Effect of Environmental and Behavioral Interventions on Pain Intensity in Preterm Infants for Heel Prick Blood Sampling in the Neonatal Intensive Care Unit

Fatemeh Baharlooei, Maryam Marofi, Zahra Abdeyazdan


Background: Recent researches suggest that preterm infants understand pain and stress. Because of the wide range of effects of pain on infants, the present study was conducted on the effect of environmental and behavioral interventions on pain due to heel‑prick blood sampling in preterm infants.

 Materials and Methods: A clinical trial was conducted among 32 infants with gestational age of 32–37 weeks in the intervention and control groups. The effects of noise reduction by earplugs, light reduction by blindfolds, reduction of nursing manipulation, and creation of intrauterine position for neonates, 30 minutes before taking blood samples until 30 minutes after it, were measured during the intervention stage. Data were collected using the Neonatal Infant Pain Scale (NIPS) in 5 stages (before intervention, 2 minutes before sampling, during the sampling, and 5 minutes and 30 minutes after the sampling). The data were analyzed using analysis of variance (ANOVA) and paired t‑test in SPSS software.

Results: The paired t‑test results showed no significant differences between the control and intervention stages in terms of pain scores at base time (P = 0.42) and 2 minutes before sampling (P = 0.12). However, at the sampling time (P = 0.0), and 5 minutes (P = 0.001) and 30 minutes after the sampling (P = 0.001), mean pain score in the intervention stage was significantly less than that in the control stage.

Conclusions: Based on the findings, environmental and behavioral interventions reduced pain and facilitated heel‑prick blood sampling in preterm infants.


Intervention; Iran; pain; preterm

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