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1.
Adv Neonatal Care ; 24(3): E40-E46, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38815281

RESUMO

BACKGROUND: The incidence of neonatal hyperbilirubinemia in Europe and the United States is estimated to be 3.2 and 4.4 per 10,000 live births, respectively. Abdominal massage for hyperbilirubinemia is considered a safe complementary treatment for infants that may increase number of defecations and decrease bilirubin levels. PURPOSE: This study was designed as a randomized controlled trial to determine the effect of abdominal massage on bilirubin levels in term infants receiving phototherapy. METHODS: The sample consisted of 43 term newborns (intervention group: 23; control group: 20) who received phototherapy in a university hospital between June 2019 and February 2021. Information and observation forms were used for data collection. The intervention group received 6 abdominal massages over 2 days, performed 3 times a day, 6 hours apart, and lasting 5 minutes each. RESULTS: Transcutaneous bilirubin levels and heart rate were significantly lower in the intervention group than in the control group at 48 hours (P = .015 and P = .033, respectively). Number of defecations was higher in the intervention group at 24 hours (P = .007) but there was no significant difference at 48 hours. The decrease in serum bilirubin between 24 and 48 hours was significantly greater in the intervention group (P = .005). IMPLICATION FOR PRACTICE AND RESEARCH: Abdominal massage was effective in reducing bilirubin levels and may increase the number of defecations. Providing massage training to the parents of infants who are discharged early could be a protective approach to prevent the rise in bilirubin levels.


Assuntos
Bilirrubina , Hiperbilirrubinemia Neonatal , Massagem , Fototerapia , Humanos , Massagem/métodos , Recém-Nascido , Bilirrubina/sangue , Fototerapia/métodos , Feminino , Masculino , Hiperbilirrubinemia Neonatal/terapia , Abdome
2.
J Emerg Nurs ; 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39033447

RESUMO

INTRODUCTION: Dyspnea associated with acute respiratory tract infections is a common cause of emergency admissions and can be distressing for children. This study aimed to evaluate the impact of a handheld fan intervention on physiological parameters in pediatric patients with dyspnea. METHODS: A total of 59 children aged 2 to 12 years presenting to an emergency department for upper respiratory tract infection between March 2022 and March 2023 were assigned to the experimental group (n = 32) or control group (n = 27) by urn randomization. Both groups received the hospital's standard care, including 3 doses of inhaled bronchodilator at 20-minute intervals. The fan intervention consisted of parents applying a handheld electric fan to the child's face at a distance of 15 cm for 5 minutes after each inhaler treatment. Oxygen saturation, heart rate, and respiratory rate were recorded before treatment and after the 3 inhaler treatments. RESULTS: There were no statistical differences in descriptive characteristics between the experimental and control groups (P > .05). Oxygen saturation values were significantly higher in the control group before treatment but showed greater increases in the intervention group after treatment (P < .001). The intervention group also exhibited greater reductions than the control group in both heart rate and respiratory rate after the third treatment than pretreatment values (P < .05). DISCUSSION: The handheld fan intervention effectively supports inhaler treatment for children with dyspnea. Further studies are recommended to assess its impact across different age groups and clinical conditions.

3.
Pediatr Res ; 93(6): 1701-1709, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36075989

RESUMO

BACKGROUND: Are thermoregulation and golden hour practices in extremely preterm (EP) infants comparable across the world? This study aims to describe these practices for EP infants based on the neonatal intensive care unit's (NICUs) geographic region, country's income status and the lowest gestational age (GA) of infants resuscitated. METHODS: The Director of each NICU was requested to complete the e-questionnaire between February 2019 and August 2021. RESULTS: We received 848 responses, from all geographic regions and resource settings. Variations in most thermoregulation and golden hour practices were observed. Using a polyethylene plastic wrap, commencing humidity within 60 min of admission, and having local protocols were the most consistent practices (>75%). The odds for the following practices differed in NICUs resuscitating infants from 22 to 23 weeks GA compared to those resuscitating from 24 to 25 weeks: respiratory support during resuscitation and transport, use of polyethylene plastic wrap and servo-control mode, commencing ambient humidity >80% and presence of local protocols. CONCLUSION: Evidence-based practices on thermoregulation and golden hour stabilisation differed based on the unit's region, country's income status and the lowest GA of infants resuscitated. Future efforts should address reducing variation in practice and aligning practices with international guidelines. IMPACT: A wide variation in thermoregulation and golden hour practices exists depending on the income status, geographic region and lowest gestation age of infants resuscitated. Using a polyethylene plastic wrap, commencing humidity within 60 min of admission and having local protocols were the most consistent practices. This study provides a comprehensive description of thermoregulation and golden hour practices to allow a global comparison in the delivery of best evidence-based practice. The findings of this survey highlight a need for reducing variation in practice and aligning practices with international guidelines for a comparable health care delivery.


Assuntos
Hipotermia , Lactente Extremamente Prematuro , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Regulação da Temperatura Corporal , Hipotermia/prevenção & controle , Unidades de Terapia Intensiva Neonatal , Polietilenos , Inquéritos e Questionários
4.
Appetite ; 188: 106766, 2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37414344

RESUMO

YouTube is an online platform that parents frequently use to access information on child health. Parents' watching YouTube videos to have information on complementary feeding requires evaluation of the videos regarding child health. This study which was conducted in descriptive design, aimed to analyze YouTube videos' content quality and reliability on complementary feeding. Searched by matching keywords "starting", "beginning", "introducing", "solid food", and "complementary feeding" through boolean operators in the English language on YouTube, on August 2022. The search identified 528 videos related to complementary feeding. Two independent researchers analyzed the content of 61 videos that met the inclusion criteria. The content quality of the videos was evaluated using the Checklist for Complementary Feeding (CCF), which was prepared by researchers in line with international guidelines, the reliability of the videos was analyzed using the DISCERN, and the content quality was evaluated using the Global Quality Score (GQS). Of the 61 videos included, 38 (62.3%) were informative, and 23 (37.7%) were misleading. The kappa value among independent observers was 0.96. The mean GQS, DISCERN, and CCF scores of the videos grouped as informative were significantly higher than the videos grouped as misleading (p = 0.000, p = 0.000, p = 0.000, respectively). There was a significant difference between the mean scores of GQS and DISCERN according to the publication source of the videos (p = 0.033 and p = 0.023, respectively). The GQS and DISCERN mean scores of the Ministrial/Academic/Hospital/Healthcare Institution channel videos were higher than the mean scores of the Individual/Parents content channel videos. Videos on YouTube about complementary feeding have high viewing rates, but also videos that are low in terms of quality and reliability.

5.
J Pediatr Nurs ; 73: 84-90, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37651942

RESUMO

BACKGROUND: Pain and fear associated with insulin injections can cause children with type 1 diabetes mellitus to avoid insulin injections and skip doses. OBJECTIVE: To evaluate and compare pain and fear levels in children aged 6-12 years receiving subcutaneous insulin injection using the manual pressure and ShotBlocker methods. METHODS: A randomized controlled study was conducted with 90 children with type 1 diabetes who were allocated using block randomization to the manual pressure, ShotBlocker, and control groups (n = 30 in each group). Fear and pain levels were rated by the children, their parents, and a member of the study team immediately before and after insulin injection using the Children's Fear Scale and Wong-Baker Faces Pain Rating Scale, respectively. RESULTS: All groups had similar self-, parent-, and researcher-reported levels of preprocedural pain and fear (p > 0.05). However, pain and fear scores were lower in the manual pressure and ShotBlocker groups than in the control group after injection (p = 0.0001). There was no significant difference in pain and fear scores between the two intervention groups (p > 0.05). CONCLUSION: Manual pressure and the ShotBlocker both reduced fear and pain associated with insulin injection in 6- to 12-year-old children with type 1 diabetes. IMPLICATIONS FOR PRACTICE: Both the manual pressure and ShotBlocker methods can easily be applied in children receiving insulin injections. As manual pressure is completely cost- and equipment-free, it is a useful option to reduce pain and fear related to insulin injection. CLINICAL TRIAL REGISTRATION NUMBER: National Institutes of Health (NIH), ClinicalTrials.gov, NCT05789810.


Assuntos
Diabetes Mellitus Tipo 1 , Criança , Humanos , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/tratamento farmacológico , Medição da Dor/métodos , Dor/etiologia , Dor/prevenção & controle , Medo , Insulina/uso terapêutico
6.
Adv Skin Wound Care ; 36(1): 1-8, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36537778

RESUMO

OBJECTIVE: To investigate whether the timing of postbath moisturizer application affected the skin moisture (SM) and body temperature (BT) of newborn infants. METHODS: The researchers conducted a randomized controlled study with 80 newborns who were monitored in a university hospital between March 2017 and May 2018. In both the control and experimental groups, newborns were bathed and dried. However, in the control group, moisturizer was applied immediately to the newborn's body, whereas in the experimental group, moisturizer was applied 10 minutes after the completion of the bath. Researchers evaluated the BT and SM of all infants both before and immediately after the bath and at 10, 20, 40, and 60 minutes postbath. RESULTS: The control and experimental groups were similar according to the descriptive characteristics of the infants (P > .05). In both groups, infants' SM values increased in the first 10 minutes after the bath compared with the prebath values (P < .05). However, the whole-body SM value of the experimental group was significantly higher than that of the control group 60 minutes postbath (P = .027). There was also a statistically significant change in the body temperatures of infants in both groups after bathing (P = .004). CONCLUSIONS: Waiting 10 minutes postbath before applying moisturizer positively affected newborns' SM and BT. Additional research with a broader age range and a more diverse sample is needed to further clarify the effects of postbath moisturizer application timing on newborns' SM and BT.


Assuntos
Regulação da Temperatura Corporal , Temperatura Corporal , Humanos , Recém-Nascido , Lactente , Fatores de Tempo , Hospitais Universitários , Banhos
7.
J Pediatr Nurs ; 58: e37-e43, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33422394

RESUMO

BACKGROUND: The use of a pacifier is recommended to support sucking reflex during transition from gavage feeding to oral feeding and ensure readiness for feeding. PURPOSE: A randomized controlled experimental design was used to determine the effect of a pacifier given before feeding on physiological characteristics and feeding performance in preterm infants initially fed orally. DESIGN AND METHODS: The data were obtained from preterm infants (N = 72) born before 31st gestational week, who were admitted to Newborn Intensive Care Unit of a training and research hospital affiliated with Ministry of Health between January 2017-July 2018 and met the case selection criteria. Heart rates, oxygen saturation levels and feeding performances of preterm infants in both groups before, during, and after feeding were compared. RESULTS: Heart rates of preterm infants in the experimental group were statistically significantly lower (Experimental: 139.64 ± 10.16; Control: 149.31 ± 8.40; p < 0.01) and their oxygen saturation levels were higher (Experimental: 97.22 ± 2.22; Control: 96.33 ± 1.93; p < 0.05). Feeding efficiency rates (Experimental: 1.94 ± 1.19; Control: 0.69 ± 0.34; p < 0.01) and the percentage of food intake (Experimental: 89.5 ± 23.93; Control: 70.86 ± 27.41; p < 0.01) of newborns in the experimental group were statistically significantly higher and their feeding duration was shorter (Experimental: 10.58 ± 8.29; Control: 16.14 ± 8.31; p < 0.01). CONCLUSIONS: It was determined that a pacifier given before feeding is effective on regulating physiological parameters and supporting feeding performance in preterm infants. PRACTICE IMPLICATIONS: The use of a pacifier in the first transition to oral feeding in preterm infants supports their sucking reflex, calms them down, and ensures the readiness for feeding.


Assuntos
Recém-Nascido Prematuro , Projetos de Pesquisa , Humanos , Recém-Nascido , Chupetas , Comportamento de Sucção , Turquia
8.
J Pediatr Nurs ; 61: 185-190, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34111838

RESUMO

BACKGROUND: Neonatal nurses require knowledge of evidence-based interventions that can be utilized for supporting oral feeding skills in preterm infants. Little is known about the impact of education/training programs on neonatal nurses' knowledge of this topic. PURPOSE: This study was conducted to determine the effect of a training program about evidence-based interventions for the transition to and support of oral feeding in preterm infants on the knowledge levels of neonatal nurses. METHODS: We conducted a pretest-posttest studywith 73 neonatal nurses in a research and training hospital. Participants completed a demographic information form and their knowledge about oral feeding in preterm infants was assessed before and after a 240-min training about the transition to oral feeding and evidence-based therapeutic interventions to promote preterm infants' oral feeding skills. RESULTS: Posttest scores evaluated at 1 week (81.6 ± 6.8) and 1 month (79.5 ± 6.5) after the training were significantly higher than pre-test scores (66.8 ± 6.9) (p < 0.001). CONCLUSION: Neonatal nurses showed higher levels of knowledge about evidence-based interventions for supporting oral feeding skills in preterm infants at 1 week and 1 month after the training program compared to their knowledge before training. IMPLICATIONS FOR PRACTICE: Providing training to neonatal intensive care nurses on the transition to oral feeding in preterm infants will increase their level of knowledge and ensure that oral feeding interventions for preterm infants can be implemented using evidence-based therapeutic methods.


Assuntos
Enfermeiros Neonatologistas , Enfermeiras e Enfermeiros , Competência Clínica , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal
9.
J Pediatr Nurs ; 53: e179-e185, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32321668

RESUMO

PURPOSE: Neonatal nurses play an important role in preterm infants' safe and successful transition to oral feeding. Little is known about neonatal nurses' knowledge and practices regarding the transition to oral feeding in preterm infants. The aim of this study was to determine neonatal nurses' knowledge levels and clinical practices related to the process of transitioning preterm infants to oral feeding. DESIGN AND METHOD: This descriptive cross-sectional study was conducted with 275 neonatal nurses working in the neonatal intensive care units of 9 different hospitals in Istanbul, Turkey. Data were collected using a participant demographic form and a questionnaire about the neonatal nurses' knowledge and practices regarding oral feeding. RESULTS: The mean knowledge score of the nurses in this study was 64.7 out of 100 (SD = ±8.7; range = 40-87.5). Rates of correct responses were particularly low for items related to cue-based feeding, interventions to promote oral-motor development, non-nutritive sucking, and infant positioning for oral feeding. All of the NICU nurses participating in the study did not use the protocols developed for transitioning preterm infants to oral feeding. CONCLUSIONS: Nurses need knowledge and practical training on evidence-based therapeutic interventions that promote oral feeding skills in preterm infants during the transition to oral feeding. The use of protocols developed for transitioning preterm infants to oral feeding is limited in NICUs. PRACTICE IMPLICATIONS: In order to facilitate safe and successful feeding, nurses should improve their knowledge and practical skills regarding the transition to oral feeding and evidence-based therapeutic interventions for preterm infants.


Assuntos
Enfermeiros Neonatologistas , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Turquia
10.
Adv Neonatal Care ; 18(6): E3-E12, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30507829

RESUMO

BACKGROUND: Newborn infants are susceptible to hypothermia during bathing due to environmental conditions. PURPOSE: This study examined the effects of 2 common newborn bathing methods used in Turkey, underrunning water bathing (URWB) and immersion tub bathing (ITB), on infant heart rate (HR), oxygen saturation, and body temperature. METHODS: In this randomized controlled study, 44 newborns were allocated to the ITB group and 36 newborns to the URWB group. Body temperature, HR, and oxygen saturation values of the newborns were compared between groups every hour during 4 hours before the bath to evaluate infants' vital sign stability. All measurements were compared at 10, 20, 40, and 60 minutes after the bath too. RESULTS: No statistically significant differences were found in vital signs performed prior to bathing as compared with after bathing; however, changes in oxygen saturation at 20 minutes after the bath were significantly higher in the ITB group (P < .05). CONCLUSION: Although both bathing methods decreased overall infant body temperature, ITB positively affected newborn oxygen saturation and HR to a greater degree compared with URWB. IMPLICATIONS FOR PRACTICE: ITB facilitated maintenance of oxygen saturation and HR during the bath and should be preferred for newborn infants to feel more relaxed. IMPLICATIONS FOR RESEARCH: These findings indicate a need for additional studies with larger sample sizes to further evaluate the effect of different bathing methods on newborn comfort.


Assuntos
Banhos/métodos , Temperatura Corporal , Frequência Cardíaca , Oxigênio/metabolismo , Feminino , Humanos , Recém-Nascido , Masculino , Enfermagem Neonatal , Oximetria , Turquia , Sinais Vitais
11.
J Perianesth Nurs ; 33(6): 781-789, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29398304

RESUMO

PURPOSE: This study was conducted to determine the effect of Interactive Therapeutic Play Education Program applied in preparing pediatric cardiac patients for surgery on the postoperative anxiety levels of such children and their mothers. DESIGN: This was a randomized controlled experimental trial. METHODS: The study was conducted on children aged 6 to 12 years, who underwent surgery for congenital heart disease, and their mothers (N = 43). FINDINGS: Anxiety levels of the children and their mothers were similar in the preoperative period, whereas postoperative anxiety levels were lower in the experimental group than in the control group (P < .05). CONCLUSIONS: As a result of this study it was determined that education provided using therapeutic play to preoperative patients aged 6 to 12 years to undergo surgery reduced the anxiety levels of children and their mothers in the postoperative period.


Assuntos
Ansiedade/prevenção & controle , Cardiopatias Congênitas/cirurgia , Mães/psicologia , Ludoterapia/métodos , Adulto , Ansiedade/epidemiologia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Cuidados Pré-Operatórios/métodos , Período Pré-Operatório
12.
Pain Manag Nurs ; 17(1): 47-53, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26459008

RESUMO

The experimental study that follows was planned to determine the effectiveness of distraction on the pain level in school-age children as they underwent venipuncture. The study sample consisted of children between the ages of 7 and 12 years who underwent venipuncture at the Training and Research Hospital in Istanbul, Turkey between February and May 2012. A total of 144 children were conveniently sampled and evenly randomized into two groups of 72 children each. The primary instrument used to test children's pain level was the Faces Pain Scale-Revised (FPS-R). During the blood draw, the experimental group was given a kaleidoscope and told to look through it and describe what they saw, then rate their pain level on the FPS-R. Results showed that during venipuncture, the pain level of the control group was significantly higher (FPS-R = 3.27 ± 2.87) than the experimental group (FPS-R = 1.80 ± 1.84; p = .001) suggesting that distraction with a kaleidoscope is effective in reducing the pain children experience during venipuncture.


Assuntos
Medição da Dor/psicologia , Dor/prevenção & controle , Dor/psicologia , Flebotomia/métodos , Flebotomia/psicologia , Jogos e Brinquedos/psicologia , Terapia de Relaxamento/instrumentação , Adolescente , Fatores Etários , Criança , Feminino , Humanos , Masculino , Fatores Sexuais , Fatores Socioeconômicos , Turquia
13.
Worldviews Evid Based Nurs ; 12(5): 289-96, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26220257

RESUMO

AIM: This study was a randomized controlled trial designed to evaluate the effect of foot reflexology applied on infants on acute pain that may arise after vaccine injection. METHODS: The sample consisted of 1- to 12-month-old infants registered in a family health center in Istanbul, Turkey, for healthcare follow-up. A total of 60 infants who met the criteria of the sample group were included in the study; 30 infants constituted the reflexology group and the other 30 constituted the control group. Although questionnaire forms were used to determine the descriptive characteristics of infant-mother pairs, the Face, Legs, Activity, Cry, Consolability (FLACC) Pain Assessment Scale was used to evaluate pain level. Infants in the reflexology group received reflexology treatment for an average of 20-30 minutes before vaccination, depending on the physical size of the infant's foot. Pain, heart rate, oxygen saturation levels, and crying periods of infants in the reflexology and control groups were evaluated before and after vaccination. RESULTS: The FLACC pain score was observed to be statistically similar between groups. After reflexology was applied to infants in the reflexology group before vaccination, it was determined that the pain score was reduced to .50 ± 1.14. In the examination performed after vaccination, FLACC pain score was found to be 5.47 ± 2.11 in the reflexology group and 9.63 ± .85 in the control group. A statistically significant difference was observed between the mean FLACC pain scores of infants in the reflexology and control groups (p = .000). The infants in the reflexology group also had lower heart rates, higher oxygen saturation, and shorter crying periods than the infants in the control group (p <.001). LINKING EVIDENCE TO ACTIONS: Reflexology before vaccine reduced the pain level experienced after vaccination. Future research needs to explore different interventional practices.


Assuntos
Dor Aguda/terapia , , Massagem/normas , Dor Aguda/prevenção & controle , Feminino , Humanos , Lactente , Masculino , Massagem/métodos , Medição da Dor/estatística & dados numéricos
14.
J Clin Nurs ; 23(3-4): 515-23, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23506257

RESUMO

AIMS AND OBJECTIVES: To establish the effectiveness of human breast milk and barrier cream (40% zinc oxide with cod liver oil formulation) applied for the skincare of newborns in the neonatal intensive care unit on the healing process of diaper dermatitis. BACKGROUND: Diaper dermatitis is the most common dermatological condition in newborns who are cared for in the neonatal intensive care unit. Recently, there are several kinds of complementary skincare methods suggested for newborns, such as sunflower oil, human breast milk, etc. Also, some chemical formulations are still being used in many neonatal intensive care units. DESIGN: Randomised controlled, prospective, experimental. METHODS: This study was carried out with a population including term and preterm newborns who developed diaper rash while being treated in the neonatal intensive care unit of a university hospital in Istanbul between February-October 2010. On completion of the research, a total of 63 newborns from human breast milk (n = 30) and barrier cream (n = 33) groups were contacted. RESULTS: Genders, mean gestation weeks, feeding method, antibiotic use, diaper area cleansing methods, diaper brands and prelesion scores of newborns in both groups were found to be comparable (p > 0·05). There was no statistically significant difference (p = 0.294) between the groups in terms of mean number of clinical improvement days, but postlesion score of the barrier cream group was statistically significantly lower (p = 0·002) than the human breast milk group. CONCLUSION: Barrier cream delivers more effective results than treatment with human breast milk, particularly in the treatment of newborns with moderate to severe dermatitis in the result of the study. RELEVANCE TO CLINICAL PRACTICE: This study will shed light on nursing care of skin for newborns who are treated in neonatal intensive care unit.


Assuntos
Dermatite das Fraldas/terapia , Leite Humano , Creme para a Pele , Feminino , Humanos , Recém-Nascido , Masculino , Estudos Prospectivos
15.
J Spec Pediatr Nurs ; 29(3): e12428, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38800888

RESUMO

PURPOSE: This single-group, quasiexperimental study was conducted to determine the effect of feeding position on the physiological parameters and feeding performance of term-born infants with cleft lip and palate (CLP) in the preoperative period. METHODS: The study sample consisted of 45 infants aged 0-6 months with CLP followed up preoperatively in our outpatient clinic between January 2021 and 2022. Infants who were being fed with a specialty bottle for babies with CLP and whose families consented to participate in the study were included. After 2 h of fasting, the infants were fed in the elevated supine (ESU) position for the first meal, then in the elevated side-lying (ESL) position for the second meal after another 2 h of fasting. The infants' heart rate and oxygen saturation values before, during, and after each feed and indicators of feeding performance were compared between the positions. RESULTS: There was no significant difference between the positions in terms of heart rate and oxygen saturation before, during, or after feeding (p > .05). There was no statistically significant difference in measures of feeding performance according to the infants' feeding position (p > .05). CONCLUSION: According to the findings obtained in this study, infants with CLP showed no statistically significant differences in heart rate, oxygen saturation, or feeding performance when fed in the ESL and ESU positions. PRACTICE IMPLICATIONS: However, despite the lack of statistical significance, both physiological values and feeding performance tended to be better when the infants were fed in the ESL position, nurses can practice ESL position according to the infant's opposite direction of the side of the cleft lip or palate.


Assuntos
Fenda Labial , Fissura Palatina , Humanos , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Masculino , Feminino , Recém-Nascido , Lactente , Posicionamento do Paciente , Alimentação com Mamadeira , Decúbito Dorsal , Frequência Cardíaca/fisiologia , Comportamento Alimentar/fisiologia
16.
Nutr Clin Pract ; 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38824273

RESUMO

BACKGROUND: Swaddling is recommended for preterm infants during feeding. Swaddling preterm infants with elastic cotton materials allows infants to easily stretch and move their extremities. This study aimed to assess the effect of bottlefeeding in a novel "elastic sac" on physiological parameters and feeding performance of preterm infants. METHODS: A randomized controlled, crossover trial was conducted with total of 26 preterm infants at 26-36+6 weeks of gestation. Infants randomly assigned to group 1 (n = 13) were bottlefed in an elastic sac (researcher-designed single-piece pouch made of soft, elastic cotton) for the first feeding and in normal clothes for the next feeding. Infants randomly assigned to group 2 (n = 13) were fed first in normal clothes and then in the elastic sac. The physiological parameters and feeding performance of the infants were assessed during each feeding. RESULTS: Preterm infants fed in the elastic sac had lower heart rate and higher oxygen saturation during and after feeding than infants fed in normal clothes (P < 0.05). Although all values were within clinically normal ranges, the findings suggest that feeding preterm infants in the elastic sac had a favorable effect on physiological parameters compared with feeding in normal clothes. There was no significant difference in the infants' feeding performance (P > 0.05). CONCLUSION: A semielevated right lateral position and flexed body posture are recommended while feeding preterm infants, which can be easily maintained using the elastic sac. Feeding preterm infants in an elastic sac may support physiologic stability during oral feeding.

17.
Games Health J ; 12(4): 330-339, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37466456

RESUMO

Objective: The use of virtual reality (VR) as a non-pharmacologic method may enable children to tolerate invasive procedures in a hospital setting easily and feel less pain. This study aimed at determining the effect of using a VR headset during venipuncture on pain level, heart rate (HR), and oxygen saturation values in children aged 7-12 years old. Materials and Methods: This was a randomized controlled experimental study. This study included 102 children (experimental group: 52; control group: 50) who visited a pediatric outpatient clinic of a university hospital in Turkey between May 2018 and May 2019. Data were collected using the Child and Family Information Form, State Anxiety Inventory for Children, Faces Pain Scale-Revised (FPS-R). Before venipuncture, state anxiety and pain scores of the children were evaluated. The children in the experimental group wore VR headsets during venipuncture. The children in the control group underwent standard venipuncture procedure. Pain scores were evaluated again in both groups after the venipuncture. Before, during, and after the venipuncture, pulse and oxygen saturation values were measured. Results: It was determined that post-procedure pain score was 1.46 ± 1.49 in the experimental group and 4.44 ± 2.26 in the control group. Post-venipuncture pain mean scores were significantly lower in the experimental group than those of the children in the control group (Z = -6.574; P = 0.001). Secondary outcomes: The mean HR during the procedure was significantly lower in the experimental group (99.27 ± 18.34/min) than in the control group (108.20 ± 21.42/min) (P = 0.026; t = -2.265). There was no statistically significant difference between the before and after the procedure difference of oxygen saturation values (Experimental group: -0.15 ± 1.54; Control Group: 0.04 ± 0.93) between groups (Z = -0.023; P = 0.982). Conclusion: It was determined that post-venipuncture pain mean scores were significantly lower in the experimental group than in the control group. VR is effective to reduce the pain of children during venipuncture. VR headsets may be recognized as effective instruments to reduce the pain level of children in hospital settings. (Clinicaltrials.gov: NCT04950478).


Assuntos
Flebotomia , Realidade Virtual , Criança , Humanos , Flebotomia/efeitos adversos , Flebotomia/métodos , Dor/etiologia , Manejo da Dor/métodos , Ansiedade/etiologia
18.
World J Pediatr ; 19(2): 139-157, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36372868

RESUMO

BACKGROUND: Globally, are skincare practices and skin injuries in extremely preterm infants comparable? This study describes skin injuries, variation in skincare practices and investigates any association between them. METHODS: A web-based survey was conducted between February 2019 and August 2021. Quantifying skin injuries and describing skincare practices in extremely preterm infants were the main outcomes. The association between skin injuries and skincare practices was established using binary multivariable logistic regression adjusted for regions. RESULTS: Responses from 848 neonatal intensive care units, representing all geographic regions and income status groups were received. Diaper dermatitis (331/840, 39%) and medical adhesive-related skin injuries (319/838, 38%) were the most common injuries. Following a local skincare guideline reduced skin injuries [medical adhesive-related injuries: adjusted odds ratios (aOR) = 0.63, 95% confidence interval (CI) = 0.45-0.88; perineal injuries: aOR = 0.66, 95% CI = 0.45-0.96; local skin infections: OR = 0.41, 95% CI = 0.26-0.65; chemical burns: OR = 0.46, 95% CI = 0.26-0.83; thermal burns: OR = 0.51, 95% CI = 0.27-0.96]. Performing skin assessments at least every four hours reduced skin injuries (abrasion: aOR = 0.48, 95% CI = 0.33-0.67; pressure: aOR = 0.51, 95% CI = 0.34-0.78; diaper dermatitis: aOR = 0.71, 95% CI = 0.51-0.99; perineal: aOR = 0.52, 95% CI = 0.36-0.75). Regional and resource settings-based variations in skin injuries and skincare practices were observed. CONCLUSIONS: Skin injuries were common in extremely preterm infants. Consistency in practice and improved surveillance appears to reduce the occurrence of these injuries. Better evidence regarding optimal practices is needed to reduce skin injuries and minimize practice variations.


Assuntos
Dermatite , Lactente Extremamente Prematuro , Lactente , Recém-Nascido , Humanos , Unidades de Terapia Intensiva Neonatal , Higiene da Pele , Modelos Logísticos
19.
J Hosp Palliat Nurs ; 24(5): E185-E196, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-35470317

RESUMO

Few studies have examined and compared neonatal physicians' and nurses' attitudes toward palliative care. This comparative study sought to evaluate attitudes toward neonatal palliative care in neonatal nurses and physicians and identify associated facilitators and barriers. This comparative, cross-sectional study included 173 neonatal intensive care unit staff (149 neonatal nurses and 24 neonatal physicians) in 2 hospitals in Istanbul, Turkey. Data were collected using the Turkish version of the Neonatal Palliative Care Attitude Scale. The results of the study revealed 8 facilitators and 9 barriers to neonatal palliative care. Nurses were significantly more likely than physicians to agree that parents are informed about palliative care options in their unit ( P = .008), that caring for dying infants is traumatic ( P = .007), and that their willingness to provide palliative care is influenced by their personal attitudes toward death ( P = .015). This study demonstrates the importance of parents' active involvement in the palliative care process, the establishment of standard policies and guidelines, and the provision of vocational and in-service education programs to support palliative care. Initiatives to strengthen facilitators and mitigate barriers are needed to optimize the implementation of palliative care in NICUs.


Assuntos
Médicos , Assistência Terminal , Atitude do Pessoal de Saúde , Estudos Transversais , Humanos , Recém-Nascido , Cuidados Paliativos , Turquia
20.
Nutr Clin Pract ; 37(4): 945-954, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34647337

RESUMO

BACKGROUND: This study was conducted to determine the effect of feeding in different positions on the gastric residual volume after feeding in preterm infants who initiated full enteral feeding. METHODS: This quasi-experimental study was conducted with the hypothesis that testing the right lateral position leads to less gastric residual than left lateral position and the prone position leads to less gastric residual than the supine position. The data were collected in four stages from 35 preterm infants. Initially, the infants were positioned in supine position and were fed. After feeding, the infant rested in the supine position for 3 h. The stomach content was aspirated, and the volume of gastric residual was measured at the 60th, 120th, and 180th min after feeding. These steps are repeated in order of in the right lateral, left lateral, and prone position. Total gastric residual volume and type of enteral feeding were evaluated. RESULTS: There was no significant difference among the positions in terms of the volume of gastric residuals in the measurements made at 60th (P = 9.552), 120th (P = .505), and 180th min (P = .430). When the amount of decrease in the gastric residual volumes was a significant difference between all measurement times in right lateral and prone positions (P < .001). CONCLUSION: Although no significant difference was determined between the positions, the smallest residual volumes were determined in the right lateral and prone positions. The amount of decrease in residual volume was significant in right lateral and prone positions.


Assuntos
Nutrição Enteral , Recém-Nascido Prematuro , Conteúdo Gastrointestinal , Humanos , Lactente , Recém-Nascido , Decúbito Ventral , Estômago/diagnóstico por imagem
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