YENİDOĞAN BEBEKLERİN STRESİNİ DEĞERLENDİRMEDE BİR YÖNTEM; TÜKÜRÜK KORTİZOL DÜZEYİ

Yıl 2017, Cilt: 6 Sayı: 3, 136 - 141, 31.12.2017

Ayşe Kahraman Zümrüt Başbakkal

Öz

Stres, fiziksel, kimyasal veya duygusal faktörlere bağlı olarak ortaya çıkan bedensel ve ruhsal gerginlik durumu ve hastalığa yatkınlığı arttıran bir faktör olarak tanımlanmaktadır. Yenidoğan yoğun bakım ortamı ve yenidoğana uygulanan girişimler güçlü birer stres ve travma kaynağıdır. Stres yenidoğan beyin gelişiminde olumsuz sonuçlara yol açabilen bir durumdur. Stresin azaltılması en önemli hemşirelik girişimlerinden biridir. Stresin azaltılması için öncelikle değerlendirilmesi gerekmektedir. Yenidoğanın stresi davranışsal ölçekler ile değerlendirilebilir, ayrıca stresin değerlendirilmesinde biyokimyasal ölçümler de kullanılmaktadır. En yaygın olarak kullanılan biyokimyasal ölçüm non-invaziv olarak elde edilen tükürük kortizol düzeyinin incelenmesidir. Derlemede yenidoğanlarda stresin değerlendirilmesinde tükürük kortizol düzeyi ölçümü, tükürük alınma zamanları, tükürük alma materyalleri ve yenidoğanlarda tükürük kortizol düzeyinin değerlendirildiği çalışmalar güncel literatür ışığında sunulmuştur..

Anahtar Kelimeler

Yenidoğan, stres, tükürük, kortizol

AN ASSESSMENT METHOD FOR THE STRESS OF NEWBORN INFANTS: SALIVARY CORTISOL LEVEL

Öz

Stress is defined as a factor which arises due to chemical or emotional factors and increasesphysical and mental state of tension and disease susceptibility. Neonatal intensive care environment and approaches applied to newborn are a powerful source of stress and trauma. Stress is a condition that can lead to negative consequences in the newborn brain development. Reducing stress is one of the most important nursing interventions. It should be evaluated primarily to reduce stress. Neonatal stress may be evaluated by behavioral scales, biochemical parameters are also used for evaluation of stress. The most commonly used biochemical test is examination of cortisol level of non-invasively obtained salivary. In the review, studies evaluating salivary cortisol measurement to evaluate stress in newborns, times for saliva taking, saliva-taking materials and salivary cortisol levels of newbornsare presented in the light of current literature.

Anahtar Kelimeler

Newborn, stress, salivary

Kaynakça

• 1. American Academy Of Pediatrics (AAP) Prevention and Management of Pain and Stress in the Neonate, Committee on Fetus and Newborn, Committee on Drugs, Section on Anesthesiology, Section on Surgery and Canadian Paediatric Society, Fetus and Newborn Committee, Pediatrics 2000;105:454-461.
• 2. Graham YP, Heim C, Goodman SH, Miller AH, Nemeroff CB. The effects of neonatal stres on brain development: Implications for psychopathology, Dev Psychopathol. 1999; 11(3): 545-65.
• 3. Coughlin ME. Transformative Nursing in the NICU, Trauma-İnformed Age Appropriate Care, Chapter 9, Prevention and Management of Pain and Stress, Springer Publishing Company, 2014, p.105.
• 4. Türkçapar H. HPA (hipotalamik-pituiter [hipofiz]-adrenal) Ekseni, Duygudurum dizisi 2001; 6:257-263.
• 5. Eisen LN, Field TM, Bandstra ES. et al. Perinatal Cocaine Effects on Neonatal Stress Behavior and Performance on the Brazelton Scale, Pediatrics, 1991;81(3):477-480.
• 6. Taddio A, Shah V, Hancock R, et al. Effectiveness of sucrose analgesia in newborns undergoing Painful Medical Procedures. CMAJ. 2008; 179(1): 37-43.
• 7. Tari A, Çiğdem Z. Prematüre Bebeklerde Biberonla Beslenmeye Geçiş Sırasında Uygulanan Geleneksel ve Gelişimsel Bakım Yöntemlerinin Karşılaştırılması, Marmara Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi, İstanbul, 2003.
• 8. İmseytoğlu D, Yıldız S. Yenidoğan Yoğun Bakım Ünitesinde Yatan Prematürelere Dinletilen Türk Müziğinin Prematürelerin Stres Belirtileri, Büyüme, Oksijen Saturasyon Düzeyi Üzerine Etkisi, İstanbul Üniversitesi, Sağlık Bilimleri Enstitüsü, Çocuk Sağlığı ve Hastalıkları Hemşireliği AD, Doktora Tezi, İstanbul, 2011.
• 9. Als H, Butler S, Kosta S, McAnulty G.The Assessment of Preterm Infants' Behavior (APIB): furthering the understanding and measurement of neurodevelopmental competence in preterm and full-term infants. Ment Retard Dev Disabil Res Rev. 2005;11(1):94-102.
• 10. Cândia MF, Osaku EF, Leite MA. et al. İnfluence of prone positioning on premature newborn infant stress assessed by means of salivary cortisol measurement: pilot study. Rev Bras Ter Intensiva. 2014 Apr-Jun;26(2):169-75.
• 11. Hellhammer DH, Wust S, Kudielka BM. Salivary cortisol as a biomarker in stress research, Psychoneuroendocrinology, 2009; 34:163-171.
• 12. Calixto C, Martinez FE, Jorge SM, Moreira AC, Martinelli CE. Correlation between plasma and salivary cortisol levels in preterm infants MDJ Pediatr 2002; 140:116-8.
• 13. Herrıngton CJ, Olomu IN., Geller SM. Salivary Cortisol As Indicators of Pain in Preterm Infants: A Pilot Study, Clin Nurs Res. 2004 Feb;13(1):53-68.
• 14. Maas C, Ringwald C, Weber K,. et al. Relationship of Salivary and Plasma Cortisol Levels in Preterm Infants: Results of a Prospective Observational Study and Systematic Review of the Literature, Neonatology 2014; 105(4): 312–318.
• 15. Cabral DM, Antonini SR, Custódio RJ, Martinelli CE Jr, da Silva CA. Measurement of salivary cortisol as a marker of stress in newborns in a neonatal intensive care unit. Horm Res Paediatr. 2013;79(6):373-8.
• 16. South MM, Strauss RA, South AP, Boggess JF, Thorp JM. The use of non-nutritive sucking to decrease the physiologic pain response during neonatal circumcision: A randomized controlled trial, Am J Obstet Gynecol. 2005 Aug;193(2):537-42.
• 17. Miles R, Cowan F, Glover V, Stevenson J, Modi N. A controlled trial of skin-to-skin contact in extremely preterm infants, Early Hum Dev. 2006; 82(7): 447-55.
• 18. Mörelius E, Hellström-Westas L, Carlén C, Norman E, Nelson N. Is a nappy change stressful to neonates? Early Hum Dev. 2006; 82(10): 669-76.
• 19. Hanson D, Hall W, Mills LL., et al. Comparison of distress and pain in infants randomized to groups receiving standard versus multiple immunizations, Infant Behavior & Development, 2010; 33: 289–296.
• 20. Keenan K, Gunthorpe D, Grace D. Parsing the relations between SES and stress reactivity: Examining individual differences in neonatal stress response, Infant Behavior & Development, 2007; 30: 134–145.
• 21. Neu M, Hazel NA, Robinson C, Schmiege SJ, Laudenslager M. Effect of holding on co-regulation in preterm infants: A randomized controlled trial, Early Hum Dev. 2014; 90(3): 141-7.
• 22. Davis EP, Townsend EL, Gunnar MR., et al. Effects of prenatal betamethasone exposure on regulation of stres physiology in healthy premature infants. Psychoneuroendocrinology. 2004 Sep;29(8):1028-36.
• 23. Takahashi Y, Tamakoshi K, Matsushima M, Kawabe T. Comparison of salivary cortisol, heart rate, and oxygen saturation between early skin-to-skin contact with different initiation and duration times in healthy, full-term infants, Early Hum Dev. 2011; 87(3): 151-7.
• 24. Badiee Z, Asghari M, Mohammadizadeh M.The calming effect of maternal breast milk odor on premature infants. Pediatr Neonatol. 2013;54(5):322-5.
• 25. Badiee Z, Nassiri Z, Armanian A. Cobedding of twin premature infants: calming effects on pain responses. Pediatr Neonatol. 2014; 55(4): 262-8.
• 26. Salimetrics LLC (2015). Collection Methods: SalivaBio Infant's Swab (SIS). https://www.salimetrics.com/assets/documents/infants_swab_saliva_collection_instructions.pdf. Erişim Tarihi: 31.05.2016.
• 27. de Weerth, C, Jansen J, Vos MH, Maitimu I, Lentjes EG. A new device for collecting saliva for cortisol determination. Psychoneuroendocrinology, 2007; 32(8-10), 1144-48.
• 28. Tryphonopoulos PD, Letourneau N, Azar R. Approaches to salivary cortisol collection and analysis in infants. Biol Res Nurs. 2014 Oct;16(4):398-408