Overview

My program of research focuses on developing and validating strategies to study pain and stress reactivity in healthy fullterm infants and those born ill or at-risk (infants exposed to pre and postnatal stressors). It incorporates the use of naturalistic systematic observation and conventional methodologies. The purpose is to comprehensively describe and measure, in fine-grained detail and in real time, microanalytic descriptions of infant responses and to make explicit environmental effects that intensify or modulate those responses. The resultant fine-grained descriptions allow novel and unique insight into the repertoire and qualitative aspects of the behaviour and into how infants normally act and interact (or fail to) with their immediate environments. In particular, they permit the identification of patterning in the infant’s composite expressions of complex phenomenon (such as pain) and recognition of otherwise unnoticed environmental factors (e.g. ambient sound, caregiving) that influence the infant’s ability to respond to, or to recover from pain – especially important when exposure to stressors are multiple or compounded.

Publications

The role of organizational context in moderating the effect of research use on pain outcomes in hospitalized children: a cross sectional study.
Yamada J, Squires JE, Estabrooks CA, Victor C, Stevens B, CIHR Team in Children’s Pain
DOI: 10.1186/s12913-017-2029-2
PubMed: 28114940
01/2017

The relationship of prenatal maternal depression or anxiety to maternal caregiving behavior and infant behavior self-regulation during infant heel lance: an ethological time-based study of behavior.
Warnock FF, Craig KD, Bakeman R, Castral T, Mirlashari J
DOI: 10.1186/s12884-016-1050-5
PubMed: 27604153
2016

Maternal mood and concordant maternal and infant salivary cortisol during heel lance while in kangaroo care.
Castral TC, Warnock F, Dos Santos CB, Daré MF, Moreira AC, Antonini SR, Scochi CG
DOI: 10.1002/ejp.566
PubMed: 25111670
03/2015

Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children.
Stevens BJ, Yamada J, Promislow S, Stinson J, Harrison D, Victor JC, Members of the CIHR Team in Children’s Pain
DOI: 10.1186/s13012-014-0120-1
PubMed: 25928349
11/2014

Self-regulation (recovery) from pain: association between time-based measures of infant pain behavior and prenatal exposure to maternal depression and anxiety.
Warnock FF, Craig KD, Bakeman R, Castral T
DOI: 10.1097/ajp.0000000000000002
PubMed: 24042350
08/2014

Pain in hospitalized children: Effect of a multidimensional knowledge translation strategy on pain process and clinical outcomes.
Stevens BJ, Yamada J, Estabrooks CA, Stinson J, Campbell F, Scott SD, Cummings G, CIHR Team in Children’s Pain
DOI: 10.1016/j.pain.2013.09.007
PubMed: 24021861
01/2014

Early educational and behavioral RCT interventions to reduce maternal symptoms of psychological trauma following preterm birth: a systematic review.
Kraljevic M, Warnock FF
DOI: 10.1097/jpn.0b013e3182a8bfe2
PubMed: 24164814
2013

Pain assessment and intensity in hospitalized children in Canada.
Stevens BJ, Harrison D, Rashotte J, Yamada J, Abbott LK, Coburn G, Stinson J, Le May S, CIHR Team in Children's Pain
DOI: 10.1016/j.jpain.2012.05.010
PubMed: 22958873
09/2012

A community-based study of sleep and behaviour problems in 12- to 36-month-old children.
Hall WA, Scher A, Zaidman-Zait A, Espezel H, Warnock F
DOI: 10.1111/j.1365-2214.2011.01252.x
PubMed: 21651607
05/2012

Canadian Pain Society Abstracts, 2012.
2012

Maternal factors regulating preterm infants' responses to pain and stress while in maternal kangaroo care.
Castral TC, Warnock FF, Ribeiro LM, de Vasconcelos MG, Leite AM, Scochi CG
PubMed: 22991104
2012

Epidemiology and management of painful procedures in children in Canadian hospitals.
Stevens BJ, Abbott LK, Yamada J, Harrison D, Stinson J, Taddio A, Barwick M, Latimer M, Scott SD, Rashotte J, Campbell F, Finley GA, CIHR Team in Children's Pain
DOI: 10.1503/cmaj.101341
PubMed: 21464171
04/2011

Canadian Pain Society Conference: April 13 – April 16, 2011, Niagara Falls, Ontario.
2011

Brief report: Maternal kangaroo care for neonatal pain relief: a systematic narrative review.
Warnock FF, Castral TC, Brant R, Sekilian M, Leite AM, Owens Sde L, Scochi CG
DOI: 10.1093/jpepsy/jsp123
PubMed: 20040606
10/2010

Measuring cortisol and DHEA in fingernails: a pilot study.
Warnock F, McElwee K, Seo RJ, McIsaac S, Seim D, Ramirez-Aponte T, Macritchie KA, Young AH
PubMed: 20169040
2010

The 2010 Annual Conference of the Canadian Pain Society.
PubMed: 20458375
2010

Canadian Pain Society Conference: May 27 ? 30, 2009, Quebec City, Quebec.
2009

The effects of skin-to-skin contact during acute pain in preterm newborns.
Castral TC, Warnock F, Leite AM, Haas VJ, Scochi CG
DOI: 10.1016/j.ejpain.2007.07.012
PubMed: 17869557
05/2008

Measuring the quality of pediatric day surgery care.
Amari E, Murray DM, Vandebeek C, Montgomery CJ, Skarsgard E, Warnock F, Ansermino JM
DOI: 10.1111/j.1945-1474.2007.tb00223.x
PubMed: 18232606
2007

Comprehensive description of newborn distress behavior in response to acute pain (newborn male circumcision).
Warnock F, Sandrin D
DOI: 10.1016/j.pain.2003.11.006
PubMed: 14736587
02/2004

Foundations of knowledge about neonatal pain.
Warnock F, Lander J
DOI: 10.1016/j.jpainsymman.2003.06.006
PubMed: 15157041
02/2004

Ethological methods to develop nursing knowledge.
Warnock FF, Allen M
DOI: 10.1002/nur.10063
PubMed: 12532369
02/2003

The notion of evidence in evidence-based practice by the Nursing Philosophy Working Group.
Romyn DM, Allen MN, Boschma G, Duncan SM, Edgecombe N, Jensen LA, Ross-Kerr JC, Marck P, Salsali M, Tourangeau AE, Warnock F, Nursing Philosophy Working Group
DOI: 10.1016/s8755-7223(03)00087-5
PubMed: 12964138
2003

Supporting the parents of children in day surgery.
Lander J, Warnock F
PubMed: 10222886
02/1999

The painful (and costly) facts about children's tonsillectomy day surgery.
Warnock FF, Lander J
PubMed: 10594990
06/1998

Pain progression, intensity and outcomes following tonsillectomy.
Warnock FF, Lander J
DOI: 10.1016/s0304-3959(97)00202-9
PubMed: 9539672
03/1998

The evolution of caring within bioethics: provision for relationship and context.
deMoissac DM, Warnock FF
PubMed: 8850920
09/1996

Research

Current Projects
Infants perceive their environments through experience, and these experiences shape their development and behaviour. The healthier and more stable the pre and postnatal environment, the more likely the infant will regulate effectively from survival states to states that reflect optimal neurodevelopment and that support long-term physical and psychosocial well being. Exposures to multiple pre and postnatal stressors, however, have additive effects that may permanently alter the infant’s nervous system and heighten their sensitivity to subsequent stressors. This is especially important in the context of health care because newborns previously exposed to stressors (infants born at-risk) will likely be exposed to multiple sensory and noxious events as part of their routine care. Hence, preventing further insult, especially during critical epochs, is crucial, and dependent upon knowledge of potential stressors and the ability to distinguish typical and atypical infant response patterns and to make use of such knowledge within the context of complex care environments. An essential component of that objective is to foster and strengthen the maternal-infant and professional-infant caregiving relationships.

I am currently undertaking several microanalytic studies to further newborn pain measurement and pain assessment within the context of infant prenatal exposure to antidepressant drugs, maternal depression and maternal and health professional caregiving. This research addresses four areas and is supported through a MSFHR Scholar award and several operating grants received from SSHRC, CIHR and HELP:

Generating microanalytic descriptions of newborn action and interaction including concurrently occurring contextual and environmental factors

Making use of innovative measurement approaches to identify atypical and atypical patterning in the composite indicators of pain and stress reactivity (self regulation)

Clarifying the regulative role of maternal caregiving on shaping newborn pain reactivity within the context of maternal depression

Clarifying the regulative role of nurse caregiving on shaping newborn pain reactivity within the context of complex health care environments.

Honours & Awards

Visiting Scholar, University of Sao Pualo, Ribeirao Preto (Brazil) – 2004

Michael Smith Foundation for Health Research Scholar Award – 2004