Keywords
neonatus
pemberian ASI
pacifier
bedung
How to Cite
Abstract
Prosedur tindakan invasif merupakan salah satu prosedur yang sering dilakukan di rumah sakit khususnya di ruang NICU dan menimbulkan nyeri pada neonatus. Beberapa manajemen nyeri non-farmakologi untuk menurunkan nyeri adalah dengan pemberian pacifier, ASI, dan bedung. Namun metode tersebut masih perlu diukur keefektifannya dalam manajemen menurunkan nyeri. Tujuan dari penelitian ini adalah untuk mengidentifikasi efektivitas terapi non-farmakologis terhadap nyeri tindakan invasif pada neonatus di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda (RSUDZA) Aceh. Penelitian ini menggunakan desain randomized control trial (RCT). Populasi dalam penelitian ini adalah seluruh neonatus risiko tinggi yang tidak mendapatkan obat sedasi di ruang NICU level IIA dan IIB RSUDZA. Jumlah sampel sebanyak 19 orang dan menggunakan teknik randomisasi alokasi yang terdiri dari empat kelompok yaitu kelompok kontrol, kelompok intervensi 1 (pemberian pacifier), kelompok intervensi 2 (pemberian pacifier dan bedung), dan kelompok intervensi 3 (pemberian ASI dan bedung). Skala nyeri pada sampel dinilai menggunakan intrumen neonatal infant pain scale (NIPS). Analisis statistik menggunakan uji normalitas, uji homogenitas, uji anova dan uji Post Hoc Bonferroni. Hasil penelitian ini menunjukkan bahwa data normal, homogen dan diperoleh p valu e0,364 yang berarti tidak ada perbedaan tingkat nyeri antar semua kelompok penelitian. Namun secara klinis, kelompok intervensi pemberian pacifier dan bedung memiliki skala nyeri terendah (2,25) dan memiliki perbedaan rerata 2,6 poin dengan kelompok kontrol. Diharapkan seluruh perawat di NICU dapat melakukan pengkajian nyeri pada neonatus terutama saat tindakan invasif agar dapat memberikan manajemen nyeri yang tepat.
References
Badan Kependudukan dan keluarga Berencana Nasional (BKKBN). Survey Demografi dan Kesehatan Indonesia Tahun 2017. 10 Februari 2017. https://www.bkkbn.go.id.
Ball, Blinder, & Cowen. (2010). Child health nursing: Partnering children & families. (2th ed). New Jersey: Pearson.
Bowden, V.R., Dickey, S.B., Greenberg, C.S. (1998). Children and their families: The continuum of care. Philadhelphia: Pa.Saunders.
Brummelte, S., Grunau, R.E, Chau, V., Poskitt, K.J., Brant, R, Vinall, J., Gover, A., Synnes, A.R., & Miller, S.P. (2012). Procedural pain and brain development in premature newborns. Annals of Neurology, 71(3), 385-396. https://doi.org/10.1002/ana.22267.
Carbajal, R., Veerapen S., Couderc, S., Jugie, M., & Ville Y. (2003). Analgesic effect of breast feeding in term neonates: Randomised controlled trial. http://www.bmj.com.
Efendi, D., Rustina, Y., and Gayatri, D. (2018) Pacifier and swaddling effective in impeding premature infant’s pain score and heart rate. Enferm Clin. 2018; 28 (Supl 1 Part A):46-50.
Goldstein, R. F. (2012). Developmental care for premature infants: A state of mind. Pediatrics Journal, e1322-e1333.
Gouin, S.,Gaucher, N., Lebel, D., Desjardins, M.P. A randomized double-blind trial comparing the effect on pain of an oral sucrose solution vs placebo in children 1 to 3 months old undergoing simple venipuncture. The Journal of Emergency Medicine, Vol.54. No.1, pp.33-39, 2017. https://doi.org/10.1016/j.jemermed.2017.08.015.
Hastono, S. (2006). Analisa Data Kesehatan. Jakarta: Universitas Indonesia.
Hockenberry, M. J., & Wilson, D. (2007). Wong’s nursing care of infants and children. 8th ed. St. Louis: Mosby Elsevier.
Johnston CC, Fernandes AM, Campbell-yeo M. Pain in neonates is defferent. 2011;152(3):S65-73.
Kashaninia, Z., Sajedi, F., Rahgozar, M., & Noghabi, F. A. (2008) The effect of kangaroo care on behavioral responses to pain of an intramuscular injection in neonates. Journal for Specialists in Pediatric Nursing. Philadelphia: Vol. 13, Iss. 4; pg. 275, 6 pgs.
Lawrence, J., Alcock, D., McGrath, P., Kay, J., MacMurray, S.B., Dulberg, C. The Development of a tool to assess neonatal pain. Neonatal Netw 1993;12:59–66.
Liaw, J.J., Yang, L., Wang, K.W., Chen, C.M., Chang, Y.C., Yin, T. Non-nutritive sucking and facilitated tucking relieve preterm infant pain during heel-stick procedures: A prospective, randomised controlled crossover trial. International Journal Of Nursing Studies. Volume 49, Issue 3, March 2012, Pages 200-309. https://doi.org/10.1016/j.ijnurstu.2011.09.017.
Liaw, J.-J., Zeng, W.-P., Yang, L., Yuh, Y.-S., Yin, T., & Yang, M.-H. (2011). Nonnutritive sucking and oral sucrose relieve neonatal pain during intramuscular injection of hepatitis vaccine. Journal of Pain and Symptom Management, 42(6), 918–30. doi:10.1016/j.jpainsymman.2011.02.016.
Marceau, J. Pilot study of a pain assessment tool in the neonatal intensive care unit. Journal of Pediatrics And Child Health. Volume 39. Issue 8. 21 October 2003. https://doi.org/10.1046/j.1440-1754.2003.00215.x
Melzack R, Wall PD. Pain mechanism: A new theory. J Stor1. 1965;150(3699):971-9.
Neuspiel, D. R. (2003). Commentary analgesic effect of breast feeding in term neonates: Randomised controlled trial. http://www.bmj.com, diperoleh tanggal 12 Februari 2009.
Notoatmodjo. (2007). Metodelogi penelitian kesehatan. Jakarta: Rineka Cipta.
Perroteau, A., Nanquette, M.C., Rousseau, A., Renolleau, S., Berard, L., Mitanchez, D., and Leblanc, J. Efficacy of facilitated tucking combined with non-nutritive sucking on very preterm infants’ pain during the heel-stick procedure: A randomized controlled trial. 2018. https://doi.org/10.1016/j.ijnurstu.2018.06.007.
Rachel, A., Fleishman, Dennis, E., and Mayock, Naonatal pain and stress: Assessment and management. Avery’s Diseases of Newborn. 10th Edition, pages 432-445. https://doi.org/10.1016/B978-0-323-40139-5.00034-6.
Ridell, R.P., Racine, N., Turcotte, K., Usman, L.S., Horton, R., Osmun, L.D.., Kohut, S.A., Stuart, J.H., Stevenns, B & Lisi, D. (2011). Nonpharmacological management of procedural pain in infants and young children: An abridge cochrane review. Pain Research and Management: The Journal of the Canadian Pain Society, 16(5), 321-330.
Sastroasmoro, S. (2012). Dasar-dasar metodologi penelitian klinis. Jakarta: Sagung Seto.
Schechter, N. L., Zempsky, W. T., Cohen, L. L., Grath, P.J., & et al. (2007). Pain reduction during pediatric immunizations: Evidence-based review and recommendations. Pediatrics. Evanston: May 2007. Vol. 119, Iss. 5; pg. E1184.
Schollin, J. (2007). Analgesic effect of expressed breast milk in procedural pain in neonates. Acta Paediatrica. Volume 93, issue 4. https://doi.org/10.1080/08035250410027959.
Thakkar, P., Arora, K., Goyal, K., Das, R.R., Javadekar, B., Aiyer, S., dan Panigrahi, S.K. To evaluate and compare the efficacy of combined sucrose and non-nutritive sucking for analgesia in newborn undergoing minor painful procedure: a randomized controlled trial. Journal of Perinatology. Volume 36, pages 67-70 (2016).
Valeri, B., Holsti, L., & Linhares, M. (2015). Neonatal pain and developmental outcomes in children born preterm: A systematic review. The Clinical Journal of Pain, 31(4), 1-31.
Valeri, B.O., Holsti, L., Linhares, M.B.M. Neonatal pain and developmental outcomes in children born preterm: A systematic review. The Clinical Journal of Pain: April 2015- volume 31 – Issue 4 – p.355-362. doi: 10.1097/AJP.0000000000000114.
Walter-Nicolet, E., Annequin, D., Biran, V., Mitanchez, D., & Tourniaire, B. (2010). Pain management in newborns: From prevention to treatment. Pediatric Drugs, 12(6), 353-365.
Witt, N., Coynor, S., Edwards, C & Bradshaw, H. (2016). A guide to pain assessment and management in the neonate. Pain Management In Pediatrics. Volume 4. Issue 1, pp 1-10.