新生兒非營養吸吮動作能力量表之信度檢測

目的：新生兒進食行為是早期的功能性活動，成功口腔進食被視為重要發展里程碑，而非營養吸吮動作是營養吸吮的重要元素。透過避免吸入性危險的非營養吸吮動作評估，治療師可安全地評估新生兒口腔進食所需的動作能力，因此發展可信有效之非營養吸吮能力評估是必要的，為此我們設計新生兒非營養吸吮動作能力量表（Non-nutritive Sucking Motor Ability Scale，NNSMAS）。本研究目的為測試新生兒NNSMAS的施測者一致性，作為施測者間信度驗證。方法：本研究由兩位職能治療師為妊娠年齡26.14至40週在新生兒加護病房與嬰兒病房的早產兒和高危險的足月產兒，於經後年齡34至40週時，進行舌部、頜部、唇部動作能力與非營養吸吮力量的評估，資料以SSPS與EXCLE軟體分析。結果：11位男性，6位女性，平均妊娠年齡為34.45週的新生兒參與研究，Pearson相關係數分析，r值介於0.861－0.987，再測信度ICCRα介於0.925－0.983。內在一致性Cronbach'sα介於0.948－0.988。結論：NNSMAS的舌部、頜部、唇部動作能力與非營養吸吮力量四個向度，有好的一致性信度。此感覺動作評估工具可能對需要評估新生兒進食問題的職能治療師有很大助益。

關鍵字

新生兒加護病房；職能治療；早產新生兒；口腔進食；非營養吸吮

並列摘要

Objective: Oral-feeding is the earliest functional activity of newborns. Successful oral-feeding is an essential developmental milestone, and non-nutritive sucking (NNS) movement is important for oral-feeding. Through the assessment of NNS movement, which avoids aspiration risks, therapists can safely evaluate newborn's motor abilities required for oral-feeding. Therefore, it is necessary to develop a reliable and valid NNS assessment. The purpose of this study was to test the reliability of the Non-Nutritive Sucking Motor Ability Scale (NNSMAS). Methods: Two occupational therapists in the neonatal intensive care unit (NICU) and baby wards assessed 4 subcategories of non-nutritive sucking (lip, tongue, jaw movement and NNS power) in neonates with postmenstrual age 34 to 40 weeks old. Results: 11 male and 6 female (mean gestational age: 34.45 weeks) were assessed in this study. Cohen's Kappa values of raters were 0.29-1.00. Pearson's correlation coefficients (r) between the two raters were 0. 861-0.987. Interclass correlation coefficient reliability α values were 0.925-0.983. The internal consistency Cronbach's α values of 4 subcategories were 0.948-0.988. Conclusions: The NNSMAS has good internal consistency. Occupational therapists may use this sensorimotor assessment to evaluate NNS of newborns who may have oral-feeding problems.

並列關鍵字

Infant ； NICU ； Non-Nutritive Sucking ； Occupational Therapy ； Oral Feeding

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