Newborn Clinical Trial
Official title:
Comparison of the Efficacy of Non-pharmacological Interventions on Pain Levels, Crying Times and Voice Decibels in Newborns: A Randomized Controlled Trial
This study aimed to investigate and compare the effects of different non-pharmacological interventions (kangaroo care, holding on mother's lap, white noise listening, ambient sound listening) on newborns' crying times, voice decibels and pain levels during heel-stick procedure
The study is a prospective, randomized controlled trial including pre and post tests of four
groups. The population of the study consisted of newborns who were followed in the Neonatal
Service of Eskişehir City Hospital. The number of newborns to be sampled was determined by
power analysis. With a 95% confidence interval, 0.25 effect size and 0.85 strength, 34
newborns are planned to be included in each group. Newborns who meet the inclusion criteria
will be randomly assigned to the groups.
In the randomization process; in the four-group design, the rooms were randomly assigned to
the study groups by drawing lots in order to eliminate the probability of influence of
newborns from each other. Internal blinding was used as a blinding method in order to ensure
complete randomization and to prevent Rosental effect. The randomization was performed by the
responsible nurse of the unit who was unaware of the pre-test and post-tests of the
application.
1. Four different groups were formed in order to prevent the causes of concern in the
randomization of patients who were leveled according to their clinical status in the
neonatal intensive care unit.
2. In the absence of neonatal intensive care environment noise, four groups were considered
due to the limitation in explaining the benefit, contribution and effect of white noise,
kangru care and being in the lap of the mother in reducing pain.
3. The newborns treated with kangaroo care and the mother's lap will be the control groups
of each other and the newborns treated with white noise and ambient sound will be the
control groups of each other.
Research hypotheses:
H1. Newborns receiving kangaroo care during the heel-stick procedure have lower pain levels
than newborns who are holding on their mother's lap.
H2. Newborns receiving kangaroo care during the heel-stick procedure have less crying time
than newborns who are holding on their mother's lap.
H3. The highest level of sound decibels in the crying process of newborns who receiving
kangaroo care during the heel-stick procedure are less than newborns who are holding on their
mother's lap.
H4. Newborns listened to white noise during the heel-stick procedure have lower pain levels
than newborns who listened to ambient sound.
H5. Newborns listened to white noise during the heel-stick procedure have less crying time
than newborns who listened to ambient sound.
H6. The highest level of sound decibels in the crying process of newborns who listened to
white noise during the heel-stick procedure are less than newborns listened to ambient sound.
In the study, NIPS (Neonatal Infant Pain Scale) will be used to evaluate the pain severity of
newborns in addition to the data form prepared by the researchers.
During the application, pulse oximetry device will be placed on each newborn right wrist,
then heart rate and SpO2 values will be recorded before, during and after the procedure. The
device will remain attached to the baby's wrist during the procedure. Then, the pain level
will be assessed with NIPS and heel-stick procedure will be initiated. To determine the
crying time, the stopwatch shall be turned on and the sound decibel meter shall be turned on
to determine the sound decibel. The general pain level of the newborns will be evaluated by
one minute before the procedure and their response to the pain for three minutes during and
after the procedure.
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