Hammock position and nesting: comparison of physiological and behavioral effects in preterm infants

Costa, Kassandra Silva Falcão; Beleza, Ludmylla de Oliveira; Souza, Lissandra Martins; Ribeiro, Laiane Medeiros

doi:10.1590/1983-1447.2016.esp.62554

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Sumário

Original Papers • Rev. Gaúcha Enferm. (Online) 37 (spe) • 2016 • https://doi.org/10.1590/1983-1447.2016.esp.62554 copy

Hammock position and nesting: comparison of physiological and behavioral effects in preterm infants

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To compare the effects of the use of hammocks versus nesting in preterm infants, after diaper changing.

Methods

quasi-experimental study, a cross-over trial with 30 preterm newborns in an intermediate care nursery (ICN) in a public hospital in Brasilia-DF, conducted from November 2011 to March 2012. The effects of the two interventions (nesting and hammock) after diaper changing were assessed. Student’s t test with a confidence level of 95% (p <0.05) was used in data analysis.

Results

In hammock position the preterm infants were found to be less stressed (p = 0.002), had fewer defining characteristics indicating nursing diagnosis “Disorganized Infant Behavior” (p = 0.05) and remained in a more suitable position for receiving intensive care compared to nesting (p = 0.04).

Conclusion

Preterm infants in hammock position, compared to nesting, were less stressed, with a more organized behavior and in a better position for receiving intensive care.

Preterm newborn; Patient positioning; Physiological stress

Time	Types of Intervention	Average	N	Standard deviation	Level of Significance
2nd minute	NBs – Hammock	2.07	30	1.20	0.01 *
2nd minute	NBs – Nest	3.27	30	2.24	0.01 *
10th minute	NBs – Hammock	1.57	30	1.01	0.00 *
10th minute	NBs – Nest	3.83	30	2.74	0.00 *
20th minute	NBs – Hammock	1.47	30	0.90	0.00 *
20th minute	NBs – Nest	2.83	30	1.84	0.00 *
40th minute	NBs – Hammock	1.17	30	0.38	0.00 *
40th minute	NBs – Nest	3.37	30	2.86	0.00 *

Time	Type of Intervention	Flexion of Upper Limbs			Flexion of Lower Limbs

		Mean	Standard deviation	Level of Significance	Mean	Standard deviation	Level of Significance
2 nd minute	NBs – Hammock	0.93	0.25	0.10	0.93	0.25	0.10
2 nd minute	NBs – Nest	0.77	0.43	0.10	0.77	0.43	0.10
10 th minute	NBs – Hammock	0.97	0.18	0.18	1.00	0.00	0.00 *
10 th minute	NBs – Nest	0.87	0.35	0.18	0.73	0.45	0.00 *
20 th minute	NBs – Hammock	0.93	0.25	0.16	0.97	0.18	0.03 *
20 th minute	NBs – Nest	0.80	0.41	0.16	0.77	0.43	0.03 *
40 th minute	NBs – Hammock	1.00	0.00	0.00 *	0.93	0.25	0.00 *
40 th minute	NBs – Nest	0.70	0.47	0.00 *	0.57	0.50	0.00 *

Time	Type of Intervention	Head in midline			Feet at the foot end

		Mean	Standard deviation	Level of Significance	Mean	Standard deviation	Level of Significance
2nd minute	NBs – Hammock	1.00	0.00	0.08	1.00	0.00	0.00 *
2nd minute	NBs – Nest	0.90	0.31	0.08	0.67	0.48	0.00 *
10th minute	NBs – Hammock	1.00	0.00	0.01*	0.97	0.18	0.00 *
10th minute	NBs – Nest	0.80	0.41	0.01*	0.67	0.48	0.00 *
20th minute	NBs – Hammock	1.00	0.00	0.00*	0.93	0.25	0.00 *
20th minute	NBs – Nest	0.70	0.47	0.00*	0.63	0.49	0.00 *
40th minute	NBs – Hammock	1.00	0.00	0.00*	0.90	0.31	0.00 *
40th minute	NBs – Nest	0.53	0.51	0.00*	0.47	0.51	0.00 *

Defining Characteristics	Type of Intervention	2nd minute			10th minute

		Mean	Standard deviation	Level of Significance	Mean	Standard deviation	Level of Significance
Physiological System	NBs – Hammock	0.53	0.29	0.21	0.40	0.28	0.12
Physiological System	NBs – Nest	0.63	0.32	0.21	0.55	0.38	0.12
Regulation Problems	NBs – Hammock	0.00	0.00	0.10	0.02	0.09	0.06
Regulation Problems	NBs – Nest	0.07	0.22	0.10	0.15	0.35	0.06
Attention-interaction system	NBs – Hammock	0.00	0.00	0.04 *	0.00	0.00	0.00 *
Attention-interaction system	NBs – Nest	0.13	0.35	0.04 *	0.27	0.45	0.00 *
System of behavioral state organization	NBs – Hammock	0.13	0.12	0.01 *	0.07	0.11	0.00 *
System of behavioral state organization	NBs – Nest	0.19	0.10	0.01 *	0.17	0.11	0.00 *
Motor system	NBs – Hammock	0.12	0.15	0.00 *	0.12	0.21	0.00 *
Motor system	NBs – Nest	0.26	0.18	0.00 *	0.31	0.18	0.00 *

Defining Characteristics	Type of Intervention	20th minute			40th minute

		Average	Standard deviation	Level of Significance	Average	Standard deviation	Level of Significance
Physiological System	NBs – Hammock	0.27	0.31	0.02 *	0.20	0.31	0.00 *
Physiological System	NBs – Nest	0.47	0.35	0.02 *	0.42	0.32	0.00 *
Regulation Problems	NBs – Hammock	0.00	0.00	0.33	0.00	0.00	0.03 *
Regulation Problems	NBs – Nest	0.02	0.09	0.33	0.13	0.32	0.03 *
Attention-interaction system	NBs – Hammock	0.00	0.00	0.04 *	0.00	0.00	0.01 *
Attention-interaction system	NBs – Nest	0.13	0.35	0.04 *	0.20	0.41	0.01 *
System of behavioral state organization	NBs – Hammock	0.05	0.11	0.14	0.02	0.06	0.00 *
System of behavioral state organization	NBs – Nest	0.09	0.10	0.14	0.13	0.11	0.00 *
Motor system	NBs – Hammock	0.10	0.12	0.00 *	0.07	0.09	0.00 *
Motor system	NBs – Nest	0.25	0.18	0.00 *	0.28	0.23	0.00 *

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[1] Corresponding author: Kassandra Silva Falcão Costa. E-mail: kassandrafcosta@gmail.com