Comparison of Pain Responses of Premature Infants to the Heelstick between Containment and Swaddling

比較早產兒使用寧握護理及布包裹對扎足跟血之疼痛反應

黃金梅(Chin-Mei Huang) ； 董宛姝(Wan-Shu Tung) ； 郭麗玲(Li-Lin Kuo) ； 張瑩如(Ying-Ju Chang)

《The Journal of Nursing Research》 12卷1期 (2004/03) Pp. 31-40

摘要

The objective of this study was to compare the effects of containment and swaddling on premature infants’ heart rates (HR), oxygen saturation (SpO2), and the Premature Infant Pain Profile (PIPP) scores after heelstick. The study used a cross-over experimental design, 32 premature infants with gestational age ＜ 37 weeks, bodyweight 2,500 grams, and no diagnosis of congenital heart disease, deformity, sepsis or Grade 3 intraventricular hemorrhage were selected as subjects. Each subject was randomly assigned to containment or swaddling once while undergoing two heelsticks in different time periods. Heart rate, oxygen saturation, facial expression and PIPP score were recorded from 5 minutes before to 11 minutes after heelstick. According to the paired t test, the results showed (1) that mean HR was higher and mean SpO2 was lower than their respective baseline values under the two interventions after heelstick (p ＜ .05), and that premature infants in swaddling returned to their baseline HR and SpO2 values in shorter time periods compared to those in containment, though the variations of HR and SpO2 between the two interventions exhibited no significant differences; and (2) that pain responses to heelstick under swaddling yielded lower scores than those under containment according to the total PIPP scores, but significant difference between the two interventions was only found at the 3rd and 7th minute. As a whole, there is little difference between the effects of swaddling and containment on attenuating physiological and behavioral stress caused by acute pain. The results of this study can serve as an evidence basis for nursing interventions in acute pain for premature infants. In clinical practice, containment and swaddling can be administered interchangeably according to patients’ individual differences.

關鍵字

早產兒 ； 扎足跟血 ； 寧握護理 ； 布包裹 ； 疼痛

並列摘要

The objective of this study was to compare the effects of containment and swaddling on premature infants’ heart rates (HR), oxygen saturation (SpO2), and the Premature Infant Pain Profile (PIPP) scores after heelstick. The study used a cross-over experimental design, 32 premature infants with gestational age ＜ 37 weeks, bodyweight 2,500 grams, and no diagnosis of congenital heart disease, deformity, sepsis or Grade 3 intraventricular hemorrhage were selected as subjects. Each subject was randomly assigned to containment or swaddling once while undergoing two heelsticks in different time periods. Heart rate, oxygen saturation, facial expression and PIPP score were recorded from 5 minutes before to 11 minutes after heelstick. According to the paired t test, the results showed (1) that mean HR was higher and mean SpO2 was lower than their respective baseline values under the two interventions after heelstick (p ＜ .05), and that premature infants in swaddling returned to their baseline HR and SpO2 values in shorter time periods compared to those in containment, though the variations of HR and SpO2 between the two interventions exhibited no significant differences; and (2) that pain responses to heelstick under swaddling yielded lower scores than those under containment according to the total PIPP scores, but significant difference between the two interventions was only found at the 3rd and 7th minute. As a whole, there is little difference between the effects of swaddling and containment on attenuating physiological and behavioral stress caused by acute pain. The results of this study can serve as an evidence basis for nursing interventions in acute pain for premature infants. In clinical practice, containment and swaddling can be administered interchangeably according to patients’ individual differences.

並列關鍵字

premature ； heelstick ； containment ； swaddling ； pain

參考文獻

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