Effectiveness of Tactile and Auditory Stimulation on Physiological Parameters among Preterm Neonates at NICU - a RCT Study Design

Abstract

Purpose: To evaluate the effectiveness of tactile & auditory stimulation on physiological parameters weight, temperature, heart rate, respiratory rate, oxygen saturation, feeding pattern, sleeping hours, crying spells and urination among preterm neonates.

Material and Methods: A quantitative research approach with true experimental research design was adopted for this study Samples: 120 preterm neonates who got admission and present in the NICU or postnatal unit of KKMCH, who satisfied inclusion criteria. Tool: The tool was developed, validated by experts and checked for its reliability Sample Size:  Open Epi, Version 3, open source calculator Sample Size for Comparing Two Means from pilot study. Total sample size 120. Among them 60 preterm neonates were assigned to experimental group and control group each randomly. Statistical analysis used: Demographic data using frequency and percentage distribution. Physiological parameters were analyzed by using mean, standard deviation, paired T test.  Structured interview schedule by Chi Square test. Association by Multiple Logistic Regression.

Findings: Out of 120 preterm neonates, 48.3 % males, 51.7 % females and 42.5 % Hindus, 52.5% Christians and 5 % Muslims. Gestational age 18.33 % between 28 - 30 weeks, 40 % between 31 - 33 weeks and 41.67 % between 34 - 36 weeks. The paired difference of mean in pre term neonates on post - intervention 3^rd day and 5^th day in experimental and control group in weight gain were 109.83, 176.33 grams & 78.16, 118.33 grams, temperature were 0.27⁰, 0.87⁰Celsius & 0.15⁰, 0.31⁰ Celsius, heart rate were 10.17, 9.30 & 4.63, 3.93 beats/ minute , respiratory rate were 5.70, 11.23 & 3.00 , 5.80 breaths / minute ,mean oxygen saturation were 2.47, 4.65% & 1.12, 2.23 % . The .mean pre intervention Vs post intervention on 5^th day  among over all physiological parameter consists of structured interview schedule in experimental group and control group includes increased feeding  pattern by 50% and 11.7%  (X² = 26.612), increased sucking pattern  by 55% and 10%  (X² = 30.572), increased duration per sleep by 68.3% and 5% (X² = 56.885), increased sleeping pattern by 61.7% and 6.7%  (X² = 43.364), decreased crying pattern by 60% and 1.7% (X² = 48.553) and increased urination pattern by 73.3% and 6.7%  (X² = 58.989) than control group.  The present study findings concluded that the tactile and auditory stimulation had positive effects on growth and maturation in preemies. It can be used in any clinical and community settings to maintain the physiological parameters among preterm neonates. 

Implications to Theory, Practice and Policy: Since massage therapy is a cost effective therapeutic technique it should be encouraged in all community especially rural poor pre term babies. Health education about massage & music therapies should be given to NICU nurses, staff nurses, village health nurses, Auxiliary nurse midwife in order to promote these therapies as a routine care in the management of preterm neonates & low birth weight babies.