探討極早期袋鼠式護理對新生兒子宮外適應之影響

Effects of Very Early Kangaroo Care on Infants' Extrauterine Adaptation

黃麗虹(Li-Hung Huang) ； 卓妙如(Miao-Ju Chwo) ； 朱德明(Der-Ming Chu) ； 張玉坤(Yu-Cune Chang)

《護理雜誌》 49卷5期 (2002/10) Pp. 37-51

https://doi.org/10.6224/JN.49.5.37

摘要

本研究是採隨機控制試驗（randomized controlled trial）以瞭解極早期袋鼠式護理對新生兒子宮外適應的影響。本研究以Conlon Anderson（1990）所設計的電腦程式（minimization program）將49對母兒的基本屬性資料輸入電腦後，藉電腦程式將個案隨機分配到袋鼠式護理組或常態護理組，此電腦程式能藉由分層化（stratification）以減低實驗組與控制組混淆變項（confounding variables）的效應，使兩組樣本的特性趨於均衡。本研究於新生兒護理完成後即開始，實驗組母兒進行60分鐘的袋鼠式護理，而控制組新生兒則依常規護理。研究結果為實驗組後測平均體溫高於控制組（37.3℃vs. 37.0℃, p = .022），而實驗組與控制組的平均心跳次數與血氧飽和濃度無差異，且都在正常範圍內。實驗組比控組出現安靜睡眠狀態（41.1% vs.13.5%, p = .001）及警覺清醒狀態（27.6% vs. 2.8%, p = .001）的比例較高。而控制組比實驗組出現嗜睡狀態（7.7% vs. 0.6%, p = .000）和哭的狀態（state 10, 11, 12）（38.5% vs. 15.1%, p = .000）的比例較高。本研究顯示極早期袋鼠式護理對新生兒生理狀況及行為狀態是安全的措施，期望藉由此實證性研究之結果，作為醫院應用於新生兒出生後照護方式之參考。

關鍵字

袋鼠式護理 ； 子宮外適應 ； 行為狀態

並列摘要

The aim of this study was to investigate the effects of very early kangaroo care on infants' extrauterine adaptation. Forty-nine mothers and their babies were randomly assigned to an experimental group (KC) or a control group by the computer minimization program designed by Conlon and Anderson (1990). The program can average the characteristics of the two sample groups by stratification. The infants in the KC group received 60 minutes skin-to-skin contact with mothers after newborn nursing care. The infants in the control group received the same care without the KC intervention. The mean body temperature of the KC group was significantly higher than control group (37.3 ℃vs. 37.0℃, p = .022). There were no differences in heart rate or oxygen saturation between the groups. Both heart rate and oxygen saturation were also within normal limits. The KC group had more quiet sleep (41.1% vs.13.5%, p = .001) and alert inactivity (27.6% vs. 2.8%, p = .001) than the control group. The control group had more drowsiness (7.7% vs. 0.6%, p = .000) and crying state (states 10, 11, 12) (38.5% vs. 15.1%, p = .000) than the KC group. In conclusion, this study demonstrates very early kangaroo care is safe and beneficial to the infant's behavioral state. From this evidence-based study, KC could be adopted for newborn infants after birth.

並列關鍵字

kangaroo care ； extrauterine adaptation ； behavioral state