Hiperbilirubinemisi olan yenidoğanlara uygulanan bebek masajının bilirubin seviyesi ve cilt nemine etkisi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Araştırma hiperbilirubinemisi olan yenidoğanlarda bebek masajının bilirubin seviyesi ve cilt nemine etkisini belirlemek amacıyla klinik, randomize kontrollü deneysel tasarımlı çalışma olarak yapılmıştır. Araştırma Düzce Üniversitesi Sağlık Uygulama ve Araştırma Merkezi Yenidoğan Ünitesinde Aralık 2021- Ağustos 2022 tarihleri arasında gerçekleştirilmiştir. Araştırmanın örneklemini, yapılan güç analizi sonucuna göre, araştırmaya katılma kriterlerine sahip 60 term yenidoğan (masaj grubu: 30; kontrol grubu: 30) oluşturmuştur. Çalışmanın veri toplama sürecinde anne ve bebeği tanıtıcı bilgi formu, bebek izlem formu, transkütan bilirubinometre ve nemölçer cihazı kulllanılmıştır. Deney grubundaki yenidoğanlara 2 gün boyunca günde 3 kez 15 dk (dakika) masaj uygulanmıştır. Masajdan 15 dk önce ve masajdan 5 dk sonra bebeklerin fizyolojik parametreleri (kalp tepe atımı, solunum, oksijen saturasyonu ) değerleri ölçülerek veri toplama formuna kaydedildi. Ayrıca uygulama öncesi, uygulamadan 24 ve 48 saat sonra bebeğin kilosu, cilt nem oranı, transkütan bilirubin düzeyi ve defakasyon sıklığı değerleri alındı ve kaydedildi. Kontrol grubundaki yenidoğanlara klinik bakım ve tedavileri dışında bir uygulama yapılmamış olup izlem başladığında kilo, fizyolojik parametreler, cilt nem oranı, transkutan bilirubin düzeyi ve defekasyon sıklığı değerleri alındı. Yine kontrol grubunda da deney grubundaki masaj uygulaması sırasında alınmış olan fizyolojik parametre ölçümleri eş zamanlı olarak alınmıştır. Süreç başladıktan 24 ve 48 saat sonraki günlük defekasyon sıklığı, kilo, cilt nem oranı ve transkütan bilirubin seviyesine bakılarak veri toplama formuna kaydedildi. Çalışmadan elde edilen verilerin değerlendirilmesinde kategorik değişkenler için sayı, yüzde, sayısal değişkenler için ise ortalama, standart sapma kullanılmış, analiz için ise Ki Kare analizi, Fisher's Exact test, Mann Whitney U, Wilcoxon analizi, Friedman Analizi kullanılmıştır. Araştırma verileri incelendiğinde masaj grubunda (10,17±1,70) kontrol grubuna (11,44±1,78) ölçülen 48 saat sonraki bilirubin seviyeleri istatistiksel açıdan anlamlı bulunmuş ve masaj grubunda bilurubin seviyesinin daha düşük olduğu gözlenmiştir (p<0,05). Masaj grubunun 48 saat sonraki defekasyon ortalaması kontrol grubuna kıyasla daha fazladır ve istatistiksel olarak anlamlıdır (p<0,05). Her iki grubun cilt nem oranı ortalamaları karşılaştırıldığında istatiksel olarak anlamlı bir fark bulunamamıştır (p>0,05). Sonuç olarak bebek masajının yenidoğanlarda defekasyon sıklığını artırma ve bilirubin seviyesini düşürmekte önemli bir etkiye sahip olduğu gözlenmektedir. Yenidoğanlara uygulanacak bebek masajının bilirubin seviyelerini düşürmede standart tedaviyi destekleyeceği, hospitalizasyonu kısaltacağı, bebeğin fizyolojik sağlığına (fizyolojik parametrelerin stabilizasyonu, boşaltımın kolaylaşması vb) olumlu etki sağlayacağı düşünülmektedir. Bu nedenle yenidoğan hemşirelik bakımında teröpatik bir yöntem olarak kullanılması önerilmektedir.
The study was conducted as a clinical, randomized controlled experimental design study to determine the effect of infant massage on bilirubin level and skin moisture in newborns with hyperbilirubinemia. The research was carried out in Düzce University Health Application and Research Center Neonatal Unit between December 2021 and August 2022. The sample of the study consisted of 60 term newborns (massage group: 30; control group: 30) who met the criteria for participation in the study, according to the results of the power analysis. In the data collection process of the study, a mother and baby information form, baby follow-up form, transcutaneous bilirubinometer and moisture meter device were used. The newborns in the experimental group were massaged 3 times a day for 15 minutes (minutes) for 2 days. Physiological parameters (heartbeat, respiration, oxygen saturation) values of the babies were measured 15 minutes before and 5 minutes after the massage and recorded in the data collection form (6 times). In addition, before the application, 24 and 48 hours after the application, the baby's weight, skin moisture rate, transcutaneous bilirubin level and defecation frequency values were taken and recorded. The newborns in the control group did not receive any treatment other than clinical care and treatment, and weight, physiological parameters, skin moisture ratio, transcutaneous bilirubin level and defecation frequency values were taken when the follow-up began. Again, in the control group, the daily defecation frequency, weight, skin moisture rate and transcutaneous bilirubin level 24 and 48 hours after the start of the process were recorded in the data collection form. In the evaluation of the data obtained from the study, number and percentage were used for categorical variables, mean and standard deviation were used for numerical variables, Chi-square analysis, Fisher's Exact test, Mann Whitney U, Wilcoxon analysis, Friedman analysis were used for analysis. When the research data were examined, the bilirubin levels measured 48 hours later in the massage group (10.17±1.70) and in the control group (11.44±1.78) were found to be statistically significant, and it was observed that the bilirubin level was lower in the massage group (p<0.05). The mean defecation of the massage group after 48 hours was higher than the control group and it was statistically significant (p<0.05). When the mean skin moisture content of both groups was compared, no statistically significant difference was found (p>0.05). As a result, it is observed that infant massage has a significant effect on increasing the frequency of defecation and decreasing the bilirubin level in newborns. It is thought that infant massage to be applied to newborns will support standard treatment in reducing bilirubin levels, shorten hospitalization, and provide a positive effect on the physiological health of the baby (stabilization of physiological parameters, facilitating evacuation, etc.). Therefore, it is recommended to be used as a therapeutic method in neonatal nursing care.
The study was conducted as a clinical, randomized controlled experimental design study to determine the effect of infant massage on bilirubin level and skin moisture in newborns with hyperbilirubinemia. The research was carried out in Düzce University Health Application and Research Center Neonatal Unit between December 2021 and August 2022. The sample of the study consisted of 60 term newborns (massage group: 30; control group: 30) who met the criteria for participation in the study, according to the results of the power analysis. In the data collection process of the study, a mother and baby information form, baby follow-up form, transcutaneous bilirubinometer and moisture meter device were used. The newborns in the experimental group were massaged 3 times a day for 15 minutes (minutes) for 2 days. Physiological parameters (heartbeat, respiration, oxygen saturation) values of the babies were measured 15 minutes before and 5 minutes after the massage and recorded in the data collection form (6 times). In addition, before the application, 24 and 48 hours after the application, the baby's weight, skin moisture rate, transcutaneous bilirubin level and defecation frequency values were taken and recorded. The newborns in the control group did not receive any treatment other than clinical care and treatment, and weight, physiological parameters, skin moisture ratio, transcutaneous bilirubin level and defecation frequency values were taken when the follow-up began. Again, in the control group, the daily defecation frequency, weight, skin moisture rate and transcutaneous bilirubin level 24 and 48 hours after the start of the process were recorded in the data collection form. In the evaluation of the data obtained from the study, number and percentage were used for categorical variables, mean and standard deviation were used for numerical variables, Chi-square analysis, Fisher's Exact test, Mann Whitney U, Wilcoxon analysis, Friedman analysis were used for analysis. When the research data were examined, the bilirubin levels measured 48 hours later in the massage group (10.17±1.70) and in the control group (11.44±1.78) were found to be statistically significant, and it was observed that the bilirubin level was lower in the massage group (p<0.05). The mean defecation of the massage group after 48 hours was higher than the control group and it was statistically significant (p<0.05). When the mean skin moisture content of both groups was compared, no statistically significant difference was found (p>0.05). As a result, it is observed that infant massage has a significant effect on increasing the frequency of defecation and decreasing the bilirubin level in newborns. It is thought that infant massage to be applied to newborns will support standard treatment in reducing bilirubin levels, shorten hospitalization, and provide a positive effect on the physiological health of the baby (stabilization of physiological parameters, facilitating evacuation, etc.). Therefore, it is recommended to be used as a therapeutic method in neonatal nursing care.
Açıklama
Anahtar Kelimeler
Hemşirelik, Nursing
