高危險早產兒住院期間，照護人員常需執行翻身擺位措施，以促進舒適照護、肢體協調發展、預防壓瘡或便於施予護理措施，過去研究多探討不同臥位對早產兒生理指標之影響，但極少針對短暫翻身擺位動作對早產兒急遽性之影響深入探討，本研究目的為探討翻身擺位過程對於早產兒心跳速率與血氧飽和濃度之影響。
研究方法採前瞻式觀察性研究設計，並採重複測量，探討24名早產兒出生1-4週，每週各一天收集3次，持續測量翻身擺位前(護理人員碰觸早產兒前)15分鐘至翻身擺位後15分鐘心跳速率及血氧飽和濃度之變化及變化事件。心跳速率和血氧飽和濃度上升事件指超過翻身擺位前平均值加2個標準差；下降事件指超過翻身擺位前平均值減2個標準差。研究結果顯示，觀察214次翻身活動中，心跳速率出現改變佔68.2%，在61次僅出現心跳速率上升活動中，回復時間為9.8±5.2分鐘；在52次僅出現心跳速率下降活動中，回復時間為11.9±3.8分鐘；在33次心跳速率上升再下降(或先下降再上升)活動中，回復時間為12.8±2.9分鐘。血氧飽和濃度出現改變佔78.5%，在123次血氧飽和濃度下降活動中，回復時間為10.3±4.6分鐘。由於觀察每次翻身活動中，發現上升或下降事件發生時間及持續時間不一，故計算若出現變化事件則持續約3分鐘以內。不同臥位轉換在血氧飽和濃度變化事件上有顯著差異(χ2(9)=18.526, p=.030)。不同生理成熟度和疾病嚴重度則無顯著差異。雖心跳速率與血氧飽和濃度之整體變化在翻身擺位前後臨床差異小，但翻身擺位對早產兒可能造成10分鐘以上的影響，而上升或下降事件對於早產兒短時間所造成衝擊不容忽視，故建議臨床照護者在翻身擺位後，若出現變化事件應持續監測至少3分鐘乃必要之舉。

In the principle of clinical criteria, positioning routine takes 2-3 hours once a day. Positioning has a direct impact on cerebral perfusion, respiratory mechanics and neurobehavioral organization system. The study aimed to explore how positioning process affect the preterm infant’s heart rate (HR) and oxygen saturation (SpO2). The study used a prospective and observational design. Twenty-four preterm infants born 1-4 weeks would be repeatedly studied, and data would be collected 3 times weekly. HR and SpO2 were measured at a 1-minute interval 15 minutes before and during, and 15 minutes after positioning. Positioning induced HR(68.2%) and SpO2(78.5%) change events, defined as HR and SpO2 greater than 2 standard deviation (SD). Positioning would impact preterm infants for 10 minutes. The average of recovery time in each change event is about 3 minutes. Caregivers should keep monitoring preterm infants’ vital signs and behavior after positioning.

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