The Effect of Pain Management Education on The Mothers in Newborn
Condition: Pain; Procedural Pain; Infant ALL
MeSH terms: Pain, Procedural
Study type: Interventional

Summary: 
      The aim of this study was to determine the effect of non-pharmacological pain management
      education given to mothers on the use of non-pharmacological methods and anxiety levels of
      mothers during routine heel blood collection (guthrie screening test) in term newborns.

      H0= There was no difference between the intervention group who received non-pharmacological
      pain management education and the control group's level of anxiety and use of
      non-pharmacological applications.

      H1= The use of non-pharmacological methods is different between the intervention group and
      the control group that received non-pharmacological pain management education.

      H2= Anxiety scores of the intervention group that received non-pharmacological pain
      management education and the control group were different.

      H3= Some characteristics and anxiety levels of mothers have an effect on their use of
      non-pharmacological methods.

      It was carried out between July - September 2021 at the Akşehir State Hospital Gynecology and
      Obstetrics Clinic, which serves in the Akşehir district of Konya province.
    

Detailed description: 
      In this study was to determine the effect of pain management education on mothers' use of
      non-pharmacological methods and anxiety levels during newborn heel blood screening.

      This study was designed as parallel group, pre-test and post-test randomized controlled
      trial.

      Based on 80% power and 95% confidence level, the sample size was calculated as 32 infants for
      each group, a total of 64 infants (G*Power 3.1.9.2).

      Randomization In this study, stratified randomization method was applied. Eight blocks of
      four were created with the permutation-blocked randomization method.

      With the computer program (randomized.org), the numbers from 1 to 6 were listed 8 times
      (6,3,5,2,2,6,6,5) and the combinations were sorted according to this group, and assignments
      were made to the intervention and control groups.

      Blinding The researcher and participant (mothers) could not be blinded since the researcher
      had to provide training and manage the process before the application. In order to avoid bias
      in the evaluation of the data, the analysis of the coded data in terms of groups was done by
      an independent statistician. After the statistical analyzes were completed and the research
      report was written, the researcher explained the coding of the intervention and control
      groups. In this way, single blindness was achieved.

      In the collection of research data; Introductory Information Form, Non-pharmacological Method
      Application Checklist and Spielberger State Anxiety Inventory were used. In addition, the
      mothers in the intervention group were given a brochure on Nonpharmacological Pain Management
      Education Nonpharmacological Pain Management Education Brochure

      This brochure was prepared by the researcher in line with the literature .The brochure
      contains methods for non-pharmacological pain management that can be applied during
      procedural painful interventions in newborns. These methods are; expressed breast milk,
      hugging, skin-to-skin contact, cuddling, calming sounds. The brochure contains information
      and drawings about the methods. The drawings were created by Architect Merve Özkald. Opinions
      were received from five experts in terms of the content, language, design and visual
      suitability of the brochure and the Content Validity Index (CGI) was calculated as 0.890.

      Data collection Voluntary Informing Consent Form was obtained from the mothers before the
      study, and the Introductory Information Form was collected from the mothers by the researcher
      by face-to-face interview method. Between the dates of the study, mothers of newborns who met
      the inclusion criteria were randomly assigned to intervention and control groups. Heel blood
      collection in all newborns; The study was carried out between the 24th and 48th hours of the
      baby's life, in the gynecology and obstetrics clinic, only in the room where the mother and
      baby stay together, without any intervention to the baby, by removing the clothes from the
      lower part of the baby in its natural position.

      The heel blood collection procedure was applied in such a way that the baby was next to the
      mother. No non-pharmacological method was used in routine practice during the procedure.

      In this study; The heel blood collection procedure was performed by the same nurse working in
      the NICU for each infant at one time and by taking the same amount of blood from each infant
      on average.

      At least half an hour before the heel blood collection, it was ensured that the babies were
      fed and their diapers were clean. During the blood collection process; Standardization of the
      blood collection technique used, the area where the blood was taken (outer side of the right
      heel), the needle used in the procedure (needle number 21), environmental factors (such as
      heat, light, noise), used antiseptic solution (70% alcohol) provided.

      To the mothers in the intervention group; At least 12 hours before the heel blood collection
      (guthrie screening test), information was given by the researcher (FU) about the purpose of
      the heel blood collection procedure and the application process, and the questions, if any,
      were answered. Afterwards, an average of 25 minutes of education was given through the
      training brochure prepared by the researcher on non-pharmacological pain management. The
      education was carried out in a language that the mother could understand, in the form of
      direct lectures and questions and answers, using the visuals in the brochure.

      The mothers in the control group, on the other hand, were informed by the researcher about
      the purpose of the heel blood collection procedure and the application process at least 12
      hours before the guthrie screening test, and their questions were answered, if any, and no
      other application was made.
    

Intervention name(s): Providing education and brochures on non-pharmacological methods that can be applied during the heel blood collection process
Intervention type(s): Procedure
Intervention description(s): Theeduvation initiative was implemented by the researcher at least 12 hours ago in the mothers' room and a brochure was given about the education.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Intervention Group Education was given about non-pharmacological methods that can be applied during the heel blood collection procedure in newborns and a brochure was given.
Control group: no intervention was made.
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: pain; procedural; newborn; heel blood collection procedure; Education on nonpharmacological methods