Evaluation of the Effectiveness of Non-pharmacological Methods During Heel Blood Collection
Condition: Infant, Newborn
Study type: Interventional

Summary: 
      Although various pharmacological methods have been used for heel puncture, their
      effectiveness has not been demonstrated. However, their use is limited due to their sedating
      effects, toxic effects, and respiratory depressant properties. In this sense, the use of
      non-pharmacological methods has been examined. Non-pharmacological methods have no side
      effects, are cheap, and are easily available/applicable. For these reasons, the fact that
      non-pharmacological methods (appropriate positioning, mother's lap, mother's voice, white
      noise, oral sucrose, classical music) have been frequently used in recent years, especially
      during painful interventions. Based on this information, the study was planned as a
      randomized controlled experimental study to compare the effects of holding the baby in the
      mother's arms, hearing white noise and mother's voice, or using them in combination during
      heel blood collection from healthy newborns.
    

Detailed description: 
      Pain is known to affect individuals of all ages. However, until the 1980s, it was widely
      believed that newborns were inadequate in perceiving and interpreting pain because their
      nervous system was not fully developed. Studies conducted after these years have shown that
      the fetus has all the anatomical structures and functions of the peripheral and central
      nervous system necessary to perceive and interpret pain from the 20th week. After this
      information, this issue started to be given more importance in newborns. The most important
      reason for this is that term and preterm newborns staying in neonatal units experience pain
      for numerous and very different reasons.

      Heel blood sampling, which is widely used for the diagnosis and follow-up of various
      diseases, causes acute pain in infants. Heel blood collection is more painful than venous
      blood collection, squeezing is another factor that causes pain. There is not enough data on
      the chronicity of pain after these procedures. However, the inability to control pain in
      newborns followed for a long time in health centers increases the risk of chronic pain.

      It has been observed that the pain sensitivity of babies who were followed up in the neonatal
      period and exposed to painful procedures changed in the next period. Therefore, it is very
      important to measure the infant's perception of pain in order to investigate the causes,
      mechanisms, and effects of pain. The pain response is very difficult to understand because
      newborns cannot express themselves verbally. Observation of hormonal, behavioral, and
      metabolic changes in the body due to pain provides data on the level of response to pain and
      the effectiveness of treatment. Evaluation of the pain response in the newborn is performed
      to reveal the pain state, to determine the level of pain, and to understand whether there is
      a need for intervention. In the routine operation of health centers, it is necessary to give
      due importance to the evaluation of pain response. It is important to observe the pain
      conditions as well as the basic vital functions of babies. It has been shown that repetitive
      heel blood sampling increases sensitivity to pain and decreases the pain threshold. In the
      light of these findings, it is thought that the heel puncture procedure to collect blood from
      the heel in the newborn period will have a negative effect on the pain response of the baby
      in the long term. Although various pharmacological methods have been used for heel puncture,
      their effectiveness has not been demonstrated. However, their use is limited due to their
      sedating effects, toxic effects, and respiratory depressant properties. In this sense, the
      use of non-pharmacological methods has been examined. Non-pharmacological methods have no
      side effects, are inexpensive, and are easily available/applicable. For these reasons, the
      fact that non-pharmacological methods (appropriate positioning, mother's lap, mother's voice,
      white noise, oral sucrose, classical music) have been frequently used in recent years,
      especially during painful interventions. Based on this information, the study was planned as
      a randomized controlled experimental study in order to compare the effects of holding the
      baby in the mother's arms, hearing white noise and mother's voice, or using them in
      combination during heel blood collection from healthy newborns.
    

Intervention name(s): Non-Pharmacological Methods
Intervention type(s): Other
Intervention description(s): All of the applications that increase the effectiveness of drugs when used together with analgesics and provide the elimination of pain by releasing our body's natural morphine and endorphins without the use of analgesics are called non-pharmacological treatment.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Newborn; Pain; Mother's voice; White noise; Mother Embrace