The effect of bathing on physiological parameters, skin, bilirubin and comfort level in infants receiving phototherapy treatment

The aim of this study was to investigate the effect of bathing on physiological parameters, skin, bilirubin and comfort level in infants receiving phototherapy treatment. The study was a single-blind, parallel group, randomised controlled experimental design. The study was conducted in the neonatal intensive care unit of Kütahya City Hospital. Data were collected from 62 infants diagnosed with hyperbilirubinemia between May 2024 and March 2025. Infants (35-40 gestational weeks) were randomly assigned to experimental (n=31) and control (n=31) groups. Late preterm and term infants in the experimental group received tub bathing before phototherapy, while infants in the control group received routine clinical care. Data were collected using the 'Neonatal Information Form', 'Neonatal Follow-up Form', 'Neonatal Skin Condition Scale' and 'ComfortNeo Scale'. Measurements were taken at four times: 10 minutes before, 30 minutes, 60 minutes and 6 hours after the start of phototherapy. Infants' total serum bilirubin levels were recorded by the investigator at two separate times, before and 24 hours after the start of phototherapy. Mann-Whitney U test, independent samples t-test, Fisher exact test with Monte Carlo correction, intraclass correlation coefficient, generalised linear model, robust ANOVA test were used for data analysis. Statistical significance level was accepted as p<0.05. The study was registered in ClinicalTrials (NCT06819150). In the study, no difference was found between the groups in the physiological parameters of the infants who were bathed before phototherapy and those who received routine clinical care (p>0.05). There was a significant difference between the groups in respiratory rate, body temperature and oxygen saturation on four measurements (p<0.05). Analyses of the infants' skin moisture measurements by region showed that, the moisture values of the forehead, abdomen, back and right leg were found to be significantly higher in the experimental group (p<0.05). While the median scores of the Skin Condition Scale were found to increase significantly over time (p<0.05). While bilirubin levels of the infants were similar between the groups (p>0.05), they decreased significantly over time during the pretest and posttest (p<0.05). While the comfort levels of the infants were similar between the groups (p>0.05), it was found that the comfort levels increased significantly over time (p<0.05). As a result, it was determined that tub bathing stabilised the physiological parameters of late preterm and term infants during phototherapy and positive effect on forehead, abdomen, back and right leg moisture levels compared to routine clinical care. Skin condition, bilirubin and comfort levels were found to be similar between in infants who received tub bath before phototherapy and those who received routine clinical care. This study supports the care of late preterm and term infants who receive tub bath during phototherapy and contributes to skin integrity and moisture balance. Key Words: bath, bilirubin, phototherapy, nurse, comfort, newborn