Title Smanjenje stresa nedonoščadi kod probira na prematurnu retinopatiju Title (english) Reduction of preterm infant stress in screening for premature retinopathy Author Maja Benc Mentor Nenad Vukojević (mentor)Committee member Tomislav Jukić (predsjednik povjerenstva)Committee member Tomislav Vidović (član povjerenstva)Committee member Nenad Vukojević (član povjerenstva)Granter University of Zagreb Defense date and country 2020-09-29, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Prematurna retinopatija ili ROP glavni je uzrok gubitka vida kod nedonoščadi.
Pravovremenim probirom na ROP i liječenjem možemo unaprijediti njihov vidni
ishod. Stoga su nedonoščad gotovo redovito izložena, dokazano stresnim i bolnim
postupcima probira. Nakon dugotrajnog vjerovanja da prijevremeno rođena djeca ne
osjećaju bol i stres, saznanje o suprotnom pokrenulo je istraživanja o mogućim
posljedicama stresa i boli na razvoj. Brojna istraživanja pokazuju da opetovana bol
može imati izravne i dugoročne posljedice na neurološki i bihevioralni razvoj
novorođenčadi. Strategije za smanjenje stresa i liječenje boli ključne su za
promicanje rasta i razvoja, te minimaliziranje dugoročnih posljedica. Proceduralna
analgezija bi trebala uključivati koncepte razvojne njege, nenutritivnog sisanja,
farmakoloških i ostalih navedenih nefarmakoloških sredstava. Nažalost, literatura ne
daje jasne dokaze da intervencije poput kapi za anesteziju, oralna saharoza ( ili
glukoza, ili dekstroza), nenutritivno sisanje i pozicioniranje blagotvorno smanjuje
stres (nelagodu) kod pregleda na ROP. Niti jedna od njih primijenjena samostalno
nije pokazala značajniju promjenu u bodovima na skali za procjenu boli.Zbog mnogih
nepoznanica u farmakokinetici i djelovanju, te nuspojavama primijenjenih lijekova za
ublažavanje stresa, za nedonoščad je prije primjene nužno sagledati korist, odnosno
štetu, koju uzrokuje primjena lijeka. Slijedom toga prilikom probira na ROP, često se
primijeni samo lokalni anestetik i/ili saharoza koja se pokazala nedovoljnim
sredstvom za ublažavanje stresa. Trenutne spoznaje nam pružaju nekoliko mogućih
alata, farmakoloških i nefarmakoloških koje možemo primijeniti bez većeg rizika, a
preporuka je da ih se koristi naizmjenično, u kombinacijama koje se u našem
okruženju pokažu najefikasnijima. Brzi napredak u tehnologijama i proširivanje
znanja o bolesti i genetici, zajedno s rastućom potrebom za učinkovitim i
pravodobnim procjenama ROP-a, može u bliskoj budućnosti u potpunosti
transformirati sadašnji dijagnostički pristup. Cilj nam je prvenstveno novim alatima
suziti broj nedonoščadi koja trebaju biti pregledana, a onda i broj potrebnih pregleda,
da se izbjegne nepotrebni stres i neugodnost za dijete, a kod djece koja moraju biti
pregledavana smanjiti neugodnost i stres.
Abstract (english) Retinopathy of prematurity or ROP is the leading cause of vision loss in preterm
infants. Timely screening and treatment of ROP can improve the visual outcome in
infants. Hence, preterm infants are repeadetly exposed to proven stressful and
painful screening procedures. After a long-held belief that premature infants do not
feel pain and stress was proven contrary, researches about possible repercussions
of stress and pain on infant development were initiated. Numerous studies reveal
that recurrent pain can have direct and long-term consequences on the neurological
and behavioral development of newborns. Strategies to reduce stress and treat pain
are crucial in promotion of growth and development, as well as minimizationof longterm consequences. Procedural analgesia should include the concepts of
developmental care, non-nutritive sucking, pharmacological and other listed nonpharmacological agents. Unfortunately, the literature does not provide clear evidence
that interventions such as anesthetic drops, oral sucrose (or glucose, or dextrose),
non-nutritive sucking, and positioning are beneficial in reduction of stress
(discomfort) due to ophthalmic examination for ROP. None of the interventions by
itselfdemonstrated a significant change in score points on the pain assessment
scale. Due to many unknown factorsabout pharmacokinetics, action and side effects
of drugs used to relieve stress, it is necessary to consider the benefits versus harms
to premature infants. Consequently, when screening for ROP, only a local anesthetic
and / or sucrose is often used, attested to be an insufficient stress reliever. Current
knowledge provides us several possible methods, pharmacological and nonpharmacological, that can be used without significant risk. It is recommended to use
those methods alternately, in combinations proven to be most effective in our
environment. Rapid advances in technology and the expansion of knowledge about
the disease and underlying genetics, together with the growing need for effective and
timely ROP assessments, may completely transform the current diagnostic approach
in the near future. Our goal is primarily to use new tools to reduce the number of
premature infants that need to be examined and then the number of requisite
examinations in order to avoid unnecessary stress and discomfort for the infant,
children who need to be examined reduce discomfort and stress.
Keywords
probir
prematurna retinopatija
nedonošče
stres
bol
Keywords (english)
screening
retinopathy of prematurity
premature infant
stress
pain
Language croatian URN:NBN urn:nbn:hr:105:869729 Study programme Title: Studies in Nursing Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2021-05-17 08:42:14
