Indexing
All Issues
Submission
Author Guidelines
Reviewers
Editorial Members
Publication Fee
Vol.2 , No. 2, Publication Date: Apr. 7, 2016, Page: 7-14
 is found to be effective. <i>Aim</i>: this study is a quasi-experimental research design aimed to assess the effect of MKC on physiologic measurements and physiologic responses to pain of a heel stick in preterm neonates. <i>Subject & Methods,</i> this study was conducted at Shebin El Kom and Cairo University hospitals. Forty five pre term neonates who were available at the time of data collection and meet the criteria for sample selection were included. <i>Tools of data collection. Tool one: Biosocial Characteristics of Neonates: It included</i> Sociodemographic characteristics of neonates and their physiological assessment records. <i>Tool two:</i> Neonatal pain assessment scale: is a behavioral scale composed of six indicators. Facial expression, cry, breathing patterns, arms, legs, and state of arousal. <i>Results:</i> The results of this study showed highly statistical significant differences between preterm neonates who were in incubator care group and pre term neonates who were in kangaroo care group regarding their physiological measurements (pulse & respiration) and their total pain response score post painful procedure where (p < 0.001). <i>Conclusion:</i> Kangaroo care had a highly significant effect on neonatal physiological measurements and physiological response to pain. <i>Recommendation:</i> Kangaroo care should be provided as a routine daily care for all neonates in NICUs du to its magic effect on infants’ physiological measurements and their physiological responses to pain.&picture=http://www.aascit.org/aascit/decorators/img/journal/894.jpg)
| [1] | Jaklein R. Younis, Paediatric Nursing Department, Faculty of Nursing, Menoufia University, Shebin El-Kom, Egypt. |
| [2] | Naglaa F. Mahmoud, Paediatric Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt. |
Background: Pain in neonates can be associated with various risks. So, 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 non pharmacologic interventions like Kangaroo Care (KC) is found to be effective. Aim: this study is a quasi-experimental research design aimed to assess the effect of MKC on physiologic measurements and physiologic responses to pain of a heel stick in preterm neonates. Subject & Methods, this study was conducted at Shebin El Kom and Cairo University hospitals. Forty five pre term neonates who were available at the time of data collection and meet the criteria for sample selection were included. Tools of data collection. Tool one: Biosocial Characteristics of Neonates: It included Sociodemographic characteristics of neonates and their physiological assessment records. Tool two: Neonatal pain assessment scale: is a behavioral scale composed of six indicators. Facial expression, cry, breathing patterns, arms, legs, and state of arousal. Results: The results of this study showed highly statistical significant differences between preterm neonates who were in incubator care group and pre term neonates who were in kangaroo care group regarding their physiological measurements (pulse & respiration) and their total pain response score post painful procedure where (p < 0.001). Conclusion: Kangaroo care had a highly significant effect on neonatal physiological measurements and physiological response to pain. Recommendation: Kangaroo care should be provided as a routine daily care for all neonates in NICUs du to its magic effect on infants’ physiological measurements and their physiological responses to pain.
Keywords
Preterm Neonates, Kangaroo Care, Physiological Response and Pain
Reference
| [01] | American Academy of Pediatrics & Canadian Paediatric Society. Prevention and management of pain in the neonate: An update. Pediatrics, (2006). 118 (5), 2231- 2241. |
| [02] | Batton DG, Barrington KJ, Wallman C: Prevention and management of pain in the neonate: an update. Pediatrics. 2007 Feb; 119 (2): 425. |
| [03] | Weissman A, Aranovitch M, Blazer S, Zimmer EZ Heel-lancing in newborns: behavioral and spectral analysis assessment of pain control methods. Pediatrics. 2009; 124 (5): e921. |
| [04] | Doesburg SM, Chau CM, Cheung TP, Moiseev A, Ribary U, Herdman AT, Miller SP, Cepeda IL, Synnes A, Grunau RE. Neonatal pain-related stress, functional cortical activity and visual-perceptual abilities in school-age children born at extremely low gestational age. Pain. 2013; 154: 1946–52. |
| [05] | Anand KJS, Palmer FB, Papanicolaou AC. Repetitive neonatal pain and neurocognitive abilities in ex-preterm children. Pain. 2013; 154: 1899–901. |
| [06] | Grunau R, Tu MT. Long-term consequences of pain in human neonates. In: Anand KJ, Stevens B, McGrath P, editors. Pain in neonates and Infants. 3rd. Philadelphia, USA: Elsevier Science B. V.; 2007. pp. 45–55. |
| [07] | Van Hulle, Vincent C. Nurses' knowledge, attitudes, and practices: regarding children’s pain. MCN AM J Matern Child Nurs. 2005; 30 (3): 177- 83. |
| [08] | Cong X, Delaney C, Vazquez V. Neonatal nurses' perceptions of pain assessment and management in NICUs: a national survey. Advances in Neonatal Care. 2013; 13: 353–60. |
| [09] | Stevens B, Riahi S, Cardoso R, et al. The influence of context on pain practices in the NICU: perceptions of health care professionals. Qualitative Health Research. 2011; 21: 757–70. |
| [10] | Ganzewinkel CJ, Anand KJ, Kramer BW, Andriessen P. Chronic Pain in the Newborn: Toward a Definition. Clin J Pain. 2013. |
| [11] | Guedj R, Danan C, Daoud P, et al. Neonatal pain management is not the same during days and nights in Intensive Care Units: Analysis from the EPIPPAIN Study. British Medical Journal Open. 2014 in press. |
| [12] | Carbajal R, Nguyen-Bourgain C, Armengaud JB. How can we improve pain relief in neonates? Expert Rev Neurother. 2008; 8 (11): 1617–20. |
| [13] | Ismail AQ, Gandhi A. Non-pharmacological analgesia: effective but underused. Archives of Disease in Childhood. 2011; 96: 784–5 |
| [14] | Johnston CC, Stevens B, Pinelli J, et al. Kangaroo Care is effective in diminishing pain response. In Kangaroo Care Annotated Bibliography and References 2015. |
| [15] | Charpak N, Ruiz JG, Zupan J, Cattaneo A, Figueroa Z, Tessier R, et al. Kangaroo Mother Care: 25 years after. Acta Paediatr. 2005; 94 (5): 514–22. |
| [16] | Bulfone, G., Nazzi, E., & Tenore, A. (2011). Kangaroo Mother Care and conventional care: A review of the literature. Professioni Infermieristiche, 64 (2), 75-82 (ITALIAN). An effective and efficient human care model is Kangaroo Mother Care. |
| [17] | Cong X, Cusson RM, Walsh S, Hussain N, Ludington-Hoe SM, Zhang D. Effects of skin-to-skin contact on autonomic pain responses in preterm infants. Journal of Pain. 2012; 13: 636–45. |
| [18] | Mitchell AJ, Yates CC, Williams DK, Chang JY, Hall RW. Does daily kangaroo care provide sustained pain and stress relief in preterm infants? Journal of Neonatal-Perinatal Medicine. 2013; 6: 45–52. |
| [19] | Sajedi, F, Kashaninia Z,, Rahgozar, M, Noghabi, F. A, The Effect of Kangaroo Care on Physiologic Responses to Pain of an Intramuscular Injection in Neonates Iran J Pediatr. Vol 17 (No 4); Pp: 339-344. |
| [20] | Johnston C, Campbell-Yeo M, Fernandes A, Inglis D, Streiner D, Zee R. Skin-to-skin care for procedural pain in neonates. Cochrane Database of Systematic Reviews. 2014. |
| [21] | Mooncey S, Giannakoulopoulos X, Glover V, Acolet D, Modi N. The effect of mother-infant skin-to-skin contact on plasma cortisol and β-endorphin concentrations in preterm newborns. Infant Behav Develop. 1997; 20 (4): 553–7. |
| [22] | Johnston CC, Filion F, Campbell-Yeo M, Goulet C, Bell L, McNaughton K, et al. Kangaroo mother care diminishes pain from heel lance in very preterm neonates: a crossover trial. BMC Pediatr. 2008; 8: 13. |
| [23] | Conde-Agudelo A, Díaz-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infantsCochrane Database Syst Rev. 2014 Apr 22; 4: CD002771. doi: 10.1002/14651858. CD002771. pub 3. |
| [24] | Ranger M, Celeste Johnston C, Rennick JE, Limperopoulos C, Heldt T, du Plessis AJ. A multidimensional approach to pain assessment in critically ill infants during a painful procedure. Clinical Journal of Pain. 2013; 29: 613–20. |
| [25] | Ganzewinkel CJ, Anand KJ, Kramer BW, Andriessen P. Chronic Pain in the Newborn: Toward a Definition. Clin J Pain. 2013. |
| [26] | Walden M, Penticuff JH, Stevens B, et al. Maturational changes in physiologic and behavioral responses of preterm neonates to pain. Adv Neonatal Care. 2001; 1 (2): 94-106. |
| [27] | Grunau R, Tu MT. Long-term consequences of pain in human neonates. In: Anand KJ, Stevens B, McGrath P, editors. Pain in neonates and Infants. 3rd. Philadelphia, USA: Elsevier Science B. V.; 2007. pp. 45–55. |
| [28] | Dood VL. Implications of kangaroo care for growth and development in preterm infants. J Obstet Gynecol Neonatal Nurs. 2005; 34 (2): 218–232. doi: 0.1177/0884217505274698. |
| [29] | Maroney DI. Recognizing the potential effect of stress and trauma on premature infants in the NICU: how are outcomes affected? J Perinatol. 2003; 23: 679–683. |
| [30] | Rodkey EN, Pillai Riddell R. The infancy of infant pain research: the experimental origins of infant pain denial. J Pain. 2013; 14: 338–50. |
| [31] | Bouza, H. (2009). The impact of pain in the immature brain. Journal Maternal Fetal and Neonatal Medicine, 22, 722-732. |
| [32] | Carbajal R, Chauvet X, Couderc S, Olivier-Martin M. Randomized trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates. BMJ. 1999; 319: 1393–1397. |
| [33] | Ferguson SA, Ward WL, Paule MG, Hall RW, Anand KJS. A pilot study of preemptive morphine analgesia in preterm neonates: effects on head circumference, social behavior, and response latencies in early childhood. Neurotoxicol Teratol. 2012; 34: 47–55. |
| [34] | de Graaf J, van Lingen RA, Simons SH, et al. Long-term effects of routine morphine infusion in mechanically ventilated neonates on children's functioning: five-year follow-up of a randomized controlled trial. Pain. 2011; 152: 1391–7. |
| [35] | Pillai Riddell R, Racine N. Assessing pain in infancy: the caregiver context. Pain Res Manag. 2009; 14: 27–32. |
| [36] | Johnston CC, Fernandes AM, Campbell-Yeo M. Pain in neonates is different. Pain. 2011; 152: S65–73. |
| [37] | Chermont, A. G., Falcao, L. B., Silva, E. H., Balda, R. C., Guinsburg R. (2009) Skin-to-Skin Contact and/or Oral 25% Dextrose for Procedural Pain Relief for Term Newborn Infants. Pediatrics, 124: 6, e1101-e1107. |
| [38] | Gradin M, Eriksson M, Holmqvist G, Holstein A, Schollin J. Pain reduction at venipuncture in newborns: oral glucose compared with local anesthetic cream. Pediatrics. 2002; 110: 1053–1057. |
| [39] | Ahola Kohut, S., Hillgrove Stuart, J., Stevens, B., Gerwitz-Stern, A. Non-pharmacological management of infant and young child procedural pain. (Review) Cochrane database of systematic reviews (Online) Issue 10, 2011, Pages CD006275. |
| [40] | Susan M. Ludington-Hoe, Ph. D., Professor and Robert B. Hosseini, M. D. Skin-to-Skin Contact Analgesia for Preterm Infant Heel Stick. Paediatr Child Health 2007; 12 (2): 137-8. |
| [41] | Ludington-Hoe, Hosseini RB, Torowicz. Skin to skin contact (Kangaroo care) analgesia for preterm infant heel stick AccN. clin Issues, 2005, 16 (3) 373-387. |
| [42] | Gray, L. Watt, L. Blass, E. Skin-to-skin contact is analgesic in healthy newborns. Pediatr. 2000; 105 (1): e14-24. |
| [43] | Gray L, Miller LW, Philip BL, et al. Breast feeding is analgesic in healthy newborns. Pediatr. 2002; 109 (4): 590-3. |
| [44] | Weller A, Feldman R. Emotion regulation and touch in infants: the role of cholecystokinin and opioids. Peptides. 2003; 24 (5): 779-88. |
| [45] | Weller A, Rozin A, Goldstein A, et al. Longitudinal assessment of pituitary-thyroid axis and adrenal function in preterm infants raised by “Kangaroo mother care”. Horm Res. 2002; 57 (1-2): 22-6. |
| [46] | Castral TC, Warnock F, Leite AM, Haas VJ, Scochi CG. The effects of skin-to-skin contact during acute pain in preterm newborns. Eur J Pain. 2008; 12 (4): 464–71. |
| [47] | Amin, A., Patel, D, Shah, N., Phatak, A., & Nimblakar, S. (2015- Feb). Report on kangaroo care practices in a tertiary level NICU in Western India – Scope for Improvement. Pediatrcis, 135 (Suppl. 1), 58. |
| [48] | Kostandy RR, Ludington-Hoe SM, Cong X, Abouelfettoh A, Bron¬son C, Stankus A, et al. Kangaroo Care (skin contact) reduces crying response to pain in preterm neonates: pilot results. Pain Manag Nurs. 2008; 9 (2): 55–65. |
| [49] | Akcan E, Yigit R, Atici A. The effect of kangaroo care on pain in premature infants during invasive procedures. Turk J Pediatr. 2009; 51 (1): 14–8. |
| [50] | Ludington-Hoe SM, Hosseini R, Torowicz DL. Skin-to-skin contact (Kangaroo Care) analgesia for preterm infant heel stick. AACN Clin Issues. 2005; 16 (3): 373–87. |
| [51] | Uvanas-Moberg K, Arn I, Magnusson D. The psychobiology of emotion: the role of the oxytocinergic system. Int J Behav Med. 2005; 12 (2): 59–65. |
| [52] | Johnston CC, Filion F, Campbell-Yeo M, Goulet C, Bell L, McNaugh¬ton K, et al. Kangaroo mother care diminishes pain from heel lance in very preterm neonates: a crossover trial. BMC Pediatr. 2008; 8: 13. |
| [53] | Johnston CC, Stevens B, Pinelli J, Gibbins S, Filion F, Jack A, et al. Kangaroo care is effective in diminishing pain response in preterm neonates. Arch Pediatr Adolesc Med. 2003; 157 (11): 1084–8. |
| [54] | Abouelfettoh A., Ludington-Hoe, S. M., Burant, C., & Visscher, M. (2011). Effect of skin-to-skin contact on preterm infant skin barrier function and hospital-acquired infection. Journal of Clinical Medicine Research, 3 (1), 36- 46. |
| [55] | Mosayebi Z; Javidpour M; Rahmati M; Hagani H; MovahedianAH. The Effect of Kangaroo Mother Care on Pain From Heel Lance in Preterm Newborns Admitted to Neonatal Intensive Care Unit: a Crossover Randomized Clinical Trial. J Compr Ped. 2014 December; 5 (4): 1-6 e22214. |
