The Association Between Noise and The Neonatal Physiological and Behavioral Status in Neonatal Intensive Care Unit at AL -Makassed Hospital, Jerusalem رسالة ماجستير

Abstract

Background: The Neonatal Intensive Care Unit is a vital space for newborns needing specific medical care. Here, the amount of noise present can greatly affect the physiological and behavioral condition of the newborns, possibly resulting in negative consequences. Recognizing how noise exposure relates to the well-being of neonates is essential for improving care methods in the Neonatal Intensive care unit. Objectives: The research aimed to explore the association between noise levels and the physiological and behavioral condition of neonates in the Neonatal Intensive Care Unit at Al-Makassed Hospital in Jerusalem. The specific goals were to identify the sources of noise, analyze its effects on physiological indicators such as heart rate, respiratory rate, and oxygen saturation, and assess its impact on neonatal behavioral patterns, including sleep habits. Methodology: The study employed a cross-sectional correlational, a non-experimental observational design to gather data from neonates admitted to the Neonatal Intensive Care Unit, particularly focusing on those who born at gestational age 28 week to 39 weeks or during these first 28 days of life. The estimated sample size, determined using the G-power 3.1 program, was 120 observations. Noise levels were measured during specified noisy and quiet periods using a Digital Environmental Meter (EM5) device. Physiological parameters such as heart rate, respiratory rate, and oxygen saturation were monitored. Neonatal behavioral states were evaluated using the Anderson Behavioral State Scale. Statistical analysis, including independent samples t-tests, was conducted to compare outcomes between noisy and quiet periods.

Results: The investigation into noise exposure within the Neonatal Intensive Care Unit uncovered significant effects on both the physiological and behavioral aspects of neonates. Physiologically, noise exposure led to a notable increase in heart rate (Mean HR: 164.07 bpm during noise time vs. 137.87 bpm during quiet time), respiratory rate (Mean RR: 52.93 bpm during noise time vs. 42.88 bpm during quiet time), and a decrease in oxygen saturation levels (Mean saturation: 83.48% during noise time vs. 95.85% during quiet time) during noisy hours compared to quiet times. Behaviorally, neonates exhibited higher levels of activity and decreased instances of sleep during noisy periods. Moreover, heart rate (r = 0.458, p<0.05) this positive correlation with the Anderson Behavioral State Scale, O2 saturation (r = -0.667, p <0.05) this negative correlation with Anderson Behavioral State Scale and Respiratory rate (r = 0.242, p <0.05) this positive correlation with the Anderson Behavioral State Scale. Statistical analysis confirmed these differences, highlighting the detrimental effects of noise on neonatal well-being in the Neonatal Intensive Care Unit environment. Conclusions: The findings underscore the detrimental effects of noise on neonatal health and well-being in the Neonatal Intensive Care Unit. Elevated noise levels were associated with physiological stress and disrupted behavioral states among neonates. Therefore, interventions to mitigate noise exposure in the Neonatal Intensive Care Unit are essential to promote optimal developmental outcomes and improve neonatal care practices.