A Randomized Controlled Trial of Early Kangaroo Care for Preterm Infants-- Effects on Temperature, Weight, Behavior, and Acuity_

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題名：	A Randomized Controlled Trial of Early Kangaroo Care for Preterm Infants-- Effects on Temperature, Weight, Behavior, and Acuity
書刊名：	The Journal of Nursing Research
作者：	卓妙如／黃秀華／朱德明／Andersonk,Gene C.／Good,Marion／Dowling,Donna A.
作者(外文)：	Chwo, Miao-ju／H. Shiau, Shiow-hwa／Chu, Der-ming
出版日期：	2002
卷期：	10:2
頁次：	頁129-142
主題關鍵詞：	早產兒；袋鼠式護理；隨機控制試驗；Preterm infant；Kangaroo care；Randomized controlled trial
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(5) 博士論文(0) 專書(0) 專書論文(0) 排除自我引用:5 共同引用:0 點閱:76

大多數有關於早產兒袋鼠式護理的研究設計是採取一組重覆測量設計(one-group repeated measure design)。此種研究設計由於缺代對照的控制組，因此前測及後測的改變都可能是因環境的變數或個案本身的變異所造成的(Kirk, 1995)。本研究採取有實驗組與控制組的隨機控制試驗(randomized controlled trial)以檢定本研究的假設，即袋鼠式護理組的早產兒比控制組的早產兒能維持較高的及穩定的體溫，體重減輕的程度較低，行為狀態較穩定，以及住院天數較短。本研究經由Conlon和Anderson (1990)所設計的電腦程式(minimization program)於早產兒出生後隔天開始，即將34對研究母兒隨機分配到袋鼠式護理組或控制組。此電腦程式能藉由分層化(stratification)使兩組樣本的特性趨於均衡，本研究分層化的變項包括：早產兒性別、出生體重、出生方式及母親生產次數。本研究結果顯示袋鼠式護理組的早產兒比控制組的早產兒能維持較高及穩定的體溫(37.3℃ vs. 37.0℃)，其行為狀態較穩定(62% vs. 22%)且較少哭泣(2% vs. 6%)，p=.000；而兩組早產兒的體重以及住院天數則無差異。本研究發現可做為實證護理臨床應用之參考，且有助於醫護人員教導及鼓勵早產兒母親，藉由皮膚接觸的方式協助早產兒維持體溫，以及早產兒自我統制式的餵食方法。

以文找文

Kangaroo care (KC) has been the intervention for preterm infants in numerous published studies. However, most well designed studies to date have used a one-group repeated measure design. This methodology is not as definitive as an experimental design. Because of the absence of a comparable control group, change between pretest and posttest may be due to any other environmental variables or normal variation of subjects (Kirk, 1995). This randomized controlled trial (RCT) was done to test the hypotheses that KC infants would have higher mean tympanic temperatures, less weight loss, more optimal behavioral states, and lower acuity (length of stay). Thirty-four eligible mother-infant dyads were randomly assigned to the KC or the control group by computerized minimization on the day following birth. Stratification variables included infant gender, birth weight, delivery method, and parity. KC infants compared to control infants had higher mean tympanic temperature (37.3℃ vs. 37℃), more quite sleep (62% vs. 22%), and less crying (2% vs. 6%) all at p = .000. No significant difference was found for weight loss and acuity (length of stay). These findings can be used for evidence-based nursing practice in Taiwan. With the knowledge attained from this RCT, nurses can educate and motivate mothers to keep their stable preterm infants warm by skin-to-skin Constance inside their clothing, thereby encouraging self-regulatory feeding.

以文找文

期刊論文
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6.	Gill, N. E.、Behnke, M.、Conlon, M.、McNeely, J. B.、Anderson, G. C.(1988)。Nonnutritive sucking and behavioral state in preterm infants before feeding。Nursing Research，37，347-350。
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9.	Ludington-Hoe, S. M.、Anderson, G. C.、Rey, H.、Argote, L. A.、Hosseini, B.(1992)。Transitional physiology and state behavior of Colombian preterm infants in skin-to-skin (kangaroo) care and open-air cribs beginning in the delivery room。Infant Behavior and Development，15，537。
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14.	Anderson, G. C.(1989)。Risk in Mother-Infant Separation Postbirth。Image: Journal of Nursing Scholarship，21(4)，196-199。
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16.	Anderson, M. H.(1990)。Evaluation of an Infrared Tympanic Membrane thermometer in Pediatric patients。Pediatrics，85(5)，854-858。
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21.	Charpak, N.、Ruiz-Pelaez, J. G.、De Calume, Z. F.、Charpak, Y.(1997)。Kangaroo Mother Versus Traditional Care for Newborn Infants ≤2000 Grams: A Randomized, Controlled Trial。Pediatrics，100(4)，682-688。
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26.	Dombrowski, M. A.、Anderson, G. C.、Santori, C.、Burkhammer, M.(2001)。Kangaroo (Skin-to-Skin) Care with a Postpartum Woman Who Felt Depressed。The American Journal of Maternal/Child Nursing，26(4)，214-216。
27.	Hadeed, A.、Ludington, S.、Siegel, S.(1995)。Skin-to-Skin Contact (SSC) Between Mother and Infant Reduces Idiopathic Apnea of Prematurity。Pediatric Research，37(4, Pt. 2)。
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會議論文
1.	Syfrett, E. B.、Anderson, G. C.、Neu, J.、Behnke, M.、Hilliard, E. M.(199610)。Very early kangaroo care beginning at birth for healthy preterm infants and mothers who choose to breastfeed: Effects on outcome。The workshop on the kangaroo-mother method for low birthweight infants。Trieste：World Health Organization, Maicrnal-Child Health Collaborating Center。
2.	Ludington, S. M.、Ferrerira, C.、Wang, J. I. J.(1995)。Preliminary cardiorespiratory, thermal, and behavioral outcomes for 10 days of skin-to-skin contact for incubator care premature infants。Petaluma, CA。
3.	黃秀華、Anderson, G. C.(1997)。Randomized controlled trial of kangaroo care with fullterm infants: Effects on maternal anxiety, breast milk maturation, breast engorgement, and breastfeeding status。Sydney, Australia。

圖書
1.	Cohen, J.(1988)。Statistical power and analysis for the behavioral sciences。Hillsdale, NJ：Lawrence Erlbaum Associates。
2.	Anderson, Gene Cranston(1999)。Kangaroo Care of the Premature Infant。Nurturing the Premature Infant: Developmental Interventions in the Neonatal Intensive Care Nursery。New York, NY。
3.	Anderson, G. C.、Behnke, M.、Gill, N. E.、Conlon, M.、Measel, C. P.、McDonie, T. E.(1990)。Self-Regulatory Gavage-to-Bottle Feeding for Preterm Infants: Effects on Behavioral State, Energy Expenditure, and Weight Gain。Key Aspects of Recovery: Improving Nutrition, Rest, and Mobility。New York, NY。
4.	(1993)。Comprehensive Neonatal Nursing: A Physiologic Perspective。Comprehensive Neonatal Nursing: A Physiologic Perspective。Philadelphia, PA。

圖書論文
1.	Anderson, G. C.(1995)。Touch and the kangaroo care method。Touch in early development。Mahwah, NJ：Erlbaum。

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