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Aims. This study examined the effectiveness of non-nutritive sucking on preterm infant pain, changes in infant behaviour and frequency of abnormal physiological signals during heel stick procedures in Taiwan. Background. Preterm infants' repetitive exposure to painful procedures may result in changes to brain organisation. Pain management should be a priority in neonatal care. Design. Randomised control trial. Methods. Preterm infants (gestational age 28·9-37 weeks) were randomised to two groups: those receiving (experimental, n = 52) or not receiving non-nutritive sucking (control, n = 52) during heel stick procedures. Pain was measured before (for three minutes), during and after (during 10-minute recovery) heel stick procedures by the Premature Infant Pain Profile, changes in infant behaviour and abnormal physiological parameters. Results. Infants in both groups had similar odds ratios for pain and moderate-to-severe pain (0·57 and 0·58, respectively), after adjusting for time effects, postconceptional age, heel stick duration, painful experiences and baseline Premature Infant Pain Profile score. The pain scores of infants with non-nutritive sucking were significantly lower than those of non-nutritive sucking infants at all eight phases of the heel stick procedures. Infants undergoing heel stick procedures in the experimental group had lower rates ratios for 'grimace' and 'hand to mouth or face' behaviours than control infants (0·73 and 0·78, respectively). Conclusion. Non-nutritive sucking effectively reduced pain, particularly mild to moderate pain and behavioural responses to pain in infants receiving heel stick procedures, suggesting that nurses can offer this intervention to relieve pain in preterm infants undergoing invasive procedures. Relevance to clinical practice. Infants should be given an appropriate-sized pacifier for comfort during painful procedures. Nurses need to be informed about the effectiveness of non-nutritive sucking, its analgesic mechanisms and how to use and incorporate it into practice. [ABSTRACT FROM AUTHOR]

Aims. The purpose of this study was to explore the relationships between specific nurse care-giving behaviours and preterm infant behavioural responses during bathing and to identify nurse behaviours associated with infant ‘stress’. Background. Although recent advances in medical technology have improved neonatal intensive care, the high mortality and morbidity rates in preterm infants have not decreased proportionally. As caregivers strive to reduce infant mortality and morbidity, a factor for consideration is which caregiver behaviours are associated with preterm infant well-being. Design. A descriptive correlational design. Method. Convenience samples of 24 preterm infants and 12 nurses were recruited. A total of 120 baths were videotaped. Infant and nurse behaviours were measured using the coding schemes developed by the researchers. Pearson coefficient correlation, non-parametric Kruskal–Wallis test, t-test and generalised linear models were methods for data analysis. Results. As nurses provided more support, stress was reduced in the infants, and their self-regulation during the bath was enhanced especially by the use of ‘containment’ and ‘positional support’. Conversely, non-therapeutic caregiver behaviours including ‘rapid and rough handling’ of the baby, ‘chatting with other people’ and ‘inappropriate handling’ increased infant ‘stress’ during the bath. Conclusion. The findings provide new information about the link between care-giving and infant responses and how caregivers can better interact with preterm infants during a very sensitive period of brain development. Relevance to clinical practice. How nurses take care of the preterm infants influences their responses to care-giving stimuli. To interact better with the infant during care-giving procedures, nurses need to provide more supportive care-giving behaviours especially ‘position support’ and ‘containment’ based on the infant’s needs, and avoid care-giving that may be too rough and occur too quickly without attending the baby’s stressful signals, positioning the baby in hyperextension posture, or chatting with other people during procedures. [ABSTRACT FROM AUTHOR]