[논문]Effects of Covering Newborn's Head after Bath on Body Temperature, Heart Rate and Arterial Oxygen Saturation

Kim, Dong-Yeon; Park, Ho-Ran

doi:10.4094/jkachn.2012.18.4.201

Effects of Covering Newborn's Head after Bath on Body Temperature, Heart Rate and Arterial Oxygen Saturation 원문보기

Journal of Korean academy of child health nursing, v.18 no.4, 2012년, pp.201 - 206

Kim, Dong-Yeon (Graduate School, The Catholic University of Korea) , Park, Ho-Ran (College of Nursing, The Catholic University of Korea)

Abstract ▼ AI-Helper

Purpose: In this study changes were observed in body temperature, heart rate and arterial oxygen saturation (SaO2) of newborns after bathing and to determine the effects of covering their heads with cotton hats after bathing. Methods: Participants were 58 newborn infants, 31 in the experimental group had their heads covered with cotton hats after their bath while 27 in the control group did not. Body temperature, arterial oxygen saturation and heart rate were measured at 8 consecutive times after bathing. Data were analyzed using t-test and repeated measures ANOVA. Results: Body temperature declined shortly after bathing. The experimental group showed faster recovery (p<.001). Heart rate increased after bathing in both groups. Heart rate in the experimental group decreased for 120 minutes and gradually increased to baseline (p<.001). In the control group, heart rate decreased for 180 minutes and then increased but did not reach the baseline (p<.001). Arterial oxygen saturation decreased shortly after bathing and recovery to the baseline was more rapid in the experimental group (30 minutes vs. 60 minutes) (p<.001). Conclusion: With significant changes observed in newborns' body temperature, arterial oxygen saturation and heart rate, covering the head right after bathing is effective in stabilizing infants' physiological system.

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문제 정의

Thus, the purpose of this study was to observe the changes of body temperature, heart rate and arterial oxygen saturation of full term newborn infants in regular interval after bathing, and to determine whether covering the head with a cotton hat shortly after bathing could exert positive effects on these changes. This study provides evidence for covering head for infants as an effective nursing intervention for infants, at risk for hypothermia.
Thus, the purpose of this study was to observe the changes of body temperature, heart rate and arterial oxygen saturation of full term newborn infants in regular interval after bathing, and to determine whether covering the head with a cotton hat shortly after bathing could exert positive effects on these changes. This study provides evidence for covering head for infants as an effective nursing intervention for infants, at risk for hypothermia.

제안 방법

As bathing could easily induce heat loss caused by evaporation, hypothermia and subsequent physiological burdens on infants should be cautiously assessed. In this study, the intervention to reduce heat loss of infants was performed by blocking the process of evaporation and immediately covering the head of infants. To prevent heat loss by evaporation, interventions including drying immediately after taking a bath and minimizing exposure of the body during bathing were used and a cotton hat was used to keep them warm.
Fifty eight full-term infants born in a University-affiliated hospital were recruited between October 2006 and March 2007. The subjects were divided into an experimental group (31 infants) and a control group (27 infants) with a randomized method using a coin. Sample size was estimated using a power analysis.
For the experimental group, infants wore hats covering above the eyebrows and ears after bathing. Then, temperature, heart rate and arterial oxygen saturation were measured again immediately after bathing, and at 30, 60, 90, 120, 180, and 240 minutes afterward. For the control group, the same procedure was used but without hats after bathing.

대상 데이터

Its accuracy was examined by the department of biomedical engineering. A monitoring instrument (N1205A, Boeblingen GmbH, Boeblingen, Germany) was used to evaluate the heart rate. Its error range was ±1 bpm.
Fifty eight full-term infants born in a University-affiliated hospital were recruited between October 2006 and March 2007. The subjects were divided into an experimental group (31 infants) and a control group (27 infants) with a randomized method using a coin.

데이터처리

General characteristics, body temperature, arterial oxygen saturation and heart rate of the two groups were analyzed with descriptive statistics, χ2-test and t-test and the serial changes of temperature, heart rate and arterial oxygen saturation were analyzed with repeated measures ANOVA.

성능/효과

In this study, it was found that bathing affected the infants’ body temperature, arterial oxygen saturation and heart rate.

후속연구

Although this study showed a significant influence of bathing to infants’ body temperature and physiological system and an effect of keeping infants’ heads warm using a cotton hat, there are some limitations. Since this study was conducted with only fullterm infants and with a limited sample size, further investigation should be taken into consideration when applying this result to pre-term infants.
Thus, this study, which investigated the influence of bathing on infants’ temperature and related physiological symptoms, would add knowledge to the current status of science.

참고문헌 (15)

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Behring, A., Vezeau, T. M., & Fink, R. (2003). Timing of the newborn first bath: A replication. Neonatal Network, 22(1), 39-46.

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Darmstadt, G. L., Bhutta, Z. A., Cousens, S., Adam, T., Walker, N., & de Bernis, L. (2005). Evidence-based, cost-effective interventions: How many newborn babies can we save? The Lancet, 365, 977-988.

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Davies, P., & Maconochie, I. (2009). The relationship between body temperature, heart rate and respiratory rate in children. Emergency Medicine Journal, 26, 641-643.

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Davis, V. (1980). The structure and function of brown adipose tissue in the neonate. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 9, 368-372.

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Gomella, T., Cunningham, D., & Eyal, F. (Eds.). (2009). Neonatology: Management, procedures, on-call problem, disease, and drugs (6th Ed.). New York: McGraw-Hill Medical.
Green, C. J., & Wilkinson, J. M. (2004). Maternal newborn nursing care plans. St. Louis: Mosby.
Hammarlund, K., Nilsson, G. E., oBerg, P. A., & Sedin, G. (1980). Transepidermal water loss in newborn infants. V. Evaporation from the skin and heat exchange during the first hours of life. Acta Paediatrica Scandinavica, 69, 385-392.

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Knobel, R., & Holditch-Davis, D. (2007). Thermoregulation and heat loss prevention after birth and during neonatal intensive-care unit stabilization of extremely low-birth weight infants. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 36, 280-287.

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Liaw, J. J., Yang, L., Yuh, Y. S., & Yin, T. (2006). Effects of tub bathing procedures on preterm infants' behavior. The Journal of Nursing Research, 14, 297-305.

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Medves, J. M., & O'Brien, B. (2004). The effect of bather and location of first bath on maintaining thermal stability in newborns. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 33, 175-182.

상세보기
Osborn, L., Dewitt, T., First, L., Zenel, J. (2005). Pediatrics. Philadelphia: Mosby.
Oski, F. A., DeAngelis, C., Feigin, R., & Warshaw, J. (1994). Principles and practice of pediatrics (2nd ed.). Philadelphia: Lippincott.
Roberts, J. (1981). Use of a stockinette cap on premature infants after delivery. Unpublished Dissertation, Texas Woman's University, Denton, TX.
Sarkar, R., Basu, S., Agrawal, R. K., & Gupta, P. (2010). Skin care for the newborn. Indian Pediatrics, 47, 593-598.

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Effects of Covering Newborn's Head after Bath on Body Temperature, Heart Rate and Arterial Oxygen Saturation 원문보기

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Effects of Covering Newborn's Head after Bath on Body Temperature, Heart Rate and Arterial Oxygen Saturation 원문보기

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