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一项观察性队列研究,旨在探讨新生儿重症特别护理病房中皮肤接触时长对新生儿生理参数的影响。

An Observational Cohort Study Examining the Effect of the Duration of Skin-to-Skin Contact on the Physiological Parameters of the Neonate in a Neonatal Intensive Special Care Unit.

作者信息

Jones Hannah, Santamaria Nick

机构信息

University of Melbourne, Victoria, Australia (Ms Jones and Dr Santamaria); and Newborn Intensive Special Care Unit, The Royal Women's Hospital, Parkville, Victoria, Australia (Ms Jones).

出版信息

Adv Neonatal Care. 2018 Jun;18(3):208-214. doi: 10.1097/ANC.0000000000000485.

Abstract

BACKGROUND

Focus on skin-to-skin contact (SSC) as a family-centered care intervention in Neonatal Intensive Special Care (NISC) Units continues to increase. Previously, SSC has been shown to improve neonatal physiological stability, support brain development, and promote bonding and attachment. Limited research exists investigating SSC duration and neonatal physiological responses.

PURPOSE

This study examined the relationship between SSC duration and the neonate's oxygen saturation, heart rate (HR), respiratory rate (RR), and temperature.

METHOD

An observational cohort study was conducted at The Royal Women's Hospital NISC Unit in Melbourne, Australia. For each neonate participant, 1 SSC with their parent was studied (parent convenience) and neonatal physiological parameters recorded, with a bivariate correlation used to explore the relationship between the duration of SSC and the percentage of time during SSC that the neonate's physiological variables remained within a target range.

FINDINGS

No correlation existed between the duration of SSC and the neonatal physiological variables of oxygen saturation, HR, RR, and temperature. However, neonatal oxygen requirement was more often reduced across the duration of SSC.

IMPLICATIONS FOR PRACTICE AND FUTURE RESEARCH

Due to previously documented benefits to neonates physiologically from SSC, and our supportive finding that SSC reduces neonatal oxygen requirement, we believe that this study adds to the evidence to support promotion of SSC in NISC Units. The duration of SSC does not appear to negatively impact the physiological effects to the neonate. Thus, SSC should be encouraged in all NISC Units to be conducted for the length of time the parent is able. This study should be repeated with a larger sample size.

摘要

背景

在新生儿重症特别护理(NISC)病房中,将肌肤接触(SSC)作为以家庭为中心的护理干预措施的关注度持续上升。此前,已有研究表明SSC可改善新生儿的生理稳定性、支持大脑发育并促进情感联结和依恋。但关于SSC持续时间与新生儿生理反应的研究有限。

目的

本研究探讨了SSC持续时间与新生儿血氧饱和度、心率(HR)、呼吸频率(RR)和体温之间的关系。

方法

在澳大利亚墨尔本皇家妇女医院NISC病房进行了一项观察性队列研究。对每位新生儿参与者,研究其与父母进行的1次SSC(父母方便参与),并记录新生儿的生理参数,采用双变量相关性分析来探讨SSC持续时间与SSC期间新生儿生理变量保持在目标范围内的时间百分比之间的关系。

结果

SSC持续时间与新生儿的血氧饱和度、HR、RR和体温等生理变量之间不存在相关性。然而,在整个SSC期间,新生儿的氧气需求量更常减少。

对实践和未来研究的启示

鉴于此前有文献记载SSC对新生儿生理有益,且我们支持性的研究结果表明SSC可降低新生儿的氧气需求量,我们认为本研究补充了证据,支持在NISC病房推广SSC。SSC持续时间似乎不会对新生儿的生理效应产生负面影响。因此,应鼓励所有NISC病房在父母能够陪伴的时间内进行SSC。本研究应以更大样本量重复进行。

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