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Lower stress responses after newborn individualized developmental care and assessment program care during eye screening examinations for retinopathy of prematurity: A randomized study

Kleberg, Agneta LU ; Warren, Inga; Norman, Elisabeth LU ; Morelius, Evalotte; Berg, Ann-Cathrine LU ; Mat-Ali, Ezam; Holm, Kristina LU ; Fielder, Alistair; Nelson, Nina and Hellström-Westas, Lena LU (2008) In Pediatrics 121(5). p.1267-1278
Abstract
OBJECTIVE. Screening examination for retinopathy of prematurity is distressing and painful. The aim of the present study was to investigate whether a Newborn Individualized Developmental Care and Assessment Program intervention during a retinopathy of prematurity examination results in less adverse behavioral, pain, and stress responses as compared with standard care. METHODS. The first 2 eye examinations in 36 preterm infants were evaluated. The infants were randomly assigned at the first eye examination to receive either Newborn Individualized Developmental Care and Assessment Program care or standard care. At the second examination, crossover of subject assignment was performed. The assessments included behavioral responses; recordings... (More)
OBJECTIVE. Screening examination for retinopathy of prematurity is distressing and painful. The aim of the present study was to investigate whether a Newborn Individualized Developmental Care and Assessment Program intervention during a retinopathy of prematurity examination results in less adverse behavioral, pain, and stress responses as compared with standard care. METHODS. The first 2 eye examinations in 36 preterm infants were evaluated. The infants were randomly assigned at the first eye examination to receive either Newborn Individualized Developmental Care and Assessment Program care or standard care. At the second examination, crossover of subject assignment was performed. The assessments included behavioral responses; recordings of heart rate, respiration, and oxygenation; pain scores (premature infant pain profile); and salivary cortisol at defined time points up to 4 hours after the eye examination. The nursing support given during the eye examinations (intervention score) were scored using predefined criteria. RESULTS. Altogether, 68 examinations were evaluated. Newborn Individualized Developmental Care and Assessment Program care was associated with better behavioral scores during the examination but there was no difference in heart rate, respiratory rate, oxygenation, or premature infant pain profile score between the 2 care strategies before or after the eye examination. Salivary cortisol increased from baseline to 30 minutes after the eye examination independent of care strategy and decreased significantly between 30 and 60 minutes when infants were subjected to Newborn Individualized Developmental Care and Assessment Program care but not after standard care. During the study period the intervention score for standard care increased and approached the score for Newborn Individualized Developmental Care and Assessment Program care at the later eye examinations. CONCLUSION. A Newborn Individualized Developmental Care and Assessment Program-based intervention during eye examination does not decrease pain responses but results in faster recovery, as measured by lower salivary cortisol 60 minutes after the examination. The differences were seen despite the influence from the Newborn Individualized Developmental Care and Assessment Program intervention on the standard care treatment that occurred during the study period. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
developmental care, stress, retinopathy of prematurity, preterm infant, NIDCAP, pain, eye examination
in
Pediatrics
volume
121
issue
5
pages
1267 - 1278
publisher
American Academy of Pediatrics
external identifiers
  • wos:000255501900073
  • scopus:44449173167
ISSN
1098-4275
DOI
10.1542/peds.2006-2510
language
English
LU publication?
yes
id
7079e347-be42-4c70-bdaa-a7d0e1f3b6c8 (old id 1204577)
date added to LUP
2008-09-17 14:29:46
date last changed
2017-09-24 04:12:05
@article{7079e347-be42-4c70-bdaa-a7d0e1f3b6c8,
  abstract     = {OBJECTIVE. Screening examination for retinopathy of prematurity is distressing and painful. The aim of the present study was to investigate whether a Newborn Individualized Developmental Care and Assessment Program intervention during a retinopathy of prematurity examination results in less adverse behavioral, pain, and stress responses as compared with standard care. METHODS. The first 2 eye examinations in 36 preterm infants were evaluated. The infants were randomly assigned at the first eye examination to receive either Newborn Individualized Developmental Care and Assessment Program care or standard care. At the second examination, crossover of subject assignment was performed. The assessments included behavioral responses; recordings of heart rate, respiration, and oxygenation; pain scores (premature infant pain profile); and salivary cortisol at defined time points up to 4 hours after the eye examination. The nursing support given during the eye examinations (intervention score) were scored using predefined criteria. RESULTS. Altogether, 68 examinations were evaluated. Newborn Individualized Developmental Care and Assessment Program care was associated with better behavioral scores during the examination but there was no difference in heart rate, respiratory rate, oxygenation, or premature infant pain profile score between the 2 care strategies before or after the eye examination. Salivary cortisol increased from baseline to 30 minutes after the eye examination independent of care strategy and decreased significantly between 30 and 60 minutes when infants were subjected to Newborn Individualized Developmental Care and Assessment Program care but not after standard care. During the study period the intervention score for standard care increased and approached the score for Newborn Individualized Developmental Care and Assessment Program care at the later eye examinations. CONCLUSION. A Newborn Individualized Developmental Care and Assessment Program-based intervention during eye examination does not decrease pain responses but results in faster recovery, as measured by lower salivary cortisol 60 minutes after the examination. The differences were seen despite the influence from the Newborn Individualized Developmental Care and Assessment Program intervention on the standard care treatment that occurred during the study period.},
  author       = {Kleberg, Agneta and Warren, Inga and Norman, Elisabeth and Morelius, Evalotte and Berg, Ann-Cathrine and Mat-Ali, Ezam and Holm, Kristina and Fielder, Alistair and Nelson, Nina and Hellström-Westas, Lena},
  issn         = {1098-4275},
  keyword      = {developmental care,stress,retinopathy of prematurity,preterm infant,NIDCAP,pain,eye examination},
  language     = {eng},
  number       = {5},
  pages        = {1267--1278},
  publisher    = {American Academy of Pediatrics},
  series       = {Pediatrics},
  title        = {Lower stress responses after newborn individualized developmental care and assessment program care during eye screening examinations for retinopathy of prematurity: A randomized study},
  url          = {http://dx.doi.org/10.1542/peds.2006-2510},
  volume       = {121},
  year         = {2008},
}