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Postural support improves distress and pain during diaper change in preterm infants
Comaru T, Miura E
Journal of Perinatology 2009 Jul;29(7):504-507
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To determine the effects of a postural support protocol on the physiological and behavioral stability of preterm infants while undergoing a diaper change. STUDY DESIGN: Forty-seven newborns having a birth weight <= 2,000 g and gestational age <= 35 weeks were included in this randomized, crossover clinical trial in a Neonatology Intensive Care Unit. The infants were observed as his or her own control and evaluated with and without the use of the proposed intervention, which was positioning the baby in a nest produced with rolled-up towels. During the observations, as control, the care model used by the unit was considered. RESULT: All babies displayed increased distress and pain scores during diaper changes. This was significantly less for babies nested compared with non-nested babies (p < 0.0001). CONCLUSION: Diaper change is a distressing procedure for preterm infants. Providing postural support during diaper changes reduces the signs of distress and pain.
Reprinted by permission from Journal of Perinatology, Macmillan Publishers Ltd.

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