Advertisement

The effect of three different methods applied during peripheral vascular access in prematures on pain and comfort levels

Published:September 06, 2022DOI:https://doi.org/10.1016/j.pedn.2022.08.016

      Highlights

      • Three different methods utilized in premature babies were found to reduce pain.
      • Three different methods utilized in premature babies were found to increase comfort.
      • It was determined that the most effective method was fetal position, kangaroo care and swaddling, respectively.
      • These techniques can be used in normal neonatal intensive care unit nursing care.

      Abstract

      Purpose

      This research was carried out to determine the influence of kangaroo care, fetal position, and swaddling on pain and comfort levels in preterm infants during peripheral vascular access.

      Design and methods

      The study was conducted as a randomized experimental study with a control group. It included 148 premature infants (kangaroo group = 37, swaddling group = 37, fetal position = 37, control group = 37) of 32–37 weeks of age who had peripheral vascular access in the NICU of a state hospital in eastern Turkey between December 2019 and June 2020. While the infants in the experimental group received kangaroo care, fetal position, and swaddling procedures during and after peripheral vascular access, the infants in the control group received conventional peripheral vascular access without extra intervention. “Newborn Infant Pain Scale (NIPS)” and “Premature Infant Comfort Scale (PICS)” were used to collect data. Data were analyzed using percentile, chi-square and ANOVA tests.

      Results

      Further analysis revealed that the fetal position was the most beneficial intervention for reducing NIPS scores and boosting PICS scores during and after peripheral vascular access in the experimental groups, followed by kangaroo care and lastly swaddling.

      Conclusion

      It was discovered that kangaroo care, fetal position, and swaddling were useful in lowering discomfort and boosting comfort levels in premature infants during and after peripheral vascular access.

      Practice implications

      Kangaroo care, fetal position and swaddling methods can be used in clinical practice in order to reduce the pain level and increase the comfort level during and after peripheral vascular access in prematures.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Akcan E.
        • Yigit R.
        • Atici A.
        The effect of kangaroo care on pain in premature infants during invasive procedures.
        The Turkish Journal of Pediatrics. 2009; 51: 14
        • Akdoğan T.
        Sağlıklı yenidoğanlarda ağrının değerlendirilmesi, emzik verme ve kucağa alma yönteminin etkisinin incelenmesi. (Yüksek Lisans tezi).
        Marmara Üniversitesi, Sağlık Bilimleri Enstitüsü, İstanbul1999
        • Alemdar D.K.
        • Tufekci F.G.
        The reliability and validity of the premature infant comfort scale’s Turkish/premature bebek konfor olcegi’nin Turkce gecerlilik ve guvenilirligi.
        Journal of Education and Research in Nursing. 2015; 12: 142-149
        • Altay G.
        Pretermlere verilen cenin pozisyonunun yenidoğanin konforuna ve emme başarısına etkisi. (Yüksek Lisans Tezi).
        Atatürk Üniversitesi, Sağlık Bilimleri Enstitüsü, Erzurum2019
        • Alves F.N.
        • Azevedo V.M.G.d.O.
        • Moura M.R.S.
        • Ferreira D.M.d.L.M.
        • Araújo C.G.A.
        • Mendes-Rodrigues C.
        • Wolkers P.C.B.
        Impacto do método canguru sobre o aleitamento materno de recém-nascidos pré-termo no Brasil: uma revisão integrativa.
        Ciência & Saúde Coletiva. 2020; 25: 4509-4520
        • Apaydın Cırık V.
        preterm yenidoğanlarda orogasrtrik tüp takma işlemi nedeniyle oluşan ağrıyı azaltmada anne sütü, sarmalama ve cenin pozisyonu verme yöntemlerinin etkisi. (Doktora Tezi).
        Akdeniz üniversitesi, Antalya2019
        • Avçin E.
        Yenidoğan bebeklerde topuk kanı alma sırasında oluşan ağrıyı azaltmada emzirme, kanguru bakımı ve cenin pozisyonunun etkisi. (Yüksek Lisans Tezi).
        Atatürk üniversitesi, Erzurum2017
        • Ayar A.Ç.
        Yenidoğanlarda ayak topuğundan kan alma işlemi sirasinda beyaz gürültü, kucağa alma ve el ile verilen cenin pozisyonunun ağri üzerine etkisi. (Yüksek Lisans Tezi).
        Avrasya Üniversitesi, Trabzon2018
        • Çağlayan N.
        • Balcı S.
        Preterm Yenidoğanlarda ağrının azaltılmasında etkili bir yöntem: cenin pozisyonu.
        FN Hem. Derg. 2014; 22: 63-68
        • Carbajal R.
        Nonpharmacological treatment of neonatal pain.
        in: Buonocore G. Bellieni C. Neonatal pain: Suffering, pain, and risk of brain damage in the fetus and newborn. Springer, Milan, Italy2008: 83-97
        • Castral T.C.
        • Warnock F.
        • Leite A.M.
        • Haas V.J.
        • Scochi C.G.
        The effects of skin-to-skin contact during acute pain in preterm newborns.
        European Journal of Pain. 2008; 12: 464-471
        • Cignacco E.
        • Hamers J.P.
        • Stoffel L.
        • Van Lingen R.A.
        • Gessler P.
        • McDougall J.
        • Nelle M.
        The efficacy of non-pharmacological interventions in the management of procedural pain in preterm and term neonates.: A systematic literature review.
        European Journal of Pain. 2007; 11: 139-152
        • Cowan S.
        Swaddling-all wrapped up.
        NZCOM. 2012; : 1-3
        • Derebent E.
        • Yiğit R.
        Yenİdoğanda ağri: Değerlendİrme ve yönetİm.
        CÜ Hemşirelik Yüksekokulu Dergisi. 2006; 10: 8-41
        • Dezhdar S.
        • Jahanpour F.
        • Bakht S.F.
        • Ostovar A.
        The effects of kangaroo mother care and swaddling on venipuncture pain in premature neonates: A randomized clinical trial.
        Iranian Red Crescent Medical Journal. 2016; 18
        • Duerden E.G.
        • Grunau R.E.
        • Guo T.
        • Foong J.
        • Pearson A.
        • Au-Young S.
        • Miller S.P.
        Early procedural pain is associated with regionally-specific alterations in thalamic development in preterm neonates.
        Journal of Neuroscience. 2018; 38: 878-886
        • Eras Z.
        • Atay G.
        • Şakrucu E.D.
        • Bingöler E.B.
        • Dilmen U.
        Yenidoğan yoğun bakım ünitesinde gelişimsel destek.
        Şişli Etfal Hastanesi Tıp Bülteni. 2013; 47: 97-103
        • Eroğlu A.
        • Arslan S.
        Yenidoğanda ağrının algılanması, değerlendirilmesi ve yönetimi.
        Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi. 2018; 8: 52-60
        • Erzurumluoğlu Z.
        • Yıldız S.
        Yenidoğanda güvenli kundaklamanın (sarmalamanın) topuk kanı alma işleminde gelişen ağrı algısına, yaşam bulgularına ve ağlama süresine etkisi. (Yüksek Lisans Tezi).
        İstanbul Üniversitesi, Sağlık Bilimleri Enstitüsü, İstanbul2014
        • Gray L.
        • Watt L.B.
        • Blass E.
        Skin-to-skin (kangaroo) contact is analgesic in healthy newborns.
        Pediatric Research. 1999; 45: 14
        • Hill S.
        • Engle S.
        • Jorgensen J.
        • Kralik A.
        • Whitman K.
        Effects of facilitated tucking during routine care of infants born preterm.
        Pediatric Physical Therapy. 2005; 17: 158-163
        • Ho S.
        • Ho L.
        Effects of facilitated swaddling for controlling procedural pain in premature neonates: A randomized controlled trial.
        The Journal of Pain. 2012; 13: S59
        • Huang C.-M.
        • Tung W.-S.
        • Kuo L.-L.
        • Ying-Ju C.
        Comparison of pain responses of premature infants to the heelstick between containment and swaddling.
        The Journal of Nursing Research: JNR. 2004; 12: 31-40
        • Johnston C.C.
        • Fernandes A.M.
        • Campbell-Yeo M.
        Pain in neonates is different.
        Pain. 2011; 152: S65-S73
        • Johnston C.C.
        • Filion F.
        • Campbell-Yeo M.
        • Goulet C.
        • Bell L.
        • McNaughton K.
        • Walker C.D.
        Kangaroo mother care diminishes pain from heel lance in very preterm neonates: A crossover trial.
        BMC Pediatrics. 2008; 8: 1-9
        • Johnston C.C.
        • Stevens B.
        • Pinelli J.
        • Gibbins S.
        • Filion F.
        • Jack A.
        • Veilleux A.
        Kangaroo care is effective in diminishing pain response in preterm neonates.
        Archives of Pediatrics & Adolescent Medicine. 2003; 157: 1084-1088
        • Kale K.
        Yenidoğanlarda topuk kanı alma sırasında oluşan ağrı düzeyine emzirme ve cenin pozisyonunun etkisi. (Yüksek Lisans Tezi).
        Trakya Üniversitesi, Edirne2018
        • Kashaninia Z.
        • Sajedi F.
        • Rahgozar M.
        • Noghabi F.A.
        The effect of kangaroo care on behavioral responses to pain of an intramuscular injection in neonates.
        Journal for Specialists in Pediatric Nursing. 2008; 13: 275-280
        • Kelmanson I.
        Swaddling: Maternal option and sleep behaviour in two-month-old infants.
        Child Care in Practice. 2013; 19: 36-48
        • Kostandy R.R.
        • Ludington-Hoe S.M.
        • Cong X.
        • Abouelfettoh A.
        • Bronson C.
        • Stankus A.
        • Jarrell J.R.
        Kangaroo care (skin contact) reduces crying response to pain in preterm neonates: Pilot results.
        Pain Management Nursing. 2008; 9: 55-65
        • Mangat A.K.
        • Oei J.-L.
        • Chen K.
        • Quah-Smith I.
        • Schmölzer G.M.
        A review of non-pharmacological treatments for pain management in newborn infants.
        Children. 2018; 5: 130
        • Meyer L.E.
        • Erler T.
        Swaddling: A traditional care method rediscovered.
        World Journal of Pediatrics. 2011; 7: 155-160
        • Obeidat H.
        • Kahalaf I.
        • Callister L.C.
        • Froelicher E.S.
        Use of facilitated tucking for nonpharmacological pain management in preterm infants: A systematic review.
        The Journal of Perinatal & Neonatal Nursing. 2009; 23: 372-377
        • Oden R.P.
        • Powell C.
        • Sims A.
        • Weisman J.
        • Joyner B.L.
        • Moon R.Y.
        Swaddling: Will it get babies onto their backs for sleep?.
        Clinical Pediatrics. 2012; 51: 254-259
        • Özyazicioğlu N.
        • Çelebioğlu A.
        Hemşirelik yüksekokulu öğrencilerinin yenidoğanda ağriya İlişkin bilgi ve görüşleri.
        Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2008; 11: 9-16
        • Shrestha M.
        • Adhikari R.
        Comparison of pain response to venepuncture versus heel lance blood sampling in term neonates.
        Journal of Nepal Paediatric Society. 2012; 32: 99-104
        • Shu S.H.
        • Lee Y.L.
        • Hayter M.
        • Wang R.H.
        Efficacy of swaddling and heel warming on pain response to heel stick in neonates: A randomised control trial.
        Journal of Clinical Nursing. 2014; 23: 3107-3114
        • Todil T.
        • Cetinkaya S.
        Investigation of early kangaroo care applied newborns who had invasive interventions in delivery room with comfortneo Behavior Scale.
        Early Child Development and Care. 2021; 1-14
        • Valizadeh L.
        • Ghahremani G.
        • Gharehbaghi M.M.
        • Jafarabadi M.A.
        The effects of flexed (fetal tucking) and extended (free body) postures on the daily sleep quantity of hospitalized premature infants: A randomized clinical trial.
        Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences. 2016; 21
        • Van Sleuwen B.
        • L’hoir M.
        • Engelberts A.C.
        • Busschers W.B.
        • Westers P.
        • Blom M.A.
        • Kuis W.
        Comparison of behavior modification with and without swaddling as interventions for excessive crying.
        The Journal of Pediatrics. 2006; 149 (512-517. e512)
        • Van Sleuwen B.E.
        • Engelberts A.C.
        • Boere-Boonekamp M.M.
        • Kuis W.
        • Schulpen T.W.
        • L’Hoir M.P.
        Swaddling: A systematic review.
        Pediatrics. 2007; 120: e1097-e1106
        • Yilmaz F.
        • Arikan D.
        The effects of various interventions to newborns on pain and duration of crying.
        Journal of Clinical Nursing. 2011; 20: 1008-1017