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Soothability and Promotion of Growth in Preterm Infants

Soothability and Promotion of Growth in Preterm Infants. 2012 State of the Science Congress on Nursing Research Holly J. Diesel, PhD, RN Patrick M. Ercole, PhD, MPH. Purpose & Hypotheses.

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Soothability and Promotion of Growth in Preterm Infants

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  1. Soothability and Promotion of Growth in Preterm Infants 2012 State of the Science Congress on Nursing Research Holly J. Diesel, PhD, RN Patrick M. Ercole, PhD, MPH

  2. Purpose & Hypotheses • To examine the effects of a flax seed pillow on premature infant soothability, weight gain and hospital length of stay • Infants receiving the intervention will be more soothed • Infants who are soothed will gain more weight • Infants who gain more weight will have shorter hospital length of stays

  3. Background & Significance Prematurity is a local and global problem Premature infants have poorer outcomes Prematurity is costly

  4. Review of the Literature • Touch • Developmental Care Model • Massage

  5. Model

  6. Power Analyses Power analysis á = .05 Effect size of 10 Standard deviation of 10 Group size of 14 83% power 80% retention total sample size of 36 Final n = 46

  7. Design Setting Inclusion/exclusion Variables XOX R X X Methods

  8. Recruitment & Enrollment IRB approval Staff in-services Pilot study

  9. Protocol Enrollment Stabilization Actiwatch Pre-intervention Intervention Post-intervention

  10. Statistical Procedures SPSS 17.0 Examination for outliers Detection of demographic differences

  11. Demographics

  12. Research Question #1 Do infants who receive the flax seed pillow intervention demonstrate greater soothability than the infants in the control group?

  13. Pre/Post Intervention HR * Statistically significant

  14. Pre/Post Intervention RR * Statistically significant

  15. Pre/Post Intervention NIPS * Statistically significant

  16. Pre/Post Intervention Activity * Statistically significant

  17. Research Question #2 Do infants who are soothed gain more weight?

  18. Comparison of Weight Gain

  19. Research Question #3 Do infants who gain more weight have shorter hospital length of stay?

  20. Comparison of Weight Gain & Hospital Length of Stay

  21. Discussion Exploratory research Confirms previous research Multiple measures with reliability/validity No adverse effects

  22. Generalizability Nursery relocation Parental involvement Care delivery variation Limitations

  23. Implications • For Research • Larger sample size • Additional populations • Additional variables • For Nursing • Additional intervention option • Opportunity for increased parental involvement

  24. Conclusion • Flax seed pillow and soothability • Safe, simple intervention to assist premature infants with transition to extra-uterine environment • Well received by nursing and parents • Increased opportunity for parental involvement

  25. References Als, H. (1982). Toward a synactive theory of development: promise for assessment and support of individuality. Infant Mental Health Journal, 3, 229-243. Anderson, G.C., Chiu, S., Dombrowski, M.A., Swinth, J.Y., Albert, J.M., & Wada, N. (2003). Mother-newborn contact in a randomized trail of kangaroo (skin-to-skin) care. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 32 (5), 604-611. Axelin, A., Salantera, S, & Lehtonen, L. (2006). Facilitated tucking by parents’ in pain management of preterm infants – a randomized crossover trial. Early Human Development, 82, 241-247. Beachy, J. (2003). Premature infant massage in the NICU. Neonatal Network, 22(3), 39- 45.

  26. References Byers, J.F. (2003). Components of developmental care and the evidence for their use in the NICU. The American Journal of Maternal/Child Nursing, 28(3), 174-180. Dieter, J.N.I, Field, T., Hernandez-Reif, M., Emory, E.K., & Redzepi, M. (2003) . Stable preterm infants gain more weight and sleep less after five days of massage therapy. Journal of Pediatric Psychology, 28(6), 403-411. Field, T., Hernandez-Reif, M., Feijo, L., & Freedman, J. (2006). Prenatal, perinatal and neonatal stimulation: A survey of neonatal nurseries. Infant Behavior and Development, 29, 24-31. Grenier, I.R., Bigsby, R., Vergara, E.R., & Lester, B.M. (2003). Comparison of motor self-regulatory and stress behaviors of preterm infants across body positions. American Journal of Occupational Therapy, 57(3), 289-287.

  27. References Grunau, R., Linhares, M., Holsti, L., Oberlander, T., & Whitfield, M.F. (2004). Does prone or supine position influence pain response in preterm infants at 32 weeks gestational age? Clinical Journal of Pain, 20(2), 76-82. Harrison, L.L. (2001). The use of comforting touch and massage to reduce stress for preterm infants in the neonatal intensive care unit. Newborn and Infant Nursing Reviews, 1(4), 235-241. Liaw, J.J. (2000). Tactile stimulation and preterm infants. Journal of Perinatal & Neonatal Nursing, 14(1), 84-103. Ream, E., & Richardson, A. (1996). Fatigue: Aconcept analysis. International Journal of Nursing Studies, 33(5), 519-529. White-Traut, R.C., Nelson, M.N., Silverstri, J.M., Patel, M., Berbaum, M., & Gu, G.G. (2004).

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