Effects of Swaddled and Sponge Bathing Methods on Signs of Stress and Pain in Premature Newborns: Implications for Evidence-Based Practice

Abstract

Aims: To determine the effects of sponge baths and swaddled bathing on premature infants' vital signs, oxygen saturation levels, crying times, pain, and stress levels.

Methods: This study was a clinical trial with a crossover design. Data were conducted in the neonatal intensive care unit of a public hospital in Denizli, Turkey. A total of 35 premature infants, who were born at 33-37 weeks gestation with a birth weight <1,500 g, were enrolled in the study. Two bathing methods were applied at 3-day intervals. Vital signs and oxygen saturation levels were measured before and at minutes 1, 5, 15, 30 after bathing. Infants' bathing was video recorded to assess pain and stress behaviors. The pain and stress behaviors of infants were evaluated by independent observers. A significance level of .05 was used for all statistical analyses.

Results: There were statistically significant differences between bathing methods on vital signs, oxygen saturation levels, and crying times. Levels of stress and pain according to bathing type were significantly higher in the sponge bath condition (p < .05).

Linking evidence to action: Swaddled bathing has a positive effect on the infant's vital signs, oxygen saturation levels, crying time, and level of stress and pain compared to the sponge bath condition. Swaddled bathing is a harmless and safe nursing practice.

Keywords: individualized developmental care; newborn; nursing care; pain; prematüre; stress.