İnfant Stress
Conditions
Keywords
newborn, stress, care, nurse, soothing voice
Brief summary
The aim of this study is to determine the effect of verbal soothing applied by the researcher during routine nursing care in the neonatal intensive care unit on neonatal stress and physiological parameters. Newborns will be divided into two groups, an intervention group and a control group, using simple randomization. Verbal soothing will be applied to the intervention group during routine nursing care (eye care, oral care, diaper changing, probe placement, weight measurement, body care), while no intervention will be performed on the infants in the control group; only routine care procedures will be applied.
Interventions
BEHAVIORALvocal soothing
Prior to the afternoon routine care in the Neonatal Intensive Care Unit, baseline assessments will be completed by the selected clinical nurse using the Neonatal Stress Scale and Neonatal Follow-up Form. During the approximately 10-minute routine care procedure (eye care, oral care, diaper change, probe repositioning, and weight measurement), the investigator will administer a verbal reassurance intervention. The intervention involves speaking to the newborn calmly, reassuringly, and lovingly from a distance of approximately 20 cm, maintaining eye contact and minimizing environmental stimuli. The volume will be kept between 45-60 dB. Outcome measurements will be repeated by the same nurse 5 minutes after the start of care and 5 minutes after the completion of care.
Sponsors
Aydin Adnan Menderes University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Verbal soothing intervention in the neonatal intensive care unit is based on the principle of a nurse speaking to the baby from a distance of approximately 20 cm, without a mask, using a calm and compassionate tone of voice and making eye contact. The intervention is applied during routine care (cleaning, diapering, weighing, etc.) and aims to provide the baby with a sense of security, calmness, and continuity. The nurse uses encouraging and loving expressions, mentioning the baby's name; environmental stimuli (noise, light) are reduced throughout the intervention, and the sound level is kept between 45-60 dB. The standard care process remains unchanged; only verbal soothing communication is added.
Eligibility
Sex/Gender
ALL
Age
0 Days to 28 Days
Healthy volunteers
No
Inclusion criteria
* Newborns with a gestational age between 32 0/7 and 36 6/7 weeks * Newborns with an APGAR score above 6 at 5 minutes * Newborns weighing over 1000 grams * Newborns not on mechanical ventilation * Newborns who have been fed at least one hour prior to care * Newborns cared for in an incubator * Newborns who have passed the hearing test
Exclusion criteria
* Presence of a condition that prevents the assessment of stress and physiological parameters (birth trauma, intracranial hemorrhage, congenital anomaly, etc.), * Undergoing an invasive procedure that causes different stress at least one hour before the care (intravenous access, aspiration procedure, etc.), * Administration of sedatives, opioids, and anticonvulsant drugs before the care.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Neonatal Stress Assessment Scale | The Neonatal Stress Scale will be completed by a pre-assigned nurse approximately 1 minute before care begins, 5 minutes after care starts, and 1 minute after care ends. The same nurse will then complete the stress scale and the newborn follow-up form. | The Neonatal Stress Assessment Scale (NISS) was developed by Ceylan and Bolışık (2017) to assess stress levels in premature infants. The scale consists of 24 items on a 3-point Likert scale, comprising 8 subgroups including facial expression, body color, breathing, activity level, soothing ability, muscle tone, extremities, and posture. Each subgroup is scored from 0 to 2 points. The minimum score is 0, and the maximum is 16. A high score indicates increased stress. The scale is evaluated through observation. It is sufficient for the infant to exhibit only one behavior from each cell in their free-standing space. A high value is valid if the infant exhibits behaviors from two different cell types (for example, if the infant shows signs corresponding to both 1 and 2 points). A stable and regular state indicates a high value of 0. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PHYSIOLOGICAL PARAMETERS | Routine nursing care will last approximately 10 minutes. The information sheet will be filled out by a nurse selected from the clinic 1 minute before, in the middle of, and 5 minutes after the routine nursing care for newborns. | The newborn care duration, oxygen saturation, and pulse of newborns in the intervention and control groups will be recorded using the newborn follow-up form. |
Contacts
CONTACTEgenaz G Yaman
Outcome results
None listed