Neonatal Behavioral Assessment Scale Article Summary
All previous information has been reviewed and is up to date. There continues to be limited research on the psychometric characteristics of this outcome measure, including validity, reliability, and standardized norms.
Summary of article utilizing the NBAS:
Effects of hammock positioning in behavioral status, vital signs, and pain in preterms: a case series study
This study sought to research and summarize the impact that hammock positioning has on preterm babies within the neonatal intensive care unit. With the use of a hammock, researchers discovered the impact that positioning had on decreasing both cardiovascular and cardiopulmonary response. The idea of hammock positioning is to replicate the intrauterine environment in order to lessen the response to noxious stimuli that is present within the NICU environment. Research is limited in regards to the hammock positioning technique, so this article mainly focused on behavioral changes as well as any changes with pain or vital signs during positioning. The hammock was utilized in one hour increments following meal time with additional support required to maintain neck and head positioning. Pain evaluation was performed using the Neonatal Facing Coding System (NFCS), vitals were measured using a standard monitor, and sleep/wake cycle was measured using the Neonatal Behavioral Assessment Scale (NBAS). The following measures were performed at 10 min prior to positioning, every 20 minutes during positioning, and 10 minutes following discontinuation of positioning.
In regards to results and the use of the NBAS, it was found to be statistically significant, with approximately 89% of infants being in deep or light sleep by the end of the 60 minute trial. No other results were relevant, with no change in pain rating, and vitals changing respectively with sleep, but nothing of great significance. It was discussed and concluded that the use of hammock positioning is not only more humane to the child, but helps to regulate a sleep/wake cycle naturally. It is a positioning device that induces sleep within neonates, and did not result in any adverse signs that would require the child to be immediately returned to the incubator.
This study explained the process in layman terms that made it easy for the reader to understand all steps of the research process. With this being the first research of its kind regarding hammock positioning, it is important to note that more research needs to be performed. As a future clinician, hammock positioning may be an option if we are placed in the NICU environment, and this study helps to support the “why”. This study did not have a control group, and did not compare to infants that were full term and considered healthy. I believe greater research needs to be performed to see if this positioning technique could benefit all children, decrease the risk of SIDS, and help decrease risk of positional plagiocephaly for infants of all ages, sizes and health status.
Reference:
Jesus, Valdecira Rodrigues De, et al. “Effects of Hammock Positioning in Behavioral Status, Vital Signs, and Pain in Preterms: a Case Series Study.” Brazilian Journal of Physical Therapy, vol. 22, no. 4, 2018, pp. 304–309., doi:10.1016/j.bjpt.2018.03.002.
3 responses to “Neonatal Behavioral Assessment Scale Article Summary”
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While more research needs to be performed, I think the outcome measure shows proof that hammock positioning can be beneficial for infants in the NICU setting. Further research should explore infants in all settings because this method appears to affordable, safe, and something that can be carried out at home or in the hospital setting.
I think the hammock use in the NICU is a great idea and seems to be very helpful for even the most vulnerable little ones. When I did observations in the NICU, they always said that a sleeping baby is a healing baby, and since this hammock allowed the neonates to get into and maintain a “deep sleep” it sounds like this is a useful tool to aid in their healing. I too would like to see further research performed on safety of the hammock in the home as there is a lot of buzz about “safe sleeping” at this time.
Nice review! What do you think about the safety of this being used in the home?