Yenidoğan bebeklere uygulanan iğneli girişimlerde non farmakolojik ağrı giderme yöntemlerinin etkililiğinin incelenmesi
The efficacy of non-pharmacological pain relief methods for injectional apply in newborn
Yazar: HATİCE BANU AKYÜREK
Danışman: PROF. DR. ZEYNEP CONK
Ege Üniversitesi / Sağlık Bilimleri Enstitüsü / Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
Derece: Yüksek Lisans, 2002
Konu: Hemşirelik = Nursing

Özet:
Kontrol ve çalışma grubundaki bebeklerin İ.SIR. birinci ve ikinci dakikalar için toplam ağrı puan ortalamaları arasındaki fark istatistiksel olarak anlamlı bulunmamıştır. Kontrol ve çalışma grubundaki bebeklerin Î.SON. birinci, ikinci ve üçüncü dakikalardaki toplam ağrı puan ortalamaları arasındaki fark çalışma grubundaki bebeklerin lebine istatistiksel olarak anlamlı bulunmuştur. Kontrol grubundaki bebeklerin İ.Ö., İ.SIR. ve İ.SON. Yenidoğan Ağn Tanılama Skalası Toplam Puan Ortalamaları (YATSTPO) Arasındaki İlişki incelendiğinde; Î.Ö. YATSTPO Be İ.SIR. YATSTPO ve İ.Ö. YATSTPO ile İ.SON. YATSTPO arasında istatistiksel olarak anlamlı bir ilişki saptanmamıştır. İ.SIR. YATSTPO ile Î.SON. YATSTPO arasında pozitif güçlü bir ilişki saptanmıştır. Çalışma grubundaki bebeklerin İ.Ö., İ.SIR. ve İ.SON. Yenidoğan Ağn Tanılama Skalası Toplam Puan Ortalamaları (YATSTPO) Arasındaki İlişki incelendiğinde, İ.Ö. YATSTPO üe İ.SIR., Î.Ö. YATSTPO ile Î.SON., Î.SIR. YATSTPO ile İ.SON. YATSTPO arasında istatistiksel olarak anlamlı bir ilişki saptanmamıştır. Araştırma sonunda; NIPS 'in güvenilir bir ağn tanılama ölçeği olduğu ve non- fârmakolojik ağrı giderme yöntemlerinin yenidoğanda ağn yanıtlarım azaltmada etkili olduğu bulunmuştur. NIPS' in klinikteki kullanım kolaylığından dolayı hemşireler ve diğer sağlık ekip üyeleri tarafmdan yaygın bir şekilde kullanılması, hekim, hemşire, anestezist ve hasta haklan savunucusundan oluşan, yenidoğan ağn tanılama ve yönetim ekibinin oluşturulması önerilmiştir.Anahtar Kelimeler: Ağrı, Yenidoğan Dönemi, Gestasyon Yaşı

Abstract:
This study was planned as discribal and serai-experimental to evaluate the pain responses given to injectional apply (capillary venosus, arterial, heel lance) before, during and after the needle-intrusive procedures by the neonates of 0-4 weekly term (gestational age >37 weeks up to 4 weeks after birth) and to examine the efficiency of non-pharmacologic pain relieve method. The sampling group of the research was 0-4 weekly term (>37 week) newborn in Health Ministry Dr. Behcet Uz Pediatric Diseases Education and Research Hospital Neonatal Clinic between November 2001-June 2002. Observation form of the babies who will be used in applying non-pharmacologic pain remove method, Neonatal Infant Pain Scale scoring form, evaluation scale of result criterions and the form which includes baby's name, gestation age, diagnosis, age at the time of the procedure, type of needle puncture and nurses charesterics (graduation school of the nurse, length of nurses working time in Neonatal Clinic, professional experience length) were used as data coDector tools. The results were evaluated by the number and percent rations, Chi-square, Fisher Exact Chi-square test, One-Way Variance Analysis (ANOVA) and Pearson's Moment Correlation Analysis. According to the results of the study the folio wings were determined; there is no difference in distrubition of the babies'and the nurses' who made injectional apply to the babies introducing features between the control and intervention group. When NIPS total point avarages' distribution was investigated at the first and second moment before the needle puncture, first and second moment during the needle puncture, first, second and third moment after the needle puncture from the view of the introducing features of the babies' and the nurses', no stastistical difference was found between the introducing procedure and the NIPS total point averages. When the control and intervention groups total pain point averages of the babies' evaluated; before, during and after the needle pucture, the difference between the babies' (both in control and intervention groups) total pain point averages at first and second moments before the needle puncture was found to be statistically meaningful in the side of the babies in intervenion group. 135In control and intervention groups, the difference between the babies' total pain point averages at the first and second moments during the needle puncture were not found to be statistically meaningfulL In control and intervention groups, the difference between the babies' total pain point averages at the first, second and third moments after the needle puncture was found to be statistically meaningfull in the side of the babies' in intervention group. In control group, when the relationship between the babies' NIPS total point averages (NIPSTPA) before, during and after needle puncture was evaluated; no significant correlation was found between NIPSTPA before needle puncture and NIPSTPA during needle puncture. It was established that there was a positive strong relationship between NIPSTPA during needle puncture and NIPSTPA after needle puncture. In intervention group, when the relationship between the babies' NIPSTPA was investigated; no significant correlation was found between NIPSTPA before needle puncture and NIPSTPA during needle puncture and between NIPSTPA before needle puncture and NIPSTPA after needle puncture. According to this study; NIPS was founded as a reliable pain assesment scale and the non-pharmacological pain rehef methods were founded effective for minimizing the pain responses in newborn. Using the NIPS by the member of health care team is recommended because of the easy usage. It is also suggested that pain assesment and management team consisting doctor, nurse, anaesthetist and the advocate of patient rights should be formed.Key Words: Pain, Neonatal Term, Gestation Age.