The effect of the facilitated tucking position in reducing vaccination-induced pain in newborns

Sibel Kucukoglu, Sirin Kurt, Aynur Aytekin, Sibel Kucukoglu, Sirin Kurt, Aynur Aytekin

Abstract

Background: This study was conducted to evaluate the pain perceptions of newborns during the hepatitis B (HBV) vaccinations performed in the facilitated tucking position and the classical holding position, respectively.

Methods: The randomized controlled experimental study was conducted between 1 September 2014 and 30 December 2014 at the neonatal intensive care unit of a Turkish university hospital. One group of infants was held in the facilitated tucking position (the treatment group; n = 30) during HBV vaccination; infants in the other group were held in the classical holding position (the control group; n = 30) during HBV vaccination. The Neonatal Infant Pain Scale (NIPS) scores of the infants in the treatment and control groups were compared during procedure. Also, the infants' physiological parameters were compared before, during, and after the procedure. Descriptive statistics, a chi-square test, and an independent samples t-test were used to assess the data.

Results: The mean pain scores of infants vaccinated in the facilitated tucking position (2.83 ± 1.18) were significantly statistically lower than the scores of infants vaccinated in the classical holding position (6.47 ± 1.07) (p < 0.05).

Conclusions: The pain perceptions of newborns held in the facilitated tucking position during HBV vaccination were lower. The facilitated tucking position, a non-pharmacological method, is recommended as an effective and useful method for reducing pain during the procedure.

Figures

Fig. 1
Fig. 1
Flow of study
Fig. 2
Fig. 2
The infant in the facilitated tucking position
Fig. 3
Fig. 3
The infant in the classical holding position

References

    1. Kyle T, Carman S: Essentials of Pediatric Nursing: Pain Management in Children. 2nd Edition. Philadelphia, PA: Lippincott Williams & Wilkins.2012.
    1. Tekin NE, Hasanoğlu R, Düşünsel AB. Pain in Newborn: Basic Pediatrics. İstanbul: Güneş Medical Publications; 2010. pp. 511–4.
    1. Walden M. Pain assessment and management. In: Verklan MT, Walden M, editors. Core curriculum for Neonatal Intensive Care Nursing. 4. Missouri, St. Louis: Saunders Elsevier; 2010. pp. 333–45.
    1. Reis EC, Roth EK, Syphan JL, Tarbell SE, Holubkov R. Effective pain reduction for multiple immunization injections in young infants. Arch Pediatr Adolesc Med. 2003;157:1115–20. doi: 10.1001/archpedi.157.11.1115.
    1. Young KD. Pediatric procedural pain. Ann Emerg Med. 2005;45:160–71. doi: 10.1016/j.annemergmed.2004.09.019.
    1. Gradin M, Eriksson M, Holmqvist G, Holstein A, Schollin J. Pain reduction at venipuncture in newborns: oral glucose compared with local anesthetic cream. Pediatrics. 2002;110:1053–7. doi: 10.1542/peds.110.6.1053.
    1. Ommaty R. Vademacum: Vital Pharmy Index. Ankara. Turkey: Pelikan Publishing; 2009. pp. 576–7.
    1. Faye MP, Jonckheere JD, Logier R, Kuissi E, Jeanne M, Rakza T, et al. Newborn infant pain assessment using hearth rate variability analysis. Clin J Pain. 2010;26:777–82. doi: 10.1097/AJP.0b013e3181ed1058.
    1. Anand KJS, Hall RW, Desai N, Shephard B, Bergqvist LL, Young TE, et al. Effects of morphine analgesia in ventilated preterm neonates: primary outcomes from the NEOPAIN randomised trial. Lancet. 2004;363:1673–82. doi: 10.1016/S0140-6736(04)16251-X.
    1. Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirella A, et al. Guidelines for procedural pain in the newborn. Acta Paediatr. 2009;98:932–9. doi: 10.1111/j.1651-2227.2009.01291.x.
    1. Ludington-Hoe SM, Hosseini RB. Skin-to-skin contact analgesia for preterm infant hell stick. AACN Clin Issues. 2005;16:373–87. doi: 10.1097/00044067-200507000-00010.
    1. Obeidat H, Kahalaf I, Callister LC, Froelicher ES. Use of facilitated tucking for nonpharmacological pain managment in preterm infants: A systematic review. J Perinat Neonatal Nurs. 2009;23:372–7. doi: 10.1097/JPN.0b013e3181bdcf77.
    1. Ward-Larson C, Horn RA, Gosnell F. The efficacy of facilitated tucking for relieving procedural pain of endotracheal suctioning in very low birthweight infants. MCN Am J Matern Child Nurs. 2004;29:151–6. doi: 10.1097/00005721-200405000-00004.
    1. Huang CM, Tung WS, Kuo LL, Chang YJ. Comparison of pain responses of premature infants to the heelstick between containment and swaddling. J Nurs Res. 2004;12:31–40. doi: 10.1097/01.JNR.0000387486.78685.c5.
    1. Axelin A, Salanterä S, Lehtonen L. “Facilitated tucking by parents” in pain management of preterm infants: a randomized crossover trial. Early Hum Dev. 2006;82:241–7. doi: 10.1016/j.earlhumdev.2005.09.012.
    1. Hill S, Engle S, Jorgensen J, Kralik A, Whitman K. Effects of facilitated tucking during routine care of infants born preterm. Pediatr Phys Ther. 2005;17:158–63. doi: 10.1097/.
    1. American Academy of Pediatrics, Committee on Fetus and Newborn, Canadian Paediatric Society, Fetus and Newborn Committee Prevention and management of pain in the neonate: an update. Adv Neonatal Care. 2007;7:151–60. doi: 10.1097/01.ANC.0000278214.49133.7d.
    1. Lopez O, Subramanian P, Rahmat N, Chin Theam L, Chinna K, Rosli R. The effect of facilitated tucking on procedural pain control among premature babies. J Clin Nurs. 2015;24:183–91. doi: 10.1111/jocn.12657.
    1. Liaw JJ, Yang L, Katherine Wang KW, Chen CM, Chang YC, Yin T. Non-nutritive sucking and facilitated tucking relieve preterm infant pain during heel-stick procedures: a prospective, randomized controlled crossover trial. Int J Nurs Stud. 2012;49:300–9. doi: 10.1016/j.ijnurstu.2011.09.017.
    1. Çağlayan N, Balcı S. An effective model of reducing pain in preterm neonates: facilitated tucking. FN Hem Derg. 2014;22:63–8. doi: 10.17672/fnhd.28974.
    1. Cignacco EL, Sellam G, Stoffel L, Gerull R, Nelle M, Anand KJ, et al. Oral sucrose and “facilitated tucking” for repeated pain relief in preterms: a randomized controlled trial. Pediatrics. 2012;129:299–308. doi: 10.1542/peds.2011-1879.
    1. Hartley KA, Miller CS, Gephart SM. Facilitated tucking to reduce pain in neonates: evidence for best practice. Adv Neonatal Care. 2015;15:201–8. doi: 10.1097/ANC.0000000000000193.
    1. Peyrovi H, Alinejad-Naenini M, Mohagheghi P, Mehran A. The effect of facilitated tucking position during endotracheal suctioning on physiological responses and coping with stress in premature infants: a randomized controlled crossover study. J Matern Fetal Neonatal Med. 2014;27:1555–9. doi: 10.3109/14767058.2013.868429.
    1. Alinejad-Naenini M, Mohagheghi P, Peyrovi H, Mehran A. The effect of facilitated tucking during endotracheal suctioning on procedural pain in preterm neonates: a randomized controlled crossover study. Glob J Health Sci. 2014;6:278–84.
    1. Vessey JA, Carlson KL, McGill J. Use of distraction with children during an acute pain experience. Nurs Res. 1994;43:369–72.
    1. Karaayvaz T. The effectiveness of oral sucrose and topical EMLA application in reducing neonatal pain during venipuncture. Turkey: Unpublished Msc Thesis. Marmaral University Institute of Health Sciences. Istanbul; 2009.
    1. Axelin A. Parents as pain killers in the pain management of preterm infants. 2010. . Accessed 28 December 2014.
    1. Schulz KF, Grimes DA. Generation of allocation sequences in randomized trials: chance, not choice. Lancet. 2002;359:515–9. doi: 10.1016/S0140-6736(02)07683-3.
    1. Lawrence J, Alcock D, McGrath P, Kay J, MacMurray SB, Dulberg C. The development of a tool to assess neonatal pain. Neonatal Netw. 1993;12:59–66.
    1. Akdovan T, Yıldırım Z. Assessment of pain in healthy neonates, investigation of the effects of pacifying and holding in arms. Perinatal J. 1999;7:107.
    1. Als H, Lawhorn G. Theoretical perspective for developmentally supportive care. In: Kenner C, McGrath JM, editors. Developmental care of newborns and infants: A guide for health professionals. Glenview. IL: St Louis: Mosby; 2004. pp. 47–63.
    1. Derebent E, Yiğit R. Pain in newborn: assessment and management. CU Hemşirelik Yüksek Okulu Derg. 2006;10:41–8.
    1. Gardner SL, Hagedorn MIE, Dickey LA. Pain and Pain Relief. In: Merenstein BG, Gardner SL, editors. Handbook of Neonatal Intensive Care. Philadelphia: Mosby Elsevier; 2006. pp. 223–72.
    1. Akyürek B, Conk Z. The efficacy of non-pharmacological pain relief methods in injection: application to newborns. Ege Üniversitesi Hemşirelik Yüksek Okulu Dergisi. 2006;22:1–17.
    1. Dağoğlu T. Newborn development and enviromental factors. In: Dağoğlu T, Görak G, editors. Basic Neonatology and Nursing Principles. Istanbul, Turkey: Nobel Medical Publications; 2008. pp. 759–67.
    1. Çağlayan N. The effect on pain of manipulating the preterm neonate into the facilitated tucking during drawing of blood from the heel. Turkey: Unpublished Msc Thesis. Istanbul University Health Sciences Institute. Istanbul; 2011.
    1. Karabudak S, Ergün S. Neonatal Diseases and Nursing Care. In: Conk Z, Başbakkal Z, Yılmaz HB, Bolışık B, editors. Pediatric Nursing. Ankara, Turkey: Akademisyen Medical Publications; 2013. pp. 289–354.

Source: PubMed

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