The Effect of Mother Baby Skin to Skin Contact during Heel Lance on the Infant's Pain and Stress

Yıl 2025, Cilt: 35 Sayı: 3, 415 - 420, 30.06.2025

Cemile Alaca , Gülsen Ataman , Hayriye Özgür , Özlem Öztürk , Zehra Özdemir

https://doi.org/10.54005/geneltip.1576829

Öz

Background: Heel lance, a procedure to collect blood from newborns, is known to be a painful experience. This study aims to determine the effects of skin-to-skin contact on pain and stress levels in newborns during the heel lance procedure.
Methods: This experimental study was conducted between October 2021 and December 2021 at a university hospital in Ankara with a gynecology and obstetrics clinic. The study included 98 newborns (intervention group, n=49; control group, n=49). During the heel lance procedure, newborns in the intervention group were held in skin-to-skin contact (SSC) with their mothers, whereas newborns in the control group were placed in a bassinet. Data were collected using the “Mother’s Demographic Information Form,” “Newborn’s Demographic Information Form,” “Procedure Response Evaluation Form,” and the “ALPS-NEO Neonatal Pain and Stress Assessment Scale.”
Results: Comparison of crying duration during the procedure showed that newborns in the SSC group cried for a shorter period than those in the control group (p<.001). Mothers in the SSC group displayed calmer behaviors more frequently than those in the control group (p<.001). The ALPS-NEO scores measured 5 minutes before, during, and 5 minutes after the procedure were lower in the SSC group than in the control group (p<.001).
Conclusion: Nurses are recommended to implement skin-to-skin contact during heel lance procedures to provide comfort to both mother and infant.

Anahtar Kelimeler

pain , stress , heel lance , newborn

Topuk Kanı Alma İşlemi Sırasında Uygulanan Anne-Bebek Ten Temasının Yenidoğanın Ağrısı ve Stresi Üzerindeki Etkisi

Öz

Giriş: Topuk kanı alma işlemi, yenidoğan için ağrılı bir işlemdir. Bu araştırmada yeni doğandan topuk kanı alma işlemi esnasında uygulanan ten tene temasın yeni doğanda ağrı ve strese etkisinin belirlenmesi amaçlanmıştır.
Yöntemler: Araştırma, deneysel olarak, Ekim 2021-Aralık 2021 tarihleri arasında Ankara’da kadın hastalıkları ve doğum kliniği bulunan bir üniversite hastanesinde doğan (girişim grubu; n=49, kontrol grubu; n=49) 98 yeni doğan ile gerçekleştirilmiştir. Girişim grubundaki bebeklerden topuk kanı alınırken anneleri ile ten tene temas (TTT) halinde olmaları sağlanmış, kontrol grubundaki bebeklerden ise pusette yatarken kan alınmıştır. Veriler; “Anneye İlişkin Tanıtıcı Özellikler Formu”, “Yeni Doğana İlişkin Tanıtıcı Özellikler Formu”, “İşleme Yanıtı Değerlendirme Formu” ve “ALPS-NEO Yeni Doğan Ağrı, Stres Değerlendirme Ölçeği” kullanılarak toplanmıştır.
Bulgular: Grupların işlem esnasında ağlama süresi karşılaştırıldığında, TTT grubundaki bebeklerin kontrol grubundakilerden daha kısa süre ağladığı görüldü (p<.001). TTT grubundaki anneler, kontrol grubundaki annelere göre daha sıklıkla sakin davranışlar sergiledi (p<.001). TTT grubundaki bebeklerin işlemden 5 dk önce, işlem esnasında ve işlemden 5 dk sonraki ALPS-NEO Scale puanları, kontrol grubundan düşüktü (p<,001)
Sonuç: Hemşirelerin, topuk kanı alma esnasında anne ve bebeği rahatlatmak için ten tene temas uygulaması önerilir.

Anahtar Kelimeler

ağrı , stres , yenidoğan , topuk kanı

Kaynakça

• 1. McPherson C, Miller SP, El-Dib M, Massaro AN, Inder TE. The influence of pain, agitation, and their management on the immature brain. Pediatr Res. 2020 Aug;88(2):168-175. doi: 10.1038/s41390-019-0744-6.
• 2. Ceylan SS, Bolışık B. Yenidoğan bebeklerde ALPS-Neo ağrı ve stres değerlendirme ölçeğinin geçerlik ve güvenirliği. Pamukkale Tıp Dergisi. 2017.
• 3. İçke S, Genç RE. Topuk kanı örneği ile yapılan ulusal yenidoğan tarama testleri ve önemi. The Journal of Pediatric Research. 2017;4(4):186-90.
• 4. Arıkan D, Sağlık S, Bekar P. Yenidoğan bebek sahibi ailelerin guthrie tanılama testi hakkında bilgi düzeyinin belirlenmesi. STED/Sürekli Tıp Eğitimi Dergisi. 2017;26(3):89-95.
• 5. 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).
• 6. Williams MD, Lascelles BDX. Early Neonatal Pain - A Review of Clinical and Experimental Implications on Painful Conditions Later in Life. Front Pediatr. 2020 Feb 7;8:30. doi: 10.3389/fped.2020.00030.
• 7. Koukou Z, Theodoridou A, Taousani E, Antonakou A, Panteris E, Papadopoulou SS, Skordou A, Sifakis S. Effectiveness of Non-Pharmacological Methods, Such as Breastfeeding, to Mitigate Pain in NICU Infants. Children (Basel). 2022 Oct 17;9(10):1568. doi: 10.3390/children9101568.
• 8. Hsieh KH, Chen SJ, Tsao PC, Wang CC, Huang CF, Lin CM, ... & Chan IC. The analgesic effect of non-pharmacological interventions to reduce procedural pain in preterm neonates. Pediatrics & Neonatology. 2019;60(4), 481-482.
• 9. García-Valdivieso I, Yáñez-Araque B, Moncunill-Martínez E, Bocos-Reglero MJ, Gómez-Cantarino S. Effect of Non-Pharmacological Methods in the Reduction of Neonatal Pain: Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2023; 20(4):3226. https://doi.org/10.3390/ijerph20043226
• 10. Gray L, Watt L, Blass EM. Skin-to-skin contact is analgesic in healthy newborns. Pediatrics. 2000;105(1):e14-e.
• 11. Kirbaş ZÖ, OdabaşI Aktaş E, Bayraktar B, Özkan H. Effect of kangaroo mother care and white noise on physiological-stress parameters in heel lancing: randomized controlled study. BMC Pediatrics. 2024;24(1):568.
• 12. 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. Annals of tropical pediatrics. 2010;30(2):119-28.
• 13. Chang J, Filoteo L, Nasr AS. Comparing the analgesic effects of 4 nonpharmacologic interventions on term newborns undergoing heel lance: A randomized controlled trial. The Journal of Perinatal & Neonatal Nursing. 2020;34(4):338-45.
• 14. Johnston CC, Stevens B, Pinelli J, Gibbins S, Filion F, Jack A, et al. Kangaroo care is effective in diminishing pain response in preterm neonates. Archives of pediatrics & adolescent medicine. 2003;157(11):1084-8.
• 15. Castral TC, Warnock F, Leite AM, Haas VJ, Scochi CG. The effects of skin-to-skin contact during acute pain in preterm newborns. European Journal of Pain. 2008;12(4):464-71.
• 16. Avcin E, Kucukoglu S. The effect of breastfeeding, kangaroo care, and facilitated tucking positioning in reducing the pain during heel stick in neonates. Journal of Pediatric Nursing. 2021;61:410-6.
• 17. Kostandy RR, Ludington-Hoe SM. Kangaroo care (Skin-to-Skin) for clustered pain procedures: A case study. World Journal of Neuroscience. 2016;6(1):43.
• 18. Chidambaram AG, Manjula S, Adhisivam B, Vishnu Bhat B. Effect of Kangaroo mother care in reducing pain due to heel prick among preterm neonates: a crossover trial. The Journal of Maternal-Fetal & Neonatal Medicine. 2014;27(5):488-90.
• 19. Athanasopoulou E, Fox JR. Effects of kangaroo mother care on maternal mood and interaction patterns between parents and their preterm, low birth weight infants: a systematic review. Infant mental health journal. 2014;35(3):245-62.
• 20. Scime NV, Gavarkovs AG, Chaput KH. The effect of skin-to-skin care on postpartum depression among mothers of preterm or low birthweight infants: a systematic review and meta-analysis. Journal of Affective Disorders. 2019;253:376-84.
• 21. McGlothen-Bell K, Recto P, McGrath JM, Brownell E, Cleveland LM. Recovering together: Mothers' experiences providing skin-to-skin care for their infants with NAS. Advances in Neonatal Care. 2021;21(1), 16-22. DOI: 10.1097/ANC.0000000000000819