Hathaway Elizabeth E, Luberto Christina M, Bogenschutz Lois H, Geiss Sue, Wasson Rachel S, Cotton Sian
Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Ohio, United States (Ms Hathaway).
Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Ohio, United States (Ms Luberto).
Glob Adv Health Med. 2015 Jul;4(4):32-7. doi: 10.7453/gahmj.2015.029.
Pain management is a frequent problem in the neonatal intensive care unit (NICU). Few studies examining effects of integrative care therapies on pain-related outcomes in neonates have included physiological outcomes or investigated the use of such therapies in a practice-based setting.
The purpose of this practice-based retrospective study was to examine the associations between integrative care therapies, particularly massage and healing touch, and pain-related outcomes among hospitalized infants.
We conducted a retrospective review of a clinical database from a level III NICU regularly delivering integrative care therapies. Paired-samples t-tests were used to examine associations between integrative care therapies and 4 pre-post outcome measures: therapist-rated pain and presentation (ranging from asleep to agitated) and neonates' heart rate and oxygen saturation.
Of 186 patients (M age=68 days), 58% were male and 67% were Caucasian. Sixty-two percent received both massage and healing touch; the remainder received a single therapy. From pre-post therapy, statistically significant changes were observed in infants' heart rate (M pre=156 vs M post=140 per minute; P<.001), oxygen saturation (M pre=95.0% vs.M post=97.4%; P<.001), and therapist-reported pain (M pre=2.8 vs M post=0.2; P<.001) and presentation (M pre=3.2 vs. M post=1.0; P<.001).
Observed improvements in pain-related outcomes suggest that massage and healing touch may be useful integrative therapies to consider as pain management options in the NICU.
疼痛管理是新生儿重症监护病房（NICU）中常见的问题。很少有研究考察综合护理疗法对新生儿疼痛相关结局的影响，这些研究既未纳入生理指标，也未在基于实践的环境中调查此类疗法的使用情况。
这项基于实践的回顾性研究旨在考察综合护理疗法，尤其是按摩和抚触，与住院婴儿疼痛相关结局之间的关联。
我们对一家定期提供综合护理疗法的三级NICU的临床数据库进行了回顾性分析。采用配对样本t检验来考察综合护理疗法与4项前后对照结局指标之间的关联：治疗师评定的疼痛和表现（范围从安静睡眠到烦躁不安）以及新生儿的心率和血氧饱和度。
186名患者（平均年龄68天）中，58%为男性，67%为白种人。62%的患者同时接受了按摩和抚触；其余患者接受单一疗法。治疗前后，婴儿的心率（治疗前平均每分钟156次，治疗后平均每分钟140次；P<0.001）、血氧饱和度（治疗前平均95.0%，治疗后平均97.4%；P<0.001）、治疗师报告的疼痛（治疗前平均2.8，治疗后平均0.2；P<0.001）和表现（治疗前平均3.2，治疗后平均1.0；P<0.001）均出现了具有统计学意义的变化。
疼痛相关结局的改善表明，按摩和抚触可能是NICU中可考虑作为疼痛管理选择的有用综合疗法。
