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包裹和海绵浴法对早产儿应激和疼痛迹象的影响:对循证实践的启示。

Effects of Swaddled and Sponge Bathing Methods on Signs of Stress and Pain in Premature Newborns: Implications for Evidence-Based Practice.

机构信息

Department of Pediatric Nursing, Faculty of Health Sciences, Pamukkale University, Denizli, Turkey.

Associate Professor, Department of Pediatric Nursing, Faculty of Nursing, Ege University, İzmir, Turkey.

出版信息

Worldviews Evid Based Nurs. 2018 Aug;15(4):296-303. doi: 10.1111/wvn.12299. Epub 2018 May 15.

Abstract

AIMS

To determine the effects of sponge baths and swaddled bathing on premature infants' vital signs, oxygen saturation levels, crying times, pain, and stress levels.

METHODS

This study was a clinical trial with a crossover design. Data were conducted in the neonatal intensive care unit of a public hospital in Denizli, Turkey. A total of 35 premature infants, who were born at 33-37 weeks gestation with a birth weight <1,500 g, were enrolled in the study. Two bathing methods were applied at 3-day intervals. Vital signs and oxygen saturation levels were measured before and at minutes 1, 5, 15, 30 after bathing. Infants' bathing was video recorded to assess pain and stress behaviors. The pain and stress behaviors of infants were evaluated by independent observers. A significance level of .05 was used for all statistical analyses.

RESULTS

There were statistically significant differences between bathing methods on vital signs, oxygen saturation levels, and crying times. Levels of stress and pain according to bathing type were significantly higher in the sponge bath condition (p < .05).

LINKING EVIDENCE TO ACTION

Swaddled bathing has a positive effect on the infant's vital signs, oxygen saturation levels, crying time, and level of stress and pain compared to the sponge bath condition. Swaddled bathing is a harmless and safe nursing practice.

摘要

目的

确定海绵浴和包裹浴对早产儿生命体征、血氧饱和度、哭泣时间、疼痛和应激水平的影响。

方法

这是一项具有交叉设计的临床试验。数据采集于土耳其代尼兹利市一家公立医院的新生儿重症监护病房。共有 35 名胎龄 33-37 周、出生体重<1500g 的早产儿入组本研究。每 3 天采用两种沐浴方法。在沐浴前和沐浴后 1、5、15、30 分钟测量生命体征和血氧饱和度。对婴儿的沐浴过程进行录像,以评估疼痛和应激行为。由独立观察者评估婴儿的疼痛和应激行为。所有统计分析的显著性水平均为 0.05。

结果

在生命体征、血氧饱和度和哭泣时间方面,沐浴方法之间存在统计学差异。与海绵浴相比,包裹浴条件下的应激和疼痛水平显著更高(p<0.05)。

实践启示

与海绵浴相比,包裹浴对婴儿的生命体征、血氧饱和度、哭泣时间、应激和疼痛水平有积极影响。包裹浴是一种无害且安全的护理实践。

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