Effects of combined use of non-nutritive sucking, oral sucrose, and facilitated tucking on infant behavioural states across heel-stick procedures: A prospective, randomised controlled trial.

Background: Pain and stress agitate preterm infants, interrupting their sleep. Frequent high arousal states may affect infants' brain development and illness recovery. Preserving infants' sleep and relieving their pain during painful procedures are both important for their health. Objectives: To com...

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Published in:International Journal of Nursing Studies Vol. 50; no. 7; pp. 883 - 895
Main Authors: Liaw, Jen-Jiuan, Luke Yang, Lee, Chuen-Ming, Fan, Hueng-Chuen, Chang, Yue-Cune, Cheng, Li-Ping
Format: research tables/charts randomized controlled trial Journal Article
Published: Elsevier B.V. 2013
Online Access:View this record in EBSCOhost
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      dt: 2013
      vid: 50
      iid: 7
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      pub: Elsevier B.V.
      place: Philadelphia, Pennsylvania
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        atl: Effects of combined use of non-nutritive sucking, oral sucrose, and facilitated tucking on infant behavioural states across heel-stick procedures: A prospective, randomised controlled trial.
      aug:
        au:
          Liaw, Jen-Jiuan
          Luke Yang
          Lee, Chuen-Ming
          Fan, Hueng-Chuen
          Chang, Yue-Cune
          Cheng, Li-Ping
        affil: School of Nursing, National Defense Medical Center, Taipei, Taiwan, ROC
      sug:
        subj:
          Treatment Related Pain Nursing
          Sucking Behavior In Infancy and Childhood
          Sucrose Administration and Dosage
          Patient Positioning In Infancy and Childhood
          Infant Behavior
          Neonatal Intensive Care Nursing
          Nursing Interventions
          Blood Specimen Collection Adverse Effects
          Human
          Funding Source
          Prospective Studies
          Randomized Controlled Trials
          Intensive Care Units, Neonatal
          Taiwan
          Convenience Sample
          Gestational Age
          Random Assignment
          Sleep
          Crying
          P-Value
          Descriptive Statistics
          Severity of Illness
          Severity of Illness Indices
          One-Way Analysis of Variance
          Infant, Premature
          Nursing Assessment
          Coefficient alpha
          Internal Consistency
          Criterion-Related Validity
          Interrater Reliability
          Intraclass Correlation Coefficient
          Spearman's Rank Correlation Coefficient
          kappa Statistic
          Data Analysis Software
          Kruskal-Wallis Test
          Regression
          Male
          Female
          Infant, Newborn
          Inpatients
          Apgar Score
          Scales
          Confidence Intervals
          Infant, Newborn: birth-1 month
          Male
          Female
      ab: Background: Pain and stress agitate preterm infants, interrupting their sleep. Frequent high arousal states may affect infants' brain development and illness recovery. Preserving infants' sleep and relieving their pain during painful procedures are both important for their health. Objectives: To compare the effectiveness of different combinations of non-nutritive sucking (sucking), oral sucrose, and facilitated tucking (tucking) with routine care on infants' sleep-wake states before, during, and after heel-stick procedures. Design: Prospective, randomised controlled trial. Setting: Level III Neonatal Intensive Care Unit in Taipei. Method: A convenience sample of 110 infants (gestational age 26.4-37 weeks) needing heel sticks were randomly assigned to five combinations of non-pharmacological treatments: sucking-oral sucrose-tucking; sucking-oral sucrose; oral sucrose-tucking; sucking-tucking; and routine care. Infant states, measured by a state-coding scheme, included quiet sleep, active sleep, transition, quiet awake, active awake, and fussing or crying. All states were recorded at 1-min intervals during four phases: baseline, intervention, heel-stick procedures, and recovery. Results: Infants receiving sucking-oral sucrose-tucking or sucking-oral sucrose experienced 52.8% (p = 0.023) and 42.6% (p = 0.063) more quiet-sleep occurrences than those receiving routine care after adjusting for phase, baseline states, non-treatment sucking during baseline and recovery, positioning, and infants' characteristics. Infants receiving oral sucrose-tucking, sucking-oral sucrose, sucking-oral sucrose-tucking, and sucking- tucking experienced 77.3% (p < 0.001), 72.1% (p = 0.008), 51.5% (p = 0.017), and 33.0% (p = 0.105) fewer occurrences of fussing or crying, respectively, than those receiving routine care after adjusting for related factors. Conclusions: The four treatment combinations differentially reduced infants' high arousal across heel-stick procedures. The combined use of oral sucrose-tucking, sucking-oral sucrose, and sucking-oral sucrose-tucking more effectively reduced occurrences of infant fussing or crying than routine care. Treatment combinations of sucking-oral sucrose- tucking and sucking-oral sucrose also better facilitated infants' sleep than routine care. To preserve infants' sleep, clinicians should use combinations of non-nutritive sucking, oral sucrose, and facilitated tucking to reduce agitation during painful procedures.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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