1
|
Akkoyun S, Arslan FT, Kacmaz T. The effect of classical and harp music on comfort, physiological parameters and cerebral oxygenation among premature infants: A multi-arm randomized controlled trial. Nurs Crit Care 2025; 30:e13279. [PMID: 40068958 DOI: 10.1111/nicc.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 11/03/2024] [Accepted: 01/17/2025] [Indexed: 05/13/2025]
Abstract
BACKGROUND Music has many positive effects on premature infants. Studies on the comfort and cerebral oxygenation of music in premature infants are limited. AIM To examine the effects of classical and harp music on the comfort, heart rate, respiratory rate, oxygen saturation and cerebral oxygenation of premature infants in a neonatal intensive care unit (NICU). STUDY DESIGN This was a three-group randomized controlled trial. METHODS This study was conducted on 84 medically stable premature infants in an NICU of a medical faculty hospital. There were three groups: the classical music group (n = 28), the harp music group (n = 28) and the routine care group (n = 28). Two or three days a week, on different days, three sessions a day, a total of 15 sessions and 30 min of classical or harp music practice were performed. The sound levels of the classical or harp music were controlled between 50 and 55 dB. No music was applied to premature infants in the routine care group. For each session, physiological parameters, cerebral oxygenation and comfort level were evaluated and measured at pretest and post-test. RESULTS According to the time and group interaction, high comfort levels were observed in the classical/harp music group (p = 0.001,η 2 $$ {\eta}^2 $$ = 0.196, CI = 0.169-0.222), heart rate (p = 0.001,η 2 $$ {\eta}^2 $$ = 0.018, CI = 0.009-0.030) and respiratory rate were low in the classical music group (p = 0.001,η 2 $$ {\eta}^2 $$ = 0.019, CI = 0.010-0.031) and oxygen saturation was high in the classical music group (p = 0.027,η 2 $$ {\eta}^2 $$ = 0.006, CI = 0.001-0.013). There was a statistically significant difference between the average cerebral oxygenation values by group (p = 0.001,η 2 $$ {\eta}^2 $$ = 0.029, CI = 0.017-0.043). CONCLUSIONS Classical or harp music is beneficial for increasing the comfort level of premature infants. Classical music is useful for stabilizing and improving heart rate, respiratory rate and oxygen saturation in premature infants. RELEVANCE TO CLINICAL PRACTICE Music is effective in increasing the comfort of premature infants and stabilizing their physiological parameters and can be applied by neonatal intensive care nurses.
Collapse
Affiliation(s)
- Sevinc Akkoyun
- Vocational School of Health Services, Selcuk University, Selçuklu, Konya, Turkey
| | | | - Tugba Kacmaz
- Neonatal Intensive Care Unit, Selcuk University Medical Faculty Hospital, Selçuklu, Konya, Turkey
| |
Collapse
|
2
|
Caprarola SD, Jones MB, Yurasek GK, O'Neill RV, Pleau C, Rowan M, Gordish-Dressman H, Wernovsky G. Increased sound levels in the cardiac ICU are associated with an increase in heart rate, blood pressure, and sedation. Cardiol Young 2025; 35:344-349. [PMID: 39655669 DOI: 10.1017/s1047951124036163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2025]
Abstract
BACKGROUND Several organizations including the Environmental Protection Agency, World Health Organization and American Academy of Pediatrics recommend that hospital sound levels not exceed 45 decibels. Yet, several studies across multiple age groups have observed higher than recommended levels in the intensive care setting. Elevated sound levels in hospitals have been associated with disturbances in sleep, patient discomfort, delayed recovery, and delirium. METHODS We measured sound levels in a pediatric cardiac intensive care unit and collected vital signs data, sedation dosing and delirium scores. During a 5-week study period, sound levels for 68 patients in 22 private and 4 semi-private rooms were monitored. RESULTS Sound levels were consistently above stated recommendations with an average daytime level of 50.6 decibels (maximum, 76.9 decibels) and an average nighttime level of 49.5 decibels (maximum, 69.6 decibels). An increase in average and maximum sound levels increased the probability of sedation administration the following hour (p-value < 0.001 and 0.01, respectively) and was predictive of an increase in heart rate and blood pressure (p-value < 0.001). CONCLUSION Sound levels in the CICU were consistently higher than recommended. An increase in heart rate, blood pressure and sedation utilization may suggest a stress response to persistent and sudden loud sounds. Given known negative impacts of excessive noise on stress, sleep, and brain development, as well as the similar adverse effects from the related use of sedative medications, reducing excessive and sudden noise may provide an opportunity to improve short- and long-term hemodynamic and neurodevelopmental outcomes in the pediatric cardiac intensive care unit.
Collapse
Affiliation(s)
- Sherrill D Caprarola
- Department of Pediatrics, Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Melissa B Jones
- Department of Pediatrics, Division of Pediatric Cardiac Critical Care, Children's National Hospital, Washington, DC, USA
| | - Gregory K Yurasek
- Department of Pediatrics, Division of Pediatric Cardiac Critical Care, Children's National Hospital, Washington, DC, USA
| | - Robin V O'Neill
- Department of Pediatrics, Division of Pediatric Cardiac Critical Care, Children's National Hospital, Washington, DC, USA
| | - Cara Pleau
- Department of Pediatrics, Division of Pediatric Cardiac Critical Care, Children's National Hospital, Washington, DC, USA
| | - Meghan Rowan
- Department of Pediatrics, Division of Pediatric Cardiac Critical Care, Children's National Hospital, Washington, DC, USA
| | - Heather Gordish-Dressman
- Department of Pediatrics, Center for Translational Research, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Gil Wernovsky
- Department of Pediatrics, Division of Pediatric Cardiac Critical Care, Children's National Hospital, Washington, DC, USA
- Department of Pediatrics, Division of Pediatric Cardiology, Children's National Hospital, Washington, DC, USA
| |
Collapse
|
3
|
Mohseni H, Ramezani M, Saki A, Poor-Alizadeh N. Comparison of the Effect of the White Noise and Sound Reduction on Behavioral Responses of Premature Infants Under Noninvasive Ventilation: A Clinical Trial. J Perinat Neonatal Nurs 2025:00005237-990000000-00077. [PMID: 39836946 DOI: 10.1097/jpn.0000000000000902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2025]
Abstract
BACKGROUND With the increasing survival rates of premature infants and their associated respiratory problems, noninvasive ventilation has gained popularity in neonatal intensive care units. On the other hand, this equipment can be stressful for infants. Objective: This study aimed to compare the effects of white noise and sound reduction on the behavioral responses of premature infants under noninvasive ventilation. Methods: This study was a randomized controlled crossover trial. Forty-two infants who met the inclusion criteria received white noise and noise reduction in a randomized sequence with a 30-minute washout period between conditions. During the noise reduction condition, infants were placed in the fetal position with earplugs. During the white noise condition, nature sounds from the White Noise Baby Sleep app were played into the incubator. Infant behavioral responses were recorded using the Anderson Behavioral State Scale on 3 consecutive days before, during, and after the intervention. Results: The independent t test showed no statistically significant difference between the 2 groups at baseline. The repeated measures analysis of variance test showed that the mean behavioral response scores of preterm infants in the sound reduction group and the white noise group differed significantly across the 3 stages on all 3 days. However, the results of mixed-effects model indicated that the sound reduction group experienced a significant decrease in behavioral response compared to the white noise group. Conclusion: Therefore, the present study suggests that sound reduction is a more effective nonpharmacological method for improving behavioral responses and reducing restlessness of premature infants under noninvasive ventilation.
Collapse
Affiliation(s)
- Hasti Mohseni
- Author Affiliations: Department of Pediatric and Neonatal Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran (Mrs Mohseni and Dr Ramezani); Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mrs (Dr Ramezani); Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran (Dr Saki); and Neonatologist, NICU Department, Hakim Hospital, Neyshabur University of Medical Sciences, Neyshabur, Iran (Dr Poor-Alizadeh)
| | | | | | | |
Collapse
|
4
|
Erol DD, Özalp Gerçeker G. Effects of White Noise and Therapeutic Touch on Pain and Comfort in Newborns during Heel Lance: A Randomized Controlled Study. Adv Neonatal Care 2024; 24:E79-E87. [PMID: 39602095 DOI: 10.1097/anc.0000000000001200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2024]
Abstract
BACKGROUND Nonpharmacological methods such as white noise and therapeutic touch can be used in pain management in neonates. PURPOSE This randomized controlled study evaluated the effects of white noise and therapeutic touch during heel lance procedures on pain, comfort levels, and physiological parameters in healthy neonates. METHODS This parallel, randomized controlled study was conducted in the Obstetrics and Gynecology Service of a regional hospital. The sample comprised 160 neonates with gestational ages of >35 weeks randomly assigned to 4 groups (white noise [WN], therapeutic touch [TT], white noise + therapeutic touch [WT], and control [CG] group). Pain and comfort levels were evaluated according to the Neonatal Infant Pain Scale, and the COMFORTneo Scale. The primary outcomes were pain and comfort levels, and the secondary outcomes were heart rate and SpO2 levels. The Kruskal-Wallis test was used to compare the scale scores among groups. RESULTS There were significant differences among groups in terms of Neonatal Infant Pain Scale and COMFORTneo scores (P < .05). The pain scores for the white noise, therapeutic touch, and white noise + therapeutic touch groups were 4.2 ± 2.0, 5.2 ± 1.6, and 3.3 ± 1.7, respectively. There was a significant difference in average heart rate during the heel lance procedure among the groups (P < .05). Pain scores of the intervention groups were lower compared to the control group. IMPLICATIONS FOR PRACTICE AND RESEARCH The combination of white noise and therapeutic touch was more effective in reducing pain and increasing comfort levels. Nurses could reduce procedural pain by applying these pain relief methods.
Collapse
Affiliation(s)
- Duygu Deniz Erol
- Department of Pediatric Nursing, İzmir Atatürk Education and Research Hospital, Neonatal Intensive Care Unit, and Dokuz Eylül University, Institute of Health Sciences, Izmir, Turkey (Ms Erol); and Pediatric Nursing Department, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey (Mrs Özalp Gerçeker)
| | | |
Collapse
|
5
|
Di Fiore JM, Liu G, Loparo KA, Bearer CF. The effect of early postnatal auditory stimulation on outcomes in preterm infants. Pediatr Res 2024; 96:1389-1396. [PMID: 38909158 PMCID: PMC11624134 DOI: 10.1038/s41390-024-03329-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/18/2024] [Indexed: 06/24/2024]
Abstract
Preterm infants are deprived of in utero sensory stimulation during the third trimester, an important period of central nervous system development. As a result, maturational trajectories are often reduced in infants born preterm. One such system affected is the brain including the auditory and respiratory control pathways. During normal pregnancy the intrauterine environment attenuates external auditory stimuli while exposing the fetus to filtered maternal voice, intra-abdominal sounds, and external stimuli. In contrast, during the third trimester of development, preterm infants are exposed to a vastly different soundscape including non-attenuated auditory sounds and a lack of womb related stimuli, both of which may affect postnatal brain maturation. Therefore, fostering a nurturing postnatal auditory environment during hospitalization may have a significant impact on related outcomes of preterm infants. Studies using a range of postnatal auditory stimulations have suggested that exposure to sounds or lack thereof can have a significant impact on outcomes. However, studies are inconsistent with sound levels, duration of exposure to auditory stimuli, and the gestational age at which infants are exposed. IMPACT: Auditory stimulation can provide a low cost and low risk intervention to stabilize respiration, improve neuronal maturation and reduce long-term sequelae in preterm infants. The potential benefits of auditory stimulation are dependent on the type of sound, the duration of exposure and age at time of exposure. Future studies should focus on the optimal type and duration of sound exposure and postnatal developmental window to improve outcomes.
Collapse
Affiliation(s)
- Juliann M Di Fiore
- Dept of Pediatrics, Case Western Reserve University, Cleveland, OH, 44016, USA
- Division of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, OH, 44016, USA
| | - Gloria Liu
- Dept of Pediatrics, Case Western Reserve University, Cleveland, OH, 44016, USA
| | - Kenneth A Loparo
- ISSACS: Institute for Smart, Secure and Connected Systems, Case Western Reserve University, Cleveland, OH, USA
| | - Cynthia F Bearer
- Dept of Pediatrics, Case Western Reserve University, Cleveland, OH, 44016, USA.
- Division of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, OH, 44016, USA.
| |
Collapse
|
6
|
Göktürk G, Sarıalioğlu A. Effect of white noise during nasal continuous positive airway pressure application on newborn's pain and stress levels, physiological parameters, and crying durations: A randomized controlled study. J Pediatr Nurs 2024; 78:e330-e337. [PMID: 39060170 DOI: 10.1016/j.pedn.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 07/21/2024] [Accepted: 07/21/2024] [Indexed: 07/28/2024]
Abstract
PURPOSE The study was conducted to determine the effects of white noise during nasal continuous positive airway pressure (CPAP) application on the newborn's pain and stress levels, physiological parameters, and crying durations. DESIGN AND METHODS The study used a randomized, controlled experimental design. The study was completed with 80 newborns (40 in the intervention group and 40 in the control group). The Newborn Descriptive Data Form, ALPS Newborn Pain and Stress Assessment Scale, and Follow-up Form were used to collect the study data. Routine nasal CPAP application was performed to newborns in the control group. White noise was played to newborns in the intervention group before, during, and after the nasal CPAP application. The study was approved by an ethics committee. RESULTS It was found that the newborn's pain and stress levels of the intervention group were lower than the control group before, during, and after the nasal CPAP application (p < 0.05). Before nasal CPAP application, the intervention group's SpO2 average was lower than that of the control group (p < 0.01). During nasal CPAP application, the intervention group's heart rate, SpO2, and crying duration averages were found to be lower than the control group (p < 0.05). After nasal CPAP application, the intervention group's crying duration average was lower than the control group (p < 0.01). CONCLUSIONS It was found that white noise before, during, and after the nasal CPAP application reduced newborns' pain and stress levels. PRACTICE IMPLICATION It is recommended that white noise be used as an easily applicable, economical, safe, and non-pharmacological method to reduce the pain and stress caused by nasal CPAP application in newborns. CLINICAL TRIALS REGISTRATION The study was registered at Clinical-Trials.gov (NCT05440669).
Collapse
Affiliation(s)
- Gülistan Göktürk
- Department of Child Health and Diseases Nursing, Şanlıurfa Training and Research Hospital, Turkey
| | - Arzu Sarıalioğlu
- Department of Child Health and Diseases Nursing, Atatürk University, Erzurum, Turkey.
| |
Collapse
|
7
|
Kim MH, Song JE, Ahn JA, You MA. Effect of White Noise on Pain Response, Heart Rate, and Oxygen Saturation During Heel Puncture in Premature Infants: A Randomized Controlled Trial. J Perinat Neonatal Nurs 2024; 38:297-305. [PMID: 37967268 DOI: 10.1097/jpn.0000000000000779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect of white noise on pain response, heart rate, and oxygen saturation during heel puncture in premature infants. METHODS A randomized, controlled, pretest-posttest design was used. The participants were premature infants admitted to the neonatal intensive care unit of a university hospital in Gyeonggi Province. Sixty premature infants were assigned to either an experimental ( n = 30) or control ( n = 30) group. The experimental group was exposed to white noise during heel puncture, and the measured variables were pain response, heart rate, and oxygen saturation. The data were analyzed using the independent t test, chi-squared test, and analysis of covariance. RESULTS Premature infants in the experimental group had a lower pain response and heart rate than the control group ( F = 81.26, P < .01; F = 7.05, P = .01), and higher oxygen saturation than the control group ( F = 4.76, P = .03). CONCLUSION These results demonstrated that the white noise intervention is an effective nursing intervention to reduce the pain response and stabilize heart rate and oxygen saturation in premature infants during heel puncture.
Collapse
Affiliation(s)
- Min Hye Kim
- Medical Center, Ajou University, Suwon, South Korea (Ms Kim); and Research Institute of Nursing Science, College of Nursing, Ajou University, Suwon, South Korea (Drs Song, Ahn, and You)
| | | | | | | |
Collapse
|
8
|
Lin S, Li L, Ren X, Zhong C, Wu K, Fang X, Liang S, Chen X, Chen J, Yang L, Wang X, Wang B. Effects of White Noise on Pain Scores and Salivary Cortisol Levels in Surgical Neonates: A Randomized Controlled Trial. Adv Neonatal Care 2024; 24:291-300. [PMID: 38815280 DOI: 10.1097/anc.0000000000001167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
BACKGROUND Neonates experience varying intensities of pain after surgery. While white noise has been used for postoperative pain relief in infants, its effects on neonates after surgery need further exploration. PURPOSE This study aimed to evaluate the effects of white noise on pain scores and salivary cortisol levels in surgical neonates. METHODS In this randomized controlled trial, 64 neonates scheduled for surgery were recruited and assigned by block randomization into 2 groups. The intervention group listened to white noise at 50 dB, while the control group listened to white noise at 0 dB, for 30 minutes 6 times for 48 hours postoperatively. Pain scores, measured by the COMFORTneo Scale, and salivary cortisol levels were compared. RESULTS Although pain scores decreased after surgery in all subjects, no statistically significant difference was observed between the 2 groups (P = .937). There was a significant difference between pre- and postintervention pain scores in the intervention group only (P = .006). Salivary cortisol levels decreased after intervention in the intervention group, but there was no significant difference between pre- and postintervention levels in the 2 groups (P = .716). IMPLICATIONS FOR PRACTICE Given the reduction in pain scores and salivary cortisol concentrations after white noise intervention, white noise shows potential as an adjunctive soothing measure for neonates after surgery. IMPLICATIONS FOR RESEARCH Future studies are needed to confirm the efficacy and utility of white noise intervention in clinical settings.
Collapse
Affiliation(s)
- Siya Lin
- Clinical Nursing Education and Research Section (Ms Lin, Dr Li, and Mss Ren and J. Chen), Department of Nursing (Ms Lin), Department of Neonatology, Pediatrics Center (Mss Zhong and Fang, and Dr B. Wang), Department of Pediatric Surgery, Pediatrics Center (Drs Wu and Yang), Department of Laboratory Medicine (Messrs Liang and X. Chen), Department of Cardiovascular Surgery (Dr X. Wang), Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Düken ME, Yayan EH. The effects of massage therapy and white noise application on premature infants' sleep. Explore (NY) 2024; 20:319-327. [PMID: 37806925 DOI: 10.1016/j.explore.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 10/10/2023]
Abstract
AIM Sleep is vital to premature infants' physical, social and emotional development. The significance of sleep duration, efficiency, and function in premature infants regarding growth development, behavior and neurological development has been increasing. MATERIALS AND METHODS This study was conducted in a randomized controlled experimental design with three groups. Premature infants at 28-37 weeks of gestation who were admitted to the Neonatal Intensive Care Unit of Şanlıurfa Mehmet Akif İnan Training and Research Hospital Haliliye Annex Building were the research population. The sample of the present study consisted of 120 premature infants in the massage therapy group (40), white noise group (40), and control group (40). RESULTS The sleep duration and sleep efficiency of the premature infants in the massage group increased compared to before the application, whereas the number of awakenings and WASO values decreased. The sleep duration of premature infants in the massaged group increased by some five hours. In the white noise group, the sleep duration increased by about two hours than the pre-treatment, and there was an increase in sleep efficiency. White noise application provided a significant decrease in the number of awakenings and WASO values in premature infants. CONCLUSION In this experimental study, which was designed with three groups, it was revealed that massage and white noise application in premature infants were significant non-pharmacological methods to increase sleep duration and sleep efficiency. It was concluded that massage therapy and white noise application is one of the considerable interventions regarding sleep duration, efficiency and functions in premature infants who left the intrauterine period early.
Collapse
Affiliation(s)
- Mehmet Emin Düken
- Health Sciences of Faculty, Department of Child Health and Diseases Nursing, Harran University, Şanlıurfa 63000, Turkey.
| | - Emriye Hilal Yayan
- Faculty of Nursing, Department of Child Health and Diseases Nursing, Inönü University, Malatya 44280, Turkey.
| |
Collapse
|
10
|
Zhu L, Zheng L. Influence of White Sound on Sleep Quality, Anxiety, and Depression in Patients with Schizophrenia. Noise Health 2024; 26:97-101. [PMID: 38904807 PMCID: PMC11530119 DOI: 10.4103/nah.nah_116_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Patients with schizophrenia frequently experience issues such as poor sleep quality, anxiety, and depression. White sound has been identified as a potential therapeutic strategy to enhance sleep quality and alleviate negative emotions. This study aimed to investigate the effectiveness of white sound in improving sleep quality, anxiety, and depression among patients with schizophrenia. MATERIALS AND METHODS This retrospective analysis included clinical data from 212 patients with schizophrenia divided into two groups based on their treatment approach. Group C (control, without white sound, n = 106) received standard pharmacological treatments, while group W (white sound, n = 106) was exposed to white sound (40-50 dB) for 2 hours nightly at 9:00 pm. All patients were assessed using the Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) before and after 12 weeks of intervention. RESULTS After 12 weeks, group W showed significant improvements in sleep latency, sleep efficiency, and overall PSQI scores compared to group C (P < 0.05). Furthermore, the HAMD and HAMA scores were significantly lower in group W (P < 0.05), indicating reduced levels of anxiety and depression. The negative symptoms score was significantly lower in group W (P < 0.05) after treatment. CONCLUSION White sound shows promise in improving sleep quality, and alleviating anxiety and depression in patients with schizophrenia.
Collapse
Affiliation(s)
- Lingli Zhu
- Department of Psychology, The Third Hospital of Quzhou, Quzhou 324000, Zhejiang, China
| | - Lifeng Zheng
- Department of Psychology, The Third Hospital of Quzhou, Quzhou 324000, Zhejiang, China
| |
Collapse
|
11
|
Zhang Q, Huo Q, Chen P, Yao W, Ni Z. Effects of white noise on preterm infants in the neonatal intensive care unit: A meta-analysis of randomised controlled trials. Nurs Open 2024; 11:e2094. [PMID: 38268285 PMCID: PMC10794858 DOI: 10.1002/nop2.2094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/14/2023] [Accepted: 12/25/2023] [Indexed: 01/26/2024] Open
Abstract
AIM To critically assess the effects of white noise on the pain level, weight gain and vital signs (heart rate, respiratory rate and oxygen saturation) of preterm infants in neonatal intensive care units (NICUs). DESIGN A systematic review and meta-analysis of randomised controlled trials (RCTs). METHODS Ten databases (PubMed, Cochrane Library, Embase, Web of Science, CINAHL, PsycINFO, SinoMed, China National Knowledge Infrastructure, VIP and Wanfang Data) were systematically reviewed from inception to July 2022. Two reviewers evaluated the risk of bias separately using the Cochrane Collaboration criteria and extracted data using a predesigned information form. RESULTS The meta-analysis included eight eligible RCTs. According to statistical analysis, white noise significantly affected the pain level, weight gain, heart rate, respiratory rate and oxygen saturation in preterm infants. Regardless of the outcome measurement timing, gestational age and birth weight of preterm infants, subgroup analysis demonstrated that white noise reduced the pain level, heart rate and respiratory rate and promoted weight gain in preterm infants in NICUs. CONCLUSION White noise is a practical and potentially useful therapy for premature neonates in NICUs. No Patient or Public Contribution.
Collapse
Affiliation(s)
- Qing Zhang
- Department of NeonatologyChildren's Hospital of Soochow UniversitySoochowChina
| | - Qiugui Huo
- Department of NeonatologyChildren's Hospital of Soochow UniversitySoochowChina
| | - Peizhen Chen
- Department of NeonatologyChildren's Hospital of Soochow UniversitySoochowChina
| | - Wenying Yao
- Department of NursingChildren's Hospital of Soochow UniversitySoochowChina
| | - Zhihong Ni
- Department of NursingChildren's Hospital of Soochow UniversitySoochowChina
| |
Collapse
|
12
|
Tian M, Gu X. Effect of White Noise Intervention Combined with Multi-dimensional Nursing Mode on Sleep Quality and Incidence of Nosocomial Infection in Patients Undergoing Hip Replacement. Noise Health 2023; 25:220-225. [PMID: 38358237 PMCID: PMC10849012 DOI: 10.4103/nah.nah_32_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/23/2023] [Accepted: 09/07/2023] [Indexed: 02/16/2024] Open
Abstract
Objective To investigate the clinical effects of white noise intervention combined with multi-dimensional nursing mode in patients receiving hip replacement (HR). Methods The study selected the clinical data of 161 patients who underwent HR in our hospital from February 2020 to February 2022 for retrospective analysis. According to patients' willingness, they were divided into the study group (n = 77, receiving white noise intervention combined with multi-dimensional nursing mode) and the control group (n = 84, receiving routine nursing). Pittsburgh sleep quality index (PSQI) scale was used to evaluate patients' sleep quality in the two groups, and the incidence of nosocomial infection in the both groups was counted. Results Before nursing and white noise intervention, the PSQI scores of patients' sleep quality in the two groups were all lower, with no obvious difference (P > 0.05). After nursing and white noise intervention, the sleep quality of the two groups was all improved, and the study group had overtly lower PSQI score and score of psychological status than the control group (P < 0.05). After nursing and white noise intervention, the study group had remarkably lower incidence of nosocomial infection than the control group (p < 0.05). Conclusion White noise intervention combined with multi-dimensional nursing mode can effectively improve the sleep quality of patients undergoing HR and reduce the incidence of nosocomial infection, which is of positive significance for promoting the recovery of postoperative limb function.
Collapse
Affiliation(s)
- Meng Tian
- Orthopedics, Baoding Second Central Hospital, Baoding, Hebei, China
| | - Xing Gu
- Neurosurgery and Orthopaedics, Hebei Medical University Fourth Hospital East Campus, Shijiazhuang, Hebei, China
| |
Collapse
|
13
|
Haslbeck FB, Mueller K, Karen T, Loewy J, Meerpohl JJ, Bassler D. Musical and vocal interventions to improve neurodevelopmental outcomes for preterm infants. Cochrane Database Syst Rev 2023; 9:CD013472. [PMID: 37675934 PMCID: PMC10483930 DOI: 10.1002/14651858.cd013472.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND Preterm birth interferes with brain maturation, and subsequent clinical events and interventions may have additional deleterious effects. Music as therapy is offered increasingly in neonatal intensive care units aiming to improve health outcomes and quality of life for both preterm infants and the well-being of their parents. Systematic reviews of mixed methodological quality have demonstrated ambiguous results for the efficacy of various types of auditory stimulation of preterm infants. A more comprehensive and rigorous systematic review is needed to address controversies arising from apparently conflicting studies and reviews. OBJECTIVES We assessed the overall efficacy of music and vocal interventions for physiological and neurodevelopmental outcomes in preterm infants (< 37 weeks' gestation) compared to standard care. In addition, we aimed to determine specific effects of various interventions for physiological, anthropometric, social-emotional, neurodevelopmental short- and long-term outcomes in the infants, parental well-being, and bonding. SEARCH METHODS We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, RILM Abstracts, and ERIC in November 2021; and Proquest Dissertations in February 2019. We searched the reference lists of related systematic reviews, and of studies selected for inclusion and clinical trial registries. SELECTION CRITERIA We included parallel, and cluster-randomised controlled trials with preterm infants < 37 weeks` gestation during hospitalisation, and parents when they were involved in the intervention. Interventions were any music or vocal stimulation provided live or via a recording by a music therapist, a parent, or a healthcare professional compared to standard care. The intervention duration was greater than five minutes and needed to occur more than three times. DATA COLLECTION AND ANALYSIS Three review authors independently extracted data. We analysed the treatment effects of the individual trials using RevMan Web using a fixed-effects model to combine the data. Where possible, we presented results in meta-analyses using mean differences with 95% CI. We performed heterogeneity tests. When the I2 statistic was higher than 50%, we assessed the source of the heterogeneity by sensitivity and subgroup analyses. We used GRADE to assess the certainty of the evidence. MAIN RESULTS We included 25 trials recruiting 1532 infants and 691 parents (21 parallel-group RCTs, four cross-over RCTs). The infants gestational age at birth varied from 23 to 36 weeks, taking place in NICUs (level 1 to 3) around the world. Within the trials, the intervention varied widely in type, delivery, frequency, and duration. Music and voice were mainly characterised by calm, soft, musical parameters in lullaby style, often integrating the sung mother's voice live or recorded, defined as music therapy or music medicine. The general risk of bias in the included studies varied from low to high risk of bias. Music and vocal interventions compared to standard care Music/vocal interventions do not increase oxygen saturation in the infants during the intervention (mean difference (MD) 0.13, 95% CI -0.33 to 0.59; P = 0.59; 958 infants, 10 studies; high-certainty evidence). Music and voice probably do not increase oxygen saturation post-intervention either (MD 0.63, 95% CI -0.01 to 1.26; P = 0.05; 800 infants, 7 studies; moderate-certainty evidence). The intervention may not increase infant development (Bayley Scales of Infant and Toddler Development (BSID)) with the cognitive composition score (MD 0.35, 95% CI -4.85 to 5.55; P = 0.90; 69 infants, 2 studies; low-certainty evidence); the motor composition score (MD -0.17, 95% CI -5.45 to 5.11; P = 0.95; 69 infants, 2 studies; low-certainty evidence); and the language composition score (MD 0.38, 95% CI -5.45 to 6.21; P = 0.90; 69 infants, 2 studies; low-certainty evidence). Music therapy may not reduce parental state-trait anxiety (MD -1.12, 95% CI -3.20 to 0.96; P = 0.29; 97 parents, 4 studies; low-certainty evidence). The intervention probably does not reduce respiratory rate during the intervention (MD 0.42, 95% CI -1.05 to 1.90; P = 0.57; 750 infants; 7 studies; moderate-certainty evidence) and post-intervention (MD 0.51, 95% CI -1.57 to 2.58; P = 0.63; 636 infants, 5 studies; moderate-certainty evidence). However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention (MD -1.38, 95% CI -2.63 to -0.12; P = 0.03; 1014 infants; 11 studies; moderate-certainty evidence). This beneficial effect was even stronger after the intervention. Music/vocal interventions reduce heart rate post-intervention (MD -3.80, 95% CI -5.05 to -2.55; P < 0.00001; 903 infants, 9 studies; high-certainty evidence) with wide CIs ranging from medium to large beneficial effects. Music therapy may not reduce postnatal depression (MD 0.50, 95% CI -1.80 to 2.81; P = 0.67; 67 participants; 2 studies; low-certainty evidence). The evidence is very uncertain about the effect of music therapy on parental state anxiety (MD -0.15, 95% CI -2.72 to 2.41; P = 0.91; 87 parents, 3 studies; very low-certainty evidence). We are uncertain about any further effects regarding all other secondary short- and long-term outcomes on the infants, parental well-being, and bonding/attachment. Two studies evaluated adverse effects as an explicit outcome of interest and reported no adverse effects from music and voice. AUTHORS' CONCLUSIONS Music/vocal interventions do not increase oxygen saturation during and probably not after the intervention compared to standard care. The evidence suggests that music and voice do not increase infant development (BSID) or reduce parental state-trait anxiety. The intervention probably does not reduce respiratory rate in preterm infants. However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention, and this beneficial effect is even stronger after the intervention, demonstrating that music/vocal interventions reduce heart rates in preterm infants post-intervention. We found no reports of adverse effects from music and voice. Due to low-certainty evidence for all other outcomes, we could not draw any further conclusions regarding overall efficacy nor the possible impact of different intervention types, frequencies, or durations. Further research with more power, fewer risks of bias, and more sensitive and clinically relevant outcomes are needed.
Collapse
Affiliation(s)
| | - Katharina Mueller
- Zentrum für Kinder und Jugendmedizin, University Freiburg, Freiburg, Germany
| | - Tanja Karen
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
| | - Joanne Loewy
- Mount Sinai Health System, The Louis Armstrong Center for Music & Medicine, New York City, USA
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Bassler
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
14
|
Qi M, Gong J, Xie Z, Moyle W, Chi Q, Du P, Li P. Effects of recorded maternal voice on anthropometric parameters and heart rate in premature infants: A pilot randomised controlled trial. J Pediatr Nurs 2023; 72:e122-e129. [PMID: 37331833 DOI: 10.1016/j.pedn.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/22/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023]
Abstract
PURPOSE To explore the benefits of a recorded maternal voice intervention on weight, recumbent length, head circumference, and heart rate of preterm infants in the neonatal intensive care unit. METHODS A pilot randomised controlled trial was conducted in this study. Preterm infants in the neonatal intensive care unit (N = 109) were recruited and randomly assigned to an intervention or control group. Both groups received routine nursing care, while preterm infants in the intervention group received a recorded maternal voice program of 20 min, twice daily for 21 days. Preterm infants' daily weight, recumbent length, head circumference, and heart rate were collected during the 21-day intervention. Participants' heart rate in the intervention group was also recorded once a day pre-during-after the recorded maternal voice program. RESULTS Preterm infants in the intervention group showed a significant increase in weight (-75.94, 95% CI -108.04, -43.85, P < 0.001), recumbent length (-0.54, 95% CI -0.76, -0.32, P < 0.001), and head circumference (-0.37, 95%CI -0.56, -0.18, P < 0.001) compared with the control group. Preterm infants in the intervention group also showed significant changes in heart rate pre-during-after the recorded maternal voice program. However, no significant differences were found in the heart rate scores between the two groups. DISCUSSION The changes in heart rate pre-during-after the intervention may help explain participants' more significant increase in weight, recumbent length, and head circumference. PRACTICE IMPLICATIONS The recorded maternal voice intervention could be incorporated into clinical practice to promote growth and development in preterm infants in the neonatal intensive care unit. STUDY REGISTRATION Australian New Zealand Clinical Trials Register, https://www.anzctr.org.au/; (registration number: ACTRN12622000019707).
Collapse
Affiliation(s)
- Meiling Qi
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; School of Nursing, College of Xinjiang Uyghur Medicine, Hetian 848099, Xinjiang, China
| | - Jingjing Gong
- Linyi People's Hospital, Linyi 276002, Shandong, China
| | - Zihui Xie
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
| | - Wendy Moyle
- School of Nursing and Midwifery, Griffith University, Nathan Campus, Brisbane, QLD 4111, Australia; Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, QLD 4111, Australia
| | - Qingyan Chi
- Linyi People's Hospital, Linyi 276002, Shandong, China
| | - Ping Du
- Linyi People's Hospital, Linyi 276002, Shandong, China
| | - Ping Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China.
| |
Collapse
|
15
|
Apaydin Cirik V, Gül U, Kihtir Z, Arayici S, Efe E, Çakmak H, Çalişkan F. The effect of using maternal voice, white noise, and holding combination interventions on the heel stick sampling. J Pediatr Nurs 2023; 70:1-11. [PMID: 36738536 DOI: 10.1016/j.pedn.2023.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/22/2023] [Accepted: 01/22/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Heel stick sampling, a common procedure in newborns, causes acute pain. AIMS This study aims to measure the outcome of five various non-pharmacologic pain relief groups; maternal voice, white noise, holding, maternal voice+holding, and white noise+holding. METHODS The study is an open label, randomized controlled trial. A total of 178 newborns were included in this study. Newborns were randomly allocated to each group; white noise (n = 31), maternal voice (n = 31), holding (n = 30), white noise+holding (n = 29), maternal voice+holding (n = 28), and control (n = 29) interventions. Newborns' pain responses were evaluated using the Neonatal Infant Pain Scale (NIPS), and the Premature Infant Pain Profile (PIPP). The primary measured outcomes were the newborns' pain levels, while the secondary outcomes were the heart rate and changes in oxygen saturation. The mean values of pain in neonates between groups were evaluated one minute before (Phase1), during (Phase2), and one minute after (Phase3) the procedure. RESULTS The research results are given with comparisons in three time periods (Phase1, Phase2 and Phase3). White noise and white noise+holding were found to have the lowest mean NIPS and PIPP score (p < 0.001). The mean heart rate was found to be the lowest in the white noise+holding group (p < 0.001). There was no significant difference between the groups in terms of oxygen saturation score (p = 0.453). CONCLUSION The white noise+holding applied to newborns during heel stick sampling were effective in pain reduction. Nurses and midwives can use white noise+holding method. IMPLICATIONS TO PRACTICE These results contribute to the pain management of newborns.
Collapse
Affiliation(s)
- Vildan Apaydin Cirik
- Karamanoğlu Mehmetbey University, Faculty of Health Sciences, Department of Midwifery, Karaman, Turkey.
| | - Uğur Gül
- Child Health Nursing Department, Nursing Faculty, Akdeniz University, Antalya, Turkey.
| | - Zeynep Kihtir
- Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
| | - Sema Arayici
- Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
| | - Emine Efe
- Child Health Nursing Department, Nursing Faculty, Akdeniz University, Antalya, Turkey.
| | - Havva Çakmak
- Akdeniz University Hospital, Akdeniz University, Antalya, Turkey.
| | - Fatma Çalişkan
- Akdeniz University Hospital, Akdeniz University, Antalya, Turkey.
| |
Collapse
|
16
|
Ren X, Li L, Lin S, Zhong C, Wang B. Effects of white noise on procedural pain-related cortical response and pain score in neonates: A randomized controlled trial. Int J Nurs Sci 2022; 9:269-277. [PMID: 35891905 PMCID: PMC9305016 DOI: 10.1016/j.ijnss.2022.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/04/2022] [Accepted: 06/09/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives To evaluate the effects of white noise on pain-related cortical response, pain score, and behavioral and physiological parameters in neonates with procedural pain. Methods A double-blind, randomized controlled trial was conducted. Sixty-six neonates from the Neonatal Intensive Care Unit in a university-affiliated general hospital were randomly assigned to listen to white noise at 50 dB (experimental group) or 0 dB (control group) 2 min before radial artery blood sampling and continued until 5 min after needle withdrawal. Pain-related cortical response was measured by regional cerebral oxygen saturation (rScO2) monitored with near-infrared spectroscopy, and facial expressions and physiological parameters were recorded by two video cameras. Two assessors scored the Premature Infant Pain Profile-Revised (PIPP-R) independently when viewing the videos. Primary outcomes were pain score and rScO2 during arterial puncture and 5 min after needle withdrawal. Secondary outcomes were pulse oximetric oxygen saturation (SpO2) and heart rate (HR) during arterial puncture, and duration of painful expressions. The study was registered at the Chinese Clinical Trial Registry (ChiCTR2200055571). Results Sixty neonates (experimental group, n = 29; control group, n = 31) were included in the final analysis. The maximum PIPP-R score in the experimental and control groups was 12.00 (9.50, 13.00), 12.50 (10.50, 13.75), respectively (median difference −0.5, 95% CI −2.0 to 0.5), and minimum rScO2 was (61.22 ± 3.07)%, (61.32 ± 2.79)%, respectively (mean difference −0.325, 95% CI −1.382 to 0.732), without significant differences. During arterial puncture, the mean rScO2, HR, and SpO2 did not differ between groups. After needle withdrawal, the trends for rScO2, PIPP-R score, and facial expression returning to baseline were different between the two groups without statistical significance. Conclusion The white noise intervention did not show beneficial effects on pain-related cortical response as well as pain score, behavioral and physiological parameters in neonates with procedural pain.
Collapse
Affiliation(s)
- Xuyan Ren
- Clinical Nursing Education & Research Section, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Li Li
- Clinical Nursing Education & Research Section, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Corresponding author.
| | - Siya Lin
- Clinical Nursing Education & Research Section, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Chunxia Zhong
- Department of Pediatrics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Bin Wang
- Department of Pediatrics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
17
|
Huang Q, Lai X, Liao J, Tan Y. Effect of non-pharmacological interventions on sleep in preterm infants in the neonatal intensive care unit: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2021; 100:e27587. [PMID: 34713833 PMCID: PMC8556050 DOI: 10.1097/md.0000000000027587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Premature infants are prone to suffer multisystem complications after birth due to the incomplete development of organ tissues and low immunity, and they require a longer period of supervised treatment in the neonatal intensive care unit (NICU). However, due to the specificity of medical care in the NICU, the sleep of preterm infants is highly susceptible that has an impact on the prognosis of preterm infants. Recently, various non-pharmacological interventions have been applied to the sleep of preterm infants in the NICU, which have shown positive outcomes. However, the efficacy and safety of them are unclear. This study aims to evaluate the effects of non-pharmacological interventions on sleep in preterm infants in the NICU through a network meta-analysis. METHODS Randomized controlled trials of non-pharmacological interventions on sleep in preterm infants in the NICU published before September 2021 will be searched in online databases, including the Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, Wanfang, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, and Web of Science. Two researchers will be independently responsible for screening and selecting eligible literatures, extracting data and evaluating the risk of bias in the included studies. Stata 14.0 software will be used for data analysis. RESULTS The results of this meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION This study will provide comprehensive and reliable evidence-based references for the efficacy and safety in different non-pharmacological interventions on sleep in preterm infants in the NICU.
Collapse
Affiliation(s)
- Qingchun Huang
- Department of Neonatology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei Province, China
| | - Xin Lai
- Department of Pediatric Critical Illness, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei Province, China
| | - Jianhua Liao
- Department of Child Health Care, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei Province, China
| | - Yingchao Tan
- Department of Neonatology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei Province, China
| |
Collapse
|
18
|
Jinhua L, Rongfang H. Response to Gray et al. (2021) Comment on 'Mothers' voices and white noise on premature infants' physiological reactions in a neonatal intensive care unit: A multi-arm randomized controlled trial'. Int J Nurs Stud 2021; 122:104049. [PMID: 34412875 DOI: 10.1016/j.ijnurstu.2021.104049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Liao Jinhua
- School of Nursing, Fujian Medical University, Fuzhou, China.
| | - Hu Rongfang
- School of Nursing, Fujian Medical University, Fuzhou, China.
| |
Collapse
|
19
|
Restin T, Gaspar M, Bassler D, Kurtcuoglu V, Scholkmann F, Haslbeck FB. Newborn Incubators Do Not Protect from High Noise Levels in the Neonatal Intensive Care Unit and Are Relevant Noise Sources by Themselves. CHILDREN (BASEL, SWITZERLAND) 2021; 8:704. [PMID: 34438595 PMCID: PMC8394397 DOI: 10.3390/children8080704] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND While meaningful sound exposure has been shown to be important for newborn development, an excess of noise can delay the proper development of the auditory cortex. AIM The aim of this study was to assess the acoustic environment of a preterm baby in an incubator on a newborn intensive care unit (NICU). METHODS An empty but running incubator (Giraffe Omnibed, GE Healthcare) was used to evaluate the incubator frequency response with 60 measurements. In addition, a full day and night period outside and inside the incubator at the NICU of the University Hospital Zurich was acoustically analyzed. RESULTS The fan construction inside the incubator generates noise in the frequency range of 1.3-1.5 kHz with a weighted sound pressure level (SPL) of 40.5 dB(A). The construction of the incubator narrows the transmitted frequency spectrum of sound entering the incubator to lower frequencies, but it does not attenuate transient noises such as alarms or opening and closing of cabinet doors substantially. Alarms, as generated by the monitors, the incubator, and additional devices, still pass to the newborn. CONCLUSIONS The incubator does protect only insufficiently from noise coming from the NICUThe transmitted frequency spectrum is changed, limiting the impact of NICU noise on the neonate, but also limiting the neonate's perception of voices. The incubator, in particular its fan, as well as alarms from patient monitors are major sources of noise. Further optimizations with regard to the sound exposure in the NICU, as well as studies on the role of the incubator as a source and modulator, are needed to meet the preterm infants' multi-sensory needs.
Collapse
Affiliation(s)
- Tanja Restin
- Department of Neonatology, Newborn Research Zurich, University Hospital Zurich, 8091 Zurich, Switzerland; (D.B.); (F.S.); (F.B.H.)
- Institute of Physiology, University of Zurich, 8057 Zurich, Switzerland; (M.G.); (V.K.)
| | - Mikael Gaspar
- Institute of Physiology, University of Zurich, 8057 Zurich, Switzerland; (M.G.); (V.K.)
| | - Dirk Bassler
- Department of Neonatology, Newborn Research Zurich, University Hospital Zurich, 8091 Zurich, Switzerland; (D.B.); (F.S.); (F.B.H.)
| | - Vartan Kurtcuoglu
- Institute of Physiology, University of Zurich, 8057 Zurich, Switzerland; (M.G.); (V.K.)
| | - Felix Scholkmann
- Department of Neonatology, Newborn Research Zurich, University Hospital Zurich, 8091 Zurich, Switzerland; (D.B.); (F.S.); (F.B.H.)
| | - Friederike Barbara Haslbeck
- Department of Neonatology, Newborn Research Zurich, University Hospital Zurich, 8091 Zurich, Switzerland; (D.B.); (F.S.); (F.B.H.)
| |
Collapse
|