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Effect of Environmental and Behavioral Interventions on Pain Intensity in Preterm Infants for Heel Prick Blood
Fatemeh Baharlooei1, Maryam Marofi2, Zahra Abdeyazdan2
1Department of Adult Health Nursing, Student Research Committee, Faculty of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Isfahan, Iran.
Insights
Environmental and behavioral interventions significantly reduced pain in preterm infants during heel-prick blood sampling. These methods eased infant discomfort and improved the sampling procedure.
Area of Science:
- Neonatal care
- Pediatric pain management
- Infant stress response
Background:
- Preterm infants demonstrate an understanding of pain and stress.
- Pain in infants can have wide-ranging effects.
- Heel-prick blood sampling is a common but painful procedure for neonates.
Purpose of the Study:
- To evaluate the effectiveness of environmental and behavioral interventions in reducing pain during heel-prick blood sampling in preterm infants.
- To assess the impact of these interventions on infant stress levels.
Main Methods:
- A clinical trial involving 32 preterm infants (32-37 weeks gestational age) was conducted.
- Interventions included noise reduction, light reduction, minimized nursing manipulation, and intrauterine positioning.
- Pain was measured using the Neonatal Infant Pain Scale (NIPS) at multiple time points.
Main Results:
- No significant pain score differences were observed before the procedure.
- Pain scores during and at 5 and 30 minutes after sampling were significantly lower in the intervention group.
- Environmental and behavioral strategies demonstrated efficacy in pain reduction.
Conclusions:
- Environmental and behavioral interventions effectively reduce pain in preterm infants during heel-prick blood sampling.
- These interventions facilitate the blood sampling procedure by minimizing infant distress.
- The findings support the implementation of these strategies in neonatal care.
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.