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研究生:林婷儀
研究生(外文):Linting Yi
論文名稱:觸摸對於早產兒疼痛兒疼痛緩解之成效探討
論文名稱(外文):The effect of human gentle touch on pain relief in preterm inifants
指導教授:蔡芸芳
學位類別:碩士
校院名稱:長庚大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2008
畢業學年度:96
論文頁數:86
中文關鍵詞:早產兒疼痛觸摸足跟穿刺
外文關鍵詞:Premature infantspaintouchheel puncture
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本研究的主要目的是在於探討早產兒在進行足跟穿刺後,給予觸摸在不同的時間點對於疼痛減輕成效之探討。本研究採類實驗性研究之重複測量設計,於北部某醫學中心以立意取樣選擇出生週數為28~37週的個案,並排除先天畸形、先天性心臟病與使用鎮靜劑的個案,共計選取22位研究對象。根據研究設計,在個案採血前5分鐘進行基礎心跳與血氧濃度之測試及疼痛得分的評估,利用抽籤決定個案接受介入措施的順序,當抽到對照組時與目前臨床上的處置相同,給予足跟穿刺後並測量個案的疼痛得分,當抽到實驗ㄧ組於足跟穿刺後給予2分鐘的觸摸介入措施,當抽到實驗二組於足跟穿刺後給予5分鐘的觸摸介入措施,當抽到實驗三組於足跟穿刺後給予10分鐘的觸摸介入措施並在足跟穿刺後2分鐘、5分鐘及10分鐘分別以早產兒疼痛量表(Premature Infant Pain Profile, PIPP)測早產兒疼痛的得分,以瞭解觸摸的介入措施對於早產兒疼痛緩解的情形。早產兒接受扎足跟血時疼痛的反應以one way ANOVA 及repeated measurement ANOVA來比較疼痛得分的不同。根據統計的結果發現在對照組、實驗ㄧ組、實驗二組及實驗三組給予觸摸的介入措施後早產兒兩分鐘、五分鐘及十分鐘的生理指標皆無統計上顯著差異,而行為指標方面對照組比實驗ㄧ組及實驗二組在眉頭皺起之秒數、鼻唇間皺摺之秒數以及疼痛的總分高,在雙眼緊閉則對照組比實驗二的秒數高,因此給予早產兒兩分鐘及五分鐘的觸摸應可以減輕其因接受足跟穿刺而導致的疼痛。建議未來可以將觸摸納入新生兒加護病房護理常規當中,以減輕早產兒的足跟穿刺後的疼痛,進而提升照護品質及減少因為疼痛所帶來的合併症。
The main purpose of this research was to examine the touching effects on relieving pain among premature infants at different time points after heel puncture. A quasi-experimental design with repeated measurement was used. Subjects were recruited from a medical center in the northern Taiwan. The inclusive criterion was age in 28~37 weeks old and exclusive criteria were having congenital malformation, congenital heart diseases, and sedative use. A total of 22 cases participated in this study. Baseline data which included heartbeats, SpO2 tests, and the pain score were first collected. Then, subjects received 4 different interventions based on drawing. In the Experimental 1 group, subjects received 2 minutes of touching after heel puncturing. In the Experimental 2 group, subjects received 5 minutes of touching after heel puncturing. In the Experimental 3 group, subjects received 10 minutes of touching after heel puncturing. In the Control group, subjects received regular care after heel puncturing. Finally, all subjects were measured their pain levels using the PIPP (Premature Infant Pain Profile) at 2 minutes, 5 minutes, and 10 minutes. One way ANOVA and repeated measurement ANOVA were used to evaluate the effects of touching on relieving pain among these premature infants. Results indicated that no significantly differences were found in physical indicators among 4 groups at 2 minutes, 5 minutes, and 10 minutes after punctures. However, in the behavior indicators, the Control group got the longer time in brow bulge、nasolabial furrow and higher total pain scores than the Experiment group 1 and the Experiment group 2. In addition, the Control group got the higher score than the Experiment group 2 in eye squeeze. Therefore, giving human gentle touch for 2 minutes or 5 minutes may reduce pain after heel puncture in premature infants. Based on results of this study, human gentle could be recommended adding into the nursing routine care to reduce pain after heel puncture in premature infants.
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