A Randomised Comparative Study Assessing Parental Anxiety Levels during Bilirubin Measurement in Neonatal Jaundice: A Comparison of Conventional Blood Taking and Transcutaneous Bilirubin Method
Bilirubin Measurement in Neonatal Jaundice
Abstract
Neonatal jaundice screening is important in preventing the progression of kernicterus and its morbidity. The transcutaneous bilirubinometer (TCB) regains popularity as a low-cost, portable neonatal jaundice screening tool whose accuracy is comparable. Its effects on parents are widely accepted as favourable; however, its impact on parental anxiety remains unproven. A randomised study was conducted at the Emergency Department of the Hospital Canselor Tuanku Muhriz (ED HCTM). Parents seeking neonatal jaundice screening were assigned randomly to the TCB or conventional blood-taking (TSB) groups. A trait anxiety score was taken before the procedure, while state anxiety was measured after, utilising Spielberger’s state-trait anxiety index (STAI) questionnaire. The scores were recorded and statistically analysed. A total of 97 parents participated in the study. No significant difference in trait anxiety existed between groups (TCB group mean score = 39.24, SD = 7.385; TSB group mean score = 36.44, SD = 10.173; p > 0.05). TCB group exhibited significantly lower state anxiety (mean score = 35.31, SD = 10.05) than TSB group (mean score = 46.65, SD = 12.63; p = 0.000). Clinically significant state anxiety was more prevalent in parents from the TSB group (50%) than the TCB (22.4%; p = 0.005). TCB is superior to TSB for parental anxiety.
Keywords :
Neonatal jaundice; parental anxiety; serum bilirubin; transcutaneous bilirubinometer,
Abstrak
Saringan jaundis neonatal adalah penting dalam mencegah perkembangan penyakit kernikterus dan morbiditinya. Bilirubinometer transkutaneus (TCB) adalah alat saringan jaundis neonatal yang berkos rendah, mudah dibawa, serta mempunyai ketepatan yang setara. Alat ini diterima secara baik oleh kebanyakkan ibu bapa; namun, impaknya terhadap kegelisahan ibu bapa belum dibuktikan. Satu kajian rawak telah dijalankan di Jabatan Perubatan Kecemasan, Hospital Canselori Tuanku Muhriz (ED HCTM). Ibu bapa yang memerlukan ujian saringan jaundis neonatal telah dibahagikan secara rawak kepada kumpulan TCB atau kumpulan pengambilan darah konvensional (TSB). Skor kegelisahan trait diambil sebelum prosedur, manakala keadaan kegelisahan diukur selepasnya menggunakan soal selidik indeks trait kegelisahan Spielberger (STAI). Skor tersebut direkodkan dan dianalisis. Seramai 97 ibu bapa telah mengambil bahagian dalam kajian ini. Tiada perbezaan signifikan dalam trait kegelisahan antara kumpulan (skor min kumpulan transkutaneus = 39.24, SD = 7.385; skor min kumpulan konvensional = 36.44, SD = 10.173; p > 0.05). Kumpulan TCB menunjukkan keadaan kegelisahan yang lebih rendah secara signifikan (skor min = 35.31, SD = 10.05) berbanding kumpulan TSB (skor min = 46.65, SD = 12.63; p = 0.000). Keadaan kegelisahan yang signifikan secara klinikal lebih ketara dalam kalangan ibu bapa daripada kumpulan TSB (50%) berbanding kumpulan TCB (22.4%; p = 0.005). TCB bukan sahaja mengurangkan keadaan kegelisahan berbanding pengambilan darah konvensional tetapi juga mengurangkan kegelisahan ibu bapa yang signifikan secara klinikal semasa ujian saringan jaundis neonatal. Oleh itu, TCB adalah alat saringan yang lebih baik apabila mengambil kira kegelisahan ibu bapa berbanding TSB.
Kata Kunci :
Jaundis neonatal; jumlah bilirubin dalam darah; keresahan ibubapa; pengesan bilirubin melalui kulit,
Correspondance Address
Dr Faizal Amri Hamzah. Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +6012-9089363 Email: drfaizalamri@ukm.edu.my
