Randomized Crossover Trial of Kangaroo Care to Reduce Biobehavioral Pain Responses in Preterm Infants: A Pilot Study
Randomized Crossover Trial of Kangaroo Care to Reduce Biobehavioral Pain Responses in Preterm Infants: A Pilot Study
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DOI：
10.1177/1099800410385839
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发表时间：
2011-04-01
影响因子：
2.5
通讯作者：
Walsh, Stephen
中科院分区：
文献类型：
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作者：
Cong, Xiaomei;Ludington-Hoe, Susan M.;Walsh, Stephen
袋鼠式护理（KC），母亲和婴儿之间皮肤对皮肤的接触，是一种很有前途的减轻疼痛反应的方法。本交叉试验测试了KC对早产儿（30-32周孕龄，2-9天大）对足跟贴的生物行为反应的影响，测量方法为早产儿疼痛量表（PIPP）、唾液和血清皮质醇。母子二人组被随机分配到先使用KC跟贴（KCH）或先使用保温箱跟贴（IH）。研究1（80分钟的研究，N - 18）测试了80分钟的KC与培养箱护理的效果。研究2（30分钟的研究，N - 10）测试了30分钟的KC在与培养箱护理之前和整个过程中。KCH和IH开始于预测量阶段，并持续到四个数据收集阶段：基线、脚跟加热、脚跟贴和恢复。在数据收集过程中每30 s测量一次PIPP反应；在基线和恢复结束时测量唾液皮质醇；并测定粘鞋跟期间血清皮质醇水平。研究1显示KCH和IH之间没有差异。研究2显示，在康复过程中的4个时间点，PIPP评分较低（p < 0.05 ~ p < 0.001），在康复结束时，唾液皮质醇较低（p < 0.05）， KCH患者在粘跟过程中血清皮质醇较低（p < 0.05）， KCH患者在粘跟过程中PIPP评分较低。30分钟的KC之前和整个跟棒减少了早产儿对疼痛的生物行为反应。
Kangaroo care (KC), skin-to-skin contact between mother and infant, is a promising method for blunting pain responses. This crossover pilot tested KC effects on biobehavioral responses to heel stick in preterm infants (30-32 weeks' gestational age, 2-9 days old) measured by Premature Infant Pain Profile (PIPP) and salivary and serum cortisol. Mother-infant dyads were randomly assigned to KC heel stick (KCH) first or incubator heel stick (IH) first. Study 1 (80-min study, N - 18) tested the effect of 80 min of KC before and throughout the heel stick procedure versus incubator care. Study 2 (30-min study, N - 10) tested 30 min of KC before and throughout the heel stick versus incubator care. KCH and IH began during a premeasurement phase and continued through four data collection phases: baseline, heel warming, heel stick, and recovery. PIPP responses were measured every 30 s during data collection; salivary cortisol was measured at the end of baseline and recovery; and serum cortisol was measured during heel stick. Study 1 showed no differences between KCH and IH. Study 2 showed lower PIPP scores at four time points during recovery (p < .05 to p < .001), lower salivary cortisol at the end of recovery (p < .05), and lower serum cortisol during heel stick for the KCH condition (p < .05) as well as clinically lower PIPP scores in the KCH condition during heel stick. Thirty minutes of KC before and throughout the heel stick reduced biobehavioral responses to pain in preterm infants.