Abstract:

Objective To design a multisensory supported device and evaluate its effectiveness on preterm infants（born before 34 weeks） during NICU hospitalization. Methods The multisensory supported device is composed of a basement，several soft cushions and an adjustable eye mask. The inner layer of the device comprises of the head and tail boundaries，serves as uterine wall-like circular boundaries. The outer skeleton is equipped with multisensory stimulation modules to provide visual，hearing，and tactile sensory stimulations for premature infants. The study was conducted in a NICU of a tertiary A children specialist hospital in Shanghai，China. The convenience sampling method was used and based on the ratio of 1∶2 between the experimental and the control group in this study. The control group was treated by standard nursing care，while the experiment group was treated with the multisensory supported device in addition to NICU conventional care. All infants were assessed during the week of admission and again at corrected gestational age of 36 weeks. The actigraphy watch which was used for 72 hours continuous record of the activities of study infants，allows the researcher to compare the activity scores，wakefulness and sleep indicators of 2 groups of infants. Results 71 preterm infants were enrolled in the study，and 60 preterm infants completed data collection for study data analysis，including 20 in the experimental group and 40 in the control group. There were no statistical differences in demographic characteristics and clinical status regarding wakefulness，sleep and physical development between the 2 groups in baseline（P>0.05）. At 36 weeks of corrected gestational age，the activity score of the experimental group was（46.61±12.14） points，and that of the control group was（57.33±18.36） points，with statistically significant differences in 2 groups （P=0.024）. The total waking time of the experimental group was（384.85±169.42） min，and that of the control group was（492.08±220.45） min，with statistically significant differences in 2 groups（P=0.049）. There was no statistical difference in other indicators between 2 groups（P>0.05）. Conclusion The multisensory supported device can reduce high-frequency unpleasant activity as well as frequent wakefulness status，which could promote the sleeping quality of preterm infants. Further studies are needed to verify further effects of the device on premature infants’ physical development.

Key words: Preterm Infant, Multisensory Support, Developmental Support Care, Pediatric Nursing

摘要：

目的 设计宫内环境模拟舱，评价该设备在NICU早产儿中的应用效果。 方法 宫内环境模拟舱包括内、外两层结构，内层结构形似鸟巢，用软体衬垫及全棉衬套包裹，外层设有感官支持功能模块，可播放母亲心音，同时配备可调节式棉质眼罩，可为早产儿提供高仿真母体宫内环境支持。采用便利抽样法，选取2022年4月—2023年2月上海市某三级甲等儿童专科医院NICU收治的出生胎龄<34周的早产儿作为试验组，选取2021年3月—2022年3月收治的早产儿作为对照组，试验组与对照组例数的比例为1∶2。试验组在常规护理的基础上使用宫内环境模拟舱进行护理，对照组使用常规护理。在早产儿入院第1周、矫正胎龄36周时，采用手表式活动记录仪分别进行连续72 h的数据采集，采集指标包括活动度评分、清醒总时长、清醒总次数、睡眠总时长、睡眠片段平均时长、最长一段睡眠片段时长，同时测量早产儿的体重、身长及头围。 结果 共招募71例早产儿，最终60例完成试验，其中试验组20例、对照组40例。矫正胎龄36周时，试验组活动度评分为（46.61±12.14）分，对照组为（57.33±18.36）分，两组比较，差异具有统计学意义（P=0.024）；试验组清醒总时长为（384.85±169.42） min，对照组为（492.08±220.45） min，两组比较，差异具有统计学意义（P=0.049）；其余指标两组比较，差异均无统计学意义（P>0.05）。 结论 使用宫内环境模拟舱可降低早产儿的活动度、减少清醒总时长，但对体格发育的影响还有待进一步研究。

关键词: 早产儿, 多感官支持, 发育支持照顾, 儿科护理学