Table 3

Literature characteristics

First author (year)	Country	Study design	Participants	Study topic	Facilitators	Barriers
Neshat27 (2023)	Iran	Qualitative (individual interviews and focus group discussions)	Nurses (n=21) Neonatologists (n=2) Assistant nurse (n=1)	Care providers’ experiences regarding barriers to maternal participation in neonatal pain management	NA	Maternal inadequate emotional readiness Maternal unfamiliarity with role Care providers’ time pressure Fear of family-care provider tension Care providers’ insufficient knowledge Neglected joint decision-making Restricted organisational participative policies
Palomaa28 (2016)	Finland	Qualitative (open-ended questionnaires)	Parents (n=140)	Factors influencing parental participation in neonatal pain alleviation	Parental counselling by staff Parents’ awareness of their own role Parents’ motivation Family-friendly facilities Good communication	Restrictive environment Lack of knowledge Everyday life requirements Underestimation of parents The nature of medical procedures Procedure-related and pain-related emotions Deteriorated health status of the child and mother Uncertainty of parenting
Axelin9 (2010)	Finland	Qualitative (semistructured interviews)	Mothers (n=23)	Mothers’ different styles of involvement in preterm infant pain care	Nurses’ support Strong maternal attachment Mothers’ empathy and rationalisation of their infants’ pain	Mothers’ stressful emotions regarding their infants’ pain and the NICU environment
Axelin29 (2015)	Finland/ Sweden/ USA	Qualitative (focus-group interviews)	Nurses (n=87)	Neonatal intensive care nurses’ perceptions of parental participation in infant pain management	Welcome for parents Parent education Nurses’ awareness of the importance of collaboration with the parents Nurses’ empowerment of parents Respect for parenthood	Nurses’ advocate for the infant Nurses’ protection of parents from infant pain Passive or absent parent
Skene10 (2012)	UK	Qualitative (focused ethnography)	Mothers (n=10) Fathers (n=8)	How parents interact with their infants and with nurses regarding the provision of comfort care in a neonatal intensive care unit	Parents’ focus and observation of infants Written information provided by nurses Nurses’ encouragement, support and guide Increased parents’ confidence Transfer of responsibility Parents’ unique knowledge of their infants	NA
Franck30 (2012)	UK	Qualitative (visits and open-ended questionnaires)	Parents (n=169)	An empirical and conceptual update of parental involvement in neonatal pain management	Strong sense of attachment Values parental involvement in comforting Strong sense of parental role Staff provide instruction on how parents can comfort Parent able to be present during painful procedures	Parent emotional difficulties Not wanting to ‘be in the way’ Parental lack of knowledge Complications of equipment or health status of the infant Staff passive attitudes and behaviours
Gale20 (2004)	UK	Qualitative (focus groups and individual interviews)	Parents (n=12)	Parents’ views of their experiences observing and coping with their infant’s pain in the neonatal intensive care unit	Staff support Involvement in parenting in the NICU Information resources	Inability to protect infant Mismatch between parent and staff perceptions of infant pain Barriers to parental role attainment Impact of painful procedures Unpreparedness for infant pain
Jyoti31 (2023)	Australia	Qualitative (open-ended questionnaires)	Parents (n=52)	Parents’ perspectives on their baby’s pain management and comfort postoperatively	Information resources Communication practices	Acute and fragile babies’ condition Mothers’ poor condition Lack of facilities available to parents COVID-19 restrictions
Marfurt-Russenberger21 (2016)	Switzerland	Qualitative (focus group interviews)	Nurses (n=17) Neonatologists (n=6)	The experiences of professionals regarding involvement of parents in neonatal pain management	Professional know-how and sound communication skills Reflective and collaborative practice among professionals Parents’ stable emotions Adequate organisational resources (time, staffing or space)	Limited know-how and communication skills Non-reflective and noncollaborative pain care practices Professionals’ control and paternalistic attitudes Limited organisational resources (time, space and infrastructure) Organisational course of action
Hassankhani32 (2020)	Iran	Qualitative (focused ethnography)	Nurses (n=15) Mothers (n=18)	Nurses and mothers experiences of their role during painful procedures on neonates in neonatal intensive care unit	Maternal tolerance and presence during the painful procedures	Maternal anxiety or protest Lack of the tolerance for painful procedures Mother’s trust in the nurse’s skills

NA, not available; NICU, neonatal intensive care unit.