Objectives-When preterm infants experience heel stick, crying commonly occurs and has adverse physical effects. A reduction in crying is desired. Kangaroo Care, skin contact between mother and infant, reduces pain as measured by the Premature Infant Pain Profile, and may reduce crying time. The purpose of the pilot was to test Kangaroo Care's effect on the preterm infant's crying response to heel-stick.Methods-A prospective cross-over study with 10 prematures 2-9 days old (30-32 weeks postmenstrual age) was conducted. Infants were randomly assigned to two sequences (Day 1 heel stick in Kangaroo Care [after 30 minutes of prone skin contact upright between maternal breasts] and Day 2 heel stick in incubator [inclined, nested and prone] or the opposite sequence) was conducted. Video tapes of Baseline, Heel Warming, Heel Stick, and Recovery phases were independently scored for audible and inaudible crying times by two research assistants. The audible and inaudible crying times for each subject in each phase were summed and the mean between the scorer's values was analyzed by repeated measures ANOVA.Results-Subject characteristics did not differ between those in the two sequences. Crying time differed between the study phases on both days (p ≤ 0.001). When in Kangaroo Care as compared to the incubator, crying time was less during the Heel stick (p = 0.001) and Recovery (p = 0.01) phases. Conclusion-BecauseKangaroo Care reduced crying in response to heel stick in medically stable preterm infants who were 2-9 days old, a definitive study is recommended.
Background: Although previous studies have demonstrated beneficial breastfeeding outcomes when cup feeding rather than bottle feeding was used for feeding preterm infants, cup feeding has not been implemented in Egypt. The aim of the current study was to examine the effect of using cup feeding as an exclusive method of feeding preterm infants during hospitalization on breastfeeding outcomes after discharge.
Introduction: Exposure to positive clinical learning experience influences the nursing students' knowledge, skills, attitudes, and interest in continuing the nursing profession. It is widely acknowledged that clinical placement evaluations while students are on placement is very useful for better understanding of what constitutes quality clinical education from the students' perspective to provide better educational experiences. Aim: The aim of the study was to assess the nursing students' satisfaction with their clinical placement experiences and the degree to which their experiences are regarded as positive. Methodology: A descriptive design was used for the purpose of the study at college of Nursing in the eastern region of Saudi Arabia. Students enrolled in clinical courses during 2010-2012 were included. Clinical placement evaluation form was used for data collection and students were asked to respond to three open ended questions asking them for the advantages and the disadvantages of each clinical placement and their suggestions for improvement. Results: The majority of the students (75.6%) agreed or strongly agreed with statements rating their satisfaction with the clinical placement. However, students were dissatisfied with short clinical exposures, staff nurses role and evaluation process from the clinical instructors.
BackgroundThe preterm infants' skin is structurally and functionally immature at birth because of immature stratum corneum barrier function, leading to problems with fluid loses, thermoregulation, and infection. Two parameters of barrier function can be non-invasively assessed: Stratum Corneum Hydration (SCH) and Transepidermal Water Loss (TEWL). Skin-to-Skin Care (SSC) is the proposed independent variable that might affect barrier function by decreasing TEWL and increasing SCH, thereby improving stratum corneum barrier function and consequently decreasing the rate of infection. No study of SSC's effects on TEWL and SCH of preterm infants could be found. The purpose of the study was to determine the effect of 5 daily Skin-to-Skin Contact sessions on infant skin hydration (SCH), transepidermal evaporated water loss (TEWL), and on SCH when TEWL was controlled, and on the presence of hospital acquired infection.MethodsA one-group pretest-test-posttest design with 10 preterm infants (28 - 30 wks GA < 32 wks postmenstrual age, and no infection at entry). Test = 90 minutes of SSC; pre-test and post-test = 30 minutes each of prone positioning in an incubator. SCH and TEWL were taken on Days 1 and 5 at the beginning, middle and end of each period using Multi-Probe Adaptor. A 3 X 3 X 2 Repeated Measures Mixed Models Design, including a covariate, was used to analyze level of Skin Hydration. Specifically, the model tested comparisons in SCH made across repetitions, time, and days, as well as all possible interactions while controlling for TEWL. Descriptive statistics described the number of positive blood cultures during hospitalization and the presence of infections four weeks post-discharge.ResultsSignificant differences in skin hydration were found across TIME (Pre-SSC, SSC, Post-SSC) (F = 21.86; p < 0.001). One infant had a positive blood culture during hospitalization; no infants had signs of infection by 4 weeks post-discharge. ConclusionsThe study has begun fulfilling the recommendation that SSC be tested as a strategy to improve skin hydration, but reveals that evaporative loss may be higher during SSC than during incubator care, and that the higher transepidermal evaporated water loss values may not necessarily be detrimental because few infections occurred even in its presence. A definitive randomized controlled trial is recommended.KeywordsSkin-to-skin contact; Skin hydration; Transepidermal water loss; Infection; Preterm
Reduction of high-risk neonates' exposure to aversive light stimulation is an important component of developmentally supportive care. In neonatal intensive care unit (NICU), usually light is reduced by reducing the room's light level or by using incubator covers. Many types of incubator covers are in use, including homemade and commercial covers. A comparative study was used to determine the light reducing capabilities of 19 homemade incubator covers, 2 commercial covers, and 1 receiving blanket. The covers were tested by covering and uncovering an incubator and an oxygen hood in the NICU during daytime and nighttime lightings. The light reducing capabilities value was determined for each cover using an Extech light dosimeter when the cover was placed over and removed from an oxyhood, and an incubator. The study showed that the light reducing capability of the commercial covers was 91.2%, the homemade covers capability was 72.1%, and the receiving blankets capability was 55.1%. A significant difference between the commercial and homemade covers was found (F = 452.50, P < 0.00). Commercial incubator covers are the most effective covers to achieve light reduction; homemade covers can be effective if made large enough so that they completely cover all sides of the incubator.
Introduction: Around the world women breastfeed without question, there is a natural assumption that the breast will be offered to the newborn infant and that breast milk will nourish the infant until weaning. However, cultural beliefs and traditions passed down by the family and friends influences the mothers’ breastfeeding experience. Previous researches about breastfeeding in Saudi Arabia have been mostly using quantitative methods of research looking at rough numbers. Study Objective: Explore and describe the breastfeeding live experience and Cultural Practices related to Exclusive breastfeeding of Saudi women who live in Al Ahsa city, Easter Region, KSA. Methods: Qualitative, in-depth interview utilized in the study. Data collected till reaching saturation from twenty mothers who were recruited from PHC Clinics during their baby’s immunization visit at six month. Results: The findings highlighted that all mothers initiated breastfeeding, some were hesitant to feed the infant the colostrum. Unfortunately, all mothers started supplementation early in infant life because some cultural practices and social influences mandates giving the baby some foods that is believed to bless the baby. Husband was the most influential family member and getting pregnant again was a reason to stop breastfeeding. Conclusion: The breastfeeding experience is not an isolated event but one that exists in a social context. Despite mothers initiate and admire the health benefits of breastfeeding, barriers to exclusive breastfeeding still remain. Bottle feeding became the norm with the societal modernization; women employment, and life styles, social support is not there, and non-spaced pregnancies. Understanding of the cultural practices related to can assist health professionals to provide culturally comptent interventions.
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