Bebeklerde Kanguru Bakımının Ağrı Üzerine Etkisi: Randomize Kontrollü Çalışma
Year 2025,
Volume: 4 Issue: 1, 1 - 9, 18.04.2025
Deniz Yiğit
,
Emel Sezici
Abstract
Amaç: Bu çalışma bebeklerde aşılama sırasında uygulanan kanguru bakımının ağrı üzerine etkisini belirlemek amacıyla yapılmıştır.
Yöntem: Araştırma, 128 sağlıklı 1 aylık bebek ve anneleri ile randomize kontrollü olarak yapılmıştır. Verilerin toplanmasında; sosyodemografik bilgi formu, Yenidoğan Bebek Ağrı Ölçeği, nabız oksimetresi ve kronometre kullanılmıştır.
Bulgular: Aşılama öncesinde, sırasında ve sonrasında gruplar arasında; NIPS skorları, oksijen satürasyon oranları ve ağlama süreleri açısından istatistiksel olarak anlamlı farklılıklar tespit edilmiştir. Aşılama işlemi öncesinde ve sırasında gruplar arasında kalp atım hızı açısından anlamlı bir fark bulunmazken, aşılama sonrasında istatistiksel olarak anlamlı bir fark tespit edilmiştir.
Sonuç: Kanguru bakımını aşılanan bebeklerde ağlama süresini, kalp atım hızını ve ağrıyı azalttığı, buna karşın kandaki oksijen satürasyon düzeylerini artırdığı belirlenmiştir.
Project Number
DPÜ-BAB No.2016-28
References
- Olsson E, Ahl H, Bengtsson K, Vejayaram DN,
Norman E, Bruschettini M, et. al. The use and
reporting of neonatal pain scales: a systematic
review of randomized trials. Pain 2021; 162(2):
353-360.
- Zhao Y, Dong Y, Cao, J. Kangaroo care for relieving
neonatal pain caused by invasive procedures:
A systematic review and meta‐analysis.
Computational Intelligence and Neuroscience
2022; 2022(1): 2577158.
- Sharma H, Ruikar M. Kangaroo mother care
(KMC) for procedural pain in infants: A meta-
analysis from the current evidence of randomized
control trials and cross-over trials. Journal of Family Medicine and Primary Care
2022; 11(4): 1250-1256.
- Sen E, Manav G. Effect of kangaroo care and oral
sucrose on pain in premature infants: A randomized
controlled trial (Prematüre bebeklerde kanguru
bakımı ve oral sukrozun ağrı üzerine etkisi:
Randomize kontrollü bir çalışma). Pain Management
Nursing 2020; 21(6): 556-564.
- Jajoo M, Mittal M, Saikia D, Kumar N. Impact of
kangaroo mother care on heart rate variability
and pain score with heel lance pain in preterm
neonates: A cross-over randomized controlled
trial. Journal of Neonatology 2024; 38(2).
- Hartley KA, Miller CS, Gephart SM. Facilitated
tucking to reduce pain in neonates: Evidence for
best practice. Advances in Neonatal Care 2015;
15(3): 201-208.
- Hills E, Rosenberg J, Banfield N, Harding C. A
multidisciplinary approach to the implementation
of non-pharmacological strategies to manage
infant pain. Infant 2020; 16(2): 78-81.
- Weng Y, Zhang J, Chen Z. Effect of non-pharmacological
interventions on pain in preterm
infants in the neonatal intensive care unit: A network
meta-analysis of randomized controlled
trials. BMC Pediatrics 2024; 24(1), 9.
- Shiff I, Bucsea O, Pillai Riddell R. Psychosocial
and neurobiological vulnerabilities of the hospitalized
preterm infant and relevant non-pharmacological
pain mitigation strategies. Frontiers in
Pediatrics 2021; 9: 568755.
- Cho ES, Kim SJ, Kwon MS, Cho H, Kim EH, Jun
EM, et al. The effects of kangaroo care in the
neonatal intensive care unit on the physiological
functions of preterm infants, maternal–infant
attachment, and maternal stress. Journal of Pediatric
Nursing 2016; 31(4): 430-438.
- Kostandy RR, Ludington-Hoe SM. Clustered
pain procedures in skin-to-skin contact (SSC)
position for full term newborns. World Journal
of Neuroscience 2017; 7(1): 38.
- Bera A, Ghosh J, Singh AK, Hazra A, Som T, Munian
D. Effect of kangaroo mother care on vital
physiological parameters of the low birth weight
newborn. Indian Journal of Community Medicine
2014; 39(4): 245-249.
- Sutar R, Baraha S, Mummidi PS. Effects of kangaroo
mother care on common vital parameters
of preterm infants. IJSR 2015; 4(12): 345-7.
- World Health Organization (WHO). Kangaroo
mother care: A practical guide, 2003. Available
at https://www.who.int/maternal_child_adolescent/
documents/9241590351/en/. Accessed
February 18, 2022.
- Saeidi R, Asnaashari Z, Amirnejad M, Esmaeili
H, Robatsangi MG. Use of “Kangaroo Care”
to alleviate the intensity of vaccination pain in
newborns. Iranian Journal of Pediatrics 2011;
21(1), 99.
- Lawrence J, Alcock D, McGrath P, Kay J, Mac-
Murray SB, Dulberg C. The development of a
tool to assess neonatal pain. Neonatal network:
NN 1993; 12(6): 59-66.
- Akdovan T, Yıldırım Z. Sağlıklı yenidoğanlarda
ağrının değerlendirilmesi, emzik verme ve kucağa
alma yönteminin etkisinin incelenmesi.
Perinatal Journal 1999; 7: 107.
- Akyurek B, Conk Z. Yenidoğan bebeklere uygulanan
iğneli girişimlerde non-farmakolojik ağri
giderme yöntemlerinin etkisinin incelenmesi.
Journal of Ege University Faculty of Nursing
2006; 22(1): 1-17.
- Yucel G, Sari HY, Olukman O. Yenidoğanlarda
tekrarlayan topuk kan alımı sırasında uygulanan
kanguru bakımının ağrı puanına etkisi. Journal
of Dr. Behcet Uz Children’s Hospital 2020; 10(2).
- Okan F, Ozdil A, Bulbul A, Yapici Z, Nuhoglu A.
Analgesic effects of skin-to-skin contact and
breastfeeding in procedural pain in healthy term
neonates (Sağlıklı term yenidoğanlarda ciltten
cilde temasın ve emzirmenin prosedürel ağrıda
analjezik etkileri). Annals of Tropical Paediatrics
2010; 30(2): 119-128.
- Johnston C, Campbell‐Yeo M, Disher T, Benoit B,
Fernandes A, Streiner D, et al. Skin‐to‐skin care
for procedural pain in neonates. Cochrane Database
of Systematic Reviews 2017; (2).
- Sajedi F, Kashaninia Z, Rahgozar M, Asadi NF.
The effect of kangaroo care on physiologic responses
to pain of an intramuscular injection
in neonates. Iranian Journal of Pediatrics 2007;
17(4): 339-344.
- Simsek DC, Gunay U, Polat S. Term ve preterm
yenidoğanda kanguru bakımına yönelik kanıta
dayalı uygulamalar. Türkiye Clinics Pediatric
Nursing-Special Topics 2021; 7(2): 53-57.
- Nimbalkar SM, Chaudhary NS, Gadhavi KV, Phatak
A. Kangaroo mother care in reducing pain in
preterm neonates on heel prick. The Indian Journal
of Pediatrics 2013; 80: 6-10.
- Dezhdar S, Jahanpour F, Bakht SF, 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(4).
- Stuard W. The effects of kangaroo care on a
newborn development and vital physiology. Clinics
Mother Child Health 2016; 13(1): 2-4.
- Kemer D, Isler, A. Yenidoğanlarda ağrı yönetiminde
kullanılan kanıt temelli nonfarmakolojik
hemşirelik uygulamaları. Balikesir Journal of
Health Sciences 2020; 9(3): 197-204.
- Gray L, Watt L, Blass EM. Skin-to-skin contact is
analgesic in healthy newborns. Pediatrics 2000;
105(1): e14-e14.
- Choudhary M, Dogiyal H, Sharma D, Datt Gupta
B, Madabhavi I, Choudhary JS, et al. To study
the effect of kangaroo mother care on pain response
in preterm neonates and to determine
the behavioral and physiological responses to
painful stimuli in preterm neonates: A study
from western Rajasthan. The Journal of Maternal-
Fetal & Neonatal Medicine 2016; 29(5): 826-
831.
- Moore ER, Bergman N, Anderson GC, Medley N.
Early skin‐to‐skin contact for mothers and their
healthy newborn infants. Cochrane Database of
Systematic Reviews 2016; (11).
- Gurbuz F, Koyuncu NE. Bebeklerde aşı uygulamaları
sırasında oluşan ağrının yönetiminde
kullanılan non-farmakolojik fiziksel yöntemler.
KTO Karatay University Health Sciences Journal
2024; 5(1): 97-107.
Effect of Kangaroo Care on Pain in Infants: A Randomized Controlled Trial
Year 2025,
Volume: 4 Issue: 1, 1 - 9, 18.04.2025
Deniz Yiğit
,
Emel Sezici
Abstract
Aim
This study was conducted to determine the effect of kangaroo care on pain during vaccination in infants.
Method
The study was conducted as a randomised controlled trial with 128 healthy one-month-old infants and their mothers. Sociodemographic information form, Neonatal Infant Pain Scale, pulse oximetry and stopwatch were used for data collection.
Results
Statistically significant differences were found between the groups before, during and after vaccination in terms of Neonatal Infant Pain Scale scores, oxygen saturation rates and crying times. While there was no significant difference between the groups in terms of heart rate before and during the vaccination procedure, a statistically significant difference was found after vaccination.
Conclusion
Kangaroo care has been found to decrease crying time, heart rate and pain in vaccinated infants, while also increasing blood oxygen saturation levels.
Ethical Statement
Dumlupinar University Clinical Studies Ethics Board14.04.2016/issue 2016-5-7
Supporting Institution
This study was supported by Dumlupinar University Scientific Research Projects Unit (DPÜ-BAB No.2016-28).
Project Number
DPÜ-BAB No.2016-28
Thanks
We thank all the doctors, staff of public health centers, and interviewees who participated in the study.
References
- Olsson E, Ahl H, Bengtsson K, Vejayaram DN,
Norman E, Bruschettini M, et. al. The use and
reporting of neonatal pain scales: a systematic
review of randomized trials. Pain 2021; 162(2):
353-360.
- Zhao Y, Dong Y, Cao, J. Kangaroo care for relieving
neonatal pain caused by invasive procedures:
A systematic review and meta‐analysis.
Computational Intelligence and Neuroscience
2022; 2022(1): 2577158.
- Sharma H, Ruikar M. Kangaroo mother care
(KMC) for procedural pain in infants: A meta-
analysis from the current evidence of randomized
control trials and cross-over trials. Journal of Family Medicine and Primary Care
2022; 11(4): 1250-1256.
- Sen E, Manav G. Effect of kangaroo care and oral
sucrose on pain in premature infants: A randomized
controlled trial (Prematüre bebeklerde kanguru
bakımı ve oral sukrozun ağrı üzerine etkisi:
Randomize kontrollü bir çalışma). Pain Management
Nursing 2020; 21(6): 556-564.
- Jajoo M, Mittal M, Saikia D, Kumar N. Impact of
kangaroo mother care on heart rate variability
and pain score with heel lance pain in preterm
neonates: A cross-over randomized controlled
trial. Journal of Neonatology 2024; 38(2).
- Hartley KA, Miller CS, Gephart SM. Facilitated
tucking to reduce pain in neonates: Evidence for
best practice. Advances in Neonatal Care 2015;
15(3): 201-208.
- Hills E, Rosenberg J, Banfield N, Harding C. A
multidisciplinary approach to the implementation
of non-pharmacological strategies to manage
infant pain. Infant 2020; 16(2): 78-81.
- Weng Y, Zhang J, Chen Z. Effect of non-pharmacological
interventions on pain in preterm
infants in the neonatal intensive care unit: A network
meta-analysis of randomized controlled
trials. BMC Pediatrics 2024; 24(1), 9.
- Shiff I, Bucsea O, Pillai Riddell R. Psychosocial
and neurobiological vulnerabilities of the hospitalized
preterm infant and relevant non-pharmacological
pain mitigation strategies. Frontiers in
Pediatrics 2021; 9: 568755.
- Cho ES, Kim SJ, Kwon MS, Cho H, Kim EH, Jun
EM, et al. The effects of kangaroo care in the
neonatal intensive care unit on the physiological
functions of preterm infants, maternal–infant
attachment, and maternal stress. Journal of Pediatric
Nursing 2016; 31(4): 430-438.
- Kostandy RR, Ludington-Hoe SM. Clustered
pain procedures in skin-to-skin contact (SSC)
position for full term newborns. World Journal
of Neuroscience 2017; 7(1): 38.
- Bera A, Ghosh J, Singh AK, Hazra A, Som T, Munian
D. Effect of kangaroo mother care on vital
physiological parameters of the low birth weight
newborn. Indian Journal of Community Medicine
2014; 39(4): 245-249.
- Sutar R, Baraha S, Mummidi PS. Effects of kangaroo
mother care on common vital parameters
of preterm infants. IJSR 2015; 4(12): 345-7.
- World Health Organization (WHO). Kangaroo
mother care: A practical guide, 2003. Available
at https://www.who.int/maternal_child_adolescent/
documents/9241590351/en/. Accessed
February 18, 2022.
- Saeidi R, Asnaashari Z, Amirnejad M, Esmaeili
H, Robatsangi MG. Use of “Kangaroo Care”
to alleviate the intensity of vaccination pain in
newborns. Iranian Journal of Pediatrics 2011;
21(1), 99.
- Lawrence J, Alcock D, McGrath P, Kay J, Mac-
Murray SB, Dulberg C. The development of a
tool to assess neonatal pain. Neonatal network:
NN 1993; 12(6): 59-66.
- Akdovan T, Yıldırım Z. Sağlıklı yenidoğanlarda
ağrının değerlendirilmesi, emzik verme ve kucağa
alma yönteminin etkisinin incelenmesi.
Perinatal Journal 1999; 7: 107.
- Akyurek B, Conk Z. Yenidoğan bebeklere uygulanan
iğneli girişimlerde non-farmakolojik ağri
giderme yöntemlerinin etkisinin incelenmesi.
Journal of Ege University Faculty of Nursing
2006; 22(1): 1-17.
- Yucel G, Sari HY, Olukman O. Yenidoğanlarda
tekrarlayan topuk kan alımı sırasında uygulanan
kanguru bakımının ağrı puanına etkisi. Journal
of Dr. Behcet Uz Children’s Hospital 2020; 10(2).
- Okan F, Ozdil A, Bulbul A, Yapici Z, Nuhoglu A.
Analgesic effects of skin-to-skin contact and
breastfeeding in procedural pain in healthy term
neonates (Sağlıklı term yenidoğanlarda ciltten
cilde temasın ve emzirmenin prosedürel ağrıda
analjezik etkileri). Annals of Tropical Paediatrics
2010; 30(2): 119-128.
- Johnston C, Campbell‐Yeo M, Disher T, Benoit B,
Fernandes A, Streiner D, et al. Skin‐to‐skin care
for procedural pain in neonates. Cochrane Database
of Systematic Reviews 2017; (2).
- Sajedi F, Kashaninia Z, Rahgozar M, Asadi NF.
The effect of kangaroo care on physiologic responses
to pain of an intramuscular injection
in neonates. Iranian Journal of Pediatrics 2007;
17(4): 339-344.
- Simsek DC, Gunay U, Polat S. Term ve preterm
yenidoğanda kanguru bakımına yönelik kanıta
dayalı uygulamalar. Türkiye Clinics Pediatric
Nursing-Special Topics 2021; 7(2): 53-57.
- Nimbalkar SM, Chaudhary NS, Gadhavi KV, Phatak
A. Kangaroo mother care in reducing pain in
preterm neonates on heel prick. The Indian Journal
of Pediatrics 2013; 80: 6-10.
- Dezhdar S, Jahanpour F, Bakht SF, 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(4).
- Stuard W. The effects of kangaroo care on a
newborn development and vital physiology. Clinics
Mother Child Health 2016; 13(1): 2-4.
- Kemer D, Isler, A. Yenidoğanlarda ağrı yönetiminde
kullanılan kanıt temelli nonfarmakolojik
hemşirelik uygulamaları. Balikesir Journal of
Health Sciences 2020; 9(3): 197-204.
- Gray L, Watt L, Blass EM. Skin-to-skin contact is
analgesic in healthy newborns. Pediatrics 2000;
105(1): e14-e14.
- Choudhary M, Dogiyal H, Sharma D, Datt Gupta
B, Madabhavi I, Choudhary JS, et al. To study
the effect of kangaroo mother care on pain response
in preterm neonates and to determine
the behavioral and physiological responses to
painful stimuli in preterm neonates: A study
from western Rajasthan. The Journal of Maternal-
Fetal & Neonatal Medicine 2016; 29(5): 826-
831.
- Moore ER, Bergman N, Anderson GC, Medley N.
Early skin‐to‐skin contact for mothers and their
healthy newborn infants. Cochrane Database of
Systematic Reviews 2016; (11).
- Gurbuz F, Koyuncu NE. Bebeklerde aşı uygulamaları
sırasında oluşan ağrının yönetiminde
kullanılan non-farmakolojik fiziksel yöntemler.
KTO Karatay University Health Sciences Journal
2024; 5(1): 97-107.