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Stress e massagem neonatal: efeitos da massagem no stress do recém-nascido pré-termo
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Advisor(s)
Abstract(s)
Este estudo experimental avaliou os efeitos da massagem nos recém-nascidos pré-termo internados em
unidades de cuidados intermédios neonatais a nível do stress.
A amostra foi constituída por 32 recém-nascidos pré-termo clinicamente estáveis e saudáveis, internados
em unidades portuguesas de cuidados intermédios neonatais. Os recém-nascidos foram distribuídos
aleatoriamente para os grupos controlo e experimental, em número igual de dezasseis. Em várias características
basais os grupos não apresentaram diferenças estatisticamente significativas, obtendo-se assim grupos
equivalentes. Durante o estudo os grupos receberam o mesmo padrão de cuidados neonatais, à exceção do
grupo experimental que recebeu a massagem.
A avaliação do stress foi feita pela medição da resposta neuro-endócrina, realizando-se no primeiro e
último dia do estudo colheitas de sangue e de urina das 24 horas para determinar os valores hormonais de
cortisol, norepinefrina e epinefrina.
Quanto aos níveis de cortisol na urina, constatámos que não existiram diferenças significativas entre os
grupos ou entre os momentos e o efeito da interacção entre o grupo e o tempo também não foi estatisticamente
significativo.
Relativamente aos níveis de cortisol no sangue, verificámos que o efeito do tempo foi estatisticamente
significativo com p <0,001. Os níveis de cortisol no sangue dos recém-nascidos pré-termo de ambos os grupos
foram idênticos nos dois momentos e registou-se, do primeiro para o segundo momento, uma diminuição
semelhante. Quer no grupo experimental quer no grupo de controlo as diferenças do primeiro para o segundo
momento foram estatisticamente significativas com p = 0,001 e p = 0,004, respectivamente.
Os efeitos do grupo, do tempo e da interacção entre as duas variáveis não foram estatisticamente
significativos quanto à variável norepinefrina urinária. Verificámos a existência de efeito significativo (p = 0,044)
do grupo sobre os níveis de norepinefrina no sangue mas os efeitos do tempo ou da interacção não foram
significativos. Em qualquer dos momentos os recém-nascidos do grupo experimental evidenciaram níveis de
norepinefrina no sangue inferiores aos dos recém-nascidos do grupo de controlo e o aumento do primeiro para
o segundo momento foi significativo com p = 0,002 no grupo experimental e p = 0,004 no grupo de controlo.
Os efeitos do grupo, do tempo e da interacção entre estas duas variáveis não foram estatisticamente
significativos em relação à epinefrina urinária. Relativamente aos níveis de epinefrina no sangue, verificamos
que nenhum dos efeitos foi estatisticamente significativo.
Com os resultados expostos concluímos que o efeito da massagem sobre o stress dos recém nascidos
pré-termo saudáveis e clinicamente estáveis internados em unidade de cuidados intermédios neonatais não foi
estatisticamente significativo.
This experimental study evaluated the effects of the massage on stress in preterm neonates that were hospitalised in neonatal intermediate care units. The sample consisted of 32 healthy and clinically stable premature neonates, hospitalised in Portuguese units of intermediate neonatal care. The premature neonates were randomly distributed in two groups - control and experimental - with 16 neonates in each group. The groups did not display statistically significant differences in basic features, thus forming equivalent groups. During the study both groups received the same pattern of neonatal care, in addition, the experimental group also received the massage. Stress levels were evaluated by measuring the levels of cortisol, norepinephrine and epinephrine (neuroendocrine catecholamines) samples of blood and urine obtained on the first and last day of the study. There was no statistically significant difference in the levels of cortisol in the urine between groups or between the first and last day. As far as the levels of cortisol and urine are concerned, we evidenced that there are not significant differences between the groups or the moments and that both the effect of the interaction between the group and the time is not statistically significant Concerning the levels of cortisol in the blood, we verified that the effect of time is statistically significant with p <0.001. The levels of cortisol in the blood of the preterm neonates from both groups were identical at the two moments and a similar reduction occurred from the first to the second moment. In the experimental group as well as in the control group the differences from the first to the second moment are statistically significant whit p=0.001 and p=0.004, respectively. In regards to the levels of urinary norepinephrine, the effects of group, time, and interaction between the two variables were not statistically significant. As for the levels of norepinephrine in the blood, we verified the existence of a significant effect (p=0.040) in the group, however the effects of time or interaction were not significant. The experimental group demonstrated inferior levels of norepinephrine in the blood at all times; and the increase between the first moment to the second was statistically significant for the experimental group (p=0.002) and for the control group (p=0.004). Neither urinary or blood epinephrine levels varied in a statistically significant fashion when comparing groups, time, or the interaction between those two variables. We conclude that the effect of massage on the stress of healthy and medically stable preterm newborns admitted to neonatal intermediate care unit was not statistically significant.
This experimental study evaluated the effects of the massage on stress in preterm neonates that were hospitalised in neonatal intermediate care units. The sample consisted of 32 healthy and clinically stable premature neonates, hospitalised in Portuguese units of intermediate neonatal care. The premature neonates were randomly distributed in two groups - control and experimental - with 16 neonates in each group. The groups did not display statistically significant differences in basic features, thus forming equivalent groups. During the study both groups received the same pattern of neonatal care, in addition, the experimental group also received the massage. Stress levels were evaluated by measuring the levels of cortisol, norepinephrine and epinephrine (neuroendocrine catecholamines) samples of blood and urine obtained on the first and last day of the study. There was no statistically significant difference in the levels of cortisol in the urine between groups or between the first and last day. As far as the levels of cortisol and urine are concerned, we evidenced that there are not significant differences between the groups or the moments and that both the effect of the interaction between the group and the time is not statistically significant Concerning the levels of cortisol in the blood, we verified that the effect of time is statistically significant with p <0.001. The levels of cortisol in the blood of the preterm neonates from both groups were identical at the two moments and a similar reduction occurred from the first to the second moment. In the experimental group as well as in the control group the differences from the first to the second moment are statistically significant whit p=0.001 and p=0.004, respectively. In regards to the levels of urinary norepinephrine, the effects of group, time, and interaction between the two variables were not statistically significant. As for the levels of norepinephrine in the blood, we verified the existence of a significant effect (p=0.040) in the group, however the effects of time or interaction were not significant. The experimental group demonstrated inferior levels of norepinephrine in the blood at all times; and the increase between the first moment to the second was statistically significant for the experimental group (p=0.002) and for the control group (p=0.004). Neither urinary or blood epinephrine levels varied in a statistically significant fashion when comparing groups, time, or the interaction between those two variables. We conclude that the effect of massage on the stress of healthy and medically stable preterm newborns admitted to neonatal intermediate care unit was not statistically significant.
Description
Keywords
Massagem Stress Recém-nascido pré-termo Massage Stress Neonate pre-term . Escola Superior de Saúde
Citation
Freitas, O. M. S. & Figueiredo, M. C. A. B. (2012). Stress e massagem neonatal: efeitos da massagem no stress do recém-nascido pré-termo. Pensar Enfermagem, 16(1), 55-79.
Publisher
Unidade de Investigação e Desenvolvimento em Enfermagem