The Effect of Massage on Pain, Comfort and Feeding Status of Preterm Infants Under Nasal Continuous Positive Airway Pressure (NCPAP)

1. Introduction Neonatal intensive care unit (NICU) is a place where postnatal babies are followed up due to respiratory distress, sepsis, congenital anomalies, prematurity and the problems caused by it. With the advances in technology and science, the survival rate of preterm babies has increased, but morbidity is increasing. Respiratory failure, which is associated with high neonatal morbidity and mortality, is a common clinical condition that negatively affects newborns according to their gestational age. Respiratory distress is generally seen physiologically due to the immaturity of the lungs of preterm infants and mechanical ventilation application support is needed. Nasal continuous positive airway pressure (NCPAP), which is most commonly used as initial treatment, is a treatment method used to provide respiratory support in preterm infants. NCPAP increases the pressure in the lungs by providing preterm babies with a continuous airflow through the nasal passage (with mask / cannula), prevents airway closure, prevents air trapping in the lungs and supports breathing. However, undesirable conditions such as pain, gastric distension, feeding intolerance, nasal injury and pneumothorax may occur in preterm infants with NCPAP application. Nonpharmacological methods such as positioning and massage can be used to prevent these complications, to increase the comfort of infants during treatment and to obtain a positive response to treatment. Massage reduces stress and pain, increases vagal activity, gastric motility and weight gain in newborns increases the frequency of defecation reduces the level of bilirubin has been reported. It has been determined that massage decreases stress levels in newborns monitored on mechanical ventilator, regulates respiratory rhythm with relaxant effect and increases the effectiveness of treatment.

When the literature was examined, although there were studies evaluating the effectiveness of massage in the neonatal unit . The study evaluating the effect of massage in preterm infants receiving NCPAP is limited. This study was planned as a randomised controlled experimental study with pre-test post-test design in order to investigate the effect of massage on pain, comfort and nutritional status in infants undergoing NCPAP in the NICU, considering that massage may be effective in reducing the effectiveness of treatment and complications that may develop due to NCPAP by reducing stress in newborns undergoing NCPAP. 2. MATERIALS AND METHODS 2.1.Purpose and Type of Research This research will be carried out as a randomised controlled experimental study in a pretest-posttest design in order to examine the effect of massage on pain, comfort and nutritional status of preterm infants who received Ncpap in the neonatal intensive care unit.

2.2. Hypotheses of the Research Massage in preterm infants receiving NCPAP therapy; H1 : has an effect on pain. H2 : has an effect on comfort. H3 : has an effect on nutritional intolerance (vomiting, abdominal distension, faecal output...).

2.3. Variables of the Research The independent variables of the study were the variables included in the Form of Descriptive Characteristics of Newborns (birth weight, gestation week and sex of the baby...).

The dependent variables of the study were pain and comfort scale scores of preterm infants, feeding intolerance status (presence of vomiting, abdominal distension, number of stools/day).