{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:41:10Z","timestamp":1791819670748,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"3-4","license":[{"start":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T00:00:00Z","timestamp":1536019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 103\u20102314\u2010B\u2010006\u2010071\u2010MY2"],"award-info":[{"award-number":["MOST 103\u20102314\u2010B\u2010006\u2010071\u2010MY2"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims and objectives<\/jats:title><jats:p>To determine the comparative efficacy of developmental care versus standard care for reducing pain and stress in preterm infants during examinations for retinopathy of prematurity (<jats:styled-content style=\"fixed-case\">ROP<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">ROP<\/jats:styled-content> examinations are routinely performed in neonatal intensive care units to detect these lesions. Pain scores recorded during and after eye examinations have revealed physiological and behavioural manifestations of pain and stress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A randomised crossover trial was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fourteen preterm infants were evaluated. The modified developmental care bundle included environmental modifications, positioning and containment, oxygen supplementation, interaction and approach and cue\u2010based individual care, which were applied before, during and after the <jats:styled-content style=\"fixed-case\">ROP<\/jats:styled-content> examination. The primary outcomes were obtained from pain and stress scores using the premature infant pain profile\u2010revised (<jats:styled-content style=\"fixed-case\">PIPP<\/jats:styled-content>\u2010R) and a behavioural evaluation. The secondary outcomes were recovery time to the baseline of the vital signs and oxygen saturation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Statistical significances were found in the care type comparison (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.013), time comparison (<jats:italic>p\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) and type\u2010by\u2010time interaction (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.005) in the <jats:styled-content style=\"fixed-case\">PIPP<\/jats:styled-content>\u2010R, and also in the care type comparison (<jats:italic>p\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001), time comparison (<jats:italic>p\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) and type\u2010by\u2010time interaction (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001) in the behavioural evaluation scores using a generalised estimating equation\u00a0(<jats:styled-content style=\"fixed-case\">GEE<\/jats:styled-content>) analysis. Recovery time for the developmental care (<jats:italic>N<\/jats:italic>\u00a0=\u00a013, mean\u00a0=\u00a08.6\u00a0\u00b1\u00a011.5\u00a0min, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a01.68\u201315.57) was significantly shorter than for the standard care (<jats:italic>N<\/jats:italic>\u00a0=\u00a011, mean\u00a0=\u00a025.5\u00a0\u00b1\u00a020.8\u00a0min, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a011.45\u201339.46), which was found to be statistically significant according to the Wilcoxon signed\u2010rank test (<jats:italic>N<\/jats:italic>\u00a0=\u00a011, <jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A bundled developmental care intervention significantly reduced pain and stress responses and the time needed for infants to recover their physiological status following the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>Since the results show the benefits of developmental care in an <jats:styled-content style=\"fixed-case\">ROP<\/jats:styled-content> examination, it can be the practical evidence basis by which to develop a standard of procedure or guideline for clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.14645","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T09:44:33Z","timestamp":1533807873000},"page":"545-559","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["A modified developmental care bundle reduces pain and stress in preterm infants undergoing examinations for retinopathy of prematurity: A randomised controlled trial"],"prefix":"10.1111","volume":"28","author":[{"given":"Ling\u2010Ju","family":"Chuang","sequence":"first","affiliation":[{"name":"Department of Nursing College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Hao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi\u2010Chia","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Statistics College of Management National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Ni","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Public Health College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nursing College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3228-4998","authenticated-orcid":false,"given":"Mei\u2010Chih","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nursing College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0355(198224)3:4<229::AID-IMHJ2280030405>3.0.CO;2-H"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-2996"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.nainr.2012.06.007"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000079542"},{"key":"e_1_2_12_6_1","volume-title":"Effects of developmental care on reducing pain and stress for preterm infants during retinopathy of prematurity (ROP) examinations (Unpublished master\u2019s thesis)","author":"Chuang L. 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