Effect of Environmental and Behavioral Interventions on Pain Intensity in Preterm Infants for Heel Prick Blood Sampling in the Neonatal Intensive Care Unit
Abstract
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.
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Salah‑zehi H, Khojasteh F, Nazarpour S. Nursing and health of mothers and Neonates (Persian). Golban Publication; 2009.
Rodrigues AC, Guinsburg R. Pain evaluation after a non‑nociceptive stimulus in preterm infants during the first 28 days of life. Early Hum Dev 2013;89:75‑9.
Nicholson J, Berthelsen D, Abad V, Williams K, Bradley J. Impact of Music Therapy to Promote Positive Parenting and Child Development. IHP 2008;13:226‑38.
Raju TN, Pemberton VL, Saigal S, Blaisdell CJ, Moxey‑Mims M, Buist S, et al. Long‑Term Healthcare Outcomes of Preterm Birth: An Executive Summary of a Conference Sponsored by the National Institutes of Health. J Pediatr 2017;181:309‑18.
Karimi R, Shabani F, Dehghan Nayeri N, Zareii K, Khalili G, Chehrazi M. Effect of Music Therapy on Physiological Pain Responses of Blood Sampling in Premature Infants (Persian). Hayat 2012;18:76‑86.
Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirelli A, et al. Guidelines for procedural pain in the newborn. Acta Paediatr 2009;98:932‑9.
Buonocore G, Bellieni C. Neonatal pain: Suffering, pain, and risk of brain damage in the fetus and newborn, 1st ed. New York: Springer; 2008.
Dunwoody C, Krenzischek D, Pasero C, Rathmell J, Polomano R. Assessment, physiological monitoring, and consequences of inadequately treated acute pain. Pain Manage Nurs 2008;9:11‑21.
Corbo MG, Mansi G, Stagni A, Romano A, van den Heuvel J, Capasso L, et al. Non‑nutritive sucking during heel‑stick procedures decreases behavioral distress in the newborn Infant. Biol Neonate 2000;77:162‑7.
Liaw JJ, Zeng WP, Yang L, Yuh YS, Ti Yin, Yang MH. Nonnutritive Sucking and Oral Sucrose Relieve Neonatal Pain During Intramuscular Injection of Hepatitis Vaccine. J Pain Symptom Manage 2011:42:918‑30.
Mörelius E, Örtenstrand A, Theodorsson E, Frostell A. A randomised trial of continuous skin‑to‑skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding, Early Hum Dev 2015;91:63‑70.
Castral T, Warnock F, Leite A, Haas V, Scochi CGS. The effect of skin to skin contact during acute pain in preterm newborns. Eur J Pain 2008;12:464‑71.
Zhu J, Hong‑Gu H, Zhou X, Wei H, Gao Y, Ye B, et al. Pain relief effect of breast feeding and music therapy during heel lance for healthy‑term neonates in China: A randomized controlled trial. Midwifery 2015;31:365‑72.
Carbajal R, Rousset A, Danan C, Coquery S, Nolent P, Ducrocq S, et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA 2008;300:60‑70.
Whipple J. The effect of music‑reinforced non‑nutritive sucking on state of preterm, low birth‑weight infants experiencing heel‑stick. J Music Ther 2008;45:227‑72.
Khoddam H, Sabzi Z. Effectiveness of oral sucrose on pain severity in term newborn undergoing heel prick (Persian). Iran J Nurs Res 2010;5:45‑51.
Catelin C, Tordjman S, Morin V, Oger E, Sizun J. Clinical, Physiologic, and Biologic Impact of Environmental and Behavioral Interventions in Neonates During a Routine Nursing Procedure. J Pain 2005;6:791‑7.
Linda S, Cindy S, Bonnie S. Pain assessment in infants and children. Pediatr Clin 2000;47:487‑512.
Lundeberg S, Lundeberg T. Pain in infants and children‑Physiological background and clinical aspects. Acupunct Relat Ther 2013;1:46‑9.
Sizun J, Westrup B, and the ESF Network Coordination Committee. Early developmental care for preterm neonates. Arch Dis Child Fetal Neonatal Ed 2004;89:384‑9.
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