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Yenidoğanlarda Ağrı Yönetiminde Kullanılan Kanıt Temelli Nonfarmakolojik Hemşirelik Uygulamaları

Year 2020, Volume: 9 Issue: 3, 197 - 204, 23.12.2020

Abstract

Amaç: Yenidoğan yoğun bakım ünitesinde yatan bir bebeğe tanı ve tedavi amacıyla ağrı ve strese neden olan pek çok ağrılı işlem uygulanmaktadır. Bu derlemenin amacı yenidoğanlarda ağrı yönetiminde kullanılan kanıt temelli nonfarmakolojik hemşirelik uygulamalarının incelenmesidir. Bu doğrultuda deneysel randomize kontrollü, meta-analiz ve sistematik derleme sonuçlarına yer verilmiştir.
Yöntem: Ağrıyı azaltmada farmakolojik yöntemler kadar nonfarmakolojik yöntemler üzerinde de durulmaktadır. Kullanılan farmakolojik yöntemlerin solunum depresyonu, hipotansiyon gibi yan etkileri olduğu belirtilmektedir. Bu nedenle nonfarmakolojik yöntemler, yenidoğana uygulanan minör invazif işlemlerde ağrı kontrolü için değerli alternatiflerdir.
Bulgular: Akut ağrılı işlemlerde ağrı davranışlarını yönetmede preterm ve term yenidoğanlarda farklı nonfarmakolojik yöntemlerin kullanılabileceğine dair önemli ölçüde kanıtlar olduğu belirtilmiştir. Yenidoğanlarda sık tekrarlanan topuk kanı alma, aspirasyon gibi ağrılı işlemler sırasında uygulanan nonfarmakolojik yöntemlerin ağrıyı azaltmada etkili olduğu bulunmuştur. Bu yöntemler arasında; masaj, kanguru bakımı, müzik dinletme, sukroz, emzik verme, sarmalama, prone pozisyonu, anne sütü/emzirme, dokunma-kucaklama, cenin pozisyonu verme, çevresel uyaranları azaltma ve bireyselleştirilmiş gelişimsel bakım uygulamaları sayılabilir.
Sonuç: Etkili ağrı yönetimi için yenidoğanların yaşadığı ağrının doğru ve zamanında tanımlanması önemlidir. Yenidoğan hemşireleri ağrıyı önlemeli, ağrıyı değerlendirmeli, kanıta dayalı uygulamalara daha fazla yer vermeli, etkili farmakolojik ve nonfarmakolojik ağrı yönetimi stratejilerini uygulayarak, bakım planını sürekli olarak değerlendirmelidir.
Anahtar Kelimeler: Ağrı, Kanıt, Nonfarmakolojik Hemşirelik Uygulamaları, Yenidoğan

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References

  • Akcan, E, Polat, S. (2017). Yenidoğanlarda Ağrı ve Ağrı Yönetiminde Hemşirenin Rolü. ACU Sağlık Bil Derg, (2), 64-69. Akcan, E, Yıgıt, R, Atıcı A. (2009). The Effect of Kangaroo Care on Pain in Premature Infants During Invasive Procedures. The Turkish journal of Pediatrics, 51 (1), 14. Akcan, E, Yiğit, R. (2015). Prematüre Bebek Ağrı Profili: Türkçe Geçerlilik ve Güvenirliliği. F.Ü.Sağ.Bil.Tıp Derg, 29 (3), 97–102. Akcan, E, Yiğit, R. (2016). Türkiye’de Yenidoğan Kliniklerinde Çalışan Hemşire ve Hekimlerin Yenidoğanda Ağrı Yönetimi ile İlgili Yaklaşımları. ACU Sağlık Bil Derg, 3, 147-153. Akdovan, T, Yıldırım, Z. (1999). Sağlıklı Yenidoğanlarda Ağrının Değerlendirilmesi, Emzik Verme ve Kucağa Alma Yönteminin Etkisinin İncelenmesi. Perinatoloji Dergisi, 7 (2), 107-107 Amerıcan Academy of Pedıatrıcs Fetus and Newborn Commıttee. (2006). Prevention and Management of Pain in the Neonate: An Update. Pediatrics, 118 (5), 2231- 2241. Anand, KJS, Hall, RW, Desaı, N, Shephard, B, Bergqvıst, LL, Young, TE, et al. (2004). Effects of Morphine Analgesia in Ventilated Preterm Neonates: Primary Outcomes From the Neopaın Randomised Trial. The Lancet, 363 (9422), 1673-1682. Badr LK, Demerjian T, Daaboul T, Abbas H, Zeineddine MH, Charafeddine L. (2017). Preterm İnfants Exhibited Less Pain During a Heel Stick When They Were Played The Same Music Their Mothers Listened to During Pregnancy. Acta Pædiatrica, 106 (3), 438-45. Bellıenı, CV, Teı, M, Coccına, F, Buonocore, G. (2012). Sensorial Saturation for Infants Pain. The Journal of Maternal-Fetal Neonatal Medicine, 25 (sup1), 79-81. Bueno, M, Yamada, J, Harrıson, D, Khan, S, Ohlsson, A, Adams-Webber, T, Stevens, B. (2013). A Systematic Review and Meta-Analyses of Nonsucrose Sweet Solutions for Pain Relief in Neonates. Pain Research Management, 18(3), 153-161. Carbajal, R, Rousset, A, Danan, C, et al. (2008). 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Year 2020, Volume: 9 Issue: 3, 197 - 204, 23.12.2020

Abstract

Project Number

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References

  • Akcan, E, Polat, S. (2017). Yenidoğanlarda Ağrı ve Ağrı Yönetiminde Hemşirenin Rolü. ACU Sağlık Bil Derg, (2), 64-69. Akcan, E, Yıgıt, R, Atıcı A. (2009). The Effect of Kangaroo Care on Pain in Premature Infants During Invasive Procedures. The Turkish journal of Pediatrics, 51 (1), 14. Akcan, E, Yiğit, R. (2015). Prematüre Bebek Ağrı Profili: Türkçe Geçerlilik ve Güvenirliliği. F.Ü.Sağ.Bil.Tıp Derg, 29 (3), 97–102. Akcan, E, Yiğit, R. (2016). Türkiye’de Yenidoğan Kliniklerinde Çalışan Hemşire ve Hekimlerin Yenidoğanda Ağrı Yönetimi ile İlgili Yaklaşımları. ACU Sağlık Bil Derg, 3, 147-153. Akdovan, T, Yıldırım, Z. (1999). Sağlıklı Yenidoğanlarda Ağrının Değerlendirilmesi, Emzik Verme ve Kucağa Alma Yönteminin Etkisinin İncelenmesi. Perinatoloji Dergisi, 7 (2), 107-107 Amerıcan Academy of Pedıatrıcs Fetus and Newborn Commıttee. (2006). Prevention and Management of Pain in the Neonate: An Update. Pediatrics, 118 (5), 2231- 2241. Anand, KJS, Hall, RW, Desaı, N, Shephard, B, Bergqvıst, LL, Young, TE, et al. (2004). Effects of Morphine Analgesia in Ventilated Preterm Neonates: Primary Outcomes From the Neopaın Randomised Trial. The Lancet, 363 (9422), 1673-1682. Badr LK, Demerjian T, Daaboul T, Abbas H, Zeineddine MH, Charafeddine L. (2017). Preterm İnfants Exhibited Less Pain During a Heel Stick When They Were Played The Same Music Their Mothers Listened to During Pregnancy. Acta Pædiatrica, 106 (3), 438-45. Bellıenı, CV, Teı, M, Coccına, F, Buonocore, G. (2012). Sensorial Saturation for Infants Pain. The Journal of Maternal-Fetal Neonatal Medicine, 25 (sup1), 79-81. Bueno, M, Yamada, J, Harrıson, D, Khan, S, Ohlsson, A, Adams-Webber, T, Stevens, B. (2013). A Systematic Review and Meta-Analyses of Nonsucrose Sweet Solutions for Pain Relief in Neonates. Pain Research Management, 18(3), 153-161. Carbajal, R, Rousset, A, Danan, C, et al. (2008). Epidemiology and Treatment of Painful Procedures in Neonates in Intensive Care Units. JAMA, 300, 60-70. Ceylan, Ss, Bolışık, B. (2017). Yenidoğan Bebeklerde ALPS-Neo Ağrı ve Stres Değerlendirme Ölçeğinin Geçerlik ve Güvenirliği. Pamukkale Tıp Dergisi, 10(1), 45-52. Chıdambaram, AG, Manjula, S, Adhısıvam, B, Vıshnu Bhat, B. (2014). Effect of Kangaroo Mother Care in Reducing Pain due to Heel Prick Among Preterm Neonates: A Crossover Trial. The Journal of Maternal-Fetal Neonatal Medicine, 27(5), 488-490. Cıgnacco, E, Hamers, JP, Stoffel, L, Lıngen, RA, Gessler, P, Mcdougall, J, Nelle, M, (2007). “The Efficacy of Non‐Pharmacological Interventions in The Management of Procedural Pain in Preterm and Term Neonates.” European Journal of Pain, 11 (2), 139-152. Cong, X, Cusson, RM, Walsh, S, Hussaın, N, Ludıngton-Hoe, SM, Zhang, D. (2012). Effects of Skin-to-Skin Contact on Autonomic Pain Responses in Preterm Infants. The Journal of Pain, 13(7), 636-645. Çağlayan, N., Balcı, S., (2014). Preterm Yenidoğanlarda Ağrının Azaltılmasında Etkili Bir Yöntem: Cenin Pozisyonu. F.N. Hem. Derg, 22 (1), 63-68. Çakşak, A. (2017). Term Bebeklerde Ayak Topuğundan Kan Alma İşlemi Sırasında Dinletilen Beyaz Gürültünün, Elle Verilen Cenin Pozisyonunun Ve Her İki Uygulamanın Birlikte Yapılmasının Ağrıya Etkisi, ESOGÜ Sağlık Bilimleri Enstitüsü, Doktora Tezi, Eskişehir. Çelebioğlu, A, Üğücü, G. (2019). Yenidoğan ve Bebeklik Döneminde Ağrı ve Hemşirelik Yönetimi. Turkiye Klinikleri Pediatric Nursing-Special Topics, 5(3), 27-34. Çöçeli, LP, Bacaksız BD, Ovayolu, N. (2008). Ağrı Tedavisinde Hemşirenin Rolü. Gaziantep Tıp Dergisi, 14, 53-8. Derebent, E, Yiğit, R. (2006). Yenidoğanda Ağrı: Değerlendirme ve Yönetim. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi, 10, 41-8. Dıego, MA, Fıeld, T, Hernandez‐Reıf, M, Deeds, O, Ascencıo, A, Begert, G. (2007). Preterm Infant Massage Elicits Consistent Increases in Vagal Activity and Gastric Motility that are Associated with Greater Weight Gain. Acta Paediatrica, 96 (11), 1588-1591. Dinçer, Ş, Yurtçu, M, Günel, E. (2011). Yenidoğanlarda Ağrı ve Nonfarmakolojik Tedavi. Selçuk Üniversitesi Tıp Dergisi, 27 (1), 46-51. Efe Özel, E, Öncel, S. (2005). Yenidoğanlarda Minör İnvaziv İşlemlerde Anne Sütünün Ağrıyı Azaltmadaki Etkisi. Hemşirelik Forumu, 42-6. Efe Özel, E. (2004). Yenidoğanlarda Ağrılı İşlemler Sırasında Nonfarmakolojik Yöntemlerin Kullanımı. MN Klinik Bilimler Selçuk Ünv. Tıp Dergisi, 10 (1), 73-5. Efe, E, Dıkmen, S, Altas, N, Boneval, C. (2013). Turkish Pediatric Surgical Nurses' Knowledge and Attitudes Regarding Pain Assessment and Nonpharmacological and Environmental Methods in Newborns' Pain Relief. Pain Management Nursing, 14 (4), 343-350. Efe, E, Savaser, S. (2007). The Effect of Two Different Methods Used Durin Peripheral Venous Blood Collection on Pain Reduction in Neonates. 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Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Derlemeler
Authors

Duygu Kemer 0000-0002-6909-8961

Ayşegül İşler 0000-0001-8448-0483

Project Number Yok
Publication Date December 23, 2020
Submission Date June 8, 2020
Published in Issue Year 2020 Volume: 9 Issue: 3

Cite

APA Kemer, D., & İşler, A. (2020). Yenidoğanlarda Ağrı Yönetiminde Kullanılan Kanıt Temelli Nonfarmakolojik Hemşirelik Uygulamaları. Balıkesir Sağlık Bilimleri Dergisi, 9(3), 197-204.

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