Article
Bias is defined as any systematic error resulting in an inaccurate estimate of the outcome of a study. In studies of complex nursing interventions, bias is particularly difficult to control because of issues related to blinding and choice of controls. The authors identify strategies to control bias in intervention studies. They conduct a literature...