Investigation of the Effect of Massage on Stress Behaviors and Salivary Cortisol Levels in Premature Infants
Project no. 23654 · Status: Kapanmış (Yayın bekleniyor) · 2022
Summary
<p><strong>Aim: </strong>This study was conducted to investigate the effect of massage on stress behaviors and salivary cortisol levels in premature infants.</p><p><strong>Methods: </strong>The study was conducted in randomized controlled experimental design. The sample of the study consisted of a total of 40 premature infants who were treated and cared for in the Neonatal Intensive Care Unit of the “T.C. Ministry of Health, Izmir Provincial Health Directorate of Health Sciences University Izmir Tepecik Training and Research Hospital” between June 2022 and June 2023. Data were collected using the “Premature Infant Introductory Information Form”, “Premature Infant Follow-up Form”, and “Newborn Stress Scale (NSS)”. The infants in the massage group were massaged by the researcher once a day for 10 minutes. The infants in the massage group were massaged by the researcher once a day for 10 minutes. The infants in the swaddling group were wrapped by the researcher once a day for 10 minutes. The vital signs (heart rate, respiratory rate, oxygen saturation, body temperature) of the infants in both the massage group and the swaddling group were recorded 1 min before the process, 5 min during the application and 1 min after the end of the process (massage and swaddling) and video camera recording was made during these processes. The video recording after the processes for both groups were watched by two specialists and the Newborn Stress Scale (NSS) was scored. Saliva samples were taken from premature infants in the massage and swaddling group 5 minutes before and 30 minutes after the process. The collected samples were centrifuged and stored at -80˚C. After the end of the data collection process, salivary cortisol levels were determined manually by enzyme immunoassay (ELISA) method using the commercial kit "Expanded Range High Sensitivity Salivary Cortisol Enzyme Immunoassay Kit". The conformity of the data to normal distribution was examined by Shapiro-Wilk test. Chi-square test, Yates correction and Fisher's Exact test, Mann-Whitney U test, Independent two sample t test, Generalized linear model method, Robust ANOVA and intraclass correlation coefficient were used to evaluate the data.</p><p><strong>Results: </strong>It was found that there was no statistically significant difference between the trimmed mean of NSS score in the massage and swaddling groups (p>0.05). The cortisol median of the massage group was 0.259 μg/dL and the cortisol median of the swaddling group was 0.342 μg/dL. There was no difference between the salivary cortisol medians of the massage group and the swaddling group (p>0.05). There was no statistically significant difference between the median cortisol values according to the interaction of group and time (p>0.05). There was no difference between the median salivary cortisol values of the massage group before and after the procedure, and there was no difference between the median salivary cortisol values of the swaddling group before and after the procedure. A statistically significant difference was found between the mean heart rate and mean body temperatures of the massage and swaddling groups (p<0.05). It was determined that the median respiratory rate of the massage and swaddling groups did not differ (p>0.05). A statistically significant difference was found between the SpO2 medians of premature infants in the massage and swaddling group (p<0.05).</p><p><strong>Conclusion:</strong> Both massage and swaddling have a positive effect on reducing the stress of premature babies. It is recommended that massage and swaddling methods, which are developmental care approaches, should be applied by neonatal nurses to reduce the stress of premature infants treated in neonatal intensive care units.</p><p><strong>Keywords</strong>; premature infant; massage; stress; salivary cortisol</p>