Duygu Gözen

Heat Loss Prevention (Help) After Birth in Preterm Infants Using Vinyl Isolation Bag or Polyethylene Wrap

OBJECTIVE To examine the effects of using vinyl isolation bags or polyethylene wrap for the prevention of postnatal hypothermia in preterm infants at ≤ 32 weeks gestation. DESIGN A prospective, randomized controlled trial. SETTING The neonatal intensive care unit (NICU) of the Istanbul Faculty of Medicine in Turkey. PARTICIPANTS Fifty-nine preterm infants. METHODS Participants were randomly assigned to either the vinyl isolation-bag experimental group (n = 22) or the polyethylene-wrap control group (n = 37). Infant body temperature was measured at four time points after birth. RESULTS Loss of body temperature was significantly less in the vinyl isolation-bag group during the first 60 minutes after birth (p = .041). Body temperature decreased by 1.41 ± 1.65 °C in the vinyl isolation-bag group and 2.75 ± 1.68 °C in the polyethylene wrap group. Body temperature was significantly less in the polyethylene wrap group compared to the vinyl isolation-bag group at birth to 60 minutes (p = .004). CONCLUSION Wrapping preterm infants of gestational age ≤ 32 weeks in vinyl bags immediately after birth is associated with lower incidences of hypothermia.

Diaper dermatitis care of newborns human breast milk or barrier cream

AIMS AND OBJECTIVES To establish the effectiveness of human breast milk and barrier cream (40% zinc oxide with cod liver oil formulation) applied for the skincare of newborns in the neonatal intensive care unit on the healing process of diaper dermatitis. BACKGROUND Diaper dermatitis is the most common dermatological condition in newborns who are cared for in the neonatal intensive care unit. Recently, there are several kinds of complementary skincare methods suggested for newborns, such as sunflower oil, human breast milk, etc. Also, some chemical formulations are still being used in many neonatal intensive care units. DESIGN Randomised controlled, prospective, experimental. METHODS This study was carried out with a population including term and preterm newborns who developed diaper rash while being treated in the neonatal intensive care unit of a university hospital in Istanbul between February-October 2010. On completion of the research, a total of 63 newborns from human breast milk (n = 30) and barrier cream (n = 33) groups were contacted. RESULTS Genders, mean gestation weeks, feeding method, antibiotic use, diaper area cleansing methods, diaper brands and prelesion scores of newborns in both groups were found to be comparable (p > 0·05). There was no statistically significant difference (p = 0.294) between the groups in terms of mean number of clinical improvement days, but postlesion score of the barrier cream group was statistically significantly lower (p = 0·002) than the human breast milk group. CONCLUSION Barrier cream delivers more effective results than treatment with human breast milk, particularly in the treatment of newborns with moderate to severe dermatitis in the result of the study. RELEVANCE TO CLINICAL PRACTICE This study will shed light on nursing care of skin for newborns who are treated in neonatal intensive care unit.

Effects of swaddled and traditional tub bathing methods on crying and physiological responses of newborns

PURPOSE The purpose of this study was to examine the effects of two bathing methods on crying duration and physiological measurements of newborns. DESIGN AND METHODS A randomized trial design was used in this study. The sample consisted of newborns (n = 80) who were admitted to neonatal intensive care unit of a university hospital located in a large city. The groups were determined as swaddled bathing (SB) (n = 40) and traditional tub bathing (TTB) (n = 40) by using random number table. All newborns were bathed 24 hours after the birth. Environmental variables were organised identically in both experimental and control groups. Duration of bathing was determined as maximum 5 min in both groups. Body temperature, heart rate (HR), and O2 saturation values were evaluated before bath, just after the bath and at 10 min after the bath. The groups were compared in terms of all vital symptoms and duration of crying during bath. Pre-bath and post-bath stress levels between newborns in both groups were compared by using the Newborn Infant Pain Scale (NIPS). RESULTS When the newborns were compared based on groups, it was observed that there was no statistically significant difference between SB and TTB groups in terms of the gestational week, APGAR score, postnatal age, and body weight. Body temperatures of the newborns in SB group just after the bath and 10 minutes after the bath were significantly higher than those in TTB group. HR was higher in TTB group in the post-bath period. NIPS scores of the newborns in SB group after bath decreased at a statistically significant level, but the scores of the newborns in TTB group increased. The results of the study indicated that SB was effective in maintaining body temperature, SpO2 level, and HR of newborns within normal limits and may decrease stress experienced during the bath. PRACTICE IMPLICATIONS Swaddled bathing decreases behavioural stress symptoms such as crying, agitation, and pulling arms and legs back unintentionally and thus the infants feel relaxed. Swaddled bathing can be recommended because swaddled bathing method decreases behavioural stress symptoms in infants.

The Effect of Foot Reflexology on Acute Pain in Infants: A Randomized Controlled Trial

AIM This study was a randomized controlled trial designed to evaluate the effect of foot reflexology applied on infants on acute pain that may arise after vaccine injection. METHODS The sample consisted of 1- to 12-month-old infants registered in a family health center in Istanbul, Turkey, for healthcare follow-up. A total of 60 infants who met the criteria of the sample group were included in the study; 30 infants constituted the reflexology group and the other 30 constituted the control group. Although questionnaire forms were used to determine the descriptive characteristics of infant-mother pairs, the Face, Legs, Activity, Cry, Consolability (FLACC) Pain Assessment Scale was used to evaluate pain level. Infants in the reflexology group received reflexology treatment for an average of 20-30 minutes before vaccination, depending on the physical size of the infants foot. Pain, heart rate, oxygen saturation levels, and crying periods of infants in the reflexology and control groups were evaluated before and after vaccination. RESULTS The FLACC pain score was observed to be statistically similar between groups. After reflexology was applied to infants in the reflexology group before vaccination, it was determined that the pain score was reduced to .50 ± 1.14. In the examination performed after vaccination, FLACC pain score was found to be 5.47 ± 2.11 in the reflexology group and 9.63 ± .85 in the control group. A statistically significant difference was observed between the mean FLACC pain scores of infants in the reflexology and control groups (p = .000). The infants in the reflexology group also had lower heart rates, higher oxygen saturation, and shorter crying periods than the infants in the control group (p <.001). LINKING EVIDENCE TO ACTIONS Reflexology before vaccine reduced the pain level experienced after vaccination. Future research needs to explore different interventional practices.Aim This study was a randomized controlled trial designed to evaluate the effect of foot reflexology applied on infants on acute pain that may arise after vaccine injection. Methods The sample consisted of 1- to 12-month-old infants registered in a family health center in Istanbul, Turkey, for healthcare follow-up. A total of 60 infants who met the criteria of the sample group were included in the study; 30 infants constituted the reflexology group and the other 30 constituted the control group. Although questionnaire forms were used to determine the descriptive characteristics of infant-mother pairs, the Face, Legs, Activity, Cry, Consolability (FLACC) Pain Assessment Scale was used to evaluate pain level. Infants in the reflexology group received reflexology treatment for an average of 20–30 minutes before vaccination, depending on the physical size of the infants foot. Pain, heart rate, oxygen saturation levels, and crying periods of infants in the reflexology and control groups were evaluated before and after vaccination. Results The FLACC pain score was observed to be statistically similar between groups. After reflexology was applied to infants in the reflexology group before vaccination, it was determined that the pain score was reduced to .50 ± 1.14. In the examination performed after vaccination, FLACC pain score was found to be 5.47 ± 2.11 in the reflexology group and 9.63 ± .85 in the control group. A statistically significant difference was observed between the mean FLACC pain scores of infants in the reflexology and control groups (p = .000). The infants in the reflexology group also had lower heart rates, higher oxygen saturation, and shorter crying periods than the infants in the control group (p <.001). Linking Evidence to Actions Reflexology before vaccine reduced the pain level experienced after vaccination. Future research needs to explore different interventional practices.

The Prevalence of Diurnal Urinary Incontinence and Enuresis and Quality of Life: Sample of School

PURPOSE Enuresis can cause loss of self-esteem in children, change relations with family and friends, and decrease the school success. This study was conducted to determine the prevalence of urinary incontinence (UI) in school children aged between 11-14 years and identify the emotions and social problems of enuretic children. MATERIALS AND METHODS A mixed methods approach was used on a group of students who reported UI by combining quantitative data from school population-based cross-sectional design with qualitative data using in-depth interview techniques. The data of this descriptive and cross-sectional study were collected from 2750 primary school students aged between 11-14 years in Istanbul. RESULTS The overall prevalence of UI was 8.6% and decreased with age. Prevalence of the diurnal enuresis in children was 67.9% and all of them had non-monosymptomatic enuresis. 83.3% of the children were identifiedwith secondary enuresis for 1-3 years. UI was significantly more common in boys and those who had frequent urinary infections, whose first degree relatives had urinary incontinence problem in childhood, and who reportedlow socioeconomic level in the family. The emotional and social effects of urinary incontinence were given in the context of childrens own expressions. CONCLUSION Urinary incontinence is an important problem of school-age children. In this study the prevalence of UI was found to be 8.6%, diurnal UI and secondary enuresis were very common, and all of the children werenon-monosymptomatic. Enuresis has negative emotional and social effects on children.