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研究生:林育伃
研究生(外文):Yhu-Yu Lin
論文名稱:非營養性吸吮對早產兒生理狀態,行為狀態,以及進食表現之影響
論文名稱(外文):The Effects of Nonnutritive Sucking on Physiological State, Behavioral State, and Feeding Performance in Preterm Infants
指導教授:盛華盛華引用關係
指導教授(外文):Sheng Hwa Chen
學位類別:碩士
校院名稱:臺北市立教育大學
系所名稱:溝通障礙碩士學位學程
學門:教育學門
學類:特殊教育學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
中文關鍵詞:早產兒非營養性吸吮生理狀態行為狀態進食表現
外文關鍵詞:preterm infantsnonnutritive suckingphysiological statebehavioral statefeeding performance
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在進食前給予早產兒非營養性吸吮被認為是一種經濟且有效的方式,能促進早產兒的進食表現,同時加以緩和早產兒在進食中,因進食壓力而產生的生理壓力及不穩定的行為狀態。許多研究皆顯示,非營養性吸吮可以促進早產兒的生理狀態及行為狀態。但是對於吸吮能力之部分,仍未有一致性的看法。故本研究擬探討非營養性吸吮是否能促進早產兒的生理狀態、行為狀態、以及進食表現。
本研究選取二十位妊娠週數小於36週之早產兒參與此研究。分為實驗組及控制組,每組有十位受試者。實驗組受試者在進食前以標準奶嘴給予三分鐘非營養性吸吮,控制組受試者在進食前則不給予任何處置。兩組分別記錄受試者進食前與進食後的生理狀態及行為狀態。同時評估受試者進食中的進食表現,包括進食精熟度、進食速率、以及吸吮模式。
研究結果顯示,在進食前有接受非營養性吸吮之早產兒,在進食後有較佳的行為狀態。同時在進食當中亦有較高的進食精熟度與進食速率。此一結果可提供給臨床語言治療師、護理人員、以及家長,做為照護早產兒時之參考。可於進食前先提供早產兒非營養性吸吮,藉以緩和其行為壓力,同時促進其進食表現。
Nonnutritive sucking is an economical and efficient intervention that may promote feeding performance in preterm infants and alleviate physiological stress and instable behavioral states of preterm infants during feeding. There have been many studies indicated that nonnutritive sucking may reduce physiological stress and modulate behavioral states. However, the results of those researches are not consistent with that whether nonnative sucking can improve the ability of nutritive sucking or not. The purpose of this study is to examine the effects of nonnutritive sucking on physiological state, behavioral state, and feeding performance in preterm infants.
Twenty preterm infants were included in this study. All preterm infants were divided into experimental group and control group. Each group has ten subjects. Three minutes nonnutritive sucking was given to the subjects of experimental group, and a control condition to the subjects of control group. Then recorded the physiological state, behavioral state of all subjects before and after bottle feeding, and evaluate the feeding performance, including feeding proficiency, feeding efficiency, and sucking pattern.
The results indicated that the preterm infants who accepted nonnutritive sucking before feeding had better behavioral state, feeding proficiency, and feeding efficiency. These results may provide clinicians and parents Information that providing nonnutritive sucking to preterm infants before feeding can alleviate behavioral states and promote feeding performance.
致謝 II
中文摘要 III
英文摘要 IV
表目次 VII
圖目次 X
第一章 緒論 1
第一節 研究動機與目的 1
第二節 研究假設 3
第三節 名詞釋義 4
第二章 文獻探討 7
第一節 早產兒進食能力問題與評估 7
第二節 非營養性吸吮對早產兒生理狀態之影響 10
第三節 非營養性吸吮對早產兒行為狀態之影響 12
第四節 非營養性吸吮對早產兒進食表現之影響 14
第三章 研究方法 17
第一節 研究架構 17
第二節 儀器設備與評估工具 18
第三節 篩選受試者 19
第四節 研究步驟與流程 19
第五節 研究信度 24
第六節 統計分析 24
第四章 研究結果 27
第一節 受試者基本資料 27
第二節 研究信度 28
第三節 進食前及進食後實驗組與控制組「生理狀態」之比較 28
第四節 進食前及進食後實驗組與控制組「行為狀態」之比較 35
第五節 實驗組及控制組受試者「進食表現」之比較 41
第六節 驗證實驗假設與結果 52
第五章 研究討論 54
第一節 非營養性吸吮對早產兒生理狀態之影響 54
第二節 非營養性吸吮對早產兒生理狀態之影響 55
第三節 非營養性吸吮對早產兒進食表現之影響 56
第四節 臨床意義 58
第五節 研究限制 58
第六節 未來研究之建議 59
第七章 結論 61
參考資料 62
附錄一 66
附錄二 68
一、 中文部分
林麗娟 (2003)。早產兒餵奶時行為之探討。輔英科技大學補助專題研究計畫成果報告,未出版。
游明理與陳月枝 (1999)。早產兒餵食前吸吮安撫奶嘴對行為狀態及餵食影響之探討。護理研究,7(5),468-478。

二、英文部分
Arvedson, J. C., & Brodsky, L. (2002). Pediatric swallowing and feeding: Assessment and management (2nd ed). New York: Singular Publishing Group.
Arverdson, J. C. (1998). Management of pediatric dysphagia. Otolaryngologic clinics of North America, 31(3), 453-476.
Comrie, J. D., & Helm, J. M. (1997). Common feeding problems in the intensive care nursery: maturation, organization, evaluation, and management strategies. Seminars in Speech and Language, 1997, 18(3), 239-260.
Hack, M., Estabrook, M. M., & Robertson, S. S. (1985). Development of sucking rhythm in preterm infants. Early Human Development, 11(2), 133-140.
Hafstrom. M., & Kjellmer, I. (2001). Non-nutritive sucking in sick preterm infants. Early Humsn Development, 63, 37-52.
Hall, K. D. (2001). Pediatric dysphagia: Resource guide. New York: Singular Publishing Group.
Hill, A. (2005). The Effects of Nonnutritive Sucking and Oral Support on the Feeding Efficiency of Preterm Infants . Newborn and Infant Nursing Reviews, 5(3), 133-141.
Hwang,Y., Tsai, W., & Chen-Sea, M. (2005). Factors Associated with Bottle Feeding Performance of Preterm Infants: A Literature Review. Journal of Occupational Therapy Association, R.O.C., 23, 13-25.
Lau, C. & Kusnierczyk, I. (2001). Quantitative evaluation of infant’s nonnutritive and nutritive sucking. Dysphagia, 16, 58-67.
McCain, G. C. (1992). Facilitating inactive awake states in preterm infants: a study of three interventions. Nursing Research, 41(3), 157-160.
Medoff-Cooper, B., McGrath, J. M., & Bilker, W. (2000). Nutritive sucking and neurobehavioral development in preterm infants from 34 weeks PCA to term. The American journal of Maternal-Child Nursing, 25(2), 64-70.
Picker, R. H., & Reyna, B. A. (2004). Effects of non-nutritive sucking on nutritive sucking, breathing, and behavior during bottle feedings of preterm infants. Advances in Neonatal Care, 4(4), 226-234.
Picker, R. H., Frankel, H. B., Walsh, K. M., & Thompson, N. M. (1996). Effects of nonnutritive sucking on behavioral organization and feeding performance in preterm infants. Nursing Research, 45(3), 132-135.
Picker, R. H., Higgins, K. E., & Crummette, B. D. (1993). The effect of nonnutritive sucking on bottle-feeding stress in preterm infants. Journal of obstetric, gynecologic, and neonatal nursing, 22(3), 230-234.
Swigert, N. B. (1998). The source for pediatric dysphagia. Illinois: LinguisSystems.
Thoyre, A. M., Shaker, C. S., & Pridham, K. F. (2005). The early feeding skills assessment for preterm infants. Neonatal Network, 24(3), 7-16.
Thoyre, S. M., & Carlson, J. R. (2003). Preterm infants' behavioural indicators of oxygen decline during bottle feeding. Journal of Advanced Nursing, 43(6),631-641.
Wolf, L. S., & Glass, R. P.(1992). Feeding and swallowing disorders in infancy: Assessment and management. Texas: The Psychological Corporation.
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