본 연구는 캥거루 케어가 신생아 발뒤꿈치 천자 시 통증생리반응, 통증행동점수(Premature Infant Pain Profile: PIPP), 통증행동지표(울음기간)에 미치는 효과를 파악하여 통증완화를 위한 간호중재법으로 활용하기 위해 시도되었다. 연구 설계는 유사 실험 설계중 비동등성 대조군 전후 시차설계이다. 연구대상은 2011년 7월부터 11월까지 D시에 소재한 일 대학병원에서 출생한 신생아로 표본 수는 ...
본 연구는 캥거루 케어가 신생아 발뒤꿈치 천자 시 통증생리반응, 통증행동점수(Premature Infant Pain Profile: PIPP), 통증행동지표(울음기간)에 미치는 효과를 파악하여 통증완화를 위한 간호중재법으로 활용하기 위해 시도되었다. 연구 설계는 유사 실험 설계중 비동등성 대조군 전후 시차설계이다. 연구대상은 2011년 7월부터 11월까지 D시에 소재한 일 대학병원에서 출생한 신생아로 표본 수는 유의수준 α=0.05, 검정력 0.8, 효과크기 0.8을 기준으로 각 집단에 26명이 필요하며 탈락을 감안하여 30명으로 정하였다. 그러나 기간 내 분만율 감소와 연구에 동의하지 않은 대상자로 인해 최종적으로 표본수는 실험군 26명, 대조군 30명이었다. 본 연구는 본교의 기관 생명 윤리심의위원회의 심의를 통과하였고 대상자 동의하에 실험을 진행하였으며 실험의 확산을 방지하기 위해 대조군 측정 후 실험군 순서로 진행하였다. 실험군은 캥거루 케어를 채혈 전 10분, 채혈 중, 채혈 종료 후 3분간 시행하였고, 통증생리반응인 심박동수와 산소포화도는 채혈 전, 천자 시, 채혈기간 중(최고 심박동수, 최저 산소포화도), 채혈 종료 후 1분에 측정하였다. PIPP는 채혈 전, 천자 시, 천자 1분, 천자 2분에 측정하였고, 울음기간은 최대 4분까지 관찰하였으며 이는 모두 촬영된 비디오를 분석하여 측정하였다. PIPP는 연구자와 신생아실 경력 3년의 연구조원이 각각 측정하여 비교, 검토하였으며 관찰자간 일치도는 90%이상이었다. 대조군은 캥거루 케어 이외의 모든 과정을 동일하게 하였고 온열기에서 복위로 눕힌 상태에서 진행하였다. 심박동수와 산소포화도는 Pulse Oxymeter (Masimo, Radical)를 이용하여 측정하였고, 통증행동점수는 Stevens등이 1996년에 개발한 PIPP를 이용하였다. 통증행동지표인 울음기간은 초단위로 최대 4분까지 측정 후 종료하였다. 캥거루 케어는 Dimenna (2006)의 연구에서 제시한 Kangaroo care guideline을 참고하여 적용하였다. 수집된 자료는 SPSS 19.0으로 분석하였고, 일반적인 특성은 실수와 백분율로, 실험군과 대조군의 일반적 특성에 대한 동질성 검증은 X2-test와 Mann Whitny U test로 분석하였다. 실험군과 대조군의 안정 시 종속변수에 대한 동질성 검증과 가설 검증은 Mann Whitney U test로 분석하였다. 연구결과는 다음과 같다. 1. 캥거루 케어를 제공받은 실험군은 대조군에 비해 천자 시기별 심박동수가 채혈 종료 후 1분에 유의하게 안정적이었다(U=250.00, p=.021). 그 이외의 심박동수와 산소포화도는 유의한 차이가 없어 제 1 가설 “캥거루 케어를 제공받은 실험군과 받지 않은 대조군의 통증생리반응에 차이가 있을 것이다”는 일부 지지되었다. 2. 캥거루 케어를 제공받은 실험군은 대조군에 비해 천자 시기별 PIPP가 유의하게 낮았고 PIPP 세부항목도 유의하게 낮아 제 2 가설 “캥거루 케어를 제공받은 실험군과 받지 않은 대조군의 통증행동점수에 차이가 있을 것이다”는 지지되었다. 3. 캥거루 케어를 제공받은 실험군은 대조군에 비해 통증행동지표인 울음기간이 유의하게 짧아 제 3 가설 “캥거루 케어를 제공받은 실험군과 받지 않은 대조군의 통증행동지표에 차이가 있을 것이다”는 지지되었다. 결론적으로 캥거루 케어가 신생아 발뒤꿈치 천자 시 통증 생리 반응 일부를 안정화시키고 통증 행동 점수를 낮추며, 울음기간을 감소시킴으로써 통증완화에 효과적임이 확인되어 임상현장에서 비약물적 통증 중재법으로 활용될 수 있을 것이라 기대된다.
본 연구는 캥거루 케어가 신생아 발뒤꿈치 천자 시 통증생리반응, 통증행동점수(Premature Infant Pain Profile: PIPP), 통증행동지표(울음기간)에 미치는 효과를 파악하여 통증완화를 위한 간호중재법으로 활용하기 위해 시도되었다. 연구 설계는 유사 실험 설계중 비동등성 대조군 전후 시차설계이다. 연구대상은 2011년 7월부터 11월까지 D시에 소재한 일 대학병원에서 출생한 신생아로 표본 수는 유의수준 α=0.05, 검정력 0.8, 효과크기 0.8을 기준으로 각 집단에 26명이 필요하며 탈락을 감안하여 30명으로 정하였다. 그러나 기간 내 분만율 감소와 연구에 동의하지 않은 대상자로 인해 최종적으로 표본수는 실험군 26명, 대조군 30명이었다. 본 연구는 본교의 기관 생명 윤리심의위원회의 심의를 통과하였고 대상자 동의하에 실험을 진행하였으며 실험의 확산을 방지하기 위해 대조군 측정 후 실험군 순서로 진행하였다. 실험군은 캥거루 케어를 채혈 전 10분, 채혈 중, 채혈 종료 후 3분간 시행하였고, 통증생리반응인 심박동수와 산소포화도는 채혈 전, 천자 시, 채혈기간 중(최고 심박동수, 최저 산소포화도), 채혈 종료 후 1분에 측정하였다. PIPP는 채혈 전, 천자 시, 천자 1분, 천자 2분에 측정하였고, 울음기간은 최대 4분까지 관찰하였으며 이는 모두 촬영된 비디오를 분석하여 측정하였다. PIPP는 연구자와 신생아실 경력 3년의 연구조원이 각각 측정하여 비교, 검토하였으며 관찰자간 일치도는 90%이상이었다. 대조군은 캥거루 케어 이외의 모든 과정을 동일하게 하였고 온열기에서 복위로 눕힌 상태에서 진행하였다. 심박동수와 산소포화도는 Pulse Oxymeter (Masimo, Radical)를 이용하여 측정하였고, 통증행동점수는 Stevens등이 1996년에 개발한 PIPP를 이용하였다. 통증행동지표인 울음기간은 초단위로 최대 4분까지 측정 후 종료하였다. 캥거루 케어는 Dimenna (2006)의 연구에서 제시한 Kangaroo care guideline을 참고하여 적용하였다. 수집된 자료는 SPSS 19.0으로 분석하였고, 일반적인 특성은 실수와 백분율로, 실험군과 대조군의 일반적 특성에 대한 동질성 검증은 X2-test와 Mann Whitny U test로 분석하였다. 실험군과 대조군의 안정 시 종속변수에 대한 동질성 검증과 가설 검증은 Mann Whitney U test로 분석하였다. 연구결과는 다음과 같다. 1. 캥거루 케어를 제공받은 실험군은 대조군에 비해 천자 시기별 심박동수가 채혈 종료 후 1분에 유의하게 안정적이었다(U=250.00, p=.021). 그 이외의 심박동수와 산소포화도는 유의한 차이가 없어 제 1 가설 “캥거루 케어를 제공받은 실험군과 받지 않은 대조군의 통증생리반응에 차이가 있을 것이다”는 일부 지지되었다. 2. 캥거루 케어를 제공받은 실험군은 대조군에 비해 천자 시기별 PIPP가 유의하게 낮았고 PIPP 세부항목도 유의하게 낮아 제 2 가설 “캥거루 케어를 제공받은 실험군과 받지 않은 대조군의 통증행동점수에 차이가 있을 것이다”는 지지되었다. 3. 캥거루 케어를 제공받은 실험군은 대조군에 비해 통증행동지표인 울음기간이 유의하게 짧아 제 3 가설 “캥거루 케어를 제공받은 실험군과 받지 않은 대조군의 통증행동지표에 차이가 있을 것이다”는 지지되었다. 결론적으로 캥거루 케어가 신생아 발뒤꿈치 천자 시 통증 생리 반응 일부를 안정화시키고 통증 행동 점수를 낮추며, 울음기간을 감소시킴으로써 통증완화에 효과적임이 확인되어 임상현장에서 비약물적 통증 중재법으로 활용될 수 있을 것이라 기대된다.
This study was conducted to find out the effects of kangaroo care on the physiological response to pain, Premature Infant Pain Profile (PIPP) and pain behaviour scale (duration of crying) when the newborns undergo heel stick to later use it as the nursing intervention method for pain relief. The exp...
This study was conducted to find out the effects of kangaroo care on the physiological response to pain, Premature Infant Pain Profile (PIPP) and pain behaviour scale (duration of crying) when the newborns undergo heel stick to later use it as the nursing intervention method for pain relief. The experimental design was the non-equivalent control group non-synchronized design among the quasi experimental designs. The subjects of the study included newborns who were born in the university hospital located in D city from July to November in 2011. The number of sample was set as 30 subjects considering that each group requires 26 subjects and there would be those who drop out based on the significance level of α=0.05, the statistical power of 0.8 and the effect size of 0.8. However, due to the subjects who did not agree to the reduced delivery rate and the research, the number of sample included 26 in the experimental group and 30 in the control group. This study has passed the review by the Institutional Review Board for this university (EU 11-20), and the experiment was conducted under the subjects’ consent. To prevent the diffusion of the experiment, the control group was measured first followed by the experimental group. Kangaroo care was given to the experimental group 10 minutes prior to the venepuncture, during the blood sampling and for three minutes after the completion of the blood sampling. Heart rate and oxygen saturation which are the physiological response to pain were measured before the blood sampling, on venepuncture, during the blood sampling, (the highest heart rate and the lowest oxygen saturation) and 1 minute after the completion of blood sampling. PIPP was measured before the blood sampling, on venepuncture, one minute after the venepuncture , two minutes after the venepuncture and the duration of crying was observed up to the maximum of four minutes. This was measured by analysing the filmed video. PIPP was each measured by the researchers and the research assistant with three years of experience in the newborn room for comparison and review. The agreement among the observers was over 90%. Every process was the same except for kangaroo care for the control group and a radiant warmer was placed on the prone position for the experiment. The heart rate and oxygen saturation were measured using the pulse Oxymeter (Masimo, Radical) and PIPP developed by Stevens et al. in 1996 was used for the pain behavior scale. The pain behavior scale, the duration of crying was measured in the unit of seconds up to the maximum of four minutes and completed. Kangaroo care was applied by referring to kangaroo care guideline suggested from the study by Dimenna (2006). SPSS 19.0 was used for analysis on the collected data and the frequency and percentage for the general characteristics. The homogeneity test was done on the general characteristics of the control and experimental group and analysed using X2-test and Mann-Whitney U test. A homogeneity test was conducted on the dependent variable for the experimental and control groups and the hypothesis was tested with Mann-Whitney U test. The results from the study are as follows. 1. The experimental group which was given kangaroo care showed that the heart rate at one minute after the completion of the blood sampling was significantly stable compared to the control group (U=250.00, p=.021). In addition, there was no significant difference in the heart rate and oxygen saturation, partially supporting the first hypothesis which states "the experimental group which was given kangaroo care will show difference in the physiological response to pain compared with the control group". 2. The experimental group which was provided kangaroo care had significantly lower PIPP for each period of the venepuncture compared to the control group. The sub categories of PIPP were significantly low, supporting the second hypothesis that states "the experimental group which was given kangaroo care and the control group which was not will show the difference in the pain behavior scale". 3. The experimental group which was given kangaroo care had a significantly shorter duration of crying which is the pain behavior scale compared to the control group. It supported the third hypothesis which states "The experimental group which was given kangaroo care will show a difference in terms of the pain behavior scale with the control group which was not given kangaroo care". In conclusion, it was affirmed that kangaroo care was effective for pain relief by reducing the part of the physiological response to pain when the newborns undergo heel stick and lowered duration of crying which is the pain behaviour scale. It is expected to be used as the nonpharmaceutical pain intervention method in the clinical setting.
This study was conducted to find out the effects of kangaroo care on the physiological response to pain, Premature Infant Pain Profile (PIPP) and pain behaviour scale (duration of crying) when the newborns undergo heel stick to later use it as the nursing intervention method for pain relief. The experimental design was the non-equivalent control group non-synchronized design among the quasi experimental designs. The subjects of the study included newborns who were born in the university hospital located in D city from July to November in 2011. The number of sample was set as 30 subjects considering that each group requires 26 subjects and there would be those who drop out based on the significance level of α=0.05, the statistical power of 0.8 and the effect size of 0.8. However, due to the subjects who did not agree to the reduced delivery rate and the research, the number of sample included 26 in the experimental group and 30 in the control group. This study has passed the review by the Institutional Review Board for this university (EU 11-20), and the experiment was conducted under the subjects’ consent. To prevent the diffusion of the experiment, the control group was measured first followed by the experimental group. Kangaroo care was given to the experimental group 10 minutes prior to the venepuncture, during the blood sampling and for three minutes after the completion of the blood sampling. Heart rate and oxygen saturation which are the physiological response to pain were measured before the blood sampling, on venepuncture, during the blood sampling, (the highest heart rate and the lowest oxygen saturation) and 1 minute after the completion of blood sampling. PIPP was measured before the blood sampling, on venepuncture, one minute after the venepuncture , two minutes after the venepuncture and the duration of crying was observed up to the maximum of four minutes. This was measured by analysing the filmed video. PIPP was each measured by the researchers and the research assistant with three years of experience in the newborn room for comparison and review. The agreement among the observers was over 90%. Every process was the same except for kangaroo care for the control group and a radiant warmer was placed on the prone position for the experiment. The heart rate and oxygen saturation were measured using the pulse Oxymeter (Masimo, Radical) and PIPP developed by Stevens et al. in 1996 was used for the pain behavior scale. The pain behavior scale, the duration of crying was measured in the unit of seconds up to the maximum of four minutes and completed. Kangaroo care was applied by referring to kangaroo care guideline suggested from the study by Dimenna (2006). SPSS 19.0 was used for analysis on the collected data and the frequency and percentage for the general characteristics. The homogeneity test was done on the general characteristics of the control and experimental group and analysed using X2-test and Mann-Whitney U test. A homogeneity test was conducted on the dependent variable for the experimental and control groups and the hypothesis was tested with Mann-Whitney U test. The results from the study are as follows. 1. The experimental group which was given kangaroo care showed that the heart rate at one minute after the completion of the blood sampling was significantly stable compared to the control group (U=250.00, p=.021). In addition, there was no significant difference in the heart rate and oxygen saturation, partially supporting the first hypothesis which states "the experimental group which was given kangaroo care will show difference in the physiological response to pain compared with the control group". 2. The experimental group which was provided kangaroo care had significantly lower PIPP for each period of the venepuncture compared to the control group. The sub categories of PIPP were significantly low, supporting the second hypothesis that states "the experimental group which was given kangaroo care and the control group which was not will show the difference in the pain behavior scale". 3. The experimental group which was given kangaroo care had a significantly shorter duration of crying which is the pain behavior scale compared to the control group. It supported the third hypothesis which states "The experimental group which was given kangaroo care will show a difference in terms of the pain behavior scale with the control group which was not given kangaroo care". In conclusion, it was affirmed that kangaroo care was effective for pain relief by reducing the part of the physiological response to pain when the newborns undergo heel stick and lowered duration of crying which is the pain behaviour scale. It is expected to be used as the nonpharmaceutical pain intervention method in the clinical setting.
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