新生儿沐浴体位的临床研究

目的探讨新生儿最佳沐浴体位。方法将664例足月分娩正常新生儿在沐浴中随机分为两组,对照组采用传统的先仰后俯的沐浴体位,观察组采用先俯后仰的沐浴体位,观察新生儿沐浴中是否安静、舒适,或哭闹不安,有无伴“拥抱反射”等症状。结果观察组上述症状明显少于对照组,χ     

早产儿沐浴的最佳证据总结

目的 收集并整合国内外与早产儿沐浴相关的证据,为临床实践提供参考。 方法 系统检索英国医学杂志最佳临床实践网站、UpToDate、美国医疗保健研究与质量局网站、加拿大安大略注册护士协会网站、英国国家卫生与临床优化研究所网站、加拿大医学会临床实践指南网站、国际指南网、WHO指南网、美国医师协会网站、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）网站、产科和新生儿护士协会网站、Cochrane Library、PubMed、中国知网、万方数据服务平台、维普中文期刊服务平台等网站和数据库,纳入与早产儿沐浴相关的证据,包括临床决策、证据总结、指南、系统评价和专家共识。检索时限为2011年1月—2021年4月。由2名研究者对纳入文献的质量进行独立评价,结合专业人员的判定,从符合标准的文献中提取证据。 结果 共纳入5篇文献,其中指南3篇、证据总结1篇、专家共识1篇。从沐浴前的评估、沐浴用品的选择、沐浴的时机、沐浴中的管理、沐浴后复温、胎脂的处理6个方面共总结27条最佳证据。 结论 该研究总结了早产儿沐浴的最佳证据,建议护理人员在评估临床情景及患儿家长意愿后选择性应用证据,以减少相关并发症或不良事件的发生,保障沐浴安全。     

Effects of bathing interval on skin condition and axillary bacterial colonization in preterm infants

AimThe objective of this study was to evaluate the effects of preterm infant bathing periods on skin condition and axillary skin colonization.BackgroundReducing the frequency of bathing in preterm infants is beneficial in reducing the risk of hypothermia and exposure to stress from frequent nursing contacts.MethodsThe subjects of this study were observed at The V hospital at the C University in South Korea between December 2012 and August 2013. A total of 32 preterm infants were included and were randomly assigned to two different bathing intervals; every four days (n = 16) and the other every two days (n = 16) bathing groups. A neonatal skin conditions were assessed on a daily basis, whereas, axillary skin colonization was measured every eight days before bathing. Data was analyzed via the SPSS program with a non-inferiority test, t-test, chi-square test, Fisher's exact test, and paired t-test.ResultsMean differences of skin condition between the four-day bathing and two-day bathing groups were 0.065 and the 97.5% one-sided confidence limit was 0.196 (less than the non-inferiority margin, 0.3). There were no statistically significant differences in skin condition and axillary skin colonization between the two groups (p > 0.05).ConclusionThe interval of bathing for preterm infants can be changed from every two days to every four days without increasing the incidence of skin condition problems or axillary skin colonization. Less-frequent bathing may decrease the chance of physiological instability caused by the caring process, while providing them with a better environment for growth and development.     

The bath environment,the bathing task,and the older adult: A review and future directions for bathing disability research

Purpose. To review existing research studies to identify optimal intervention strategies for remediation and prevention of bathing disability and future directions for bathing disability research.

Method. Bathing disability, defined as problems in the interaction between the person and the environment during bathing performance, is examined through a comprehensive, narrative literature review.

Results. Most studies focus on the relationship between the person and the environment (such as assistive device use and environmental hazards) while fewer studies focus on analysis of the bathing task or the interaction of the person, environment, and bathing task. Of intervention studies, most do not focus solely on remediation of bathing disability and outcomes vary widely.

Conclusions. In order to help remediate and prevent bathing disability, it will be necessary to better understand and measure the person-environment-occupation interaction involved in bathing as it relates to specific groups of older adults.     

Sauna bathing frequency in Finland and the impact of COVID-19

ObjectivesRecent research has revealed multiple potential health benefits of frequent sauna bathing. Finland is a country with extraordinary sauna culture and bathing opportunities. However, coronavirus disease 2019 (COVID-19) pandemic introduced regulations and unprecedented closures to shared sauna facilities. In this study we aimed to examine the previously unknown baseline bathing frequency and its possible change during the epidemic.DesignWe investigated several aspects of sauna bathing with self-reports: the frequency, its possible changes, reasons for change, and beliefs about its health effects among a representative sample of thousand Finns aged 18–75 years. This online survey was administered in May 2020.ResultsBefore the pandemic, 59 % of our respondents had enjoyed sauna at least once a week. Since the pandemic began, up to 23 % had reduced or stopped their bathing. This was often due to restricted sauna access. However, 11 % of respondents bathed more frequently and attributed this change to seeking relaxation and passing time. These findings demonstrate a surprising flexibility in this health-promoting national pastime. Men were more active bathers than women overall and women under 35 enjoy sauna more seldom than older women. Only 7.9 % of all respondents bathed at least four times a week, exceeding a suggested threshold for maximum health benefits.ConclusionsFinnish people are active sauna bathers. The COVID-19 pandemic demonstrated that the frequency of bathing is dependent on good access to sauna facilities. This flexibility and wide access could be exploited to improve public health in the long term if more frequent bathing became a standard.     

The change of hemodynamics and heart rate variability on bathing by the gap of water temperature

Bathing in Japanese style may carry negative effects as water pressure on the chest and thermal stimulus on hemodynamics take place. We have explored the influence of bathing in high temperature water on the change of heart rate variability (HRV). Fourteen young healthy male adults, ageing in range from 28 to 42 years old (the average was 35.8 years old) were selected and took a hot water bath (38 and 41 °C) for 15 min long. Bathing in 38 °C water brought no significant change in heart rate (HR) and blood pressure (BP), and the HR in 41 °C increased in early stage. In HRV, high frequency (HF) power did not have significant change with little increase in early stages of bathing in 38 °C and decreased continuously in 41 °C. Low frequency (LF) power and very low frequency (VLF) power decreased gradually in later stages of bathing, but the degree of decrease was larger in 41 °C. In this study, data concerning dizziness after bathing at 41 °C was obtained (we named it as a “dizzy case”). HF and LF trends in this case followed the same pattern in comparison with others' average, but the decrease was larger. Additionally, there was no increase in the LF/HF at later stage of bathing. It is thought that this reflects a decreased in autonomic nerve activity. In normal subjects the VLF increased in later stages of 38 and 41 °C bathing, but in the dizziness-experiencing subject, the increase was very significant. It is conceivable that this reflected excessive parasympathetic reflex. Except the dizzy case HF decreased continuously in later stage of bathing in both 38 and 41 °C, but VLF slightly increased. Recently there was an express opinion that the VLF correlates with the prognosis; therefore the change of VLF in this study is very interesting.Based upon the results of this study we propose that the optimum period of time for bathing in water 41 °C in temperature is 5 min or less, and that for water 38 °C in temperature is 10 min or less.     

Sources of support for older people after discharge from hospital: 10 years on

AIMS OF THE STUDY: The aim of this research was to find out who supports older people at home after discharge from hospital and if sources of support have changed between the 1980s and the 1990s. BACKGROUND: More and more older people are being discharged from hospital earlier and this creates additional pressures on families, community health and social services and the independent care sector. The research was concerned with how sources of support may have changed in a 10-year period. METHODS: A comparison is made of two separate nonrandom samples, taken 10 years apart, of older people following discharge from hospital. Interviews were conducted in participants' homes to establish levels of dependence and the source of support given in response to the need for help with personal and domestic activities of daily living. RESULTS: Although limited by the use of relatively small, nonrandom samples, the research found that proportions needing help with domestic activities were higher than those needing help with personal activities of daily living. Although dependence for help with bathing had declined between the 1980s and 1990s, help was still needed with bathing and dressing. Unmet need for help with bathing remained a problem in the 1990s. A growing role for home helps was identified, especially in personal care (bathing and dressing), where support from district nurses had declined. By the 1990s, home helps were doing less cooking and housework, including heavy laundry. Relatives were doing more of most domestic activities except shopping, which was being carried out by home helps. CONCLUSIONS: The paper concludes by arguing that hospitals should consider if pressures to discharge older people more quickly might hinder the discharge planning process and communication between hospital and community sectors.     

The effect of massage,wipe bathing and tub bathing on physiological measurements of late premature newborns: A randomized controlled trial

ObjectiveThe aim of this randomized experimental study is to analyze the effect of massage, wipe bathing and tub bathing on physiological measurements of late premature newborns.Designand Methods: This randomized experimental study was conducted on 192 newborns at the gestational week of 34 or higher in the neonatal intensive care unit of a university hospital. The researchers applied massage (n: 48), tub bathing (n: 48), and wipe bathing (n: 48) to the newborns. The control group (n: 48) received no intervention except for the routine clinical practices. The newborns' physiological measurements before, immediately after and 30 min after the interventions were taken and recorded on the “Newborn Follow-up Form.” The newborns’ physiological measurements were assessed by independent evaluators who were blinded to the purpose of the study at different phases across the massage, wipe bathing and tub bathing protocols. The statistical analysis was performed using percentages, means, repeated analysis, variance analysis, Bonferroni analysis.ResultsNo difference was found in the massage, wipe bathing, tub bathing and control groups' mean physiological measurements (pulse, respiration, oxygen saturation, blood pressure, body temperature) (p > 0.05).     

Hyperthermic effects of hand bathing: benefits of incorporating finger flexion-extension exercise

[Purpose] The purpose of our study was to compare the effects of hand bathing using plain water and water supplemented with inorganic salt and carbonated gas and to assess the hyperthermic effects of performing finger flexion-extension exercise while bathing in water with carbonated gas and inorganic salt and without water. [Subjects and Methods] Sixteen healthy, young males were subjected to plain water bathing, CO₂ bathing, kineto-CO₂ bathing, or no bathing. CO₂ bathing involved bathing in a solution of artificial bath additives including inorganic salts and carbon dioxide. Partial bathing of the hand was implemented for 20 minutes at 41 °C. The concentration of carbonic gas was set at 33 ppm. In the kineto-CO₂ bathing condition, finger flexion-extension exercise was performed at 60 laps per minute in the same solution used in CO₂ bathing. The control group engaged in the same exercise as those in the kineto-CO₂ bathing group, but without bathing. [Results] A significant increase in deep-body temperature was observed in the CO₂ bathing and kineto-CO₂ bathing conditions compared with both the plain water bathing and control condition. [Conclusion] Significantly heightened hyperthermic effects were observed when finger flexion-extension exercise was performed during CO₂ bathing.Key words: Hyperthermia, CO2bathing, Flexion-extension exercise     

Sudden death while bathing

We describe the epidemiologic and pathophysiologic features of sudden death while bathing. The leading cause of death is cardiovascular disease (60.4%), followed by cerebrovascular disease (18.7%) and drowning (11.2%). Because hydrostatic pressure, autonomic nervous reflexes or endocrine system reflect on hemodynamic changes while bathing, the elderly persons or patients with cardiovascular disease are often suffered from fatal cardiac events. To find the detail pathophysiologic changes while bathing, exact cause of death should be examined by autopsies. Furthermore, elderly or handicapped persons should be supervised by their families for preventing drowning.     

The bath environment, the bathing task, and the older adult: a review and future directions for bathing disability research

Purpose. To review existing research studies to identify optimal intervention strategies for remediation and prevention of bathing disability and future directions for bathing disability research.

Method. Bathing disability, defined as problems in the interaction between the person and the environment during bathing performance, is examined through a comprehensive, narrative literature review.

Results. Most studies focus on the relationship between the person and the environment (such as assistive device use and environmental hazards) while fewer studies focus on analysis of the bathing task or the interaction of the person, environment, and bathing task. Of intervention studies, most do not focus solely on remediation of bathing disability and outcomes vary widely.

Conclusions. In order to help remediate and prevent bathing disability, it will be necessary to better understand and measure the person-environment-occupation interaction involved in bathing as it relates to specific groups of older adults.     

The varying effects of warm-water bathing therapies: partial bathing decreases exercise tolerance to levels similar to full-body bathing

[Purpose] The purpose of this study was to determine differences in postural sway and tolerance to exercise before and after full-body, forearm, and lower leg bathing in warm-water. [Subjects and Methods] Thirteen healthy, young adult males were subjected to full-body, forearm, and lower leg bathing at 41 °C for 10 minutes. [Results] The 2-point discrimination sense value and total trajectory length significantly decreased after bathing. [Conclusion] In summary, we found that warm-water bathing sharpens plantar sensation, and thus may help to prevent falls in the elderly. Even partial forearm and lower leg bathing increased exercise tolerance to levels similar to full-body bathing.Key words: Warm-water bathing, Static balance, Exercise test     

Changes in plasma lactate and pyruvate concentrations after taking a bath in hot deep seawater

The use of deep seawater (DSW) in thalassotherapy has begun in Japan. To clarify the health effects of DSW on the human body, we investigated the changes in plasma lactate and pyruvate concentrations, or subjective judgment scores, after bathing at rest in 9 healthy young men. Subjects were immersed for 10 minutes in DSW, surface seawater (SSW), and tap water (TW) heated to 42 degrees C. Plasma samples were collected before bathing, immediately after bathing, and 60 minutes after bathing. The scores were obtained by an oral comprehension test. In the DSW bathing, plasma lactate and pyruvate concentrations showed no significant changes immediately after bathing or 60 minutes after bathing. In contrast, subjects who bathed in SSW showed a significant decrease in lactate concentrations 60 minutes after bathing compared with immediately after bathing. Subjects who bathed in TW showed a significant increase in lactate concentrations immediately after bathing compared with before bathing, and they showed a significant decrease in lactate and pyruvate concentrations 60 minutes after bathing. We found no significant change in the thermal sensation score in the DSW bathing, though significant differences were found between before and immediately after bathing in the SSW and TW groups. Moreover, the score decreased significantly 60 minutes after bathing compared to immediately after bathing in the TW bathing. Higher concentrations of salts contained DSW such as sodium, nitrate-nitrogen, phosphate-phosphorus, and silicate-silicon may have a good influence on human health. Although additional studies are needed to support our findings, DSW is the mildest water to the human body among the three kinds of water, since no significant changes in the items measured were found only in DSW.     

Life Starts at Home: Bathing,Exertion and Participation for People With Mobility Impairment

Objective

To investigate the relationship between perceived exertion while bathing/dressing/grooming and associations with social-recreational activities outside the home for individuals with mobility impairment (MI).

The sauna and children

In Finland sauna bathing by infants and children is guided by an empirically acquired parental understanding of the limits of safe heat "exposure". Finnish children are rarely allowed into a sauna alone before they are 7 years old. Finnish parents observe the post sauna bathing behaviour of their children, and this helps them to establish safe limits of exposure and avoid any adaptation problems. The after effects of sauna bathing of children reported in this study are substantial enough to warrant clinical paediatric involvement in unravelling the relation between the psychosomatic symptoms reported by children and their exposure to the raised temperature. There is also the need, even in Finland, of investigating the sauna bathing of children to establish objective criteria for promoting safe sauna bathing habits. Sauna bathing is a centuries old family tradition in Finland. There are 1.4 million saunas in a country with population of some 4.8 million people. Most families either have their own sauna or one close to where they live. In addition, Finnish children have access to sauna facilities at local sporting, recreation and swimming centres. Sauna bathing often takes place in connection with physical education (PE) lessons or sporting club activities for those over the age of 7 years. The average Finnish family takes a sauna bath once a week, and Finnish children are introduced to sauna bathing in early infancy. Although exposure to the raised temperatures normally encountered in a sauna can cause thermoregulatory imbalances in children there are no established guidelines for the safe use of saunas by infants and children.     

Cardiovascular and Other Health Benefits of Sauna Bathing: A Review of the Evidence

Sauna bathing, an activity that has been a tradition in Finland for thousands of years and mainly used for the purposes of pleasure and relaxation, is becoming increasingly popular in many other populations. Emerging evidence suggests that beyond its use for pleasure, sauna bathing may be linked to several health benefits, which include reduction in the risk of vascular diseases such as high blood pressure, cardiovascular disease, and neurocognitive diseases; nonvascular conditions such as pulmonary diseases; mortality; as well as amelioration of conditions such as arthritis, headache, and flu. The beneficial effects of sauna bathing on these outcomes have been linked to its effect on circulatory, cardiovascular, and immune functions. It has been postulated that regular sauna bathing may improve cardiovascular function via improved endothelium-dependent dilatation, reduced arterial stiffness, modulation of the autonomic nervous system, beneficial changes in circulating lipid profiles, and lowering of systemic blood pressure. This review summarizes the available epidemiological, experimental, and interventional evidence linking Finnish sauna bathing and its effects on cardiovascular outcomes and other disease conditions on the basis of a comprehensive search for observational studies, randomized controlled trials, and non–randomized controlled trials from MEDLINE and EMBASE from their inception until February 24, 2018. An overview of the postulated biological mechanisms underlying the associations between sauna bathing and its health benefits, areas of outstanding uncertainty, and implications for clinical practice is also provided.     

Using Home Modifications to Promote Self-Maintenance and Mutual Care

Old-age homes, while not a recent phenomenon in India, are growing in number, especially in the southern part of the country. A study of nearly 50 such homes had, as one focus, the extent to which these facilities have modified the physical environment to enable residents to age in place. Not all desirable home modifications (HMs) are widely available; for example, only 25% had special seating in bathing areas, 48% used ramps and 21% employed handrails in hallways and bathing areas. In addition, many HMs are inelegant or primitive by U.S. and European standards, but still provide needed environmental support for residents. These HMs are important to enhance self-maintenance and also to enable residents to help each other. Mutual care helps build and maintain a sense of community, in keeping with Indian traditions of village-level concern for common well-being, and substitutes for small numbers of staff. With huge numbers of Indian elders (c. 170 million) in the next century, greater use of HMs in group homes will be vital to ensure a high quality of life.     

Problems of aging: relieving itching in the geriatric patient.

Itching is a common condition in elderly patients and probablpy is caused by a combination of factors, low humidity being one of the most important. After determining that the patient does not have systemic pruritus, the physician should give advice about trying to increase the ambient humidity and about bathing, eg, to decrease the number of baths or showers, use warm water rather than very hot water, and soap only the axillary, anal, and pubic areas. In some instances the use of steroid creams or lotions may be helpful.