The effect of hydrocolloid tape and facial massage on nasal injury, comfort and stress in premature infants during noninvasive mechanical ventilation

Aim: The aim of this study was to evaluate the effect of hydrocolloid patch use and facial massage on nasal septum injury, stress and comfort in premature infants receiving noninvasive mechanical ventilation (NIMV) support. Material and Method: The study was conducted as a single-blind, randomized controlled experimental study. The study was conducted with 108 premature infants between 28-34 gestation weeks (Hydrocolloid tape group: 36, facial massage group: 36, control group: 36) who were hospitalised in the 3rd level neonatal intensive care unit (NICU) between February 2023 and February 2024, received NIMV support and met the inclusion criteria. The data of the study were collected using the Newborn Introductory Information Form, Newborn Skin Condition Assessment Scale (NSCAS), Nasal Injury Scale (NIS), Premature Infant Comfort Scale (PICS) and Newborn Stress Scale (NSS). Parametric methods were used to analyze the data. One-way ANOVA test was used to compare quantitative continuous data between groups. Scheffe was used as a complementary post-hoc analysis to determine differences after the ANOVA test. Repeated measures ANOVA test and complementary Bonferroni test were used to compare intra-group measurements. In all calculations and interpretations, the statistical significance level was taken as p<0.05. Results: The preterm infants included in the study did not differ significantly between the groups according to descriptive and clinical characteristics except gender (p>0.05). NIS scores, NSCAS scores, PICS scores and NSS scores showed significant differences between the groups. In all evaluations, the highest NIS and NSCAS scores were observed in the control group and the lowest NIS and NSCAS scores were observed in the hydrocolloid tape group. When the NSS scores of the groups were analysed, it was found that the lowest was in the group in which facial massage was applied and the highest was in the control group (p<0.05). When the PICS scores between the groups were analysed, it was determined that the highest was in the facial massage group and the lowest was in the control group (p<0.05). Conclusions: In the study, it was concluded that hydrocolloid tape application was more effective than facial massage application in preventing nasal injuries and decreased the skin condition score, but facial massage application was more effective in decreasing the stress score and increasing the comfort level in premature infants receiving NIMV support. Keywords: Nasal injury, hydrocolloid tape, noninvasive mechanical ventilation premature, facial massage