Behavioral interventions reduce infant distress at immunization
Behavioral interventions reduce infant distress at immunization
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DOI：
10.1001/archpedi.154.7.719
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发表时间：
2000-07-01
影响因子：
--
通讯作者：
Mendelow, D
中科院分区：
文献类型：
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作者：
Felt, BT;Mollen, E;Mendelow, D
目的 评估简单的免疫行为干预措施对初级保健机构中婴儿和父母痛苦的行为和生化指标的有效性。设计：受试者按顺序入组至对照组（标准护理）和干预组。干预父母（n = 57）获得了有关帮助其婴儿进行免疫接种的技术信息。标准护理家长 (n = 45) 没有收到此信息。免疫接种被录像并针对婴儿和父母的行为进行编码。使用视觉模拟量表，父母在研究登记时、免疫接种后立即和结帐时对婴儿和他们自己的舒适度进行评分。在研究登记时以及免疫后 15、30 和 60 分钟从婴儿和父母收集的唾液样本通过标准放射免疫测定法测定皮质醇浓度。使用chi(2)、方差分析和一般线性模型对数据进行分析。使用分层线性模型分析免疫后唾液皮质醇变化的模式。背景：两个夏天（1997 年和 1998 年）的单一城市儿科诊所。受试者：2 至 24 个月大的婴儿 (n = 102) 及其父母。 主要结果指标： 婴儿痛苦的持续时间（以秒为单位）；家长使用行为干预；婴儿和父母唾液皮质醇浓度（以纳摩尔/升为单位）。结果：干预父母更有可能在免疫前对其婴儿使用行为技术（P < .05）。干预婴儿在免疫接种时的总婴儿痛苦较短 (P < .01)，并且这些婴儿在免疫接种后立即被父母评为更舒适 (P < .001)。免疫后 15 分钟、30 分钟和 60 分钟时，干预婴儿的唾液皮质醇水平较低 (P < .05)。结论：免疫前简单的行为干预与婴儿痛苦的行为和生化指标的减少相关。
Objectives To assess the effectiveness of simple behavioral interventions at immunization on behavioral and biochemical indicators of distress in infants and parents in a primary care setting.Design: Subjects were enrolled sequentially to control (standard care) and intervention groups. intervention parents (n = 57) were provided information about techniques to help their infants at immunization. Standard care parents (n = 45) did not receive this information. Immunizations were videotaped and coded for infant and parent behaviors. Using a visual analog scale, parents rated their infant's and their own comfort at study enrollment, immediately after immunization, and at checkout. Saliva samples collected from infants and parents at study enrollment and at 15, 30, and 60 minutes after immunization were assayed for cortisol concentration by standard radioimmunoassay. Data were analyzed using chi(2), analysis of variance, and general linear modeling. Patterns of salivary cortisol change after immunization were analyzed using hierarchical linear modeling.Setting: A single, urban pediatric practice during 2 summers (1997 and 1998). Subjects: Infants 2 to 24 months of age (n = 102) and their parents.Main Outcome Measures: Duration of infant distress (in seconds); parent use of behavioral intervention; infant and parent salivary cortisol concentrations (in nanomoles per liter).Results: Intervention parents were more likely to use a behavioral technique with their infants before immunization (P < .05). Total infant distress was shorter for intervention infants at immunization (P < .01), and these infants were rated as more comfortable by their parents (P < .001) immediately after immunization. Salivary cortisol levels were lower for intervention infants at 15, 30, and 60 minutes after immunization (P < .05).Conclusion: Simple behavioral interventions before immunization are associated with reductions in behavioral and biochemical indicators of infant distress.