背景:尽管常规护士护理对早产儿的整体健康至关重要,方法的变化可能对早产儿的应激反应和行为状态产生不同的影响。
目的:本系统评价的目的是检查新生儿重症监护病房的常规护士护理及其对早产儿应激反应和行为状态的影响。
方法:使用PubMed进行了系统搜索,Embase,2013年至2023年发表的研究的CINAHL。
方法:纳入的研究纳入了胎龄<37周龄的早产儿,并调查了护士护理实践及其对应激反应和/或行为状态的影响。
方法:遵循系统评价和荟萃分析指南的首选报告项目,有关研究设计的数据,方法,调查结果,并对局限性进行了提取和总结。纳入的研究使用国家卫生评估偏倚,肺,和血液研究所质量评估工具。
结果:纳入评价的所有13项研究均获得了相当的质量评级。护士护理活动,包括吸吮,换尿布,洗澡,称重,与心率和呼吸频率的增加有关,血压,能量消耗,和运动反应,较低的氧饱和度,更少的睡眠状态
结论:调整护士护理频率和持续时间,使护理与婴儿状态保持一致,整合发展护理策略可能会减少婴儿的应激反应并支持行为休息。需要进一步的研究来了解护理活动如何影响早产儿的应激反应和行为状态,帮助确定可修改的护理压力源,以促进最佳发展。
BACKGROUND: Although routine nurse caregiving is vital for the overall health of preterm infants, variations in approaches may exert distinct effects on preterm infants\' stress responses and behavior state.
OBJECTIVE: The purpose of this systematic review was to examine routine nurse caregiving in the neonatal intensive care unit and its effect on stress responses and behavior state in preterm infants.
METHODS: A systematic search was conducted using PubMed, Embase, and CINAHL for studies published between 2013 and 2023.
METHODS: Included studies enrolled preterm infants born <37 weeks gestational age and investigated nurse caregiving practices and effects on stress responses and/or behavior state.
METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data about study design, methods, findings, and limitations were extracted and summarized. Included studies were evaluated for bias using the National Health, Lung, and Blood Institute quality assessment tools.
RESULTS: All 13 studies included in the review received a fair quality rating. Nurse caregiving activities, including suctioning, diaper changes, bathing, and weighing, were associated with increases in heart and respiratory rates, blood pressure, energy expenditure, and motor responses, lower oxygen saturations, and fewer sleep states.
CONCLUSIONS: Adapting nurse caregiving frequency and duration, aligning caregiving with infant state, and integrating developmental care strategies may reduce infant stress responses and support behavioral rest. Further research is needed to understand how caregiving activities affect stress responses and behavior state in preterm infants, aiding in identifying modifiable caregiving stressors to promote optimal development.