신생아에서 채혈 시 음악제공이 통증행동 반응에 미치는 효과
The Effect of Hearing Music on Pain Response during Blood Sampling in Neonates
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목적: 신생아에서 채혈 중 통증완화를 위한 비약물적 중재방법의 하나인 음악이 통증행동 반응에 미치는 영향을 알아보고자 연구를 시행하였다. 방법: 본 연구의 대상은 2011년 5월 1일부터 9월 30일까지 한양대학교 구리병원의 신생아실과 신생아중환자실에 입원한 신생아로 보호자의 동의를 얻은 신생아 20명을 대상으로 신생아 1명당 2회의 다른 채혈시기에 한 번은 음악을 제공하고(음악군), 다른 한 번은 음악제공 없이(대조군) 채혈한 후 3분간 신생아에 대한 비디오 녹화를 통하여두 군 간에 통증 정도를 비교 평가하였다. 신생아 통증 정도는 신생아 영아 통증척도(neonatal infant pain scale,NIPS)를 이용하였고, 울음지속시간도 함께 측정하였다. 신생아 통증 척도는 신생아실에서 5년 이상 근무한 간호사 두 명이 녹화된 비디오테이프를 보며 점수를 측정하였고, 음악군과 대조군의 통증점수 비교는 t-test를 사용하였다. 결과: 신생아들의 평균나이는 6±5일(1-16일)이었고 채혈 시 평균 재원일수는 3±2일이었으며 평균 재태기간은 38±2주(35-41주)였다. 40회의 채혈 중 요골동맥천자는 21회(52.5%), 발뒤꿈치 채혈은 19회(47.5%)였다. NIPS점수는음악군에서 대조군에 비해 낮았으며(5.6±1.1 vs 6.5±0.7, P＜0.007) 이 중 울음과 팔 움직임에 의미 있는 차이를보였고(울음 1.6±0.5 vs 1.9±0.3, P＜0.03; 팔 움직임 0.3±0.5 vs 0.7±0.5, P＜0.02), 얼굴표정, 호흡양상, 다리움직임, 각성상태, 울음지속시간은 두 군간에 유의한 차이는 없었다. 결론: 신생아 채혈 중 음악이 신생아 통증척도를 감소시켰다. 따라서, 음악이 신생아의 통증 관리를 위한 효율적인 중재 방법의 하나가 될 수 있을 것이다.
Abstract
Purpose: We studied this study to see the effect of hearing music on response to pain during needling. We hypothesized that music would reduce pain in newborns. Methods: Twenty term and near-term newborns were enrolled for the study. They were admitted to neonatal intensive care unit of Hanyang University Guri Hospital from May 1, 2011 to September 30, 2011. We evaluated pain response to needling, such as arterial puncture or heel prick, by using Neonatal Infant Pain Scale (NIPS; facial expression, crying, breathing patterns, arms, legs, state of arousal) and duration of crying through video recording. We started video recording when the newborns were stable with 0 score of NIPS, and continued for 3 minutes after needling. Each newborn took video-recordings in 2 separate periods. One was done with hearing music (Music group) and the other without music (Control group). Two observers reviewed the videotapes and gave final scores in agreement. T-test was done for comparisons of pain scale and duration of crying between music and control groups. Results: Mean age and hospital days at test of the subjects were 6±5 days of life (1-16 days of life) and 3±2 days, respectively. Twenty-one of 40 needlings (52.5%) for blood sample were from radial arterial puncture and 19 (47.5%) from heel prick. The music group had lower NIPS score than the controls (5.6±1.1 vs 6.5±0.7, P=0.006). Among the NIPS parameters, the music group had lower scores in crying and arm (crying, 1.6±0.5 vs 1.9±0.3, P=0.028; arm, 0.3±0.5 vs 0.7±0.5, P=0.01) parameters. The remaining parameters such as facial expression, leg, breathing patterns and state of arousal, and duration of crying were not significantly different in 2 groups. Conclusion: c reduced pain response to needling in newborns. Music could be one of modalities to relieve pain during routine medical procedures in newborns.
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