Co-bedding as a Comfort measure For Twins undergoing painful procedures (CComForT Trial)

<p>Abstract</p> <p>Background</p> <p>Co-bedding, a developmental care strategy, is the practice of caring for diaper clad twins in one incubator (versus separating and caring for each infant in separate incubators), thus creating the opportunity for skin-to-skin contact and touch between the twins. In studies of mothers and their infants, maternal skin-to-skin contact has been shown to decrease procedural pain response according to both behavioral and physiological indicators in very preterm neonates. It is uncertain if this comfort is derived solely from maternal presence or from stabilization of regulatory processes from direct skin contact. The intent of this study is to compare the comfort effect of co-bedding (between twin infants who are co-bedding and those who are not) on infant pain response and physiologic stability during a tissue breaking procedure (heelstick).</p> <p>Methods/Design</p> <p>Medically stable preterm twin infants admitted to the Neonatal Intensive Care Unit will be randomly assigned to a co-bedding group or a standard care group. Pain response will be measured by physiological and videotaped facial reaction using the Premature Infant Pain Profile scale (PIPP). Recovery from the tissue breaking procedure will be determined by the length of time for heart rate and oxygen saturation to return to baseline. Sixty four sets of twins (n = 128) will be recruited into the study. Analysis and inference will be based on the intention-to-treat principle.</p> <p>Discussion</p> <p>If twin contact while co-bedding is determined to have a comforting effect for painful procedures, then changes in current neonatal care practices to include co-bedding may be an inexpensive, non invasive method to help maintain physiologic stability and decrease the long term psychological impact of procedural pain in this high risk population. Knowledge obtained from this study will also add to existing theoretical models with respect to the exact mechanism of comfort through touch.</p> <p>Trial registration</p> <p>NCT00917631</p

The effect of kangaroo care on weight gain of premature neonates in hospitalized in neonatal intensive care units

A major problem faced by premature infants is impaired physical growth in their.Therefore The aim of thisstudy was todetermine the effect of Kangaroo mother care ( KMC) on weight gainof premature neonates. In a quasi-experimental studyon 46couplesmothers andpremature infants hospitalized in two experimental and control groups were placed done. In the experimental group KC was given one time a day for 30 minutes after feeding for four weeks.( withFace to Facethe trainingand booklet of KMCpreparedby the researcher). The infant weight in two groups was measured at the time of four weeks by the electronic weighting scale with an accuracy of ± 10 gr. DataanalysisusingChi-squaretest, t-test, Mann-Whitneyand was done. infants' weight gain in the experimental intervention groupwassignificantly higher than inthe control group (p=0.009) which was statistically significant. The application of kangaroo care by preterm infants' weight gain. Therefore the study recommended the application of kangaroo care for all preterm infants as part of the routine daily care to preterm infants admitted to the NICU

Effect of family empowerment on asthma control in school-age children

Background: Recent surveys have showed that asthma control still remains suboptimal. Family members have an extensive impact on the level of asthma control in school-age children. Family empowerment has a positive impact on the quality of life of school-age children with asthma. This study aimed to determine the efficacy of family empowerment on asthma control in school-age children. Materials and Methods: Forty-five children with asthma (6�12 years) and their parents were enrolled in a pediatric asthma clinic during their follow-up visits. The family empowerment program consisted of self-directed educational material, lectures (a nurse-focused format), group interaction (a learner-focused format), group discussions, and demonstration of educational films. The primary outcome was change in asthma control measured by the C-ACT questionnaire. Results: In this study, 45 patients were enrolled and randomly divided into two groups: intervention (n=23) and control (n=22). Demographic variables including age and sex were not significantly different between the two groups. There were no significant differences in pre-test asthma control scores between the intervention and control groups at pre-test (p=0.82). However, there was a significant difference in asthma control scores between the intervention and control groups at post-test (p<0.001). In the intervention group, in which children experienced family empowerment, asthma control scores were significantly higher at post-test compared to pre-test (p<0.001). Conclusion: Family empowerment significantly improved asthma control in school-age pediatric patients. This program could be proposed for proper asthma control and complication-reducing management of the disease. This program is recommended more broadly for other age groups. © 2018 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran

"EFFECT OF DISCHARGE PLAINING ON PHYSICAL STATUS OF NEONATES "

This survey has been conducted to indicate the positive effects of implementing neonates continuous care patterns on their physical health as well as early diagnosis and decrease of complications in 6 weeks after delivery. This quasi-experimental study has been conducted on 118 mothers and their neonates in one maternity hospital in IRAN. Neonates were assigned in control and experimental groups. Discharge planning included mothers face to face interview, training in hospital, the determination of readiness for discharge and follow up by home visit and telephone call. Data were collected by demographic questionnaire and physical status check lists for neonates. Statistical comparison of the two groups shows that physical status of neonates was significantly better in experimental group than control group (P &lt; 0.001). Accordingly, the implication of discharge planning by nurses could be useful in improving the neonatal physical status and decreasing their problems after birth

THE EFFICACY OF ORAL GLUCOSE FOR RELIEVING PAIN FOLLOWING INTRAMUSCULAR INJECTION IN TERM NEONATES

Pain in neonates can be associated with various risks and it seems essential to find a simple and acceptable method for relieving pain. Pharmacologic agents are not recommended in neonates for pain relief in minor procedures but orally administered glucose solution is found to be effective. The objective of this study was to assess the efficacy of oral 30% glucose during intramuscular injection in term neonates. Sixty-four healthy term neonates were recruited for this study during 1 month. The inclusion criteria were gestational age 37-42 weeks, birth weight 2500-4000 gr, and Apgar score &gt; 7. The intervention consists of administration of either 2 ml of oral 30% glucose or 2ml of sterile water 2 minutes before injection. The primary out come measure was the cumulative Neonatal Infant Pain Scale (NIPS) score at 3 minutes after injection. Thirty-two neonates received 30% glucose and 32 neonates received sterile water. The cumulative NIPS score at 3 minutes after injection for neonates given 30% glucose was significantly (P = 0.000) lower than for neonates given sterile water. The heart rate immediately after injection for neonates given 30% glucose was significantly (P = 0.002) lower than for neonates given sterile water. Oral 30% glucose given 2 minutes before injection was effective in reducing neonatal pain following injection. It is a simple, safe and fast acting analgesic and should be considered for minor invasive procedures in term neonates

Intramuscular injections in newborns: analgesic treatment and sex-linked response

Aim: To compare the analgesic effect of 3 treatments to relieve the pain produced by intramuscular injections (IMI) in term newborns, and to assess sex-linked differences in their response to pain. Material and methods: We studied 62 babies. Each baby received antibiotic IMIs for clinical aims. During each IMI, one of the following analgesic treatments was utilized: oral 33% glucose (OG), sensorial saturation (SS), or topic anesthetic cream (TAC). SS is a validated analgesic method, based on the combination of three stimulations (tactile, acoustic and gustative). During the IMI, pain level was assessed with the use of the DAN scale, a validated neonatal pain scale. All babies who received 3 distinct analgesic procedures for 3 distinct IMIs were enrolled. Mean pain scores of the 3 analgesic treatment groups were compared. We then compared mean pain scores of females vs males in the whole cohort and within each treatment group. Results: The 95% Confidence Intervals of pain scores were: 5.6-6.5 for TAC, 1.4-2.3 for OG and 0.6-1.2 for SS: when treated with TAC, babies' pain scores were significantly higher than with OG or SS ( p &lt;0.0001); when treated with OG, babies' pain scores were higher than SS (p = 0.001). Females' mean pain score was significantly higher than males' mean pain score: (95% CI: 2.9-4.1 vs 2.0-3.1; p=0.001). OG and SS produced significantly higher mean DAN scores in females than in males. Also in the TAC group females' mean DAN scores were higher than males, though this last difference was not statistically significant. Conclusion: This is the first study to show the effectiveness of non-pharmacologic analgesia in relieving IMI pain. It is also the first study to clearly show that the sex-differences in pain perception are present since birth