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題名:Comparison of Pain Responses of Premature Infants to the Heelstick between Containment and Swaddling    
著者:Chin-Mei Huang(黃金梅) ;Wan-Shu Tung(董宛姝) ;Li-Lin Kuo(郭麗玲) ;Ying-Ju Chang(張瑩如)
關鍵字:早產兒 ; 扎足跟血 ; 寧握護理 ; 布包裹 ; 疼痛 ; premature ; heelstick ; containment ; swaddling ; pain
刊名:The Journal of Nursing Research
摘要: 中文摘要PDF ; 英文摘要PDF

本研究之目的在比較寧握及布包裹護理對扎足跟血之早產兒的心跳、血氧飽和度及疼痛量表得分之差異。研究方法是採交叉配對實驗設計,研究對象為32 位出生週數少於37 週、體重 ≤ 2,500 公克及未被診斷為先天心臟病、畸形、敗血症或第三度及以上腦室出血的早產兒。同一研究對象在不同時段接受扎足跟血檢查時,分別隨機抽樣寧握及布包裹護理,在扎足跟血前5 分及之後11 分鐘同時監測心跳、血氧飽和度、臉部表情變化及PIPP (Premature Infant Pain Profile) 量表得分;以配對t 檢定發現:(1) 扎足跟血後接受兩種護理處置時,平均心跳及血氧飽和濃度分別大於及小於基準值 (p < .05),接受布包裹之早產兒比寧握護理組回復到基準值的時間快,但兩種護理處置之下,心跳及血氧飽和濃度均無顯著差異。(2) PIPP 之總得分顯示布包裹護理處置對於扎足跟血之疼痛比寧握護理的得分低,但兩種護理處置之下,在第三分及第七分鐘有顯著之差異 (p < .05)。整體而言,使用布包裹及寧握護理對於急性疼痛所產生之生理行為上的壓力之穩定作用並無太大之差異,本研究結果提供早產兒急性疼痛護理的實證基礎,在臨床上布包裹及寧握護理可以依早產兒個別差異相互取代使用。
The objective of this study was to compare the effects of containment and swaddling on premature infants' heart rates (HR), oxygen saturation (SpO2), and the Premature Infant Pain Profile (PIPP) scores after heelstick. The study used a cross-over experimental design, 32 premature infants with gestational age < 37 weeks, bodyweight 2,500 grams, and no diagnosis of congenital heart disease, deformity, sepsis or Grade 3 intraventricular hemorrhage were selected as subjects. Each subject was randomly assigned to containment or swaddling once while undergoing two heelsticks in different time periods. Heart rate, oxygen saturation, facial expression and PIPP score were recorded from 5 minutes before to 11 minutes after heelstick. According to the paired t test, the results showed (1) that mean HR was higher and mean SpO2 was lower than their respective baseline values under the two interventions after heelstick (p < .05), and that premature infants in swaddling returned to their baseline HR and SpO2 values in shorter time periods compared to those in containment, though the variations of HR and SpO2 between the two interventions exhibited no significant differences; and (2) that pain responses to heelstick under swaddling yielded lower scores than those under containment according to the total PIPP scores, but significant difference between the two interventions was only found at the 3rd and 7th minute. As a whole, there is little difference between the effects of swaddling and containment on attenuating physiological and behavioral stress caused by acute pain. The results of this study can serve as an evidence basis for nursing interventions in acute pain for premature infants. In clinical practice, containment and swaddling can be administered interchangeably according to patients' individual differences.


The Journal of Nursing Research 12卷1期 (2004.3)
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Developing an Instrument to Measure Quality of Life of Patients with Hyperhidrosis/ Chun-Hua KuoMiaofen YenPao-Chen Lin
Comparison of Pain Responses of Premature Infants to the Heelstick between Containment and Swaddling/ Chin-Mei HuangWan-Shu TungLi-Lin KuoYing-Ju Chang
A Study of the Empowerment Process for Cancer Patients Using Freire's Dialogical Interviewing/ Li-Chun ChangI-Chuan LiChieh-Hsing Liu
The Effect of Acupressure with Massage on Fatigue and Depression in Patients with End-Stage Renal Disease/ Yi-Ching ChoShiow-Luan Tsay
First-Time Taiwanese Expectant Fathers' Life Experiences during the Third Trimester of Pregnancy/ Chien-Huei KaoAnn Long
Functional Recovery among Elderly People One Year after Hip Fracture Surgery/ Pi-Chu LinSu-Yu Chang

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