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Düken ME, Yayan EH. The effects of massage therapy and white noise application on premature infants' sleep. Explore (NY) 2024; 20:319-327. [PMID: 37806925 DOI: 10.1016/j.explore.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 10/10/2023]
Abstract
AIM Sleep is vital to premature infants' physical, social and emotional development. The significance of sleep duration, efficiency, and function in premature infants regarding growth development, behavior and neurological development has been increasing. MATERIALS AND METHODS This study was conducted in a randomized controlled experimental design with three groups. Premature infants at 28-37 weeks of gestation who were admitted to the Neonatal Intensive Care Unit of Şanlıurfa Mehmet Akif İnan Training and Research Hospital Haliliye Annex Building were the research population. The sample of the present study consisted of 120 premature infants in the massage therapy group (40), white noise group (40), and control group (40). RESULTS The sleep duration and sleep efficiency of the premature infants in the massage group increased compared to before the application, whereas the number of awakenings and WASO values decreased. The sleep duration of premature infants in the massaged group increased by some five hours. In the white noise group, the sleep duration increased by about two hours than the pre-treatment, and there was an increase in sleep efficiency. White noise application provided a significant decrease in the number of awakenings and WASO values in premature infants. CONCLUSION In this experimental study, which was designed with three groups, it was revealed that massage and white noise application in premature infants were significant non-pharmacological methods to increase sleep duration and sleep efficiency. It was concluded that massage therapy and white noise application is one of the considerable interventions regarding sleep duration, efficiency and functions in premature infants who left the intrauterine period early.
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Affiliation(s)
- Mehmet Emin Düken
- Health Sciences of Faculty, Department of Child Health and Diseases Nursing, Harran University, Şanlıurfa 63000, Turkey.
| | - Emriye Hilal Yayan
- Faculty of Nursing, Department of Child Health and Diseases Nursing, Inönü University, Malatya 44280, Turkey.
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Carneiro MMC, Ribeiro SNS, Menegol NA, Okubo R, Montemezzo D, Sanada LS. Nest positioning on motor development, sleep patterns, weight gain in preterm infants: systematic review. Pediatr Res 2024:10.1038/s41390-023-02972-w. [PMID: 38409428 DOI: 10.1038/s41390-023-02972-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/24/2023] [Accepted: 12/03/2023] [Indexed: 02/28/2024]
Abstract
The aim was to evaluate the effects of Nest Positioning (NP) on motor development, sleep patterns, and weight gain in preterm newborns (PTNB) hospitalized in a neonatal intensive care unit (NICU). This study was constructed based on PRISMA guideline criteria. Systematic research was carried out in electronic databases: MEDLINE via PubMed, Web of Science, Scopus, and VHL-BIREME following the PICOS strategy. Studies with PTNB populations who were hospitalized in the NICU and received therapeutic NP as an intervention strategy in this population were included in this study. We sought outcomes related to sleep patterns, weight gain, and motor development. After selection, 12 studies were included in this systematic review, of which 5 (41.7%) evaluated motor development as their primary outcome, 6 (50%) sleep-wake cycle patterns, and 1 (8.3%), weight gain and, subsequently, hospital discharge. Qualitative results indicate that prolonged exposure to decubitus variations may favor PTNB hospitalized in NICUs acquiring flexor postures, stimulate their midline, and increase their total sleep time. Studies reported no adverse effects regarding the use of NP. Evidence suggests that NP benefits motor development and sleep pattern in PTNB hospitalized in NICUs. IMPACT: Nest positioning improves sleep quality in preterm newborns hospitalized in neonatal intensive care unit. Nest positioning improves motor development in preterm newborns hospitalized in neonatal intensive care unit. No evidence of nest positioning on weight gain was observed. Half of the included clinical studies showed good methodological quality. Nesting positioning is a secure and cost-effective method.
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Affiliation(s)
- Mayara M C Carneiro
- Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Simone N S Ribeiro
- Faculdade Ciências Médicas de Minas Gerais, Instituto de Previdência dos Servidores do Estado de Minas Gerais, Belo Horizonte, Brazil
| | - Natália A Menegol
- Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Rodrigo Okubo
- Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Dayane Montemezzo
- Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Luciana Sayuri Sanada
- Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.
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de Groot ER, Ryan MA, Sam C, Verschuren O, Alderliesten T, Dudink J, van den Hoogen A. Evaluation of Sleep Practices and Knowledge in Neonatal Healthcare. Adv Neonatal Care 2023; 23:499-508. [PMID: 37595146 PMCID: PMC10686278 DOI: 10.1097/anc.0000000000001102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
BACKGROUND Developmental care is designed to optimize early brain maturation by integrating procedures that support a healing environment. Protecting preterm sleep is important in developmental care. However, it is unclear to what extent healthcare professionals are aware of the importance of sleep and how sleep is currently implemented in the day-to-day care in the neonatal intensive care unit (NICU). PURPOSE Identifying the current state of knowledge among healthcare professionals regarding neonatal sleep and how this is transferred to practice. METHODS A survey was distributed among Dutch healthcare professionals. Three categories of data were sought, including (1) demographics of respondents; (2) questions relating to sleep practices; and (3) objective knowledge questions relating to sleep physiology and importance of sleep. Data were analyzed using Spearman's rho test and Cramer's V test. Furthermore, frequency tables and qualitative analyses were employed. RESULTS The survey was completed by 427 participants from 34 hospitals in 25 Dutch cities. While healthcare professionals reported sleep to be especially important for neonates admitted in the NICU, low scores were achieved in the area of knowledge of sleep physiology. Most healthcare professionals (91.8%) adapted the timing of elective care procedures to sleep. However, sleep assessments were not based on scientific knowledge. Therefore, the difference between active sleep and wakefulness may often be wrongly assessed. Finally, sleep is rarely discussed between colleagues (27.4% regularly/always) and during rounds (7.5%-14.3% often/always). IMPLICATIONS Knowledge about sleep physiology should be increased through education among neonatal healthcare professionals. Furthermore, sleep should be considered more often during rounds and handovers.
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Affiliation(s)
- Eline R. de Groot
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Mary-Anne Ryan
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Chanel Sam
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Olaf Verschuren
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Thomas Alderliesten
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Agnes van den Hoogen
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
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Talus E, Seppänen H, Mikkonen K, Palomaa AK, Pölkki T. The competence of neonatal intensive care nurses: A systematic review. NURSE EDUCATION TODAY 2023; 128:105892. [PMID: 37393653 DOI: 10.1016/j.nedt.2023.105892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/04/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE The objective was to conduct a systematic review describing the competencies required from nurses working in neonatal intensive care settings. DESIGN Systematic review. DATA SOURCES A total of eight databases, including PubMed, Scopus, CINAHL, MEDLINE, Mednar, Web of Science, ProQuest and Medic, were screened for relevant literature during February and September 2022. REVIEW METHODS The systematic review process followed Joanna Briggs Institute guidelines. The inclusion criteria were: 1) (P = population) registered nurses; 2) (C = concept) the competence; 3) (C = context) nursing in neonatal intensive care units; and 4) cross-sectional study as study method. A critical appraisal tool for cross-sectional studies from Joanna Briggs Institute was used by two independent reviewers. After data extraction, thematic analysis was performed. RESULTS The database searches yielded a total of 8887 studies and after two independent evaluations, a total of 50 eligible studies were identified comprising of 7536 registered nurses working in neonatal intensive care units across 19 countries. The studies described four main competence themes: 1) neonatal care interventions; 2) caring for a dying infant; 3) family-centered care; and 4) neonatal intensive care interventions. CONCLUSION Previous research has focused on evaluating specific competencies that are necessary in the neonatal intensive care setting. There is a need for research concerning the overall competence of nurses working in neonatal intensive care units. There was a lot of variety within the quality of the eligible studies and within the used instruments. PROTOCOL REGISTRATION This systematic review was registered in Prospero (PROSPERO 2022 CRD42022308028).
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Affiliation(s)
- Eeva Talus
- Research Unit of Health Sciences and Technology, University of Oulu, Finland Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute, The Finnish Centre of Excellence, Helsinki, Finland.
| | - Hanna Seppänen
- Research Unit of Health Sciences and Technology, University of Oulu, Finland Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute, The Finnish Centre of Excellence, Helsinki, Finland
| | - Kristina Mikkonen
- Research Unit of Health Sciences and Technology, University of Oulu, Finland Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute, The Finnish Centre of Excellence, Helsinki, Finland
| | - Anna-Kaija Palomaa
- Research Unit of Health Sciences and Technology, University of Oulu, Finland Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute, The Finnish Centre of Excellence, Helsinki, Finland
| | - Tarja Pölkki
- Research Unit of Health Sciences and Technology, University of Oulu, Finland Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute, The Finnish Centre of Excellence, Helsinki, Finland
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Firmino C, Rodrigues M, Franco S, Ferreira J, Simões AR, Castro C, Fernandes JB. Nursing Interventions That Promote Sleep in Preterm Newborns in the Neonatal Intensive Care Units: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10953. [PMID: 36078666 PMCID: PMC9518210 DOI: 10.3390/ijerph191710953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Sleep is a crucial factor for the psychological and physiological well-being of any human being. In Neonatal Intensive Care Units, preterm newborns' sleep may be at risk due to medical and nursing care, environmental stimuli and manipulation. This review aims to identify the nurses' interventions that promote sleep in preterm newborns in the Neonatal Intensive Care Units. An integrative review was conducted following Whittemore and Knafl's methodology and the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The research was carried out on the electronic databases PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ScienceDirect, with a timeframe from 2010 to 2021. A total of 359 articles were initially identified. After selection and analysis, five studies were included in the sample. Interventions by nursing staff that promote sleep in preterm newborns in the Neonatal Intensive Care Units fall within three categories: environmental management, relaxation techniques and therapeutic positioning. Nurses play a vital role in implementing interventions that promote preterm newborns' sleep. They can positively affect preterm newborns' sleep by controlling environmental stimuli and applying relaxation techniques and therapeutic positioning to their care practices.
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Affiliation(s)
- Catarina Firmino
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal
| | - Marlene Rodrigues
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal
| | - Sofia Franco
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal
| | - Judicília Ferreira
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal
| | - Ana Rita Simões
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal
| | - Cidália Castro
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
| | - Júlio Belo Fernandes
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC), 2829-511 Almada, Portugal
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Gulia S, Kaur K, Devi S, Singh S, Rohilla KK. Nurses in NICUs' views on nosocomial infection prevention. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:158. [PMID: 35847150 PMCID: PMC9277762 DOI: 10.4103/jehp.jehp_1019_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 11/15/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Basic infection control measures are required in India's health-care setting in Neonatal Intensive Care Units (NICUs) to lower the prevalence of hospital-associated infections. The aim of the present study was to assess practices followed by nurses of NICUs for nosocomial infection prevention. MATERIALS AND METHODS From January to February 2020, a descriptive cross-sectional study was conducted. Participants in the study were chosen by total enumeration sampling technique, i.e., 60 nurses were included in this study who working in tertiary care institutions, India. The study respondents' knowledge and practice for nosocomial infection control strategies were assessed by using a 30-item and 27-item questionnaires, respectively. SPSS (version 23.0) was used to analyze the data collected. RESULTS Results showed that all nurses (100%) were females, belongs to the age group of 26-35 years (82%), hold professional qualifications (34%) in GNM as well as post basic BSc nursing, married (72%), had 1-5 years of professional experience (66%), and working in the NICUs for 1-3 years (74%). Most of nurses (55%) had never attended any session on nosocomial infection prevention. Nurses of NICUs (70%) had just a moderate degree of understanding on nosocomial infection prevention. Nurses' practice showed good practise (60%) for nosocomial infection prevention in NICUs. CONCLUSIONS The necessity to adopt health-care policy about nosocomial infections and execution of regular training program to upgrade and refresh nurses' knowledge and practices regarding for nosocomial infection control measures is indicated to fill gap among knowledge and practices concerning nosocomial infection control and prevention.
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Affiliation(s)
- Shilpa Gulia
- Department of Obstetrical Nursing, College of Nursing, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
| | - Kiran Kaur
- Department of Obstetrical Nursing, College of Nursing, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
| | - Shankuntala Devi
- Department of Obstetrical Nursing, College of Nursing, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
| | - Sandeep Singh
- Department of Pediatric Medicine, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
| | - Kusum K. Rohilla
- Department of Nursing, College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Weber AM, Jackson YC, Elder MR, Remer SL, Parikh NA, Hofherr JJ, Voos KC, Kaplan HC. Application of a Risk Management Framework to Parent Sleep During Skin-to-Skin Care in the NICU. J Obstet Gynecol Neonatal Nurs 2022; 51:336-348. [PMID: 35288109 PMCID: PMC9086109 DOI: 10.1016/j.jogn.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/30/2022] Open
Abstract
As NICU staff work to increase the frequency, duration, and comfort of skin-to-skin care (SSC) sessions, barriers to implementation are frequently encountered. Safety concerns are often raised when parents fall asleep during SSC intentionally or unintentionally. We present a risk management framework that we use in clinical practice to address risk related to parent sleep during SSC. Our approach is based on the steps of the Risk Management Life Cycle, which include the following: establish context, identify risk, analyze risk, respond to risk, and monitor and adapt response to risk. Clinicians may use this framework in clinical practice to manage risks related to prolonged SSC, specifically when parents relax and fall asleep during SSC.
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Sato MH, Pedreira MDLG, Avelar AFM, Tsunemi MH, Orsi KCSC, Pradella-Hallinan MLDC, Avena MJ, Pinheiro EM. Influence of Ear Protectors on the Sleep of Preterm Newborns: A Randomized Controlled Clinical Study. Clin Nurs Res 2018; 29:260-267. [PMID: 30338694 DOI: 10.1177/1054773818806171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to compare the effect of ear protectors on the sleep of preterm newborns during the "quiet" times in intermediate care nursery. This was a clinical, randomized, controlled crossover study conducted in two neonatal units in São Paulo, Brazil. The sample consisted of preterm infants who met the inclusion and exclusion criteria for the study. Polysomnography and unstructured observation were used for data collection. Twenty-four preterm infants with a mean gestational age of 33.2 weeks and current weight of 1.747 g were analyzed. There was no significant difference in the total sleep time of preterm infants with and without the use of ear protectors. Newborns with lower gestational age showed a significant reduction in total sleep time with the use of ear protectors (p < .05). The use of ear protection did not increase the total sleep time for preterm infants.
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Affiliation(s)
| | | | | | | | | | | | | | - Eliana Moreira Pinheiro
- Federal University of São Paulo, Brazil.,Fundação de Amparo à Pesquisa do Estado de São Paulo, Brazil
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Lan HY, Yang L, Hsieh KH, Yin T, Chang YC, Liaw JJ. Effects of a supportive care bundle on sleep variables of preterm infants during hospitalization. Res Nurs Health 2018; 41:281-291. [PMID: 29675875 DOI: 10.1002/nur.21865] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/10/2018] [Accepted: 01/12/2018] [Indexed: 01/18/2023]
Abstract
Sleep is important for preterm infants' brain development, but they are frequently exposed to painful procedures in the neonatal intensive care unit (NICU) that disturb their sleep cycle and affect their growth. The purpose of this study was to examine the prolonged effects of a supportive care bundle (modulation of the infants' states, non-nutritive sucking, facilitated tucking, and oral sucrose feeding) on preterm infants' sleep variables (sleep efficiency, total sleep time, sleep latency, and frequency of wake bouts) during hospitalization. The team recruited 65 preterm infants (gestational age at birth 28-36 weeks, average birth weight 1,652 g) from a Level III NICU at a medical center in Taiwan. Infants were randomly assigned to one of two treatment conditions to be administered while receiving intrusive procedures: (1) control condition (usual care, including routine procedures, positioning, and gentle touch); or (2) intervention condition in which the supportive care bundle was added to usual care. Sleep variables were measured using actigraphy for a baseline of three continuous days on the 6th to 8th days after birth and again for 3 continuous days when infants weighed ≧1,950 g. Two forms of generalized estimating equation analyses with control of significant covariates were used for data analysis. The supportive care bundle not only significantly increased sleep efficiency and total sleep time but also significantly decreased duration of sleep latency and frequency of wake bouts. These results provide evidence to support the incorporation of the supportive care bundle into NICU clinical practice during intrusive procedures.
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Affiliation(s)
- Hsiang-Yun Lan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.,School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Luke Yang
- Department of Social Work, Hsuan Chuang University, Taipei, Taiwan
| | - Kao-Hsian Hsieh
- Department of Pediatrics, Tri-Service General Hospital, Taipei, Taiwan
| | - Ti Yin
- School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Song-Shan Branch, Tri-Service General Hospital, Taipei, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, Taipei, Taiwan
| | - Jen-Jiuan Liaw
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
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van den Hoogen A, Teunis CJ, Shellhaas RA, Pillen S, Benders M, Dudink J. How to improve sleep in a neonatal intensive care unit: A systematic review. Early Hum Dev 2017; 113:78-86. [PMID: 28720290 DOI: 10.1016/j.earlhumdev.2017.07.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
UNLABELLED There is increasing evidence that sleep plays a major role in the development of neural pathways in the neonatal brain. Several studies have suggested evidence-based approaches to improve sleep for infants admitted to the neonatal intensive care unit (NICU); however, in many neonatal centers very few of these strategies seem to be implemented in routine care. OBJECTIVE To systematically review the literature to determine interventions promoting neonatal sleep on the NICU, in order to develop key guidelines to improve neonatal sleep. METHODS A systematic search was conducted according to the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for conducting and reporting systematic reviews. The search was performed in Pubmed, CINAHL and the Cochrane Library on 19 September 2016 and again on 28 January 2017. RESULTS In total, fourteen studies were included (10 RCT's and three quasi-experimental study designs): four studies were of high quality, eight of moderate quality and two of low quality. Two studies investigating kangaroo care reported significant effect on infant sleep behavior, two studies comparing Yakson and Gentle Human Touch (GHT) found significant effect on behavioral states and one study reported an increase in sleep behavior using different sleep surfaces. One study showed a significant effect on sleep patterns using music as an intervention and one study showed no significant effect using music. Two studies showed no significant effect on infant sleep using cycled light and different types of LED-light and one study showed significant effect of cycled lightning. There were no effects of Neonatal Individualized Developmental Care Program (NIDCAP) or massage therapy. CONCLUSION Although many different interventions have been reported to promote sleep in infants who require intensive care, there is great heterogeneity across studies: the methods of sleep assessment, the targeted sleep behaviors, and the study populations vary significantly across published reports. Based on the results there seems to be insufficient evidence to recommend any new intervention to promote neonatal sleep on the NICU. However because of the importance of sleep for the development of the neonatal brain we do suggest some key guidelines based on moderate evidence, expert opinion and parental values to improve sleep on the NICU and to direct future neonatal sleep studies.
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Affiliation(s)
- Agnes van den Hoogen
- University of Utrecht, Medical and Clinical Health Science, The Netherlands; Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands
| | - Charlotte J Teunis
- University of Utrecht, Medical and Clinical Health Science, The Netherlands
| | - Renée A Shellhaas
- Department of Pediatrics & Communicable Diseases (Division of Pediatric Neurology), University of Michigan, Ann Arbor, MI, USA
| | - Sigrid Pillen
- Sleep Medicine Center, Kempenhaeghe, Heeze, The Netherlands
| | - Manon Benders
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands.
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Lan HY, Yin T, Chen JL, Chang YC, Liaw JJ. Factors Associated With Preterm Infants’ Circadian Sleep/Wake Patterns at the Hospital. Clin Nurs Res 2017; 28:456-472. [DOI: 10.1177/1054773817724960] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This prospective repeated-measures study explored potential factors (postmenstrual age, body weight, gender, chronological age, illness severity, and circadian rhythm) related to preterm infants’ circadian sleep/wake patterns. Circadian sleep/wake patterns were measured using an Actiwatch for 3 continuous days in preterm infants (gestational age of 28-36.4 weeks) in a neonatal intensive care unit and hospital nursery. Potential factors associated with circadian sleep/wake patterns were analyzed using the generalized estimating equation. For our sample of 30 preterm infants, better sleep/wake patterns were associated with male gender, younger postmenstrual and chronological age, lower body weight, and less illness severity. Preterm infants’ total sleep time ( B = 41.828, p < .01) and percentage of sleep time ( B = 3.711, p < .01) were significantly longer at night than during the day. These findings can help clinicians recognize preterm infants’ sleep problems, signaling the need to provide individualized support to maintain these infants’ sleep quality during their early life.
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Affiliation(s)
- Hsiang-Yun Lan
- National Defense Medical Center, Taipei City, Taiwan (R.O.C.)
| | - Ti Yin
- National Defense Medical Center, Taipei City, Taiwan (R.O.C.)
- Nursing Department, Song-Shan Branch,Tri-Service General Hospital, Taipei City, Taiwan (R.O.C.)
| | | | | | - Jen-Jiuan Liaw
- National Defense Medical Center, Taipei City, Taiwan (R.O.C.)
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