Janet Yamada's research while affiliated with Ryerson University and other places

Publications (65)

Chapter
Abundant published evidence demonstrates the pain-reducing effects of sweet solutions in human infants and animals. Analgesic effects persist up to around 1 year of age in human infants, though there is less research to support analgesic effects in older infants and, for the existing research, effects are more moderate than seen in the neonatal per...
Chapter
Despite great strides in evidence-based pain assessment and management strategies, infants and children still experience acute pain (including multiple painful procedures) and chronic pain during hospitalization. Translating best evidence on pain assessment and management into clinical practice remains a challenge. The knowledge- or evidence-to-pra...
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Background Parents of children born preterm with a disability often experience profound psychological distress with transition from neonatal to rehabilitation services. Four interventions were found effective to support parents throughout this critical transition period whereby parental stress can threaten the child’s development. Purpose To exami...
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Introduction This study builds on our prior research, which identified that older rural patients and families (1) view preparation for detecting and responding to worsening health conditions as their most pressing unmet transitional care (TC) need and (2) perceive an evidence-based intervention, preparing them to detect and respond to warning signs...
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Background: Hospitalized infants undergo multiple painful procedures daily. Despite the significant evidence, procedural pain assessment and management continues to be suboptimal. Repetitive and untreated pain at this vital developmental juncture is associated with negative behavioral and neurodevelopmental consequences. To address this knowledge...
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Background: Orally administered sucrose is effective and safe in reducing pain intensity during single, tissue-damaging procedures in neonates, and is commonly recommended in neonatal pain guidelines. However, there is wide variability in sucrose doses examined in research, and more than a 20-fold variation across neonatal care settings. The aim o...
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Objectives: This study aimed to apply a theory-based approach to identify barriers and enablers to implementing the Alberta Primary Care Asthma Pediatric Pathway (PCAPP) into clinical practice. Phase 1 included an assessment of assumptions underlying the intervention from the perspectives of the developers. Phase 2 determined the perceived barrier...
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Background Despite substantial research on pediatric pain assessment and management, health care professionals do not adequately incorporate this knowledge into clinical practice. Organizational context (work environment) is a significant factor in influencing outcomes; however, the nature of the mechanisms are relatively unknown. The objective of...
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Background and objectives: Inadequate pain treatment leaves hospitalized children vulnerable to immediate and long-term sequelae. A multidimensional knowledge translation intervention (ie, the Evidence-based Practice for Improving Quality [EPIQ]) improved pain assessment, management, and intensity outcomes in 16 units at 8 Canadian pediatric hospi...
Article
Background: Administration of oral sucrose with and without non-nutritive sucking is the most frequently studied non-pharmacological intervention for procedural pain relief in neonates. Objectives: To determine the efficacy, effect of dose, method of administration and safety of sucrose for relieving procedural pain in neonates as assessed by va...
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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...
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The aim of this systematic review was to evaluate the effectiveness of toolkits as a knowledge translation (KT) strategy for facilitating the implementation of evidence into clinical care. Toolkits include multiple resources for educating and/or facilitating behaviour change. Systematic review of the literature on toolkits. A search was conducted o...
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Background: Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A...
Article
BACKGROUND: Procedural pain assessment and management have been extensively studied through multiple research studies over the past decade. Results of this research have been included in numerous pediatric pain practice guidelines.
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...
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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
The Evidence-Based Practice Identification and Change (EPIC) strategy is a multifaceted knowledge translation intervention. Although the intervention promoted evidence-based practice, the process of delivering the intervention components is not well understood. The purpose of this study was to determine the construct validity of the Process Evaluat...
Article
Procedural pain assessment and management have been extensively studied through multiple research studies over the past decade. Results of this research have been included in numerous pediatric pain practice guidelines. To systematically review the quality of existing practice guidelines for acute procedural pain in children and provide recommendat...
Article
Hospitalized children frequently receive inadequate pain assessment and management despite substantial evidence to support effective pediatric pain practices. The objective of this study was to determine the effect of a multidimensional knowledge translation intervention, Evidence-based Practice for Improving Quality (EPIQ), on procedural pain prac...
Chapter
Abundant evidence demonstrates pain-reducing effects of sweet solutions in human infants and animals. Analgesic effects persist up to around 1 year of age in human infants, although the effects are more moderate than seen in the neonatal period. Effects are considered to be due to the relationship between sweet taste and the endogenous opiate syste...
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...
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Full-text available
Although clinical narratives – described as free-text notations – have been noted to be a source of patient information, no studies have examined the composition of pain narratives in hospitalized children’s medical records. OBJECTIVES: To describe the structure and content of health care professionals’ narratives related to hospitalized children’s...
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Although documentation of children’s pain by health care professionals is frequently undertaken, few studies have explored the nature of the language used to describe pain in the medical records of hospitalized children. OBJECTIVES: To describe health care professionals’ use of written language related to the quality and quantity of pain experience...
Article
<⁄span> Sucrose has been demonstrated to provide analgesia for minor painful procedures in infants. However, results of trials investigating other sweet solutions for neonatal pain relief have not yet been synthesized. <⁄span> To establish the efficacy of nonsucrose sweet-tasting solutions for pain relief during painful procedures in neonates. <⁄...
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Unlabelled: Numerous acute pediatric pain assessment measures exist; however, pain assessment is not consistently performed in hospitalized children. The objective of this study was to determine the nature and frequency of acute pain assessment in Canadian pediatric hospitals and factors influencing it. Pain assessment practices and pain intensity...
Article
Background: Extensive evidence exists showing analgesic effects of sweet solutions for newborns and infants. It is less certain if the same analgesic effects exist for children one year to 16 years of age. This is an updated version of the original Cochrane review published in Issue 10, 2011 (Harrison 2011) titled Sweet tasting solutions for reduc...
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Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions as...
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In this qualitative descriptive study, we explored health care professionals' perceptions of the influence of context (i.e., organizational culture, structure, resources, capabilities/competencies, and politics) on evidence-based pain practices. A total of 16 focus groups with 147 health care professionals were conducted in three neonatal intensive...
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...
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The goal was to review published studies of analgesic effects of sweet solutions, to ascertain areas with sufficient evidence of effectiveness and areas of uncertainty. Databases searched included Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature database, and PsycINFO, using the terms pain*, infant*, neonat*, newborn*,...
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
There has been clinical enthusiasm for treating short bowel patients with human recombinant growth hormone and/or glutamine in hopes of reducing parenteral nutrition dependency. It has been more than a decade since Byrne and colleagues reported enhanced absorption of nutrients, improved weight gain, and reduction in parenteral nutrition requirement...
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To compare the efficacy of oral sweet solutions to water or no treatment in infants aged 1-12 months during immunisation. Randomised controlled trials (RCTs) were retrieved through internet searches or manual searches of reference lists. Search terms included newborn, infant, pain, sucrose and alternative names for sweet solutions. Summary estimate...
Article
Health care professionals caring for neonates (birth to 28 days of life) and infants up to 1 year of age have a professional and ethical responsibility to provide safe and effective pain management during painful procedures. Despite 14 years of research reports highlighting that sick infants are exposed to large numbers of painful procedures with m...
Article
The Evidence-Based Practice Identification and Change (EPIC) intervention is a complex multifaceted knowledge translation strategy that combines the use of evidence and continuous quality improvement to change health care professional practices. However, there is no measure to evaluate the fidelity (degree to which the intervention was implemented...
Article
Background: Administration of oral sucrose with and without non-nutritive sucking is the most frequently studied non-pharmacological intervention for procedural pain relief in neonates. Objectives: To determine the efficacy, effect of dose and safety of oral sucrose for relieving procedural pain in neonates. Search methods: We used the standar...
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This paper is a report of a study to compare the importance and usefulness ratings of physiological and behavioural indicators of pain in neonates at risk for neurological impairment by nurse clinicians and pain researchers. Neonates at risk for neurological impairment have not been systematically included in neonatal pain measure development and h...
Article
Critically appraise research evidence on effectiveness of internet self-management interventions on health outcomes in youth with health conditions. Published studies of internet interventions in youth with health conditions were evaluated. Electronic searches were conducted in EBM Reviews-Cochrane Central Register of Controlled Trials, Medline, EM...
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Acute pain is a common experience for hospitalized children. Despite mounting research on treatments for acute procedure-related pain, it remains inadequately treated. To critically appraise all systematic reviews on the effectiveness of acute procedure-related pain management in hospitalized children. Published systematic reviews and meta-analyses...
Article
Approximately 10% of infants admitted to a Neonatal Intensive Care Unit (NICU) are at risk for Neurological Impairment (NI). While we have limited knowledge on the influence of NI risk on pain responses, we have no knowledge of how these responses change over time. To compare physiological and behavioural pain responses of infants at three levels o...
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Background: There is a plethora of infant pain measures; however, none of them have been validated for extremely low for gestational age (ELGA) infants (<27 weeks' gestation). To date, clinicians, researchers and parents use information gleaned from more mature infants to make inferences about pain in ELGA infants. Using physiological or behaviora...
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Hospitalized infants undergo multiple, repeated painful procedures. Despite continued efforts to prevent procedural pain and improve pain management, clinical guidelines and standards frequently do not reflect the highest quality evidence from systematic reviews. OBJECTIVE: To critically appraise all systematic reviews on the effectiveness of proce...
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Full-text available
BACKGROUND: Acute pain is a common experience for hospitalized children. Despite mounting research on treatments for acute procedure-related pain, it remains inadequately treated. OBJECTIVE: To critically appraise all systematic reviews on the effectiveness of acute procedure-related pain management in hospitalized children. METHODS: Published syst...
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The primary purpose was to determine the underlying structure of the vulnerable infant's response to an acute painful procedure. The secondary purpose was to explore the influence of context (e.g., risk for neurological impairment [NI] and gestational age [GA]). A descriptive cohort design determined contributions of selected indicators to the stru...
Article
As preterm and term infants in the neonatal intensive care unit (NICU) undergo multiple stressful/painful procedures, research is required that addresses chronic stress. To determine whether (a) hair cortisol levels differed between term and preterm infants exposed to stress in the NICU and (b) an association exists between hair cortisol levels and...
Article
The primary purpose was to determine the underlying structure of the vulnerable infant's response to an acute painful procedure. The secondary purpose was to explore the influence of context (e.g., risk for neurological impairment [NI] and gestational age [GA]). A descriptive cohort design determined contributions of selected indicators to the stru...
Article
To examine the satisfaction with and feasibility of a computer-based teaching module to teach healthcare professionals how to use and apply the Premature Infant Pain Profile (PIPP) to clinical scenarios. Sixty-eight healthcare professionals who were employed in the neonatal intensive care unit (NICU) on a full-time or part-time basis and had receiv...
Article
Multiple researchers have validated indicators and measures of infant pain. However, infants at risk for neurologic impairment (NI) have been under studied. Therefore, whether their pain responses are similar to those of other infants is unknown. Pain responses to heel lance from 149 neonates (GA>25-40 weeks) from 3 Canadian Neonatal Intensive Care...
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The aim of this study was to systematically review the psychometric properties, interpretability and feasibility of self-report pain intensity measures for children and adolescents for use in clinical trials evaluating pain treatments. Databases were searched for self-report measures of single-item ratings of pain intensity for children aged 3-18 y...
Article
The aim of this descriptive exploratory study was to determine the perspectives of parents and children with cancer on a home chemotherapy program. Qualitative analyses were used to organize data from 24 parents and 14 children into emerging themes. Themes included (1) financial and time costs, (2) disruption to daily routines, (3) psychological an...
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A number of infant pain measures have been developed over the past 15 years incorporating behavioural and physiologic indicators; however, no reliable or valid measure exists for infants who are at risk for neurological impairments (NI). The objective of this study was to establish consensus about which behavioural, physiologic and contextual indic...
Article
Preterm neonates undergo numerous painful procedures in the neonatal intensive care unit (NICU). Sucrose, with and without pacifiers, is effective and safe for relieving pain from single painful events. However, repeated use of sucrose for multiple painful procedures has not been adequately evaluated. The study objectives were to: 1) determine the...
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The objective of this study was to describe adolescents' with cancer experience in an adventure therapy program from a health related quality of life (HRQL) perspective. A qualitative descriptive research method was used. Eleven adolescents and five health professionals participated in a guided group adventure therapy expedition in a remote area of...
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The goal of this study was to determine the perspectives of healthcare professionals (HPs) from community and hospital settings involved in a paediatric home chemotherapy programme. Using a prospective descriptive study design, HPs including paediatricians, community nurses, hospital clinic nurses, administrators and pharmacists were interviewed us...
Article
Sucrose provides pain relief for newborn babies having painful procedures such as needles or heel lances. Newborn babies undergoing painful procedures need help to have their pain reduced. This is done routinely for major procedures but may not be done for tests (such as taking blood) or needles. Drugs can be used to reduce pain but there are sever...
Article
In the past decade, our knowledge of pain in newborn infants has advanced considerably. However, infants at significant risk for neurologic impairment (NI) have been systematically excluded from almost all research on pain in neonates. The objectives of this study were to compare: (a). the nature, frequency and prevalence of painful procedures, (b)...
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To determine how well therapeutic randomized controlled trials (RCTs) in the Journal of Pediatric Psychology (JPP) met the CONSORT criteria as compared to pediatric trials in the Journal of Clinical and Consulting Psychology (JCCP), which served as a control. Nine trials were found in JPP and 19 clinical trials were retrieved from JCCP. The modifie...

Citations

... 27,28 Nurses are considered to be key members of the transitional care team. 29,30 Their crucial role encompasses evaluating the transitional care plan, recognizing potential problems and then resolving them in order to improve patient safety. 31 Involvement of nurses in medicines management of transitional care helps with the provision of access to care for patients with fragmented care or those at high risk of readmission. ...
... In this context, neonatal pain identification methods (e.g. cry, motor activity, and facial expression) have been implemented and applied in the clinical practice (Grunau et al. 1998;Guinsburg 1999;Caetano et al. 2013;Cong et al. 2013;Maxwell et al. 2019;Bueno et al. 2020). Even though crying is the newborn main communication, it could be triggered by non-painful stimuli, such as hunger and/or other discomforts. ...
... Oral sucrose is a commonly administered, effective, and safe non-pharmacologic intervention used for its analgesic effect in neonates [12]. There is insufficient evidence on its mechanism of action, minimum effective dose, consistency in pain relief, and long-term neurodevelopmental outcomes with repeated doses in neonates [13][14][15]. Animal studies have shown that the analgesic effect of sucrose is a developmentally transient phenomenon [16]. Another non-pharmacologic intervention studied for pain relief in neonates is breast milk. ...
... Effective implementation of personalised care in severe asthma requires an understanding of determinants that influence behaviour change [12]. The Theoretical Domains Framework (TDF) has been proposed as a mechanism to understand the factors that influence HCP behavioural change [12] and has been used in different clinical areas [13][14][15][16]. The TDF comprises 14 domains, which can be used to explore influencing factors and support tailored interventions [17]. ...
... The evidence-base that does exist is inconsistently embedded within practice. 12 Despite this, parents manage their children's pain with expertise borne out of experience. 3,13 When pain spirals out of control or a new pain occurs, parents turn to clinicians for assessment of their child's pain; and, among many questions, they need answers about the cause and implications of the pain, and they want their child's pain managed. ...
... Procedural pain, state anxiety, and itch are usually treated in children with burns using non-pharmacological and pharmacological interventions [3]. According to a review of systematic reviews, hypnotherapy and distraction are supported by the most robust evidence of efficacy for paediatric procedural pain and distress in comparison to other non-pharmacological interventions [4]. Distraction techniques are among the most investigated and popular non-pharmacological interventions in paediatric burns [3]. ...
... Coupling these strategies align well with existing literature, as previous evidence-based knowledge translation interventions demonstrates sustained improvement in paediatric pain practices. 20 Assessment and reassessment of pain are central to optimising pain management, but given current constraints on healthcare systems, reassessment of any condition or symptom in stable patients, including pain, is often the most challenging element of care. Pain is reassessed in only 15% of ED patients nationally. ...
... 22 Nonpharmacological methods are used in addition to pharmacological methods before or during the ROP examination to provide pain control in preterms. 2,19,21 Sucrose in pain control Stevens et al 23 reported that sucrose solution use in the ROP examination effectively reduced PIPP scores (by 24%-33%). The policy statement published jointly by the American Academy of Ophthalmology, AAP, and American Pediatric Ophthalmology and Strabismus Association mentions that sucrose use for pain control in routine practice is worth consideration. ...
... The methods are similar to those described previously. 32 Eight Canadian university-affiliated pediatric healthcare centers (sites) involved with the CIHR Team in Children's Pain were included in the study. Eligible sites had at least 4 clinical units with 15 or more beds, excluding psychiatric and emergency care units. ...
... [15][16][17][18] Needs regarding access to evidence include further education on pain management as well as the need for, and awareness of, evidence-based resources, for clinicians and patients, caregivers, and family members. 15,19,20 These barriers and needs have been identified within samples including a range of stakeholder types, including knowledge users (i.e., health professionals, administrators, policymakers, educators), researchers (including research trainees), and patients, caregivers, and family members; however, differences in the specific barriers and needs among these stakeholder types are not known. This missing perspective impedes effective dissemination and implementation of evidence-based practices to prevent and manage children's pain. ...