بحث4

Document Sample
بحث4 Powered By Docstoc
					Title                 Cross-cultural Study of the differences in behaviors between Saudi Arabian
                      Newborn and the American Newborns using the Brazelton Neonatal
                      assessment Scale.
Author(s)             Salma Abd el Atty Moawed, Joanna W. Ward
Contact Info          Office   : +966-1-4355010, ext. 118
                      Mobile   : +966-5-05237509
                      e-mail   : smoawed@ksu.edu.sa
Department            Maternity & Child Health Care Nursing Department
Major                 Professor of Maternity & Gynecological Nursing, family planning
                      practitioner, and licensed midwife
Citation              Tanta Medical Journal, Volume 18, Number 1, June: 1531:1573
Year of Publication   1990
Sponsor               Higher Institute of Nursing, Alexandria University, CRN, MSN,
                      Department of Nursing, King Faisal Specialist Hospital &
                      Research Center
Type of Publication Journal
ISSN                  1110-1415
URI/DOI
Full Text (Yes-No)    YES
Key Words             Behaviors, Newborn, Brazelton
Abstract              Cross-cultural studies of human behavior at birth present an
                      opportunity to broaden the perspective in underlying processes of
                      development and provide a context within which to learn about and
                      understand the capacities and strategies of infants. Manipulation of
                      experimental conditions dealing with human infants and their
                      environments is difficult, but unique cultures can present us with
                      natural variations which can further our knowledge.
                      The newborn’s characteristics (gestational age, size, weight, and sex)
also are considered. These forces create a behavioral phenotype, the
expression of genetic endowment in a particular environment. This
behavioral phenotype acts on and responds to the care giving
environment in ways that represent the phylogenetic adaption for the
species to a given cultural setting.
The infant, being a product of his/her phylogenetic and ontogenetic
history, elicits from the care giving environment what he or she needs
for his/her own organization and for the preservation of the species
through the culture. Thus, the parent-infant day becomes a microcosm
of the culture at large. By this unique adaption, the infant shapes the
practices and expectations of the culture. Simultaneously, the infant is
shaped by such postnatal environmental forces as methods of care and
handling, the familial constellation, physical setting, and the larger
goals, expectations, and needs of the culture.
Studying Saudi Arabia culture, then, became a way of broadening the
perspective on underlying a way of broadening the perspective on
underlying processes of development and provided a context within
which to learn about and understand the capacities and strategies of
infants. Moreover, it presented an opportunity to extend the range and
variability of forms of adaptive behavior, making it possible to expand
the basic principles and understanding of the process of organization
and development.
The purposes of this study are; to assess the performance of normal
Saudi Arabian newborns on the Barzelton Neonatal Behavioral
Assessment Scale during the first, third and fourteenth days of life; as
well as to identify differences in behaviors between the Saudi Arabian
newborns and the American newborns on the third and fourteenth
days of life.
This was a comparative exploratory study that focused on assessing the
behavioral characteristics of Saudi Arabian newborns in Riyadh, Saudi
Arabia at Maternity Children’s Hospital Nasseriya Delivery Center and
at King Faisal Specialist Hospital and Research Center. The first was a
Ministry of Health Hospital; the second was a tertiary care center. The
design of the study was interventional factor searching and factor-
relating. A convenience sample of 20 normal, full-term newborns at
Maternity Children’s Hospital – Nasseriya were examined, as well as a
convenience sample of 17 normal, full-term newborns from KFSH
was examined. Anthropometric measurements of height and weight;
and the Brazelton Neonatal Behavioral Assessment Scale. The Rohrer
ponderal index was calculated from the anthropometric measurements
on the date of birth. Prior to beginning any exam, written permission
was obtained from the mothers by the researchers.
The Brazelton Neonatal Behavioral Assessment Scale (27 behavioral
items) administration involved observing the newborns as they
changed their state from sleeping to alert to crying and back down to a
quite state.
In the first six cluster scores high scores represented better
performance in a range from one to nine. A mean cluster score
between 1-5 was considered as low to average, 4-6 as average, and 6-9
as above average to high in these first six clusters. However, with the
reflexes cluster being scored by adding up the baby’s abnormal
responses, lower scores are better with a total range from zero-20
The Rohrer Ponderal Index (PI) is a weight-or-length ratio which was
employed to determine fetal nutritional status that might not be
ascertained via the birth weight or gestational age assessment. PI
calculations for American newborns of 37-42 weeks gestation are: 2.2
for the 3rd percentile, 2.3 for the 10th percentile, and 2.7 for the 90th
percentile.
The demographic data for the two Saudi samples were compared using
non-parametric (Mann-Whitney) tests. On analyzing the BNBAS
scores, data were grouped into seven clusters-habituation, orientation,
motor, range of state; regulation of state; autonomic stability, and
reflexes. The mean cluster scores for each exam were then compared
on the first and fourteen day exams for each setting using the
Wilcoxon sign rank test. A direct comparison of both settings was also
done using the Mann-Whitney test. Next, the two setting were
combined and compared to the U.S.A. sample in Boston using the t-
test.
Since both groups of babies scored low in range of state behavior on
both exams with only questionable difference on the third day it is not
considered to be of any real significance. On the fourteenth day there
definitely
Since both groups of babies scored low in range of state behavior on
both exams with only questionable difference on the third day it is not
considered to be of any real significance. On the fourteenth day there
definitely was no significant difference in range of state between the
Saudi Arabian and American babies. Both Saudi Arabian and American
babies scored in the average range for regulation of state with no
significant difference between the two samples. For reflex behavior
both samples were normal with no significant differences.
This research opens up a whole new avenue of nursing research for
the advanced clinical pediatric or maternal child practitioner interested
in studying newborn behavior in a variety of settings and more
importantly, in a combination of research and teaching. An
experimentally designed study could be done with a control group and
a treatment group to further test and support the advantageous
outcomes of using the BNBAS as a teaching tool with new parents.
Finally, the Nasseriya and KFSH sample were combined and
compared to the American Newborn in Boston. The BNBAS
differentiated the two groups in habituation, orientation, motor and
autonomic stability with the Saudi Arabian babies scoring higher.

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:88
posted:2/24/2013
language:Unknown
pages:5