Comparison of Different Methods for Reducing Pain in Heel Blood in Newborns
Condition: Pain
Study type: Interventional

Summary: 
      Newborns are exposed to painful invasive procedures from the first hours of their lives. It
      is stated that the functional and anatomical structure of the neural pathways of newborns
      with many systems immature develops well enough to feel pain and they have the ability to
      remember after experiencing pain. Physiological symptoms (increase in heart rate and blood
      pressure, increase in oxygen saturation, etc.) as a result of painful procedures (vascular or
      heel lance collection, venous or arterial catheterization, subcutaneous and intramuscular
      injection, chest tube insertion, intubation, aspiration, etc.) applied for diagnosis and
      treatment in newborns. falling), crying behavior and metabolic problems. In conclusion, the
      energy resources required for the growth and development of newborns are used to cope with
      pain, and it is reported that repetitive painful procedures increase mortality and morbidity
      in newborns.

      Heel lance, which is applied to all newborns within the scope of the newborn screening
      program, is one of the painful invasive procedures for newborns. Heel lance should be taken
      as capillaries in the first 48 hours after feeding or until the first week of life of
      newborns. In the literature, non-pharmacological methods applied to reduce the severity of
      pain felt by newborns during heel lance, which also causes tissue integrity deterioration; It
      has been observed that studies examining the effects of breast milk, swaddling, holding,
      breastfeeding, music, oral sucrose, non-nutritive sucking, skin-to-skin contact (SSC) and
      positioning. SSC, breastfeeding and swaddling + holding methods are among the methods that
      can be easily used by mothers and nurses. Nurses working in the maternity ward where heel
      lance sampling is performed in the hospital have a key role in reducing the pain level of
      newborns by collaborating with the families of the babies.
    

Detailed description: 
      This study was conducted to compare three different methods (breastfeeding, skin-to-skin
      contact, swaddling + holding) in reducing the pain felt during routine heel lance from term
      newborns within the scope of the National "Newborn Screening Program" of the Ministry of
      Health.

      Hypotheses; H1: Breastfeeding method is more effective than skin-to-skin contact and
      swaddling + holding methods in reducing pain due to heel lance in newborns.

      H2: Skin-to-skin contact method is more effective than breastfeeding and swaddling + holding
      methods in reducing pain due to heel lance collection in newborns.

      H3: Swaddling + holding method is more effective than breastfeeding and skin-to-skin contact
      methods in reducing the pain associated with heel lance collection in newborns.

      Statistical power analysis was performed at the end of the study in line with the data
      collected from a total of 90 newborns, 30 of whom were in each study group. The power of the
      study was found to be 0.81 - 0.99 at the alpha = 0.05 significance level, and the effect size
      was between 0.02 and 0.68.
    

Intervention name(s): breastfeeding; skin to skin contact; swaddling and holding
Intervention type(s): Other; Other; Other
Intervention description(s): The NIPS (Neonatal Infant Pain Scale) pain score, heart rate and oxygen saturation of the newborn were recorded by the researcher in the study group, 2 minutes before the heel lance, 10 seconds during the heel lance, and 2 minutes after the heel lance was completed.
In order to determine the crying time of newborns in all three study groups, the voice recorder and stopwatch were turned on two minutes before and 2 minutes after the heel lance.; The NIPS (Neonatal Infant Pain Scale) pain score, heart rate and oxygen saturation of the newborn were recorded by the researcher in the study group, 2 minutes before the heel lance, 10 seconds during the heel lance, and 2 minutes after the heel lance was completed.
In order to determine the crying time of newborns in all three study groups, the voice recorder and stopwatch were turned on two minutes before and 2 minutes after the heel lance.; The NIPS (Neonatal Infant Pain Scale) pain score, heart rate and oxygen saturation of the newborn were recorded by the researcher in the study group, 2 minutes before the heel lance, 10 seconds during the heel lance, and 2 minutes after the heel lance was completed.
In order to determine the crying time of newborns in all three study groups, the voice recorder and stopwatch were turned on two minutes before and 2 minutes after the heel lance.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Comparison of three different methods
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: heel lance; breastfeeding; swaddling and holding; skin to skin contact