不同力道的嬰兒按摩對早產兒生理指標、體重、餵食量之影響

The Effect of Different Pressure Baby Massage for Physical Parameters, Body Weight, Feeding Amount in Preterm Infants

背景：許多文獻指出嬰兒按摩可以促進早產兒神經功能成熟，促進體重增加，利於產生良好的睡眠及清醒狀態，但按摩力道缺乏實證文獻依據。 目的：探討不同力道的嬰兒按摩對早產兒生理指標(體溫、心跳速率、呼吸速率、血氧飽和濃度)、體重、餵食量之影響。 方法：採實驗性設計及立意取樣，收集地點在北區某醫學中心之新生兒輕度及中重度加護病房，收案樣本數共為60位，隨機分配到實驗組A、B及控制組，實驗組A接受適度力道按摩(指執行按摩活動後早產兒皮膚顏色會發白且有凹陷之情形)，實驗組B則接受輕度力道按摩(指執行按摩活動後早產兒皮膚顏色無任何的改變且無凹陷之情形)。而研究結果則以一般線性模式之廣義估計方程式(Generalized Estimating Equation, GEE)進行統計分析。 結果：研究結果顯示不同力道嬰兒按摩對早產兒在體溫、呼吸、體重、餵食量方面與控制組比較皆達顯著差異(p < .05)，且給予適度力道嬰兒按摩之早產兒，其生理指標較為穩定，且在體重及餵食量方面皆有明顯增加的情形。 結論：本研究顯示早產兒執行按摩後並不會造成生理指標不穩定，且不論適度或是輕度力道按摩活動，對於早產兒而言皆是安全的護理活動，故建議將效益鼓勵並推廣至臨床早產兒處置措施之運用。

Background: A lot of literature shows that baby massage in preterm infants can improve their maturity of nervous function, weight gain and create a good sleep/awake state. However there is no evidence-based reference to support the pressure of baby massage. Purpose: To explore the effectiveness of performing different pressure of baby massage in the physical parameters (including body temperature, heart rate, respiratory rate, and saturation), body weight, feeding amount, and behavior state of preterm infants. Methods: The study was performed at the neonatal Intensive Care Unit and New Born Center nurseries of the childrens’s hospital in north Taiwan. For this prospective, experimental research design, sixty preterm infants were randomly assigned to either the control or the experimental group A or B. Experimental group A received moderate pressure massage (slight skin color change from pink to white or slight indentations in skin for all infants). Experimental B received light pressure massage (skin color no change and no indentations in skin for all infants). Results: The results showed the significant differences between the control and the experimental groups on the body temperature, respiratory rate, body weight, and feeding amount of preterm infants (p < .05). The premature infants with moderate pressure of baby massage had more stable physical parameters. Conclusions: This study demonstrates that baby massage is a safe nursing intervention for the preterm infants. This study can be applied to clinical preterm infant care.