Effect of Kangaroo Care and Swaddling Methods on Pain Level and Crying Time During Heel Blood Collection

Among the non-pharmacological methods frequently used to reduce the effects of invasive interventions on the newborn; Practices such as reducing environmental stimuli, individualized developmental care, music therapy, breast milk, pacifier giving, sucrose, non-nutritive sucking, oral sucrose, kangaroo care, facilitated tucking position, and sweet solutions, massage and touching, positioning, nesting, kangaroo care, fetal positioning are included.

This study is a prospective, randomized and controlled trial. In this study aim, the effect of kangaroo care and swaddling methods applied during heel blood collection on the pain levels and crying times in newborns will be examined.

Sample of the study consisted of a total of 120 newborns who met the sample selection criteria and were selected via randomization method. Newborns were divided into three groups; kangaroo care group (n=40), swaddling group (n=40), and control group (n=40).

Data were collected using the Infant-family Information Form, NIPS - Neonatal Infant Pain Scale, and Crying Follow-up Form.

• Kangaroo Care (Behavioral): Kangaroo care will be applied so that the infant and mother will have skin-to-skin contact, and heel blood will be taken.
• Swaddling (Behavioral): Heel blood will be taken while the infant was swaddled in the maternal holding.

Primary outcomes

• NIPS (Neonatal Infant Pain Scale) [during the heel blood collection procedures]: It was developed to evaluate interventional pain in newborns. Its Turkish adaptation was in 1999. NIPS is an assessment tool that focuses on six behavioral responses of newborns: facial expressions, crying, breathing, arm movements, leg movements, and arousal. A score between 0 and 7 is obtained from the scale, and as the score obtained from the scale increases, the pain of newborns also increases. In the Turkish adaptation study of the scale, the Cronbach's alpha value was calculated as 0.83 before the procedure, 0.83 during the procedure and 0.86 after the procedure.

Secondary outcomes

• Crying times [during the heel blood collection procedures]: Duration of crying were recorded.
• Processing time [during the heel blood collection procedures]: Duration of heel blood collection procedure were recorded.

Sex: All, ages: 1 Day to 4 Days, accepts healthy volunteers

Inclusion Criteria:

* Parents who volunteered and gave consent to participate in the research
* Full term neonates (38-42 weeks of gestation)
* Underwent heel stick blood drawing for routine metabolic screening,
* Aged 1 to 4 days
* Passed the hearing screening
* Birth weight between 2500-4400 grams
* Parents who know how to read, write and speak Turkish.

Exclusion Criteria:

* Parents with any mental problems
* Infants with any chronic disease and congenital anomalies.

• Selda Ateş Beşirik, PhD., Principal investigator, Burdur Mehmet Akif Ersoy University
• Emine Geçkil, Professor, Study director, Necmettin Erbakan University