国际护讯：安慰性触摸有益于新生儿重症护理

Comforting Touch Has Benefits in Neonatal Intensive Care

Preterm babies benefit from a type of soothing, rhythmic touch known as the M Technique, according to a pilot randomized controlled trial.

The researchers observed positive effects on weight as well as on physiologic and behavioral measures in babies who received the technique during a 5-week period relative to a matched control group.

"Babies in neonatal intensive care are a vulnerable population, and they encounter a lot of negatives during their stay," Joan Smith, PhD, from the Division of Nursing and Newborn Intensive Care at St. Louis Children's Hospital, Missouri, "I wanted to see if we could help with some type of positive effect. Indeed, we had very positive immediate responses with the M Technique."

The M Technique is composed of structured, stroking movements, done in a set sequence at a set pressure and speed. It has been shown to be useful in many patient populations, including critically ill patients and hospice patients. The M stands for manual ― a structured, manual method of touch ― which distinguishes it from massage.

In a prior feasibility study, Dr. Smith and her team showed that the M Technique was safe to perform in preterm babies in the neonatal intensive care unit (NICU). And after just 1 session, they observed improved physiologic and behavioral effects in the babies.

In the latest study, the researchers investigated the cumulative effects of the M Technique in the NICU.

Physiologic parameters of heart rate, respiration, oxygen saturation, and behavioral states all improved both from baseline to during and post intervention, said Dr. Smith. There were also positive effects on growth velocity in the babies who received the M Technique.

Stress Reliever

"In addition to clinical outcomes, the people working on our team also felt the responses were very positive. Some of our therapists are starting to incorporate as part of their touch therapy," said Dr. Smith.

"It's very easy to learn," she said. "We learned the technique over 4 days. The biggest thing you have to know is the appropriate pressure to apply."

As part of their training in the M Technique, the researchers performed it on each other. "It was so relaxing, almost all of us fell asleep," said Mary Raney, a developmental care expert at St. Louis Children's Hospital who participated in the study.

"We experienced firsthand how it can be a stress releaser. When I was performing it, I felt like it calmed me down, because it is very rhythmic and I could feel the person relax," she said.

"It does require you to have a strong developmental background to be good at reading cues from the baby and be able to identify what pressure that infant likes," she explained. "You can tell very quickly how the baby responds, and if someone interrupts you, you can feel how the baby tenses."

The beauty of the technique "is that it is easy to learn and it is something we can teach parents to do," Raney said.

安慰性触摸有益于新生儿重症护理

M技术是一种舒缓的、有节奏的触摸技术根据随机对照试验，此项技术对早产儿有好处。

研究人员通过5个周期与对照组比较，接受这项技术的婴儿的生理和行为举止受到积极的影响。

“在新生儿重症监护室的婴儿都是比较脆弱的群体，他们能遇到很多负面影响。”琼.史密斯博士，来自密苏里州圣路易斯市儿童医院，“我想知道我们是否能带给患者一些积极的影响，事实上，M技术带来了立竿见影的效果。”

M技术是由基本框架，抚摸动作构成，要按照一定的顺序和设定的压力和速度完成。它的效果已经被很多人群证实，包括危重症患者和临终老年患者。M代表手工（手动）--接触（触摸）--其结构和手法有别于按摩。

在前期可能性的研究中，史密斯博士和她的团队证实了M技术在ＮＩＣＵ实施的安全性。在研究第一阶段后，他们观察到婴儿生理和行为的改善。

在最新的研究中，研究者调查了Ｍ技术在新生儿重症监护室的累积效果。

心率、呼吸、血氧饱和度等生理参数，行为状态，对比干预前和干预后都得到了改善，史密斯博士说。Ｍ技术对婴儿的生长速度也有积极的影响。

压力缓解

“除了临床成果，我们的工作人员对此也有积极反响，我们的一些治疗师把这纳入他们触摸疗法的一部分。”史密斯博士说。

“这项技术很容易学习。”她说。“我们学了４天多。最重要的就是要知道采用适当的压力。”

作为Ｍ技术培训的一部分，研究人员彼此进行试验。“很放松，几乎所有人要睡着了，”玛丽雷尼，圣路易斯儿童医院的一位参与研究的脑力开发的保健专家这样说。

“我们亲身经历和怎么能释放压力，当我给别人演示时，我感觉它能让我冷静下来，因为节奏感很强，我能感觉到这个人的放松，”她说。

“它不需要你有关于脑力开发的强大知识背景来识别婴儿喜欢什么程度的压力，”她解释说。“你能感觉到婴儿的反应，如果有人在你操作时打断你，你可以感觉到婴儿的紧张。”

“这项技术的好处在于它很容易学习，我们还可以教婴儿的父母做这些。”雷尼说。