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干预策略减轻新生儿操作性疼痛中的白噪声:系统评价。

Intervention strategies for white noise alleviating procedural pain in newborns: A systematic review.

机构信息

Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

出版信息

J Clin Nurs. 2023 Aug;32(15-16):4265-4282. doi: 10.1111/jocn.16601. Epub 2022 Dec 18.

Abstract

AIMS AND OBJECTIVE

To systematically evaluate the current intervention strategies of white noise alleviating procedural pain in newborns.

METHODS

This review was conducted following the PRISMA guideline. Seventeen databases National Guideline Clearinghouse, up to date, Clinical Evidence, BMJ best practice, Cochrane library, OVID, PubMed, Medline, EMBASE, Web of Science, CHINHAL, Medlive, China Biology Medicine disc, Chinese Clinical Trial Registry, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data Knowledge Service Platform were employed, and the studies about pain-relieving with white noise in newborns published before June 2022 was included. Quality of studies was evaluated by using the Cochrane Handbook for Systematic Reviews of Interventions.

RESULTS

18 studies were included, with sample sizes ranging from 32-296 cases. Intervention indices included duration, distance, volume, music type and outcome measure. Duration varies from study to study, from 5 min before to 5 min after the procedures. The distance was controlled at 10-60 cm, volume was controlled at 45-60 dB and music type was selected from Orhan Osman's album "Kolic" in most studies. Outcome measures included physiological indicators, neurophysiological indicators, behavioural indicators and pain score. Differences in duration leading to different white noise effects was found, but no studies have shown whether there is an effect of different volume, distance or music type.

CONCLUSIONS

Based on this review, we recommend the following intervention strategies: the duration is set from 1 min before to 3 min after the procedures, the distance is decided according to the actual clinical situation, the volume is controlled at 45-55 dB (55 dB is optimal), the music type is selected to simulate intrauterine sounds, and outcome measures can choose physiological indicators, neurophysiological indictors, behavioural indicators and pain score depending on specific department and population. It is important to further explore the best intervention strategies.

RELEVANCE TO CLINICAL PRACTICE

In addition to providing a set of intervention strategies, this review could be used as evidence for relieving procedural pain in newborns.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution. Data were obtained from others' literature.

摘要

目的和目标

系统评估白噪声缓解新生儿程序性疼痛的当前干预策略。

方法

本研究遵循 PRISMA 指南进行。使用了 17 个数据库(国家指南清理中心,最新的临床证据,BMJ 最佳实践,考科蓝图书馆,OVID,PubMed,Medline,EMBASE,Web of Science,CHINHAL,Medlive,中国生物医学文献数据库,中国临床试验注册中心,中国国家知识基础设施,中国科技期刊数据库,万方数据知识服务平台),纳入了截至 2022 年 6 月发表的关于新生儿白噪声止痛的研究。使用 Cochrane 干预系统评价手册评估研究质量。

结果

纳入了 18 项研究,样本量从 32 例到 296 例不等。干预指标包括持续时间、距离、音量、音乐类型和结果测量。持续时间因研究而异,从操作前 5 分钟到操作后 5 分钟不等。距离控制在 10-60 厘米,音量控制在 45-60 分贝,大多数研究选择了 Orhan Osman 的专辑“Kolic”中的音乐类型。结果测量包括生理指标、神经生理指标、行为指标和疼痛评分。不同持续时间导致的白噪声效果不同,但没有研究表明音量、距离或音乐类型是否有影响。

结论

基于本综述,我们建议以下干预策略:持续时间设置为操作前 1 分钟至操作后 3 分钟,距离根据实际临床情况决定,音量控制在 45-55dB(55dB 最佳),音乐类型选择模拟宫内声音,结果测量可以根据具体科室和人群选择生理指标、神经生理指标、行为指标和疼痛评分。进一步探索最佳干预策略很重要。

临床相关性

除了提供一套干预策略外,本综述还可作为缓解新生儿程序性疼痛的证据。

患者或公众贡献

无患者或公众贡献。数据来自他人的文献。

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