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Promoting health in premature infants: with special focus on skin-to-skin contact and development of valid pain assesment
Örebro universitet, Institutionen för medicinska vetenskaper.
2017 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Premature infants are at greater risk for both short- and long-term negative outcomes than infants born at full term. Premature infants have an immature nervous system and are not developmentally prepared to process the often excessive stimuli and frequent painful procedures of intensive care. Skin-to-skin contact between the infant and the parent is beneficial for both infant and parents and can also humanize the intense environment of the neonatal intensive care unit. The aim of the thesis, to promote health in premature infants had two parts: (1) to investigate aspects of skin-to-skin contact (SSC) within neonatal care, and (2) to contribute to the development of a valid method for pain assessment in premature infants. In Study I, questionnaires about the implementation of SSC and staff’s attitudes toward the method were sent to all neonatal units in the Nordic countries. SSC was offered in all 87% of the units that responded, but to different extents in different countries. Medical risks and the physical environment were considered barriers to SSC, and the infant’s general development was considered the primary benefit. In Study II, 20 fathers of premature infants were interviewed about their experiences with SSC. The fathers’ overall experiences were positive and SSC made them feel involvedin their infant’s care. They also described the  environment as an obstacle, but the experience as both gratifying and challenging. In Study III, SSC with their mothers was shown to have a pain-relieving effect on premature infants undergoing a blood test. This effect was examined through nearinfrared spectroscopy (NIRS) over the somatosensory cortex. In Study IV the Premature Infant Pain Profile - Revised was translated and culturally adapted into Finnish, Icelandic, Norwegian and Swedish. In summary, SSC was used to various degrees in the Nordic countries, fathers seemed to appreciate the method, which made them feel more involved, and SSC provided pain relief during a blood test.

Ort, förlag, år, upplaga, sidor
Örebro: Örebro University , 2017. , s. 63
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 157
Nyckelord [en]
Near-infrared spectroscopy, Neonatal intensive care, Pain assessment, Premature infant, Skin-to-skin contact
Nationell ämneskategori
Allmänmedicin
Identifikatorer
URN: urn:nbn:se:oru:diva-54775ISBN: 978-91-7529-183-3 (tryckt)OAI: oai:DiVA.org:oru-54775DiVA, id: diva2:1066219
Disputation
2017-04-07, Örebro universitet, Campus USÖ, hörsal C3, Södra Grev Rosengatan 32, Örebro, 09:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2017-01-17 Skapad: 2017-01-17 Senast uppdaterad: 2018-01-13Bibliografiskt granskad
Delarbeten
1. Skin-to-skin care in neonatal intensive care units in the Nordic countries: a survey of attitudes and practices
Öppna denna publikation i ny flik eller fönster >>Skin-to-skin care in neonatal intensive care units in the Nordic countries: a survey of attitudes and practices
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2012 (Engelska)Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, nr 10, s. 1140-1146Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aim: To investigate the application of skin-to-skin care (SSC) in the Nordic countries, the existence of guidelines for SSC and the attitudes of neonatal staff towards SSC.

Methods: One questionnaire was distributed at unit level and one at staff level in all Nordic neonatal intensive care units (n = 109).

Results: The unit questionnaire was answered by 95 (87%) units and the staff questionnaire by 1446 staff members (72%). All units offered SSC to various degrees, but guidelines only existed at 47% of them. Units in Denmark, Norway and Sweden seemed to use SSC earlier, longer and in more medically complicated situations than units in Finland and Iceland. Seventy-seven per cent of the units had private rooms where parents and infants could stay together, still the physical environment of the units limited the use of SSC. Medical risks were considered the main barrier for further implementation of SSC, while general development and early interaction were the most frequently mentioned benefits.

Conclusion: Skin-to-skin care is implemented in all Nordic neonatal units, but offered to various degrees, to various populations and to varying extents. Danish, Norwegian and Swedish units are offering SSC more extensively than units in Finland and Iceland.

Ort, förlag, år, upplaga, sidor
Hoboken, USA: Wiley-Blackwell, 2012
Nyckelord
Kangaroo mother care, neonatal care, newborn infant, skin-to-skin care
Nationell ämneskategori
Omvårdnad
Forskningsämne
Medicin; Omvårdnadsvetenskap
Identifikatorer
urn:nbn:se:oru:diva-25710 (URN)10.1111/j.1651-2227.2012.02802.x (DOI)000309408200022 ()22849363 (PubMedID)2-s2.0-84867101431 (Scopus ID)
Tillgänglig från: 2012-09-04 Skapad: 2012-09-04 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
2. Skin-to-skin contact facilitates a more equal parenthood: a qualitative study from fathers’ perspectives
Öppna denna publikation i ny flik eller fönster >>Skin-to-skin contact facilitates a more equal parenthood: a qualitative study from fathers’ perspectives
(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nationell ämneskategori
Allmänmedicin
Identifikatorer
urn:nbn:se:oru:diva-56354 (URN)
Tillgänglig från: 2017-03-15 Skapad: 2017-03-15 Senast uppdaterad: 2018-01-13Bibliografiskt granskad
3. Skin-to-skin contact reduces near-infrared spectroscopy pain responses in premature infants during blood sampling
Öppna denna publikation i ny flik eller fönster >>Skin-to-skin contact reduces near-infrared spectroscopy pain responses in premature infants during blood sampling
2016 (Engelska)Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, nr 4, s. 376-380Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aim: This study investigated if skin-to-skin contact could provide pain relief, measured with near infrared spectroscopy (NIRS), during venepuncture in premature infants.

Methods: Ten infants born at 26-35 weeks of gestation were examined during a blood sampling procedure with venepuncture under two different conditions: in skin-to-skin contact with their mother or lying in their incubator or crib. A double-channel NIRS device was used and oxygen saturation and heart rate were measured using pulse oximetry. The infant's face and the pulse oximetry values were videotaped throughout the procedures, so that we could carry out a pain assessment using the Premature Infant Pain Profile - Revised (PIPP-R).

Results: We found a significantly smaller increase in oxygenated haemoglobin on the contralateral side during venepuncture when the infants were in skin-to-skin contact with their mothers, compared to when they were laying in their incubator or crib. When venepuncture was compared with a sham procedure, oxygenated haemoglobin increased significantly more with the infant in the incubator or crib than held skin-to-skin, but no significant differences could be seen in the PIPP-R results between the two groups.

Conclusion: This study showed that skin-to-skin contact between premature infants and their mothers during venepuncture had a pain-relieving effect.

Ort, förlag, år, upplaga, sidor
Wiley-Blackwell, 2016
Nyckelord
Near infrared spectroscopy, newborn infant, pain, skin-to-skin contact
Nationell ämneskategori
Pediatrik
Forskningsämne
Pediatrik
Identifikatorer
urn:nbn:se:oru:diva-45724 (URN)10.1111/apa.13180 (DOI)000371892200018 ()26342142 (PubMedID)
Forskningsfinansiär
Magnus Bergvalls Stiftelse
Anmärkning

Funding Agencies:

Örebro University Hospital Research Foundation

Nils Svenningsens minnesfond

Stiftelsen Allmana BBs minnesfond

Research Committee at Region Örebro County 

Tillgänglig från: 2015-09-07 Skapad: 2015-09-07 Senast uppdaterad: 2018-09-04Bibliografiskt granskad
4. Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)
Öppna denna publikation i ny flik eller fönster >>Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)
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(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nationell ämneskategori
Allmänmedicin
Identifikatorer
urn:nbn:se:oru:diva-56355 (URN)
Tillgänglig från: 2017-03-15 Skapad: 2017-03-15 Senast uppdaterad: 2018-01-13Bibliografiskt granskad

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