References
Physiological and behavioural effects of preterm infant positioning in a neonatal intensive care unit
Abstract
Aim
To compare the effect of sleeping position on physiological and behvioural responses in preterm infants.
Methods
A quasi-experimental study was conducted in a neonatal intensive care unit in the south of Brazil. The sample was 24 preterm newborns with gestational age ≤32 weeks, who were randomly separated into four groups: right side position, supine position, left side position and prone position. The physiological and behavioral variables were evaluated before, during and after positioning.
Findings
During the intervention, heart rate decreased in right side position, supine position, and prone position. The respiratory rate reduced in all positions and peripheral oxygen saturation remained stable in most positions. Behavioural scores were reduced in supine, left side and prone positions.
Conclusions
Positioning according to a standard operating procedure was able to produce more positive responses in prone and supine position groups during the intervention.
Premature births account for 11.1% of the total number of births worldwide. In Brazil, the percentage is slightly higher, at 11.9% (World Health Organization (WHO), 2012; Blencowe and Cousens, 2013; UNICEF, 2014). As a result of the demands often associated with prematurity, the preterm infant generally requires hospitalisation, in many cases for prolonged periods. In addition, the preterm infant's system and organ immaturity can lead to difficulty in adapting to life in its neuropsychomotor development, which may cause delays and extrauterine alterations in the long term (Ministério da Saúde, 2011a).
According to the synactive theory of newborn behavioural organisation and development (Als, 1982), the adaptation of the preterm infant to the neonatal intensive care unit (NICU) environment varies according to his or her ability to change their behaviour in response to a stimulus; to achieve a well-regulated balance; and to maintain the energy required to sustain life. This theory is divided into five subsystems: physiological, motor, behavioural state, attention, and interaction and regulatory (Ministério da Saúde, 2011a). Neuropsychomotor development is the result of a number of factors inherent to the preterm infant and his or her environment, which influence behaviour (Rodrigues and Bolsoni-Silva, 2011).
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