The purpose of this study was to (a) describe the physiological and behavioural responses of premature infants to a tissue-damaging stimulus and (b) determine how severity of illness and behavioural state influenced these responses. A convenience ample of 124 premature infants between 32 and 34 weeks gestational age was obtained from one neonatal unit in a Montreal teaching hospital. Physiological (heart rate, oxygen saturation, intracranial pressure) and behavioural (facial expression and cry) data were collected during the baseline, warming, stick and squeeze phases of a routine heelstick procedure. Behavioural state and severity of illness were assessed using instruments by Prechtl (1974) and Georgieff, Mills and Bhatt (1989). Demographic data were collected from the medical record. Data analysis was performed utilizing repeated measures multivariate analysis of variance (RM MANOVA), multivariate analysis of variance (MANOVA) and repeated measures multivariate analysis of covariance (RM MANOVA). There were significant differences in physiological and behavioural parameters between baseline and stick including: (a) an increase in maximum heart rate, (b) a decrease in minimum oxygen saturation, (c) an increase in intracranial pressure and (d) an increase in the proportion of all facial actions. For those infants who cried during both the stick and squeeze phase, the fundamental frequency, harmonic structure and peak spectral energy were significantly increased during the stick as compared to the squeeze. Behavioural state was found to modify the facial expression variables and severity of illness modified the acoustic cry variables. An interaction between behavioural state and severity of illness influenced maximum heart rate. There was no significant relationship between physiological and behavioural outcomes. Both categories of outcomes provide important but different information about the premature infant's response to a tissue-damaging stimulus. A multidimen
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.41152 |
| Date | January 1993 |
| Creators | Stevens, Bonnie |
| Contributors | Johnston, Celeste (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (School of Nursing.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001327504, proquestno: NN87916, Theses scanned by UMI/ProQuest. |
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