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ID 19924
file
title alternative
Pain responses of preterm infants to blood sampling procedure
creator
Isago, Naoko
subject
早期産児
採血
反応
自己鎮静行動
睡眠覚醒状態
preterm infant
blood sampling procedure
pain response
self-regulatory behaviors
behavioral state
NDC
Medical sciences
abstract
本研究の目的は,採血に対する早期産児の行動的反応と生理学的反応および児の発達に伴う反応の変化を明らかにし,採血時の早期産児への看護介入について検討することであった.在胎24~30過で出生した早期産児7名に対して,採血場面の観察を1~2週間ごとに,児が修正37~40週になるまで継続して行い,呼吸心拍モニターとビデオ録画により表情反応,自己鎮静行動,睡眠覚醒状態(state),心拍数,血中酸素飽和度(SpO2)についてデータを収集した.得られた結論は次の通りであった.1.採血を受ける早期産児は,処置中に眉を隆起させる,目を強く閉じる,鼻唇溝が深くなる,の表情反応を示し,穿刺直後にはこの3つが同時に生じる傾向があった.また,処置中にもかかわらず表情反応が出現しない場合,在胎週数が短い,修正退数が早い,低酸素状態,自己鎮静行動をとっている,などの要因が考えられた.2.早期産児は,処置中であっても深睡眠の状態になることがあり,それには児が自ら刺激を遮断している場面や,自己鎮静行動を伴う場面,低酸素を伴う場面があった.3.早期産児は,採血の刺激に対して自己鎮静行動をとることができ,自己鎮静行動によって睡眠覚醒状態が睡眠の方向へ移行するが,早期産児に必要とされる深睡眠の状態は,児が自らとる自己鎮静行動だけでは得ることが難しいと考えられた.4.示唆された早期産児の採血時における看護介入は,早期産児が痛みの知覚を持つと認識した上で児を観察し,微細な反応を確実にとらえること,環境からの刺激や採血による刺激をできる限り減少させること,児の自己鎮静行動を促進すること,であった.
abstract
The purposes of this study were: a) to clarify behavioral and physiological responses to blood sampling procedure in preterm infants, b) to clarify change the responses with infants' development, and c) to examine nursing interventions in preterm infants during blood sampling procedure. Subjects were seven preterm infants who were born between 24 and 30 weeks gestational age and hospitalized in NICU. The data was collected longitudinally every one or two weeks until infants were 37 to 40 weeks postconceptional age. Facial expressions, self-regulatory behaviors and behavioral states were recorded by videotape. The data also included heart rate and oxgen saturation by using ECG monitor. Results were as follows: 1. Preterm infants expressed brow bulge, eye squeeze and nasolabial furrow during blood sampling procedure, and expressed these three actions all together when infants were sticked. Disappearance of facial expressions during procedure was related to early gestational age, young postconceptional age, hypoxia and self-regulatory behaviors. 2. The deep sleep state during procedure was related to behaviors of shut stimuli out, self-regulatory behaviors and hypoxia. 3. Preterm infants' self-regulatory behaviors toward blood sampling stimuli made there behavioral state lower except the deep sleep state. 4. Nursing interventions in preterm infants during blood sampling procedure were: a) to observe infants' responses in detail recognizing infants' pain perception, b) to decrease the stimuli of infants' surroundings or blood sampling procedure, and c) to promote infants' self-regulatory behaviors.
journal title
Journal of Japan Academy of Neonatal Nursing
volume
Volume 7
issue
Issue 1
start page
24
end page
32
date of issued
2000-03
publisher
日本新生児看護学会
issn
1343-9111
ncid
language
jpn
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
publisher
rights
Copyright (c) 2000 日本新生児看護学会
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