Document Detail


Effects of tub bathing procedures on preterm infants' behavior.
MedLine Citation:
PMID:  17345759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although medical advances have increased the survival rate of preterm infants, morbidity in terms of neurodevelopmental impairment has not decreased for this population. This results in caregivers having to reconsider how neonatal intensive care unit (NICU) caregiving impacts on preterm infants. The purpose of this study was to examine the effects of different phases of a routine tub bath on preterm infants' distress and state behavior in the NICU. The study used an exploratory repeated measures design that focused on preterm infants' distress and state behavior, and evaluated the effects of three phases of a routine tub bath, which were performed according to standard unit practice in the NICU. Thirteen nurses repeatedly bathed 12 infants on different days, and 64 baths were videotaped for the purpose of assessing the variety of distress behavior. The procedures of one bath could be categorized into three phases designated to Phases I, II, and III. The variables were measured by a preterm infant behavioral coding scheme developed for this research. The inter-rater reliability of the instrument ranged from .82 to .99. Mixed effects analysis of variance was used to analyze the differences among the bath phases in the occurrences of distress and state behavior. The results showed significant statistical difference among most distress behaviors during the three phases (e.g. "startle, jerk, tremor" F ratio = 25.62, p < .001; "finger splay, grasping, fisting" F ratio = 49.99, p < .001; "grimace" F ratio = 36.55, p < .001; "fussing or crying" F ratio = 25.27, p < .001), with the exception of "extension, arching and squirming". In particular, the occurrence of distress and state behavior increased significantly in phase II. Routine tub bathing not only disrupts preterm infants' sleep but also causes an increase in distress behavior. Preterm infants' stress increases with the intrusiveness of nursing procedures. NICU caregivers should consider the effects of routine nursing activities that influence the infants, and modify handling to promote techniques to promote preterm infants' recovery, growth and development.
Authors:
Jen-Jiuan Liaw; Luke Yang; Yeong-Seng Yuh; Ti Yin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of nursing research : JNR     Volume:  14     ISSN:  1682-3141     ISO Abbreviation:  J Nurs Res     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-03-09     Completed Date:  2007-03-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101128757     Medline TA:  J Nurs Res     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  297-305     Citation Subset:  IM; N    
Affiliation:
School of Nursing, National Defense Medical Center. jiuan@ndmctsgh.edu.tw
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Baths / adverse effects*,  nursing,  psychology
Child Psychology
Clinical Nursing Research
Crying
Facial Expression
Health Services Needs and Demand
Humans
Infant Behavior* / physiology,  psychology
Infant Care / methods*,  psychology
Infant, Newborn
Infant, Premature* / physiology,  psychology
Intensive Care, Neonatal / methods
Neonatal Nursing / methods*
Nursing Assessment
Nursing Evaluation Research
Nursing Staff, Hospital / education,  organization & administration
Risk Factors
Stress, Psychological / etiology*,  prevention & control,  psychology
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