2.50
Hdl Handle:
http://hdl.handle.net/10755/150341
Type:
Presentation
Title:
Efficacy of Kangaroo care in reducing crying in preterm infants
Abstract:
Efficacy of Kangaroo care in reducing crying in preterm infants
Conference Sponsor:Sigma Theta Tau International
Conference Year:1991
Author:Anderson, Gene, PhD
P.I. Institution Name:Case Western Reserve University
Title:Professor
Significance, Purpose, and Design: Because of crying, especially

hard crying, is associated with prolonging patency of the foramen

ovale (Dinwiddie et al., 1979), increasing intracranial blood

pressures (Brazy, 1988), decreasing brain perfusion (Reynolds et

al., 1988), and creating hypoxic states (Brazy, 1988),

interventions that are effective in reducing crying need to be

identified. Kangaroo Care, skin-to-skin placement of the preterm

infant upright between his mother's breasts while still under

neonatal intensive care, has been found to be effective in

modulating the behavioral states, specifically the amount of

quiet sleep (Ludington-Hoe, 1990), but its efficacy in relation

to crying states has not been analyzed. Clinicians have

expressed concern that close contact with the mother, though

comforting while contact is maintained, is associated with more

crying once contact is discontinued. To learn the effect of KC

on the frequency and duration of crying and to examine the

relationship between KC's presence/absence and crying, a

pretest-post-test randomized controlled clinical trial with 24

preterm infants was performed. Methods: The Anderson Behavioral

State Scale (ABSS)(Anderson, 1988), a twelve state scale that

differentiates between Fussy, Cry, and Hard Cry states by amount

of body movement, skin color change, and vocal quality and

intensity of the cry was used each minute throughout three

consecutive interfeeding intervals (Pre-KC or Pre-Control, KC or

Control, and post-KC or post-Control). Infants were randomly

assigned by Zellen technique to the KC (N=11) or control (N=13)

group. Observations were made for thirty seconds each minute by

one of three neonatal nurses who had been trained to reliability

with the ABSS and who maintained an interrater reliability of .90

or greater. Calculations were based on 3410 pre-KC/Control, 3205

KC/Control, and 3356 post-KC/Control period observations.

Subjects were between 32-37 weeks GA whose average birthweight

was 1982.50 grams, weight on study date was 2076.58 grams. and

postnatal complications score was 8.05. For the pretest,

post-test and control periods the preterm infants were lying

undisturbed in the lateral position in open air cribs, clothed in

head cap, t-shirt, and diaper, and swaddled in one blanket while

tucked beneath another from one feeding to another with feedings

scheduled three hours apart. Kangaroo Care was placement of the

infant, wearing only a diaper, upright skin-to-skin between his

mother's breasts and covered over his back by a medium weight

velour blouse that the mother wore as she sat beside the crib in

a fully and continuously illuminated level II NICU that

simultaneously housed 4-5 other infants. Crying frequency is

defined as the number of crying episodes observed in each period;

duration is the number of consecutive observations of the same

state within each period.

Results: Data analysis is continuing. Potentially disturbing sounds

and events, such as telephones, alarms, intercom, medical rounds,

conversation, and trash can noises, occurred 87-89 percent of the

time throughout all three periods. Crying data will be analyzed

using measures of central tendency and general linear model two-

factor (period and group) repeated measures analysis of variance.

When significant differences were found, post-hoc tests to delineate

source of difference will be performed. Each period will be divided

three subperiods to further delineate the temporal characteristics of

crying episodes. The subperiods are the first 30 minutes and last

30 minutes of each period, and the middle minutes. The duration

of middle minutes varies due to clinical realities of feeding

infants every three hours. Subperiod data will be examined to

determine if crying episodes are related to feeding times,

nursing intervention, and/or initiation or withdrawal of maternal

contact. Implications for practice will be discussed.



Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEfficacy of Kangaroo care in reducing crying in preterm infantsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/150341-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Efficacy of Kangaroo care in reducing crying in preterm infants</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1991</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Anderson, Gene, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Case Western Reserve University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">gca@po.cwru.edu</td></tr><tr><td colspan="2" class="item-abstract">Significance, Purpose, and Design: Because of crying, especially<br/><br/>hard crying, is associated with prolonging patency of the foramen<br/><br/>ovale (Dinwiddie et al., 1979), increasing intracranial blood<br/><br/>pressures (Brazy, 1988), decreasing brain perfusion (Reynolds et<br/><br/>al., 1988), and creating hypoxic states (Brazy, 1988),<br/><br/>interventions that are effective in reducing crying need to be<br/><br/>identified. Kangaroo Care, skin-to-skin placement of the preterm<br/><br/>infant upright between his mother's breasts while still under<br/><br/>neonatal intensive care, has been found to be effective in<br/><br/>modulating the behavioral states, specifically the amount of<br/><br/>quiet sleep (Ludington-Hoe, 1990), but its efficacy in relation<br/><br/>to crying states has not been analyzed. Clinicians have<br/><br/>expressed concern that close contact with the mother, though<br/><br/>comforting while contact is maintained, is associated with more<br/><br/>crying once contact is discontinued. To learn the effect of KC<br/><br/>on the frequency and duration of crying and to examine the<br/><br/>relationship between KC's presence/absence and crying, a<br/><br/>pretest-post-test randomized controlled clinical trial with 24<br/><br/>preterm infants was performed. Methods: The Anderson Behavioral<br/><br/>State Scale (ABSS)(Anderson, 1988), a twelve state scale that<br/><br/>differentiates between Fussy, Cry, and Hard Cry states by amount<br/><br/>of body movement, skin color change, and vocal quality and<br/><br/>intensity of the cry was used each minute throughout three<br/><br/>consecutive interfeeding intervals (Pre-KC or Pre-Control, KC or<br/><br/>Control, and post-KC or post-Control). Infants were randomly<br/><br/>assigned by Zellen technique to the KC (N=11) or control (N=13)<br/><br/>group. Observations were made for thirty seconds each minute by<br/><br/>one of three neonatal nurses who had been trained to reliability<br/><br/>with the ABSS and who maintained an interrater reliability of .90<br/><br/>or greater. Calculations were based on 3410 pre-KC/Control, 3205<br/><br/>KC/Control, and 3356 post-KC/Control period observations.<br/><br/>Subjects were between 32-37 weeks GA whose average birthweight<br/><br/>was 1982.50 grams, weight on study date was 2076.58 grams. and<br/><br/>postnatal complications score was 8.05. For the pretest,<br/><br/>post-test and control periods the preterm infants were lying<br/><br/>undisturbed in the lateral position in open air cribs, clothed in<br/><br/>head cap, t-shirt, and diaper, and swaddled in one blanket while<br/><br/>tucked beneath another from one feeding to another with feedings<br/><br/>scheduled three hours apart. Kangaroo Care was placement of the<br/><br/>infant, wearing only a diaper, upright skin-to-skin between his<br/><br/>mother's breasts and covered over his back by a medium weight<br/><br/>velour blouse that the mother wore as she sat beside the crib in<br/><br/>a fully and continuously illuminated level II NICU that<br/><br/>simultaneously housed 4-5 other infants. Crying frequency is<br/><br/>defined as the number of crying episodes observed in each period;<br/><br/>duration is the number of consecutive observations of the same<br/><br/>state within each period.<br/><br/>Results: Data analysis is continuing. Potentially disturbing sounds<br/><br/>and events, such as telephones, alarms, intercom, medical rounds,<br/><br/>conversation, and trash can noises, occurred 87-89 percent of the<br/><br/>time throughout all three periods. Crying data will be analyzed<br/><br/>using measures of central tendency and general linear model two-<br/><br/>factor (period and group) repeated measures analysis of variance.<br/><br/>When significant differences were found, post-hoc tests to delineate<br/><br/>source of difference will be performed. Each period will be divided<br/><br/>three subperiods to further delineate the temporal characteristics of<br/><br/>crying episodes. The subperiods are the first 30 minutes and last<br/><br/>30 minutes of each period, and the middle minutes. The duration<br/><br/>of middle minutes varies due to clinical realities of feeding<br/><br/>infants every three hours. Subperiod data will be examined to<br/><br/>determine if crying episodes are related to feeding times,<br/><br/>nursing intervention, and/or initiation or withdrawal of maternal<br/><br/>contact. Implications for practice will be discussed.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T10:22:08Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T10:22:08Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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