| 摘要: | Purpose: Even routine procedures can cause pain and stress, and can be
harmful to the fast-growing brain of preterm infants. Mitigating pain and
stress with sucrose and analgesics has side effects; thus, an alternate choice
is the use of natural breast milk and infants’ sensory capabilities. Therefore,
this study examined the effects of different integrations of sensory experiences—
mother’s breast milk odor and taste (BM-OT), heartbeat sounds
(HBs), and non-nutritive sucking (NNS)—on preterm infant’s behavioral
stress during venipuncture.
Design: This study was a prospective, randomized controlled trial.
Methods: Infants born preterm (<37 weeks’ gestational age) were enrolled
in the study through convenience sampling, and randomly assigned to the
following conditions: (condition 1) routine care (n = 36); (condition 2) BMOT
(n = 33); (condition 3) BM-OT + HBs (n = 33); or (condition 4) BM-OT
+ HBs + NNS (n = 36). Crying duration from puncture to recovery period
was recorded using a voice recorder. Facial actions and body movements
were measured using an infant behavioral coding scheme and transformed
into frequencies during seven stages: baseline (stage 0), disinfecting (stage 1),
venipuncture (stage 2), and the recovery period for 10 minutes (stages 3–6).
Findings: Data were analyzed for 138 preterm infants. The corresponding
median times to stop crying for conditions 1, 2, 3, and 4 were 137, 79, 81,
and 39 s, respectively; the instantaneous occurrence rates of stopping crying
for conditions 2, 3, and 4 were 1.469, 1.574, and 2.996 times greater than
for condition 1, respectively. Infants receiving conditions 3 and 4 had significantly
fewer occurrences of facial actions (stage 6 and stages 4–6, respectively)
and body movements (stages 3–6 for both); however, there were no
significant reductions in stress behaviors for condition 2 (BM-OT).
Conclusions: The combination of BM-OT, HBs, and NNS could be provided
to preterm infants as interventions to prevent and reduce behavioral stress,
and facilitate pain recovery during venipuncture procedures.
Clinical Relevance: Clinicians should be educated about how to recognize
preterm infants’ behavioral stress, and to incorporate different sensory
combinations of respective mothers’ BM, HBs, and NNS into painful procedures
to help preterm infants recover from distress. |
