The role of parental embrace in children's pain management during invasive procedures: A systematic review
DOI: https://doi.org/10.33024/minh.v8i10.1483
Family Centered Care Invasive Procedure Pain Management Parental Holding
Abstract
Background: Children undergoing invasive procedures in hospitals, such as IV insertion or injection, often experience significant pain and anxiety, especially in critically ill children. Non-pharmacological interventions such as parental holding have been studied as an effective approach in reducing children's pain responses during procedures.
Purpose: To analyze the scientific evidence regarding the role of parental holding in pain management in children during invasive procedures, including in critically ill children.
Method: A search was conducted through PubMed, Scopus, and ScienceDirect databases following PRISMA guidelines. Inclusion criteria included RCT design, population of children undergoing invasive procedures, parental holding intervention, and outcomes in the form of pain intensity and/or anxiety. A total of 1,324 articles were identified, while 8 studies met the criteria and were analyzed narratively.
Results: Showed that parental holding is effective in reducing children's pain and anxiety, as well as increasing emotional comfort for both children and parents. Despite its proven benefits, implementation of this intervention is still limited in clinical practice and lacks standardized guidelines, especially in pediatric intensive care units.
Conclusion: Parental hugs have been shown to be effective in reducing procedural pain in infants and children during invasive procedures.
Downloads
References
Cobo, M. M., Moultrie, F., Hauck, A. G., Crankshaw, D., Monk, V., Hartley, C., & Slater, R. (2022). Multicentre, randomised controlled trial to investigate the effects of parental touch on relieving acute procedural pain in neonates (Petal). BMJ Open, 12(7), e061841.
Conde‐Agudelo, A., Belizán, J. M., & Diaz‐Rossello, J. (2012). Cochrane Review: Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Evidence‐Based Child Health: A Cochrane Review Journal, 7(2), 760-876.
Filippa, M., Poisbeau, P., Mairesse, J., Monaci, M. G., Baud, O., Hüppi, P., & Kuhn, P. (2019). Pain, parental involvement, and oxytocin in the neonatal intensive care unit. Frontiers in psychology, 10, 715.
Gastaldi, A. B., Delmonego, L., Plautz, K., Cavichioli, N., Packer, M. H., de Oliveira Weinfurter, J., & Delwing-de Lima, D. (2024). Acute effect of gold nanoparticles on neuropathic pain in a model of regional complex pain syndrome. Caderno Pedagógico, 21(9), e7449-e7449.
Girgin, B. A., & Göl, İ. (2020). Reducing pain and fear in children during venipuncture: a randomized controlled study. Pain Management Nursing, 21(3), 276-282.
Hanafi, H., Daryanto, B., & Gunawan, A. (2024). Prevalence and comorbid for late-stage chronic kidney disease (CKD) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) due to urinary obstruction. Indonesian Journal of Medical Laboratory Science and Technology, 6(2), 143-150.
Hashavya, S., Pines-Shwartz, N., Guzner, N., Ohana Sarna Cahan, L., & Gross, I. (2023). The impact of parental presence on invasive procedures in the pediatric emergency department: A prospective study. Journal of Clinical Medicine, 12(17), 5527.
Hauck, A. (2024). Measuring analgesic efficacy in neonates using a brain-derived outcome measure: a multicentre randomised controlled trial on gentle parental touch (Doctoral dissertation, University of Oxford).
Hignell, A., Carlyle, K., Bishop, C., Murphy, M., Valenzano, T., Turner, S., & Sgro, M. (2020). The Infant Cuddler Study: Evaluating the effectiveness of volunteer cuddling in infants with neonatal abstinence syndrome. Paediatrics & Child Health, 25(7), 414-418.
Kılınc, D., & Çağlar, S. (2025). The Effect of Mother's Gentle Human Touch on Preterm Neonate's Pain and Maternal Anxiety During Venipuncture in Turkiye. Research in Nursing & Health.
Klug, J., Hall, C., Delaplane, E. A., Meehan, C., Negrin, K., Mieczkowski, D., & Sood, E. (2020). Promoting parent partnership in developmentally supportive care for infants in the pediatric cardiac intensive care unit. Advances in Neonatal Care, 20(2), 161-170.
Lass, S. T., & Nunn, M. (2023). Implementation of Kangaroo Care in a Pediatric Cardiac Intensive Care Unit. Critical Care Nursing Clinics of North America, 35(3), 255-264.
Letzkus, L., Frazier, K., & Keim-Malpass, J. (2021). Assessment of pain and sleep symptoms in children at high risk for cerebral palsy in a pediatric neurodevelopmental clinic: Implications for future quality improvement interventions. Journal of pediatric nursing, 60, 293-296.
Meert, K. L., Clark, J., & Eggly, S. (2013). Family-centered care in the pediatric intensive care unit. Pediatric Clinics of North America, 60(3), 761.
Özdemir, A. A., Kurt, F. Y., Küçükoğlu, S., Atay, S., Aşki, N., & Aylanç, H. (2025). Paternal and Maternal Holding-Cuddling for Procedural Pain in Healthy Term. Journal of Nursology.
Palomares González, L., Hernández Caravaca, I., Gómez García, C. I., & Sánchez-Solís de Querol, M. (2023). Parental presence during invasive pediatric procedures: what does it depend on?. Revista Latino-Americana de Enfermagem, 31, e3828.
Ponthier, L., Ensuque, P., Guigonis, V., Bedu, A., Bahans, C., Teynie, F., & Medrel-Lacorre, S. (2020). Parental presence during painful or invasive procedures in neonatology: A survey of healthcare professionals. Archives de Pédiatrie, 27(7), 362-367.
Rahyanti, N. M. S., Nurhaeni, N., & Wanda, D. (2017). Could a certain sitting position reduce the pain experienced by a child? The benefits of parental holding and an upright position. Comprehensive Child and Adolescent Nursing, 40(sup1), 8-13.
Rheel, E., Malfliet, A., Van Ryckeghem, D. M., Pas, R., Vervoort, T., & Ickmans, K. (2022). The impact of parental presence on their children during painful medical procedures: a systematic review. Pain Medicine, 23(5), 912-933.
Roshanray, A., Rayyani, M., Dehghan, M., & Faghih, A. (2020). Comparative effect of mother's hug and massage on neonatal pain behaviors caused by blood sampling: a randomized clinical trial. Journal of tropical pediatrics, 66(5), 479-486.
Sabeti, F., Mohammadpour, M., Pouraboli, B., Tahmasebi, M., & Hasanpour, M. (2021). Health Care Providers' experiences of the non-pharmacological pain and anxiety management and its barriers in the Pediatric Intensive Care Units. Journal of pediatric nursing, 60, e110-e116.
Sağlık, D. S., & Çağlar, S. (2019). The effect of parental presence on pain and anxiety levels during invasive procedures in the pediatric emergency department. Journal of Emergency Nursing, 45(3), 278-285.
Santy, W. H., Ugrasena, I., Arief, Y. S., Hidayah, N., Firdaus, F., & Utami, R. (2023). Development of non-pharmacological pain management (behavioral intervention) model based on family-centered empowerment in toddlers with invasive procedures. Bali Medical Journal, 12(2), 1311-1315.
Tao, C., Zhang, L., Tang, J., He, C., Liu, Q., Li, Y., & Chen, Y. (2025). Effect of multisensory stimuli on neonatal pain during blood sample collection: a network meta-analysis of randomized controlled trials. European Journal of Pediatrics, 184(12), 1-11.
Treiman-Kiveste, A., Kangasniemi, M., Kalda, R., & Pölkki, T. (2023). Parental participation in their infants’ procedural pain alleviation with Nonpharmacologic methods in Estonia. Pain Management Nursing, 24(6), 641-649.
World Health Organization. (2022). Guidelines for the management of acute pain in children. Retrieved from: https://www.who.int/who-revision-of-pain-management-guidelines.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Nona Mulyani Aronggear, Allenidekania Allenidekania, Nani Nurhaeni, Robiyatul Adawiyah
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
