title: Retinopathy of prematurity screening, stress related responses, the role of nesting.
abstract: OBJECTIVE
  In a prospective study the degree of distress caused by retinopathy of prematurity (ROP) screening in a cohort of preterm infants was assessed and the modifying effects of nesting in reducing their discomfort was evaluated.
  
  
  METHODS
  38 preterm infants were included in the study. 19 infants were placed in a nest with boundaries (intervention group) and 19 infants were placed on a cot blanket (control group). Observations were made 2 minutes before, throughout, and 2 minutes after ROP examination. The factors observed were crying responses, neurobehavioural activity, and physiological changes (heart rate, oxygen saturation). Recordings were made using a video camera for crying and neurobehavioural activity and an Oxypleth monitor for heart rate and oxygen saturation.
  
  
  RESULTS
  During ROP screening, the total group of 38 infants (nested and non-nested combined) displayed increased neurobehavioural activity (p < 0.01) and crying (p < 0.01). The increased activity and crying coincided with the invasive part of the procedure. The distress caused by ROP screening was significantly less for the nested group compared with the non-nested group for both movement activity (p < 0.01) and crying (p < 0.01). The physiological data, heart rate, and oxygen saturation were not statistically significant.
  
  
  CONCLUSIONS
  ROP screening is distressing for preterm infants. Nesting can significantly reduce this discomfort. The findings in this study are of value in designing more optimal ROP examination schedules for infants.
authors.affiliation: Department of Neonatology, National Maternity Hospital, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Slevin
authors.forename: J F
authors.initials: JF
authors.lastname: Murphy
authors.forename: L
authors.initials: L
authors.lastname: Daly
authors.forename: M
authors.initials: M
authors.lastname: O'Keefe
mesh_terms: D001513:Beds; D015331:Cohort Studies; D003448:Crying; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000209:etiology*; D014787:Vision Tests / Q000523:psychology*