Integrative Care Therapies and Physiological and Pain-related Outcomes in Hospitalized Infants

doi:10.7453/gahmj.2015.029

. 2015 Jul;4(4):32-7.

doi: 10.7453/gahmj.2015.029.

Integrative Care Therapies and Physiological and Pain-related Outcomes in Hospitalized Infants

Elizabeth E Hathaway¹, Christina M Luberto², Lois H Bogenschutz³, Sue Geiss⁴, Rachel S Wasson⁵, Sian Cotton⁶

Affiliations

¹ Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Ohio, United States (Ms Hathaway).
² Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Ohio, United States (Ms Luberto).
³ Division of Child Life and Integrative Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States (Ms Bogenschutz).
⁴ Division of Child Life and Integrative Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States (Ms Geiss).
⁵ Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Ohio, United States (Ms Wasson).
⁶ Division of Child Life and Integrative Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States (Dr Cotton).

PMID: 26331102
PMCID: PMC4533649
DOI: 10.7453/gahmj.2015.029

Integrative Care Therapies and Physiological and Pain-related Outcomes in Hospitalized Infants

Elizabeth E Hathaway et al. Glob Adv Health Med. 2015 Jul.

. 2015 Jul;4(4):32-7.

doi: 10.7453/gahmj.2015.029.

Authors

Elizabeth E Hathaway¹, Christina M Luberto², Lois H Bogenschutz³, Sue Geiss⁴, Rachel S Wasson⁵, Sian Cotton⁶

Affiliations

¹ Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Ohio, United States (Ms Hathaway).
² Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Ohio, United States (Ms Luberto).
³ Division of Child Life and Integrative Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States (Ms Bogenschutz).
⁴ Division of Child Life and Integrative Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States (Ms Geiss).
⁵ Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Ohio, United States (Ms Wasson).
⁶ Division of Child Life and Integrative Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States (Dr Cotton).

PMID: 26331102
PMCID: PMC4533649
DOI: 10.7453/gahmj.2015.029

Abstract
in English, Chinese, Spanish

Background: Pain management is a frequent problem in the neonatal intensive care unit (NICU). Few studies examining effects of integrative care therapies on pain-related outcomes in neonates have included physiological outcomes or investigated the use of such therapies in a practice-based setting.

Objective: The purpose of this practice-based retrospective study was to examine the associations between integrative care therapies, particularly massage and healing touch, and pain-related outcomes among hospitalized infants.

Methods: We conducted a retrospective review of a clinical database from a level III NICU regularly delivering integrative care therapies. Paired-samples t-tests were used to examine associations between integrative care therapies and 4 pre-post outcome measures: therapist-rated pain and presentation (ranging from asleep to agitated) and neonates' heart rate and oxygen saturation.

Results: Of 186 patients (M age=68 days), 58% were male and 67% were Caucasian. Sixty-two percent received both massage and healing touch; the remainder received a single therapy. From pre-post therapy, statistically significant changes were observed in infants' heart rate (M pre=156 vs M post=140 per minute; P<.001), oxygen saturation (M pre=95.0% vs.M post=97.4%; P<.001), and therapist-reported pain (M pre=2.8 vs M post=0.2; P<.001) and presentation (M pre=3.2 vs. M post=1.0; P<.001).

Conclusion: Observed improvements in pain-related outcomes suggest that massage and healing touch may be useful integrative therapies to consider as pain management options in the NICU.

背景：疼痛控制是新生儿重症监护室 (NICU) 经常遇到的一个难题。在评估整合护理疗法对新生儿疼痛相关指标之影响的研究中，几乎没有研究探讨生理指标或评估此类疗法在诊所环境中的应用情况。目的：这项基于实践的回顾性研究旨在分析整合护理疗法，特别是按摩和康复性抚摸，与住院婴儿的疼痛相关指标之间的关系。方法：我们对经常实施整合护理疗法的 III 级 NICU 的临床数据库进行了回顾性审核。我们采用配对样本 t 检验分析了整合护理疗法与以下 4 个治疗前-治疗后评估指标的关系：治疗师评定的疼痛、新生儿的疼痛表现（从睡眠到烦躁不等）、新生儿的心率和血氧饱和度。结果：在 186 名患儿中（平均年龄 = 68 天），有 58% 为男婴，67% 为白种人。62% 接受了按摩联合康复性抚摸，其余仅接受了单一疗法。从治疗前到治疗后，婴儿的心率（治疗前均值 = 156 次/分，治疗后均值 = 140 次/分；p<0.001）、血氧饱和度（治疗前均值 = 95.0%，治疗后均值 = 97.4%；p<0.001）、治疗师评定的疼痛（治疗前均值 = 2.8，治疗后均值 = 0.2；p<0.001）以及疼痛表现（治疗前均值 = 3.2，治疗后均值 = 1.0；p<0.001）均观察到了有统计显著性的改变。结论：疼痛相关指标的改善表明，按摩和康复性抚摸是有效的整合疗法，可考虑作为疼痛控制方案用于 NICU 中。.

Antecedentes: El tratamiento del dolor es un problema frecuente en la unidad de cuidados intensivos neonatales (UCIN). Pocos de los estudios que examinan los efectos de los tratamientos integradores sobre los resultados relacionados con el dolor en neonatos han incluido los resultados fisiológicos o investigado el uso de este tipo de tratamientos en un entorno basado en la práctica.

Objetivo: El objetivo de este estudio retrospectivo basado en la práctica fue examinar la asociación entre los tratamientos integradores de atención, especialmente el masaje y el toque sanador, y los resultados relacionados con el dolor entre los lactantes hospitalizados.

Métodos: Realizamos una revisión retrospectiva de una base de datos clínica de una UCIN de nivel III que proporcionaba regularmente tratamientos integradores de atención. Se utilizaron pruebas t de muestras pareadas para examinar las asociaciones entre los tratamientos integradores de atención y cuatro medidas de resultados anteriores y posteriores: dolor puntuado por el terapeuta y presentación (desde dormido hasta sueño agitado) y frecuencia cardíaca y saturación de oxígeno de los neonatos.

Resultados: De 186 pacientes (Medad = 68 días), el 58 % eran hombres y el 67 % eran de raza caucásica. El 62 % recibió tanto masajes como toque sanador; el resto recibió un solo tratamiento. A partir del tratamiento anterior y posterior, se observaron cambios estadísticamente significativos en la frecuencia cardíaca de los lactantes (Manterior = 156 frente a Mposterior = 140 por minuto; P < 0,001), saturación de oxígeno (Manterior = 95,0 % frente a Mposterior = 97,4%; P < 0,001) y dolor notificado por el terapeuta (Manterior = 2,8 frente a Mposterior = 0,2; P < 0,001) y presentación (Manterior = 3,2 frente a Mposterior = 1,0; P < 0,001).

Conclusión: Las mejoras observadas en los resultados relacionados con el dolor sugieren que el masaje y el toque sanador podrían ser tratamientos integradores útiles a considerar como opciones de tratamiento del dolor en la UCIN.

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References

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[1] Carbajal R, Rousset A, Danan C, et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA. 2008. July 2;300(1):60–70. - PubMed

[2] Carbajal R, Rousset A, Danan C, et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA. 2008. July 2;300(1):60–70. - PubMed

[3] Simons SH, van Dijk M, Anand KS, Roofthooft D, van Lingen RA, Tibboel D. Do we still hurt newborn babies? A prospective study of procedural pain and analgesia in neonates. Arch Pediatr Adolesc Med. 2003. November;157(11):1058–64. - PubMed

[4] Simons SH, van Dijk M, Anand KS, Roofthooft D, van Lingen RA, Tibboel D. Do we still hurt newborn babies? A prospective study of procedural pain and analgesia in neonates. Arch Pediatr Adolesc Med. 2003. November;157(11):1058–64. - PubMed

[5] Taddio A, Shah V, Gilbert-MacLeod C, Katz J. Conditioning and hyperalgesia in newborns exposed to repeated heel lances. JAMA. 2002. August 21;288(7):857–61. - PubMed

[6] Taddio A, Shah V, Gilbert-MacLeod C, Katz J. Conditioning and hyperalgesia in newborns exposed to repeated heel lances. JAMA. 2002. August 21;288(7):857–61. - PubMed

[7] Walker SM. Neonatal pain. Paediatr Anaesth. 2014. January;24(1):39–48. - PMC - PubMed

[8] Walker SM. Neonatal pain. Paediatr Anaesth. 2014. January;24(1):39–48. - PMC - PubMed

[9] Livingston K, Beider S, Kant AJ, Gallardo CC, Joseph MH, Gold JI. Touch and massage for medically fragile infants. Evid Based Complement Alternat Med. 2009. December;6(4):473–82. - PMC - PubMed

[10] Livingston K, Beider S, Kant AJ, Gallardo CC, Joseph MH, Gold JI. Touch and massage for medically fragile infants. Evid Based Complement Alternat Med. 2009. December;6(4):473–82. - PMC - PubMed

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Integrative Care Therapies and Physiological and Pain-related Outcomes in Hospitalized Infants

Affiliations

Integrative Care Therapies and Physiological and Pain-related Outcomes in Hospitalized Infants

Authors

Affiliations

Abstract
in English, Chinese, Spanish

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Cited by

References

LinkOut - more resources

Full Text Sources

Other Literature Sources

Abstract in English, Chinese, Spanish

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References

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Full Text Sources

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Abstract
in English, Chinese, Spanish