Hemşirelik Uygulamalarının Prematüre Bebeklerin Near Infrared Spectroscopy Düzeylerine Etkisi
Yıl 2024,
Cilt: 34 Sayı: 5, 650 - 656, 31.10.2024
Ezgi Ayvaz
,
Ayfer Açıkgöz
Öz
Amaç: Bu çalışma yenidoğan yoğun bakım ünitesi (YYBÜ)’nde yatan prematüre bebeklerde yapılan hemşirelik bakım uygulamalarının bebeklerin Near Infrared Spectroscopy (NIRS) düzeylerine etkisini belirlemek amacıyla yapılmıştır.
Materyal ve Metod: Kesitsel analitik bir çalışmadır. Araştırma, Eskişehir’de bir hastanenin YYBÜ’de gerçekleştirilmiştir. Çalışmamızda örneklem hesabına gidilmemiş olup 1 Mart- 26 Nisan 2019 tarihleri arasında NICU’da yatan, çalışma seçim kriterlerine uyan ve ebeveynlerinden bilgilendirme sonrası onam alınan tüm yenidoğanlar dahil edilmiştir. Çalışma 40 yenidoğan ile tamamlanmıştır. Veri toplamak amacıyla “Tanımlayıcı Bilgi Formu”, ve “Yapılan İşlemler Çizelgesi” kullanılmıştır. Çalışmada elde edilen veriler IBM SPSS 24 paket programı ile değerlendirilmiştir.
Bulgular: Çalışma kapsamına alınan hemşirelik bakım uygulamaları ile yenidoğanların Near Infrared Spectroscopy (NIRS) değerleri, oksijen saturasyonları (SpO2) ve kalp tepe atım (KTA) değerleri arasında önemli fark olduğu saptanmıştır (p<0.01).
Sonuç ve Öneriler: Çalışma sonucunda prematüre bebeklere yapılan hemşirelik bakım uygulamalarının bebeklerin serebral oksijenlenmesini olumsuz etkilediği belirlenmiştir. Önerimiz; prematüre bebeklere yapılan hemşirelik uygulamalarında hassas davranılması, bu uygulamaların gerekli olmadıkça bebeğe yapılmaması, uzun sürecek toplu bakım uygulamalarının farklı zamanlara bölünmesi ve bebeklerin dinlenmesine izin verilmesidir.
Kaynakça
- Hartley C, Slater R. Neurophysiological measures of nociceptive brain activity in the newborn infant the next steps. Acta paediatrica 2014; 103(3):238-242.
- McPherson C, Miller SP, El-Dib M, Massaro AN, Inder TE. The influence of pain, agitation, and their management on the immature brain. Pediatric research 2020; 88(2):168-175.
- Umur A. Prematüreler İçin Hemşirelik Bakım Standartları Oluşturulması ve Etkinliğinin Değerlendirilmesi 2008. (Doctoral dissertation, Marmara Universitesi (Turkey)
- Volpe JJ. Intracranial hemorrhage: Neurology of the newborn. Philadelphia, PA: Saunders Elsevier 2008; 481-588.
- Williams MD, Lascelles BDX. Early neonatal pain a review of clinical and experimental implications on painful conditions later in life. Frontiers in Pediatrics 2020; 8:30.
- Slater R, Cantarella A, Franck L, Meek J, Fitzgerald M. How well do clinical pain assessment tools reflect pain in infants? PLoS Medicine 2008; 5(6): e129.
- Ranger M, Johnston CC, Rennick JE, Limperopoulos C, Heldt T, Du Plessis AJ. A multidimensional approach to pain assessment in critically ill infants during a painful procedure. The Clinical Journal of Pain 2013; 29(7): 613.
- Karunakaran KD, Peng K, Berry D, Green S, Labadie R, Kussman B, Borsook D. NIRS measures in pain and analgesia: fundamentals, features, and function. Neuroscience & Biobehavioral Reviews 2021; 120:335-353.
- Scarapicchia V, Brown C, Mayo C, Gawryluk JR. Functional magnetic resonance imaging and functional near-infrared spectroscopy: insights from combined recording studies. Frontiers in Human Neuroscience 2017; 11:419.
- Çağlayan N, Balcı S. Preterm Yenidoğanlarda ağrının azaltılmasında etkili bir yöntem: cenin pozisyonu. Florence Nightingale Hemşirelik Dergisi 2014; 22(1):63-68.
- Karakoç A, Türker F. Effects of white noise and holding on pain perception in newborns. Pain Management Nursing 2014; 15(4):864-870.
- Acikgoz A, Yildiz S. Effects of open and closed suctioning systems on pain in newborns treated with mechanical ventilation. Pain Management Nursing 2015; 16(5):653-663.
- Bartocci M, Bergqvist LL, Lagercrantz H, Anand KJS. Pain activates cortical areas in the preterm newborn brain. Pain 2006; 122(1-2):109-117.
- Olsson E, Ahlsén G, Eriksson M. Skin‐to‐skin contact reduces near‐infrared spectroscopy pain responses in premature infants during blood sampling. Acta Paediatrica 2016; 105(4):376-380.
- Slater R, Cantarella A, Gallella S, Worley A, Boyd S, Meek J, Fitzgerald, M. Cortical pain responses in human infants. Journal of Neuroscience 2006; 26(14):3662-3666.
- Jacob E. Pain Assessment and Management in Children, In: Hockenberry, M. J. Wilson, D. (Eds.), Wong’s Essentials of Pediatric Nursing, Eighth Edition, Elsevier 2009; 159-194.
- Slater L, Asmeron Y, Boskovic D, Angeles DG. Procedural pain and oxidative stress in premature neonate. J Pain 2012; 13:590–7.
- De Clifford-Faugère G, Lavallée A, Aita M. Olfactive stimulation interventions for managing procedural pain in preterm and full-term neonates: A systematic review protocol 2017; 6(1):203.
- Axelin A, Salantera S, Lehtonen L. “Facilitated tucking by parents” in pain management of preterm infants: A randomized crossover trial. Early Human Development 2006; 82(4):241–247.
- Coughlin M, Gibbins S, Hoath S. Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice, J Adv Nurs. 2009; 65(10):2239–2248.
- Valeri BO, Liisa H, Linhares M. Neonatal Pain and Developmental Outcomes in Children Born Preterm: A Systematic Review. Clinical Journal of Pain 2015; 31:355-62.
- Amantai M. Çok Düşük Doğum Ağırlıklı Bebekler Halk Sağlığı Sorunudur. Türkiye Sağlık Bilimleri ve Araştırmaları Dergisi 2021; 4(2):52-63. (in Turkish)
- Imenshahidi M, Hosseinzadeh H. Berberine neuroprotection and antioxidant activity. In Oxidative Stress and Dietary Antioxidants in Neurological Diseases. Academic Press 2020; 199-216.
- Yiğit Ş, Ecevit A, Altun KÖ. Yenidoğan döneminde ağrı ve tedavisi rehberi. Türk Neonatoloji Derneği 2015; 1-59.
The Effect of Nursing Practices on the Near Infrared Spectroscopy Levels of Premature Infants
Yıl 2024,
Cilt: 34 Sayı: 5, 650 - 656, 31.10.2024
Ezgi Ayvaz
,
Ayfer Açıkgöz
Öz
Aim: This study was conducted to determine the effect of nursing care practices on the Near Infrared Spectroscopy (NIRS) levels of premature infants in the neonatal intensive care unit (NICU).
Materials and Method: This is a cross-sectional, analytical study. It was conducted over the in the NICU of a hospital in Eskişehir province. We did not calculate sample size, but included in the study, after the parents had been informed about the research, the entire universe of neonates in the NICU who matched the inclusion criteria during the period March 1 - April 26, 2019. The study was completed with 40 neonates. Data collection was performed with a “Descriptive Data Form,” and a “Procedures Performed Chart.” The data were evaluated with the IBM SPSS 24 package program.
Results: A significant difference was discovered between the nursing care practices included in the study and the neonates’ Near Infrared Spectroscopy (NIRS) values, oxygen saturation (SpO2), and peak heart rates (PHR) (p<0.01).
Conclusion and Recommendations: At the end of the study, we concluded that the nursing care practices conducted with premature infants had an adverse impact on cerebral oxygenation. We suggest that nursing practices carried out with premature infants be executed with sensitivity and care; no unnecessary practice should be implemented, and lengthy collective care practices should be divided into convenient increments so that the neonates are allowed to rest in-between.
Keywords: Nursing care, NIRS, premature, neonate, neonatal intensive care unit
This study was sponsored by a University Scientific Research Projects Unit. Project code: 2018-2334
Etik Beyan
Prior to the start of the study, ethics committee approval was received from T.C. Karatay University Clinical Studies Ethics Committee (approval dated 05.06.2018, numbered 41901325-050.99) and permission was also obtained from the hospital administration where the study was to be conducted. Only the infants of parents who had given their informed consent were included in the study.
Destekleyen Kurum
This study was sponsored by the Eskişehir Osmangazi University Scientific Research Projects Unit. Project code: 2018-2334
Kaynakça
- Hartley C, Slater R. Neurophysiological measures of nociceptive brain activity in the newborn infant the next steps. Acta paediatrica 2014; 103(3):238-242.
- McPherson C, Miller SP, El-Dib M, Massaro AN, Inder TE. The influence of pain, agitation, and their management on the immature brain. Pediatric research 2020; 88(2):168-175.
- Umur A. Prematüreler İçin Hemşirelik Bakım Standartları Oluşturulması ve Etkinliğinin Değerlendirilmesi 2008. (Doctoral dissertation, Marmara Universitesi (Turkey)
- Volpe JJ. Intracranial hemorrhage: Neurology of the newborn. Philadelphia, PA: Saunders Elsevier 2008; 481-588.
- Williams MD, Lascelles BDX. Early neonatal pain a review of clinical and experimental implications on painful conditions later in life. Frontiers in Pediatrics 2020; 8:30.
- Slater R, Cantarella A, Franck L, Meek J, Fitzgerald M. How well do clinical pain assessment tools reflect pain in infants? PLoS Medicine 2008; 5(6): e129.
- Ranger M, Johnston CC, Rennick JE, Limperopoulos C, Heldt T, Du Plessis AJ. A multidimensional approach to pain assessment in critically ill infants during a painful procedure. The Clinical Journal of Pain 2013; 29(7): 613.
- Karunakaran KD, Peng K, Berry D, Green S, Labadie R, Kussman B, Borsook D. NIRS measures in pain and analgesia: fundamentals, features, and function. Neuroscience & Biobehavioral Reviews 2021; 120:335-353.
- Scarapicchia V, Brown C, Mayo C, Gawryluk JR. Functional magnetic resonance imaging and functional near-infrared spectroscopy: insights from combined recording studies. Frontiers in Human Neuroscience 2017; 11:419.
- Çağlayan N, Balcı S. Preterm Yenidoğanlarda ağrının azaltılmasında etkili bir yöntem: cenin pozisyonu. Florence Nightingale Hemşirelik Dergisi 2014; 22(1):63-68.
- Karakoç A, Türker F. Effects of white noise and holding on pain perception in newborns. Pain Management Nursing 2014; 15(4):864-870.
- Acikgoz A, Yildiz S. Effects of open and closed suctioning systems on pain in newborns treated with mechanical ventilation. Pain Management Nursing 2015; 16(5):653-663.
- Bartocci M, Bergqvist LL, Lagercrantz H, Anand KJS. Pain activates cortical areas in the preterm newborn brain. Pain 2006; 122(1-2):109-117.
- Olsson E, Ahlsén G, Eriksson M. Skin‐to‐skin contact reduces near‐infrared spectroscopy pain responses in premature infants during blood sampling. Acta Paediatrica 2016; 105(4):376-380.
- Slater R, Cantarella A, Gallella S, Worley A, Boyd S, Meek J, Fitzgerald, M. Cortical pain responses in human infants. Journal of Neuroscience 2006; 26(14):3662-3666.
- Jacob E. Pain Assessment and Management in Children, In: Hockenberry, M. J. Wilson, D. (Eds.), Wong’s Essentials of Pediatric Nursing, Eighth Edition, Elsevier 2009; 159-194.
- Slater L, Asmeron Y, Boskovic D, Angeles DG. Procedural pain and oxidative stress in premature neonate. J Pain 2012; 13:590–7.
- De Clifford-Faugère G, Lavallée A, Aita M. Olfactive stimulation interventions for managing procedural pain in preterm and full-term neonates: A systematic review protocol 2017; 6(1):203.
- Axelin A, Salantera S, Lehtonen L. “Facilitated tucking by parents” in pain management of preterm infants: A randomized crossover trial. Early Human Development 2006; 82(4):241–247.
- Coughlin M, Gibbins S, Hoath S. Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice, J Adv Nurs. 2009; 65(10):2239–2248.
- Valeri BO, Liisa H, Linhares M. Neonatal Pain and Developmental Outcomes in Children Born Preterm: A Systematic Review. Clinical Journal of Pain 2015; 31:355-62.
- Amantai M. Çok Düşük Doğum Ağırlıklı Bebekler Halk Sağlığı Sorunudur. Türkiye Sağlık Bilimleri ve Araştırmaları Dergisi 2021; 4(2):52-63. (in Turkish)
- Imenshahidi M, Hosseinzadeh H. Berberine neuroprotection and antioxidant activity. In Oxidative Stress and Dietary Antioxidants in Neurological Diseases. Academic Press 2020; 199-216.
- Yiğit Ş, Ecevit A, Altun KÖ. Yenidoğan döneminde ağrı ve tedavisi rehberi. Türk Neonatoloji Derneği 2015; 1-59.