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 Comparison of clustered care with three and four procedures on behavioral responses of preterm infants: Randomized crossover clinical trial  Valizadeh L[1], Avazeh M [2]*, Hosseini MB[3], Asghari Jafarabadi M[4], Conneman N[5], Babaei N[6]  Received: 13 Jul , 2014 Accepted: 15 Sep , 2014  Abstract  Background & Aims: Preterm infants hospitalized in the Neonatal Intensive Care Unit (NICU) are under repeated stress, and they are suffering from sleep deprivation. In this respect, one of recommended strategies is clustered care. On the other hand, direct observation of infant behaviors has been emphasized at time of nursing care. The aim of this study was to compare the behavioral responses in preterm infants in clustered care with three and four noninvasive procedures.  Materials & Methods: This study was a randomized crossover clinical trial performed in NICU of Al-Zahra teaching hospital, Tabriz, Iran in 2013. Thirty one preterm infants were studied at 32 weeks age by clustered care with three and four procedures, and observable behavioral symptoms were assessed. The analysis of data was done with the use of STATA 10 software at 0.05 significant level.  Results: The findings showed that mean of behavioral symptoms indicated stability in before, during and after of clustered care with three procedures, and it was 1.48, 2.03, 2.45 respectively, and four procedures 2.68, 4.23, 2.87 and behavioral symptoms indicative stress of three procedures were 2.06, 2.52, 1.97 and four procedures 2.97, 4.03, 3.03. Significant differences were not found in before and after phases between two interventions but it was significant during phase (P=0.035).  Conclusion: Although clustered care with three procedures can be assumed more acceptable, clustered care with four procedures is shown acceptable too, both of them could be recommended for preterm infants.  Key words: Preterm infants, clustering, caring, behavioral symptoms   Address: Nursing & Midwifery faculty of Tabriz University of Medical Sciences, Tabriz, Iran.  Tel: (+98)4114796770,Fax:(+98)4114796969  Email: M.avazeh@yahoo.com    [1]Associate professor, academic member, Nursing & Midwifery faculty of Tabriz University of Medical Sciences, Tabriz, Iran.    [2] MS students, Nursing & Midwifery faculty of Tabriz University of Medical Sciences, Tabriz, Iran. (Corresponding Author)  [3]Associate professor of Neonatology, academic member, Tabriz University of Medical Sciences, Tabriz, Iran.    [4] PhD, Assistant Professor of Road Traffic Injury Prevention Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.  [5] Neonatologist and Senior NIDCAP trainer at ErasmusMC_Sophia Childrens Hospital, Rotterdam, Netherlands.  [6] MS students, Nursing & Midwifery faculty of Tabriz University of Medical Sciences, Tabriz, Iran.

Keywords: Preterm infants, clustering, caring, behavioral symptoms

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