Effect of the Artificial Night with Facilitated Tucking and Artificial Night Alone on the Physiological Indices of Premature Infants

Document Type : Original Article


1 Neonatal Intensive Care Unit, Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Research Center Of Prevention and Epidemiology, Health Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran


Background: Preterm birth and admission to neonatal intensive care unit as stressors can cause physiological
instability that may lead to prolong hospitalization and mortality. This study aimed to determine the effect of artificial
nights and facilitated tucking on the physiological indices of premature infants.
Methods: This randomized clinical trial was conducted on 60 preterm infants admitted to the neonatal intensive care
unit at Shohadaye Kargar Hospital in Yazd, Iran, during 2017-18. The infants were selected through a convenient
sampling method, and were randomly assigned into three groups of arti icial nights with facilitated tucking (group 1)
(n=20), arti icial nights (group 2) (n=20) and control group (group 3) (n=20). Subsequently, the physiological indices
(i.e., heart rate, respiration rate, arterial oxygen saturation) were measured twice a day at 7:00 a.m. and 19:00 p.m. for
3 days. The data were analyzed in SPSS software (version 20). A p-value less than 0.05 was considered statistically
Results: There was a significant difference among the three groups in terms of mean values of heart, respiratory, and
arterial oxygen saturation rates (P<0.05). The irst experimental group obtained a greater reduction in heart rate and
respiratory rate on the third day (at 19:00 p.m.), as well as a greater increase in arterial oxygen saturation rate on the
second (at 19:00 p.m.) and third days (at 7:00 a.m. and 19:00 p.m.), compared to the other two groups (P<0.05).
Additionally, , the mean value of heart and respiratory rates were lower and arterial oxygen saturation rates were
higher in the intervention group 1, compared to the other groups.
Conclusion: According to the results of the study, the simulation of the mother’s womb environment through creating
artificial night and maintaining facilitated tucking resulted in the improvement of physiological indices of the
premature infants. Furthermore, artificial night together with facilitated tucking leads to better results, compared to
artificial night alone.


1. Parsa P, Karimi S, Basiri B, Roshanaei G. The effect of kangaroo mother care on physiological parameters of premature infants in Hamadan City,Iran. Pan Afr Med J. 2018; 89:30.
2. Verklan MT, Walden M. Core Curriculum for neonatal intensive care nursing-e-book. New York:Elsevier Health Sciences; 2014. P. 197-205.
3. Als H. Developmental care in the newborn intensive care unit. Curr Opin Pediatr. 1998;10(2):138-42.
4. Ahmadi F, Mohammadi E. Physical examination for nurses. Tarbiat Modares Univ J. 2003; 24(4):23-5.
5. Potter PA, Perry AG, Hall AE, Stockert PA.Fundamentals of nursing. New York: ElsevierMosby; 2014. P. 442-6.
6. Coughlin M, Gibbins S, Hoath S. Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice. J Adv Nurs. 2009; 65(10):2239-48.
7. Sheikh Bahaeddinzade E. Examination, diagnosis and nursing cares in the NICU. 2nd ed.Tehran:Boshra Publisher; 2014. P. 97.
8. Leifer G. Maternity nursing-e-book: an introductory text. New York: Elsevier Health Sciences; 2013.P. 419.
9. Corff KE, Seideman R, Venkataraman PS, Lutes L,Yates B. Facilitated tucking: a nonpharmacologic comfort measure for pain in preterm neonates. J Obstet Gynecol Neonatal Nurs. 1995; 24(2):143-8.
10. Ward-Larson C, Horn RA, Gosnell F. The efficacy of facilitated tucking for relieving procedural pain of endotracheal suctioning in very low birthweight infants. MCN Am J Matern Child Nurs. 2004;
11. Axelin A, Salanterä S, Lehtonen L. ‘Facilitated tucking by parents’ in pain management of preterm infants-a randomized crossover trial. Early Hum Dev. 2006; 82(4):241-7.
12. Reyhani T, Aemmi SZ, Sannadgol V, Boskabadi H.The effect of creating an artificial night on physiological changes in preterm infants. Int J Pediatr. 2014; 2(4.3):407-12.
13. Reyhani T, Mohebi T, Boskabadi H, Gholami H. The effect of facilitated tucking during venipuncture on pain and physiological parameters in preterm infants. Evid Based Care. 2012; 2(2):47-56.
14. Peyrovi H, Alinejad-Naeini M, Mohagheghi P, Mehran A. The effect of facilitated tucking position during endotracheal suctioning on physiological responses and coping with stress in premature infants: a randomized controlled crossover study. J Matern Fetal Neonatal Med. 2014; 27(15):1555-9.
15. Cignacco EL, Sellam G, Stoffel L, Gerull R, Nelle M, Anand KJ, et al. Oral sucrose and “facilitated tucking” for repeated pain relief in preterms: a randomized controlled trial. Pediatrics. 2012;129(2):299-308.
16. Taheri P, Abbasi E, Abdeyazdan Z, Fathizadeh N. The effects of a designed program on oxygen saturation and heart rate of premature infants hospitalized in neonatal intensive care unit of Al-Zahra Hospital in Isfahan in 2008-2009. Iran J NursMidwifery Res. 2010; 15(2):66.
17. Liaw JJ, Yang L, Wang KW, Chen CM, Chang YC, Yin T. Non-nutritive sucking and facilitated tucking relieve preterm infant pain during heel-stick procedures: a prospective, randomised controlled crossover trial. Int J Nurs Stud. 2012; 49(3):300-9.
18. Morag I, Ohlsson A. Cycled light in the intensive care unit for preterm and low birth weight infants. Cochrane Database Syst Rev. 2013; 8:CD006982.