Women's and Newborn Health Program, IWK Health Centre, Halifax, Nova Scotia, Canada.
BMC Pediatr. 2009 Dec 11;9:76. doi: 10.1186/1471-2431-9-76.
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 been shown to decrease procedural pain response according to both behavioral and physiological indicators in very preterm neonates. It is uncertain if this comfort is derived solely from maternal presence or from stabilization of regulatory processes from direct skin contact. The intent of this study is to compare the comfort effect of co-bedding (between twin infants who are co-bedding and those who are not) on infant pain response and physiologic stability during a tissue breaking procedure (heelstick).
METHODS/DESIGN: Medically stable preterm twin infants admitted to the Neonatal Intensive Care Unit will be randomly assigned to a co-bedding group or a standard care group. Pain response will be measured by physiological and videotaped facial reaction using the Premature Infant Pain Profile scale (PIPP). Recovery from the tissue breaking procedure will be determined by the length of time for heart rate and oxygen saturation to return to baseline. Sixty four sets of twins (n = 128) will be recruited into the study. Analysis and inference will be based on the intention-to-treat principle.
If twin contact while co-bedding is determined to have a comforting effect for painful procedures, then changes in current neonatal care practices to include co-bedding may be an inexpensive, non invasive method to help maintain physiologic stability and decrease the long term psychological impact of procedural pain in this high risk population. Knowledge obtained from this study will also add to existing theoretical models with respect to the exact mechanism of comfort through touch.
NCT00917631.
同床共被，一种发育护理策略，是指将穿尿布的双胞胎放在一个保温箱中护理（而不是将他们分开并放在两个保温箱中分别护理），从而为双胞胎提供皮肤接触和触摸的机会。在对母亲及其婴儿的研究中，根据非常早产儿的行为和生理指标，母亲的皮肤接触已被证明可以减少操作过程中的疼痛反应。尚不确定这种舒适感仅源自母亲的存在，还是源自直接皮肤接触对调节过程的稳定作用。本研究旨在比较同床共被（同床共被的双胞胎与未同床共被的双胞胎之间）对组织穿刺过程（足跟采血）中婴儿疼痛反应和生理稳定性的舒适效果。
方法/设计：将入住新生儿重症监护病房的医学稳定早产儿双胞胎随机分配到同床共被组或标准护理组。疼痛反应将通过使用早产儿疼痛评估量表（PIPP）测量生理和录像面部反应来评估。通过心率和血氧饱和度恢复到基线的时间来确定从组织穿刺过程中恢复的情况。将招募 64 对双胞胎（n = 128）参加该研究。分析和推论将基于意向治疗原则。
如果确定双胞胎在同床共被时具有安慰作用，可以减轻痛苦的操作，那么改变当前的新生儿护理实践，包括同床共被，可能是一种廉价、非侵入性的方法，可以帮助维持生理稳定性，并减少这个高风险人群中操作疼痛的长期心理影响。从这项研究中获得的知识也将增加关于触摸的确切安慰机制的现有理论模型。
NCT00917631。
