Relationships between nurse care-giving behaviours and preterm infant responses during bathing: a preliminary study

Authors

  • Jen-Jiuan Liaw,

    1. Authors:Jen-Jiuan Liaw, PhD, RN, Assistant Professor, School of Nursing, National Defense Medical Center, Taipei, Taiwan; Luke Yang, PhD, Assistant Professor, Department of Social Welfare, Hsuan Chuang University, Hsinchu, Taiwan; Hsiu-Ling Chou, PhD, RN, Assistant Professor and Supervisor, Department of Nursing, Oriental Institute of Technology & Far Eastern Memorial Hospital, Taipei, Taiwan; Meei-Horng Yang, MS, RN, Assistant Director, Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan; Shih-Ching Chao, MSN, RN, Instructor, School of Nursing, National Defense Medical Center, Taipei, Taiwan
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  • Luke Yang,

    1. Authors:Jen-Jiuan Liaw, PhD, RN, Assistant Professor, School of Nursing, National Defense Medical Center, Taipei, Taiwan; Luke Yang, PhD, Assistant Professor, Department of Social Welfare, Hsuan Chuang University, Hsinchu, Taiwan; Hsiu-Ling Chou, PhD, RN, Assistant Professor and Supervisor, Department of Nursing, Oriental Institute of Technology & Far Eastern Memorial Hospital, Taipei, Taiwan; Meei-Horng Yang, MS, RN, Assistant Director, Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan; Shih-Ching Chao, MSN, RN, Instructor, School of Nursing, National Defense Medical Center, Taipei, Taiwan
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  • Hsiu-Ling Chou,

    1. Authors:Jen-Jiuan Liaw, PhD, RN, Assistant Professor, School of Nursing, National Defense Medical Center, Taipei, Taiwan; Luke Yang, PhD, Assistant Professor, Department of Social Welfare, Hsuan Chuang University, Hsinchu, Taiwan; Hsiu-Ling Chou, PhD, RN, Assistant Professor and Supervisor, Department of Nursing, Oriental Institute of Technology & Far Eastern Memorial Hospital, Taipei, Taiwan; Meei-Horng Yang, MS, RN, Assistant Director, Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan; Shih-Ching Chao, MSN, RN, Instructor, School of Nursing, National Defense Medical Center, Taipei, Taiwan
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  • Meei-Horng Yang,

    1. Authors:Jen-Jiuan Liaw, PhD, RN, Assistant Professor, School of Nursing, National Defense Medical Center, Taipei, Taiwan; Luke Yang, PhD, Assistant Professor, Department of Social Welfare, Hsuan Chuang University, Hsinchu, Taiwan; Hsiu-Ling Chou, PhD, RN, Assistant Professor and Supervisor, Department of Nursing, Oriental Institute of Technology & Far Eastern Memorial Hospital, Taipei, Taiwan; Meei-Horng Yang, MS, RN, Assistant Director, Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan; Shih-Ching Chao, MSN, RN, Instructor, School of Nursing, National Defense Medical Center, Taipei, Taiwan
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  • Shih-Ching Chao

    1. Authors:Jen-Jiuan Liaw, PhD, RN, Assistant Professor, School of Nursing, National Defense Medical Center, Taipei, Taiwan; Luke Yang, PhD, Assistant Professor, Department of Social Welfare, Hsuan Chuang University, Hsinchu, Taiwan; Hsiu-Ling Chou, PhD, RN, Assistant Professor and Supervisor, Department of Nursing, Oriental Institute of Technology & Far Eastern Memorial Hospital, Taipei, Taiwan; Meei-Horng Yang, MS, RN, Assistant Director, Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan; Shih-Ching Chao, MSN, RN, Instructor, School of Nursing, National Defense Medical Center, Taipei, Taiwan
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Jen-Jiuan Liaw, Assistant Professor, PhD, RN, 161 Sec. 6 Mingchuan E. Rd, Neihu 114, Taipei, Taiwan. Telephone: 011 886 2 87923100 ext. 18764. E-mail:jiuan@mail.ndmctsgh.edu.tw

Abstract

Aims.  The purpose of this study was to explore the relationships between specific nurse care-giving behaviours and preterm infant behavioural responses during bathing and to identify nurse behaviours associated with infant ‘stress’.

Background.  Although recent advances in medical technology have improved neonatal intensive care, the high mortality and morbidity rates in preterm infants have not decreased proportionally. As caregivers strive to reduce infant mortality and morbidity, a factor for consideration is which caregiver behaviours are associated with preterm infant well-being.

Design.  A descriptive correlational design.

Method.  Convenience samples of 24 preterm infants and 12 nurses were recruited. A total of 120 baths were videotaped. Infant and nurse behaviours were measured using the coding schemes developed by the researchers. Pearson coefficient correlation, non-parametric Kruskal–Wallis test, t-test and generalised linear models were methods for data analysis.

Results.  As nurses provided more support, stress was reduced in the infants, and their self-regulation during the bath was enhanced especially by the use of ‘containment’ and ‘positional support’. Conversely, non-therapeutic caregiver behaviours including ‘rapid and rough handling’ of the baby, ‘chatting with other people’ and ‘inappropriate handling’ increased infant ‘stress’ during the bath.

Conclusion.  The findings provide new information about the link between care-giving and infant responses and how caregivers can better interact with preterm infants during a very sensitive period of brain development.

Relevance to clinical practice.  How nurses take care of the preterm infants influences their responses to care-giving stimuli. To interact better with the infant during care-giving procedures, nurses need to provide more supportive care-giving behaviours especially ‘position support’ and ‘containment’ based on the infant’s needs, and avoid care-giving that may be too rough and occur too quickly without attending the baby’s stressful signals, positioning the baby in hyperextension posture, or chatting with other people during procedures.

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