ผลของการพยาบาลด้วยการจัดสิ่งแวดล้อมร่วมกับการฟังบทสวดอภัยปริตรต่อคุณภาพการนอนหลับในทารกเกิดก่อนกำหนด

Abstract

This cross-over experimental research design aimed to compare the sleep quality including deep sleep, active sleep, and total sleep of preterm infants who received routine nursing care, nursing care for environmental management, apaiparit chant listening, and nursing care for environmental management with apaiparit chant listening. Purposive sampling was used to select 32 preterm infants admitted in the neonatal intensive care unit, Phatthalung Hospital. All preterm infants were randomly allocated to either group 1 (with the sequence routine nursing care, C; nursing care with environmental management, E; apaiparit chant listening, A; and nursing care for environmental management with apaiparit chant listening, EA; n = 8), group 2 (with the sequence E, A, EA, and C; n = 8), group 3 (with the sequence A, EA, C, and E; n = 8), or group 4 (with the sequence EA, C, E, and A; n = 8). Each preterm infants received one intervention per day during 12.00 noon -02.00 p.m. Data were collected using: 1) a demographic data record form, and 2) a sleep-wake behaviors of premature infant assessment form with its manual. The content validity of the tool was verified by 3 experts. The inter-rater reliability of the sleep-wake behaviors assessment between the expert and the researcher, and the researcher and the research assistant was estimated with 240 events, yielding an agreement of 95.83, and 97.50 percent, respectively. The demographic data were analyzed using frequency, percentage, mean, and standard deviation. The differences of the overall means of deep sleep, active sleep, and total sleep were analyzed using one-way analysis of variance, and compared with each paired using Scheffe's test. The results revealed that 1. There were significant differences of overall means of deep sleep, active sleep, and total sleep of preterm infants who received the routine nursing care, nursing care for environmental management, apaiparit chant listening, and nursing care for environmental management with apaiparit chant listening (p < 001) 2. When comparing means of each sleep stage, the results were as follows. 2.1 The mean of deep sleep of preterm infants in the routine nursing care group was lower than those of preterm infants in the nursing care for environmental management, apaiparit chant listening, and the nursing care for environmental management with apaiparit chant listening groups (p < .001). The mean of deep sleep of preterm infants in the nursing care for environmental management group was lower than those of preterm infants in the apaiparit chant listening, and the nursing care for environmental management with apaiparit chant listening groups (p < 001). There was a non significant difference of means of deep sleep of preterm infants between the apaiparit chant listening and the nursing care for environmental management with apaiparit chant listening groups (p > .05). The order of the study group having means of deep sleep from the highest to lowest was as follows: 1) nursing care for environmental management with apaiparit chant listening, 2) apaiparit chant listening, 3) nursing care for environmental management, and 4) routine nursing care groups. 2.2 The mean of active sleep of preterm infants in the routine nursing care group was higher than those of preterm infants in the apaiparit chant listening and nursing care for environmental management with apaiparit chant listening groups (p < 001). The means of active sleep of preterm infants in the nursing care for environmental management group was higher than that of preterm infants in the nursing care for environmental management with apaiparit chant listening group (p < 05). There were non significant differences of means of active sleep of preterm infants between the routine nursing care and the nursing care for environmental management groups, between the nursing care for environmental management and the apaiparit chant listening groups, and between the apaiparit chant listening and the nursing care for environmental management with apaiparit chant listening groups (p > 05). The order of the study group having means of active sleep from the highest to lowest was as follows: 1) routine nursing care, 2) nursing care for environmental management, 3), apaiparit chant listening, and 4) nursing care for environmental management with apaiparit chant listening groups. 2.3 The mean of total sleep of preterm infants in the routine nursing care group was lower than those of preterm infants in the apaiparit chant listening, and nursing care for environmental management with apaiparit chant listening groups (p < 001). The means of total sleep of preterm infants in the nursing care for environmental management group was lower than those of preterm infants in the apaiparit chant listening (p < 01) and the nursing care for environmental management with apaiparit chant listening groups (p < .001). There were non significant differences of means of total sleep of preterm infants between the routine nursing care and the nursing care for environmental management groups, and between the apaiparit chant listening and the nursing care for environmental management with apaiparit chant listening groups (p > .05). The order of the study group having means of total sleep from the highest to lowest was as follows: 1) nursing care for environmental management with apaiparit chant listening, 2) apaiparit chant listening, 3) nursing care for environmental management, and 4) routine nursing care groups. Based on the results of this study, nurses can use the nursing care for environmental management with apaiparit chant listening or apaiparit chant listening if they cannot manage environment as an alternative way to enhance sleep of preterm infants.