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    Please use this identifier to cite or link to this item: http://tkuir.lib.tku.edu.tw:8080/dspace/handle/987654321/93117


    Title: Effects of combined use of non-nutritive sucking, oral sucrose, and facilitated tucking on infant behavioural states across heel-stick procedures: A prospective, randomised controlled trial
    Authors: Liaw, Jen-Jiuan;Yang, Luke;Lee, Chuen-Ming;Fan, Hueng-Chuen;Chang, Yue-Cune;Li-Ping Cheng
    Contributors: 淡江大學數學學系
    Keywords: Behavioural states;Facilitated tucking;Non-nutritive sucking;Oral sucrose;Infants;pain
    Date: 2013-07
    Issue Date: 2013-11-21 16:49:09 (UTC+8)
    Publisher: Bromley: Elsevier Ltd
    Abstract: Background
    Pain and stress agitate preterm infants, interrupting their sleep. Frequent high arousal states may affect infants’ brain development and illness recovery. Preserving infants’ sleep and relieving their pain during painful procedures are both important for their health.

    Objectives
    To compare the effectiveness of different combinations of non-nutritive sucking (sucking), oral sucrose, and facilitated tucking (tucking) with routine care on infants’ sleep–wake states before, during, and after heel-stick procedures.

    Design
    Prospective, randomised controlled trial.

    Setting
    Level III Neonatal Intensive Care Unit in Taipei.

    Method
    A convenience sample of 110 infants (gestational age 26.4–37 weeks) needing heel sticks were randomly assigned to five combinations of non-pharmacological treatments: sucking–oral sucrose–tucking; sucking–oral sucrose; oral sucrose–tucking; sucking–tucking; and routine care. Infant states, measured by a state-coding scheme, included quiet sleep, active sleep, transition, quiet awake, active awake, and fussing or crying. All states were recorded at 1-min intervals during four phases: baseline, intervention, heel-stick procedures, and recovery.

    Results
    Infants receiving sucking–oral sucrose–tucking or sucking–oral sucrose experienced 52.8% (p = 0.023) and 42.6% (p = 0.063) more quiet-sleep occurrences than those receiving routine care after adjusting for phase, baseline states, non-treatment sucking during baseline and recovery, positioning, and infants’ characteristics. Infants receiving oral sucrose–tucking, sucking–oral sucrose, sucking–oral sucrose–tucking, and sucking–tucking experienced 77.3% (p < 0.001), 72.1% (p = 0.008), 51.5% (p = 0.017), and 33.0% (p = 0.105) fewer occurrences of fussing or crying, respectively, than those receiving routine care after adjusting for related factors.

    Conclusions
    The four treatment combinations differentially reduced infants’ high arousal across heel-stick procedures. The combined use of oral sucrose–tucking, sucking–oral sucrose, and sucking–oral sucrose–tucking more effectively reduced occurrences of infant fussing or crying than routine care. Treatment combinations of sucking–oral sucrose–tucking and sucking–oral sucrose also better facilitated infants’ sleep than routine care. To preserve infants’ sleep, clinicians should use combinations of non-nutritive sucking, oral sucrose, and facilitated tucking to reduce agitation during painful procedures.
    Relation: International Journal of Nursing Studies 50(7), pp.883-894
    DOI: 10.1016/j.ijnurstu.2012.08.021
    Appears in Collections:[數學學系暨研究所] 期刊論文

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