2.50
Hdl Handle:
http://hdl.handle.net/10755/166320
Category:
Abstract
Type:
Presentation
Title:
Physiologic and Behavioral Responses to Pain in the Preterm Neonate
Author(s):
Mainous, Rosalie
Author Details:
Rosalie Mainous, MSN/MN/MNSc/MNE, University of Louisville School of Nursing, Louisville, Kentucky, USA, (updated February 2015) email: rosalie.mainous@wright.edu
Abstract:
Pain management in the preterm neonate relies on the accurate assessment of the phenomenon and is a particularly significant area for research based practice. The purpose of this study is to describe the physiologic and behavioral responses of the preterm neonate to a painful stimulus -- the heel stick, with the specific aim of comparing physiologic and behavioral responses of preterm neonates to a heel warming-heel stick procedure to a heel warming only procedure. Utilizing the Model of Synactive Organization of Behavioral Development proposed by Als (1982) for the behavioral piece and the developmental anatomy perspective for the physiologic piece, the researcher hypothesized that preterm neonates undergoing heel warming and heel stick would have higher mean heart rates, respiratory rates, arterial blood pressure, lower mean SpO2 values, and a different pattern of behavioral states when compared to heel warming only. After conducting a pilot study with nine subjects and calculating a power analysis, it was determined that 50 subjects would be included, 25 each in randomly assigned groups which differed for order of treatment (nociceptive versus non-nociceptive). Each subject will serve as their own control and compared to a baseline of the outcome variables. Sample is from two urban, level III, neonatal intensive care units in Louisville, KY. All subjects will be between 30 and 38 weeks of gestational age (to minimize habituation) and free from narcotics either prenatally or postnatally. The study is a true experimental, repeated measures, cross over design with a descriptive component. There are 5 dependent variables (HR, RR, B/P, SpO2 and state), 3 independent variables (treatment, sequence of treatment, and repeated measures) and 1 covariate of gestational age. After collection of consent from either parent; subjects will be videotaped while receiving the two treatments: a nociceptive stimulus that includes a 5-minute heel warming with a subsequent heel stick for a blood draw and a non-nociceptive 5-minute heel warming only treatment. Physiologic data will be collected using a Hewlett-Packard CR monitor, Accutor 3 blood pressure machine with recorder and a Nellcorr 200 pulse oximeter. Behavioral state will be scored based on Als et al (1982) State System Scale (A states only). Preliminary findings demonstrate significant differences for 3 of the 4 physiologic variables and will be analyzed via ANCOVA. Analysis is ongoing for the behavioral data which will use a Mann Whitney U. A second rater is used for every fifth subject to maintain interrater reliability of the behavioral data and is set at a .90 using a Cohens Kappa test. Analysis will be complete Fall, 1995. Implications for tool development, practice and future research will be derived. Much is also being learned with regard to conduct of behavioral research.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
Feb 29 - Mar 2, 1996
Conference Host:
Southern Nursing Research Society
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePhysiologic and Behavioral Responses to Pain in the Preterm Neonateen_GB
dc.contributor.authorMainous, Rosalieen_US
dc.author.detailsRosalie Mainous, MSN/MN/MNSc/MNE, University of Louisville School of Nursing, Louisville, Kentucky, USA, (updated February 2015) email: rosalie.mainous@wright.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/166320-
dc.description.abstractPain management in the preterm neonate relies on the accurate assessment of the phenomenon and is a particularly significant area for research based practice. The purpose of this study is to describe the physiologic and behavioral responses of the preterm neonate to a painful stimulus -- the heel stick, with the specific aim of comparing physiologic and behavioral responses of preterm neonates to a heel warming-heel stick procedure to a heel warming only procedure. Utilizing the Model of Synactive Organization of Behavioral Development proposed by Als (1982) for the behavioral piece and the developmental anatomy perspective for the physiologic piece, the researcher hypothesized that preterm neonates undergoing heel warming and heel stick would have higher mean heart rates, respiratory rates, arterial blood pressure, lower mean SpO2 values, and a different pattern of behavioral states when compared to heel warming only. After conducting a pilot study with nine subjects and calculating a power analysis, it was determined that 50 subjects would be included, 25 each in randomly assigned groups which differed for order of treatment (nociceptive versus non-nociceptive). Each subject will serve as their own control and compared to a baseline of the outcome variables. Sample is from two urban, level III, neonatal intensive care units in Louisville, KY. All subjects will be between 30 and 38 weeks of gestational age (to minimize habituation) and free from narcotics either prenatally or postnatally. The study is a true experimental, repeated measures, cross over design with a descriptive component. There are 5 dependent variables (HR, RR, B/P, SpO2 and state), 3 independent variables (treatment, sequence of treatment, and repeated measures) and 1 covariate of gestational age. After collection of consent from either parent; subjects will be videotaped while receiving the two treatments: a nociceptive stimulus that includes a 5-minute heel warming with a subsequent heel stick for a blood draw and a non-nociceptive 5-minute heel warming only treatment. Physiologic data will be collected using a Hewlett-Packard CR monitor, Accutor 3 blood pressure machine with recorder and a Nellcorr 200 pulse oximeter. Behavioral state will be scored based on Als et al (1982) State System Scale (A states only). Preliminary findings demonstrate significant differences for 3 of the 4 physiologic variables and will be analyzed via ANCOVA. Analysis is ongoing for the behavioral data which will use a Mann Whitney U. A second rater is used for every fifth subject to maintain interrater reliability of the behavioral data and is set at a .90 using a Cohens Kappa test. Analysis will be complete Fall, 1995. Implications for tool development, practice and future research will be derived. Much is also being learned with regard to conduct of behavioral research.en_GB
dc.date.available2011-10-27T14:44:45Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:44:45Z-
dc.conference.dateFeb 29 - Mar 2, 1996en_US
dc.conference.hostSouthern Nursing Research Societyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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