title: Preterm infants' behaviors and skin conductance responses to nurse handling in the NICU.
abstract: Stress response patterns are indicative of the neonate's unique ability to cope with environmental demands and can be evaluated through autonomic and behavioral response parameters.
  
  
  OBJECTIVE
  To characterize stress responses during tactile stimulation to standard nurse handling in the NICU, and their association with severity of illness in preterm infants.
  
  
  METHODS
  Thirty preterm neonates were studied at postnatal day 4-5 during standard nurse caregiving. Heart rate (HR), respiratory rate (RR), skin conductance responses per second (SCR/s), and NIDCAP® stress behaviors were recorded before and during care. Non-parametric tests were used to assess differences from before to during care. Pearson's correlations were used to determine the association of biological and behavioral variables to the score for neonatal acute physiology (SNAP), a severity of illness index.
  
  
  RESULTS
  HR, RR, SCR/s and NIDCAP® behaviors (motor and attentional cues, and ability to self-console) increased from before to during the care (p < 0.01). NIDCAP® behaviors showed a significant negative association to the SNAP score (R = -0.45, p < 0.05).
  
  
  CONCLUSIONS
  HR, RR, SCR/s and NIDCAP® behaviors significantly increased during care. NIDCAP® stress behaviors were influenced by the severity of illness of the infant, while SCR/s was not influenced by severity of illness.
authors.affiliation: a The Simulation Center, the Acute Clinic, Institute of Clinical Medicine, Medical Faculty, University of Oslo , Oslo , Norway .
authors.forename: Veronika
authors.initials: V
authors.lastname: Zeiner
authors.affiliation: a The Simulation Center, the Acute Clinic, Institute of Clinical Medicine, Medical Faculty, University of Oslo , Oslo , Norway .
authors.forename: Hanne
authors.initials: H
authors.lastname: Storm
authors.affiliation: b Department of Pediatrics , Pennsylvania State University, College of Medicine , Hershey , PA , USA , and.|c Division of Newborn Medicine , Penn State Children's Hospital , Hershey , PA , USA.
authors.forename: Kim Kopenhaver
authors.initials: KK
authors.lastname: Doheny
mesh_terms: D015331:Cohort Studies; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology*; D006339:Heart Rate; D006801:Humans; D018730:Infant Behavior / Q000502:physiology* / Q000523:psychology; D007224:Infant Care; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology* / Q000523:psychology; D007363:Intensive Care Units, Neonatal; D008297:Male; D009726:Nurses; D011446:Prospective Studies; D056152:Respiratory Rate; D012720:Severity of Illness Index; D013312:Stress, Physiological / Q000502:physiology*; D014110:Touch / Q000502:physiology*
keywords: Behavioral responses; preterm infants; skin conductance responses