Destekleyici Konumlandırmanın Preterm Yenidoğanlarda COMFORT Ölçek Puanlarına Etkisi

Abstract

Amaç: Prematüre bebekler, çevresel stres faktörlerine karşı özellikle yaşamın ilk haftalarında daha savunmasızdır. Bu süre zarfında, özellikle bebeklerin etrafında kullanılan destekleyici konumlandırma, kendilerini uterus içinde olduğu gibi daha iyi hissetmelerini sağlar. Bu çalışmanın amacı, yenidoğan yoğun bakım ünitesinde destekleyici konumlandırmanın; prematüre bebeklerin kilo alımı, yaşamsal belirtileri, beslenme intoleransları, ventilasyon süreleri, hastanede kalış süreleri ve konfor ölçeği puanları üzerine etkisini değerlendirmektir. Gereç ve Yöntemler: Çalışmaya rastgele olarak seçilen, 25'i desteklenen grupta ve 25'i kontrol grubunda olmak üzere toplam 50 prematüre bebek dahil edildi. Desteklenen gruptaki bebekler pozisyon malzemesi olarak yumuşak örtüler ve yastıklarla yuvalandı. Kontrol grubunda yuvalama ya da kundaklama yoktu. Bebeklerin demografik özellikleri, konfor ölçeği skorları, kalp hızı, solunum hızı ve oksijen satürasyonu kaydedildi ve karşılaştırıldı. Bulgular: Desteklenen grup ve kontrol grubunun sırasıyla ortalama gestasyonel haftaları 32,9±2,5 (26-36) ve 32,7±2,8 (26-36) hafta (p=0,791), ortalama doğum ağırlıkları ise 1554±492 (680-2380) ve 1772±439 (590-2375) gramdı (p=0,105). Kilo alımı, ventilatör günleri ve hastanede kalış günleri gruplar arasında benzerdi, ancak ortalama oksijen satürasyonu ve derin sedasyon gösteren konfor ölçeği skorları desteklenen grupta günlük bakım sonrası daha yüksekti (sırasıyla; p=0,024, p<0,001). Sonuç: Destekleyici konumlandırmanın hastanede kalış süresi, ventilasyon ve kilo alımı üzerine etkisi olmamakla birlikte prematüre bebeklerin ortalama oksijen satürasyonu ve konfor ölçeği puanları üzerinde olumlu etkisi vardır ve yenidoğan bakımında önerilmektedir.

Keywords

• Hemşirelik bakımı
• yoğun bakım üniteleri
• yenidoğan
• erken doğum
• hasta konforu

Effect of Supportive Positioning on COMFORT Scale Scores in Preterm Newborns

Abstract

Aim: Premature babies are vulnerable to environmental stress factors mostly in the first weeks of life. During this time, supportive positioning, especially used all-around the baby, makes them feel better as if they are in utero. The aim of the study was to evaluate the effect of supportive positioning on weight gain, vital signs, feeding intolerance, duration of ventilation, duration of hospitalization and comfort scale scores of the premature babies in neonatal intensive care unit. Material and Methods: A total of 50 premature infants were recruited into the study randomly, 25 in the supported group and 25 in the control group. The babies in the supported group were nested with soft blankets and pillows as position material. There was no nesting or swaddling in the control group. Demographic findings, comfort scale scores, heart rate, respiratory rate and oxygen saturation of infants were recorded and compared. Results: Mean gestational weeks and birth weights of the supported and control groups were 32.9±2.5 (26-36) vs. 32.7±2.8 (26-36) weeks (p=0.791) and 1554±492 (680-2380) vs. 1772±439 (590-2375) g (p=0.105), respectively. Weight gain, ventilator days and days of hospitalization were similar in groups, however mean oxygen saturation and comfort scale scores showing deep sedation were higher in the supported group (p=0,024, p<0,001, respectively) after daily care. Conclusion: Although supportive positioning does not have an effect on duration of hospitalization, ventilation and weight gain, it has a positive effect on mean oxygen saturation and comfort scale scores of premature infants and recommended in newborn care.

Keywords

• Nursing care
• intensive care units
• neonatal
• preterm birth
• patient comfort

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