Zeiner Veronika, Storm Hanne, Doheny Kim Kopenhaver
a The Simulation Center, the Acute Clinic, Institute of Clinical Medicine, Medical Faculty, University of Oslo , Oslo , Norway .
b Department of Pediatrics , Pennsylvania State University, College of Medicine , Hershey , PA , USA , and.
J Matern Fetal Neonatal Med. 2016;29(15):2531-6. doi: 10.3109/14767058.2015.1092959. Epub 2015 Oct 6.
Stress response patterns are indicative of the neonate's unique ability to cope with environmental demands and can be evaluated through autonomic and behavioral response parameters.
To characterize stress responses during tactile stimulation to standard nurse handling in the NICU, and their association with severity of illness in preterm infants.
Thirty preterm neonates were studied at postnatal day 4-5 during standard nurse caregiving. Heart rate (HR), respiratory rate (RR), skin conductance responses per second (SCR/s), and NIDCAP® stress behaviors were recorded before and during care. Non-parametric tests were used to assess differences from before to during care. Pearson's correlations were used to determine the association of biological and behavioral variables to the score for neonatal acute physiology (SNAP), a severity of illness index.
HR, RR, SCR/s and NIDCAP® behaviors (motor and attentional cues, and ability to self-console) increased from before to during the care (p < 0.01). NIDCAP® behaviors showed a significant negative association to the SNAP score (R = -0.45, p < 0.05).
HR, RR, SCR/s and NIDCAP® behaviors significantly increased during care. NIDCAP® stress behaviors were influenced by the severity of illness of the infant, while SCR/s was not influenced by severity of illness.
应激反应模式表明新生儿应对环境需求的独特能力,可通过自主神经和行为反应参数进行评估。
描述新生儿重症监护病房(NICU)中标准护理操作时触觉刺激期间的应激反应,及其与早产儿疾病严重程度的关联。
在出生后第4 - 5天对30名早产儿进行标准护理期间进行研究。在护理前和护理期间记录心率(HR)、呼吸频率(RR)、每秒皮肤电导率反应(SCR/s)以及新生儿个体化发育护理与评估计划(NIDCAP®)应激行为。采用非参数检验评估护理前后的差异。使用Pearson相关性分析来确定生物学和行为变量与新生儿急性生理学评分(SNAP,一种疾病严重程度指数)之间的关联。
护理期间HR、RR、SCR/s以及NIDCAP®行为(运动和注意力线索以及自我安慰能力)均较护理前增加(p < 0.01)。NIDCAP®行为与SNAP评分呈显著负相关(R = -0.45,p < 0.05)。
护理期间HR、RR、SCR/s以及NIDCAP®行为显著增加。NIDCAP®应激行为受婴儿疾病严重程度影响,而SCR/s不受疾病严重程度影响。