护理干预对早产儿疼痛的临床作用

目的 探讨早产儿疼痛的临床表现,观察护理干预对早产儿疼痛的临床效果.方法 选取46例早产儿,随机分为干预组和对照组,每组23例.对照组不给予任何干预措施；干预组给予抚触、非营养性吸吮等减轻疼痛的护理干预措施.按早产儿疼痛量表( PIPP)进行评分,观察护理干预对早产儿疼痛的临床效果.结果 干预组PIPP评分小于对照组(P＜0.01).干预组的早产儿疼痛面容和啼哭的持续时间、心率和血氧饱和度均显著短于非干预的早产儿(P＜0.05).结论 早产儿疼痛可造成一系列近期和远期不良影响,进行相应的护理干预可减少早产儿的疼痛.     

蔗糖液联合非营养性吸吮对早产儿反复操作性疼痛的干预效果

[目的]观察蔗糖液联合非营养性吸吮对早产儿反复操作性疼痛的干预效果及其安全性。[方法]根据纳入标准便利选取需要经历反复操作性疼痛的早产儿67例并将其随机分为对照组和干预组,对照组经历反复操作性疼痛时接受常规护理,干预组接受蔗糖液联合非营养性吸吮护理,采用早产儿疼痛评分量表(PIPP)评估早产儿疼痛,采用安全性评定指标评估蔗糖液联合非营养性吸吮的安全性。[结果]干预组早产儿PIPP评分低于对照组(P0.05),两组安全性评定指标之间的差异无统计学意义。[结论]蔗糖液联合非营养性吸吮对早产儿反复操作性疼痛干预效果具有持久性、安全性。     

非药物性护理干预在下肢动脉闭塞患者疼痛中的应用

目的探讨非药物性护理干预在下肢动脉闭塞患者疼痛中的作用.方法对120例下肢动脉闭塞患者进行了统计,随机分为干预组与药物组.干预组60例,用非药物性护理干预镇痛;药物组60例,根据疼痛程度使用止痛药物.并将干预组与药物组进行疗效对比.结果非药物护理干预对于轻、中度下肢动脉闭塞患者疼痛有明显效果,对重度、极度疼痛患者药物治疗效果优于非药物干预组.结论正确、及时应用非药物性护理干预,对减轻下肢动脉闭塞患者的痛苦、提高下肢动脉闭塞患者生活质量具有重要意义.     

非药物疼痛干预对早产儿生长发育的影响

目的 探讨非药物疼痛干预对早产儿生长发育的影响.方法 将我科2005年2月～2007年2月收治的需经鼻饲喂养的早产儿60例,随机分为非药物疼痛干预组30例(简称干预组),对照组30例.对两组早产儿体重、头围增长情况,睡眠、烦躁时间、胃肠功能紊乱发生情况、呼吸暂停情况等各项临床指标进行观察比较.并追踪随访至校正年龄1周岁时,应用CDCC婴幼儿智能发育量表进行智力测试,对精神发育指数(MDL),运动发育指数(PDL)进行分析比较.结果 两组早产儿体重、头围、睡眠时间、烦躁时间、胃肠功能紊乱发生情况、呼吸暂停情况及MDL、PDL等比较,均有统计学意义(P＜0.05).结论 非药物疼痛干预能加快早产儿体格生长及智能发育.     

早产儿视网膜病变筛查操作性疼痛非药物干预的研究进展

视网膜病变筛查对早期识别早产儿视网膜病变至关重要, 但筛查过程导致的操作性疼痛严重影响早产儿的生长发育。本文对国内外缓解早产儿视网膜病变筛查操作性疼痛的非药物干预方法进行综述, 旨在为医护人员更好地开展早产儿视网膜病筛查操作性疼痛管理提供理论依据。     

非药物性护理干预在下肢动脉闭塞患者疼痛中的应用

目的探讨非药物性护理干预在下肢动脉闭塞患者疼痛中的作用。方法对120例下肢动脉闭塞患者进行了统计，随机分为干预组与药物组。干预组60例，用非药物性护理干预镇痛；药物组60例，根据疼痛程度使用止痛药物。并将干预组与药物组进行疗效对比。结果非药物护理干预对于轻、中度下肢动脉闭塞患者疼痛有明显效果，对重度、极度疼痛患者药物治疗效果优于非药物干预组。结论正确、及时应用非药物性护理干预，对减轻下肢动脉闭塞患者的痛苦、提高下肢动脉闭塞患者生活质量具有重要意义。     

非药物性护理干预在癌症患者疼痛中的应用

目的 探讨非药物性护理干预在癌症患者疼痛中的作用。方法 对160例不同程度癌痛病人进行了统计,随机分为干预组与药物组。干预组80例,用非药物性护理干预镇痛;药物组80例,按三阶梯药物止痛;并将干预组采用非药物性护理干预与药物止痛结合,与药物组疗效对比。结果 非药物性护理干预对于轻、中度癌痛患者有明显效果,疼痛缓解有效率可达80％,与药物组无明显差别;但对于重度疼痛,缓解效果不明显,疗效不如药物组;将非药物性护理干预与药物镇痛结合应用,可大大提高镇痛效果,有效率达95％。结论 正确、适时、及时应用非药物性护理干预,对减轻癌症病人痛苦、提高癌症患者生存质量具有重要意义。     

早产儿疼痛30例早期干预研究

将60例早产儿随机分为干预组和对照组各30例,干预组予抚触、非营养性吸吮等减轻疼痛的措施,必要时予止痛、镇静药物治疗;对照组不予干预措施.按早产儿疼痛量表(PIPP)评分表进行评分,评分内容包括心率、血氧饱和度、三种面部活动、孕周和行为状态(如安静或睡眠)等.干预组PIPP评分小于对照组(P<0.01).早期干预可减少疼痛对早产儿的不利影响.     

家庭参与式护理在缓解NICU早产儿操作性疼痛中的应用

目的 :分析家庭参与式护理对NICU早产儿进行足跟采血导致的操作性疼痛的影响。方法 :采用便利抽样法选择长沙市某三级甲等医院2018年6月至2019年2月入科的早产儿,将72名早产儿随机分为干预组(37名)和对照组(35名)。对照组接受NICU常规镇痛措施,干预组在此基础上,还接受父母协同生活护理、感知觉干预和袋鼠式护理等家庭参与式护理。运用早产儿疼痛修订版简表评估实施3次、5次和7次家庭参与式护理后两组首轮足跟采血的疼痛程度。结果 :干预后,干预组早产儿疼痛评分降低(P0.05),且低于对照组(P0.05)。干预组早产儿心率降低(P0.05),血氧饱和度上升(P0.05),啼哭人数减少(P0.05)。结论 :家庭参与式护理可缓解早产儿操作性疼痛,增加父母与早产儿的有效沟通和交流,促进早产儿家庭亲密,是一种安全、有效、费用低廉的早产儿疼痛管理方式,建议在临床逐步推广。     

早产儿疼痛30例早期干预研究

将60例早产儿随机分为干预组和对照组各30例，干预组予抚触、非营秃性吸吮等减轻疼痛的措施，必要时予止痛、镇静药物治疗；对照组不予干预措施。按早产儿疼痛量表（PIPP）评分表进行评分，评分内容包括心率、血氧饱和度、三种面部活动、孕周和行为状态（如安静或睡眠）等。干预组PIPP评分小于对照组（P〈0．01）。早期干预可减少疼痛对早产儿的不利影响。     

Nurses’ experiences of caring for preterm infants in pain: A meta-ethnography

ObjectivePreterm infants are subjected to numerous painful procedures during their neonatal intensive care unit (NICU) hospitalization. Despite advancements in pain alleviation, nurses remain challenged to provide timely and effective pain management for preterm infants. Greater understanding of the lived experience of nurses caring for preterm infants in pain could provide novel insights to improve pain management for this vulnerable population. The aim of this meta-ethnography was to synthesize and interpret qualitative findings of nurses’ experiences of taking care of preterm infants in pain.MethodsAn extensive literature search in PubMed, CINAHL, PsycINFO, Scopus, BIOSIS and ProQuest Dissertation and Theses Database was conducted, including studies within the past 10 years. Two nursing researchers conducted data extraction and analysis independently. Inclusion criteria were applied to search for qualitative studies of nurse participants who worked in the NICU taking care of preterm infants. Studies published in a language other than English, articles that did not include qualitative data and qualitative data that could not be extracted from the findings or did not discuss nurses’ experiences were excluded. Critical Appraisal Skills Programme was used for literature quality evaluation.ResultsEight studies remained after further screening according to inclusion and exclusion criteria. These eight studies were conducted from 2013 to 2018 and totally enrolled 205 nurses from Iran, Canada, the United States, Finland, Sweden, Switzerland, and Australia. Five themes emerged on the nurses’ perspectives of taking care of preterm infants in pain: 1) They sense the neonatal pain; 2) Adverse consequences of unrelieved pain; 3) Barriers of managing pain; 4) Concerns of available approaches for pain relief; 5) Failure to work with parents.ConclusionsThis meta-ethnography identified nurses’ understanding of pain in preterm infants that can be assessed, and they acknowledged that unrelieved pain could cause developmental deficits in infants. The barriers are lack of training and support on pain assessment and intervention in preterm infants. Optimizing workload and environment, developing age-specified pain assessment and intervention, receiving emotional support and training, and building up a rapport with parents are urgent needs for nurses to provide better care to infants having pain.     

Effect of Kangaroo Care and Oral Sucrose on Pain in Premature Infants: A Randomized Controlled Trial

BackgroundPremature infants hospitalized in the neonatal intensive care unit are routinely exposed to many painful procedures. Pain experienced during the neonatal period may lead to negative outcomes, especially in preterm neonates, hence pain in infants should be reduced. Kangaroo care and oral sucrose are some of the methods that can help reduce pain.AimThis study aimed to compare the effects of kangaroo care and oral sucrose on pain relief in preterm infants during heel lancing.MethodsOur study involved 64 infants. The infants were randomly divided into two groups using a randomized block design of drawing out slips from a thick, non-transparent envelope. There were 64 slips in this envelope (32 for kangaroo care and 32 for oral sucrose). Kangaroo care was given to the preterm infants in the first group and oral sucrose to those in the second group. In both groups, heart rate and oxygen saturation were measured and pain score was evaluated by two observers using the Premature Infant Pain Profile (PIPP) before, during, and 2 minutes after blood sampling by heel lancing.ResultsThere was a statistically significant difference between the groups in favor of the kangaroo group in terms of change in the PIPP values after heel lancing. Kangaroo care is more effective than oral sucrose in pain relief during heel lancing in preterm infants.ConclusionsIn addition to many benefits it offers to infants, kangaroo care can be used to reduce pain during painful procedures in premature infants.     

袋鼠式护理对新生儿重症监护室早产儿操作性疼痛的影响

目的:探讨新生儿重症监护室(NICU)早产儿执行疼痛性操作时应用袋鼠式护理对改善操作性疼痛的效果.方法:将本院N IC U收治的90例早产儿按入科顺序分为对照组和观察组.对照组45例早产儿接受N IC U常规护理,观察组45例早产儿接受常规护理和袋鼠式护理.比较两组早产儿操作性疼痛评分及血氧饱和度(SPO2)、心率(H...     

Oral Glucose and Listening to Lullaby to Decrease Pain in Preterm Infants Supported with NCPAP: A Randomized Controlled Trial

BackgroundPreterm infants spend the early days of their lives in neonatal intensive care units, where they undergo many minor painful procedures. There are many nonpharmacologic methods that can effectively reduce the pain response of neonates who undergo routine procedures.AimsThis study aimed to investigate whether oral glucose and listening to lullabies could bring pain relief during the removal and reinsertion of the tracheal tube and also oronasopharyngeal suctioning in premature infants to whom nasal continuous positive airway pressure was applied.DesignA double-blind, randomized controlled trial.SettingThis study was conducted in the neonatal intensive care unit in the tertiary setting between November 2012 and September 2013.Participants/SubjectsA total of 106 preterm infants were divided into three groups, including 37 infants in the control group, 35 infants in the lullaby group, and 34 infants in the glucose group.MethodsAll preterm infants were randomly assigned to either the intervention groups or the control group. Pain responses were assessed using the Neonatal Infant Pain Scale and the Premature Infant Pain Profile.ResultsAn assessment of the pain severity of the preterm infants after the intervention indicated that the preterm infants in the lullaby and glucose groups had lower pain, whereas the preterm infants in the control group experienced more pain (p < .05).ConclusionThe findings suggest that pain could be reduced significantly in preterm infants after the suggested intervention, although further studies are required to identify the benefits of lullabies or glucose in infants during other painful procedures.     

The effect of Yakson and Gentle Human Touch methods on pain and physiological parameters in preterm infants during heel lancing

BackgroundVarious non-pharmacologic methods are used to alleviate pain in preterm infants who spend their first days in neonatal intensive care units (NICU) because they are exposed to numerous painful interventions.ObjectiveTo determine the effects of Yakson and Gentle Human Touch (GHT) methods on pain and physiologic parameters during heel lancing procedures in preterm infants.Design and methodsThis was a randomised controlled trial. The study was conducted in a NICU between June 2018 and June 2019. A total of 90 preterm infants were divided into three groups: 30 infants in the Yakson group, 30 infants in the GHT group, and 30 infants in the control group. All preterm infants were randomly divided into groups. Pain responses were evaluated using the Neonatal Infant Pain Scale.ResultsIt was found that pain scores and heart rates were significantly lower during and after heel lancing in preterm infants in the Yakson and GHT groups than in the control group, the difference was statistically significant (p < .001).Practical implicationsYakson and GHT applied to preterm infants during heel lancing has positive effects on pain and physiologic parameters.     

对NICU早产儿实施发育支持护理的效果评价

目的 探讨发育支持护理对早产儿特别是极低出生体质量儿及病重儿的影响.方法 将NICU住院的120例早产儿按收住顺序分为实验组和对照组各60例,对照组予以传统常规护理,实验组在此基础上制订照顾计划、优化治疗环境、减轻疼痛、鸟巢式护理和袋鼠式护理、实施非营养性吸吮,并比较两组早产儿在体质量、进奶量、平均住院时间方面的差异....     

Behavioral responses to pain are heightened after clustered care in preterm infants born between 30 and 32 weeks gestational age

OBJECTIVE: To compare biobehavioral pain responses of preterm infants born at differing gestational ages (GAs) when pain was preceded by a rest period or by a series of routine nursing interventions. METHODS: In a randomized, within subjects, cross-over design, facial (Neonatal Facial Coding System), sleep/wake state and heart rate (HR) responses of 43 preterm infants [mean birth weight: 1303 g (range 590 g to 2345 g); mean GA at birth: 30 weeks (range 25 to 32)] were examined across 3 phases of blood collection (Baseline, Lance, and Recovery) under 2 conditions: pain after a 30-minute rest period versus pain after a series of routine nursing interventions (clustered care). Infant behavioral responses were coded from continuous bedside videotapes. HR was analyzed using custom physiologic signal processing software. RESULTS: Infants born at earlier GA (<30 wk) had equally intense facial responses during the Lance phase regardless of condition. However, later born infants (> or =30 wk GA) showed heightened facial responses indicative of sensitized responses during blood collection when it was preceded by clustered care (P=0.05). Moreover, later born infants had significantly lower facial (P=0.05) and HR (P=0.04) reactivity during Recovery when blood collection followed clustered care. DISCUSSION: Earlier born preterm infants showed heightened states of arousal and poor ability to modulate HR during Recovery when an invasive procedure was preceded by routine tactile nursing procedures. Alternatively, later born infants exhibited sensitized responses when clustered care preceded blood collection. Our findings support the importance of cue based individualized approaches to care.     

Extremity movements help occupational therapists identify stress responses in preterm infants in the neonatal intensive care unit: a systematic review

BACKGROUND: Accurate assessment and treatment of pain and stress in preterm infants in neonatal intensive care units (NICU) is vital because pain and stress responses have been linked to long-term alterations in development in this population. PURPOSE: To review the evidence of specific extremity movements in preterm infants as observed during stressful procedures. METHODS: Five on-line databases were searched for relevant studies. For each study, levels of evidence were determined and effect size estimates were calculated. Each study was also evaluated for specific factors that presented potential threats to its validity. RESULTS: Eighteen studies were identified and seven comprised the review. The combined sample included 359 preterm infants. Six specific movements were associated with painful and intrusive procedures. CLINICAL IMPLICATIONS: A set of specific extremity movements, when combined with other reliable biobehavioural measures of pain and stress, can form the basis for future research and development of a clinical stress scale for preterm infants.     

Oral sucrose and pain relief for preterm infants.

The frequency of painful procedures performed on preterm infants in the neonatal intensive care unit (NICU) presents a challenge to nurses who are attempting to provide effective pain relief, and to the infants themselves who may suffer adverse consequences in response to repeated painful procedures. One new pain relief intervention under study is the administration of oral sucrose, which may activate endogenous opioid systems within the body. Studies with preterm infants that have examined the use of oral sucrose as an analgesic during heelsticks and venipunctures have shown that sucrose is effective in reducing pain. Sucrose may also be combined with nonnutritive sucking to provide significant pain relief. The use of oral sucrose is now recommended with a wide range of painful procedures in the NICU. Promising results have been observed in studies with both term and preterm infants, but less research has occurred with preterm infants. Additional research is warranted to determine the most effective approaches for the administration of sucrose, to examine the effectiveness of sucrose with additional types of painful procedures, and to examine the effects of long-term repeated use of sucrose.     

Oral sucrose as analgesia for neonates: How effective and safe is the sweet solution? A review of the literature

The objective of this literature review was to evaluate the safety and effectiveness of sucrose as analgesia for neonates. The review synthesizes the evidence relating to an emerging common clinical practice to assist practitioners to provide evidence based care. A search of published articles was undertaken with forty-six articles returned of which ten met the inclusion criteria. Newborns needing intensive care are routinely subjected to invasive procedures that cause distress and pain but numerous studies have shown that pain relief remains poorly managed. Sucrose is becoming the accepted non-pharmacological intervention for managing acute procedural pain. Administration has been associated with calming effects and reductions in observed pain behaviours in preterm and term infants aged up to 1 year. This review found that in preterm and full term neonates up to the first month of life there is evidence to suggest that oral sucrose, with or without non-nutritive sucking, is effective and safe for reducing pain responses. A number of studies found that other non-pharmacological methods such as breastfeeding and non-nutritive sucking can also be effective. It is recommended that future studies investigate the potential effects after continuous use of sucrose during painful procedures for very preterm and sick infants.