The Effect of Positioning on Preterm Infants' Sleep-Wake States and Stress Behaviors During Exposure to Environmental Stressors

Wednesday, 24 July 2013

Li-Chi Huang, EdD, RN1
Li-Li Chen, PhD, RN1
Yu-Shan Chang, BSN, RN2
Niang-Huei Peng, PhD3
(1)School of Nursing, China Medical University, Taichung, Taiwan
(2)China medical University Hospital, Taichung, Taiwan
(3)Nursing department, Nursing College, Central Taiwan University, Taichung, Taiwan

Learning Objective 1: Preterm infants' in the prone position is better for promoting their sleep and deceasing their response to stress after adjusting for environmental stressors.

Learning Objective 2: Positioning and environmental stressors affected sleep-wake states and in part, stress behaviors for infants whose positions were changed between supine and prone in study.

Purpose: This pape is a report of a study of the effects of prone and supine sleeping positions on preterm infants’ sleep-wake states and stress behaviors during exposure to environmental stressors.

Methods: The study design was quasi-experiment, and it was undertaken in 2008. Twenty-two preterm infants were enrolled. Each infant was moved to either the supine or prone position for an hour at a time. Infants were videotaped and the sleep-wake states, stress behaviors and environmental conditions (light, noise, and stimulation/handling) were recorded during the observation period. The Generalized Estimating Equations (GEE) was used to examine the relationships among the research variables.  

Results: A total of 80 observations from 22 infants were accrued. In the supine position, preterm infants demonstrated more frequent waking states after adjusting for various environmental stressors. In addition, these same infants demonstrated more frequent stress behaviors in the supine position after adjusting for various environmental stressors.  

Conclusion: These results suggest that the prone position is a more favorable position for facilitating sleep and reducing stress for preterm infants exposed to varying environmental stressors within the acute care setting. Preterm infants present different stress behaviors in response to varying types of environmental stimuli. Nurse should aware those different environmental stressors affect the preterm infant’s stats and stress behaviors differently. A practice standard should be adopted for reduce sound levels and handing stimuli.