| Learning Objective #1: Discuss factors that affect the time required to recover to baseline heart rate and oxygen saturation rates following multiple caregiving activities | |||
| Learning Objective #2: Explain caregiving interventions to reduce recovery time following caregiving activities with preterm infants |
DESIGN: Longitudinal descriptive comparative.
POPULATION: A convenience sample of 81 preterm infants in four age groups were recruited from a Level III NICU between 1999-2001.
CONCEPTS: Theoretical model combined Levine's (1967) Conservation Model and Als (1982) Synactive Theory of Development. Biobehavioral variables: heart rate, oxygen saturation, and infant behaviors. Contextual variables: gestational age at treatment, severity of illness, maternal age and smoking history, duration of cluster, and number of painful procedures.
METHODS: Computer acquisition of physiological data synchronized with real time video recordings from 4 cameras captured caregiving activities and infant behavior for 4 hours every day during the first week of life, and weekly thereafter until discharge. Caregiving clusters (multiple caregiving activities provided without a 2 minute rest period between activities) were coded from the videotapes into 3 epochs: ten minute baseline, cluster, and twenty minutes following end of cluster. Data analysis included logistic regression, stepwise regression, and descriptive statistics.
FINDINGS: More than one thousand clusters were studied. Gestational age at treatment (GESTAT) was the best predictor of recovery to baseline for oxygen saturation, and both GESTAT and painful procedures within the caregiving clusters predicted recovery to baseline heart rate. A twenty minute rest period was adequate for most infants, but approximately one fifth failed to recover within twenty minutes.
CONCLUSIONS: Younger gestational age infants and those who experienced a painful procedure within the cluster were the least likely to recover within the twenty minute recovery period.