Available online 8 September 2022

ABSTRACTContext

The aim of neonatal pain management is to reduce pain and help the baby cope with pain.

Objective

: This study aimed to determine the effect of Helfer skin tap technique (HSTT) on hepatitis B vaccine intramuscular (IM) injection pain in neonetes.

Design

Randomized controlled study

Setting

This study was conducted with neonatal infants born vaginally in the delivery room of a state hospital in Turkey.

Participants

This study was conducted total 60 neonates including 30 in the HSTT group and 30 in the Routine Technique (RT) group.

Interventions

Participants were randomized into the HSTT group and the Routine Technique (RT) group.

Main Outcome Measures

Data were collected using a questionnaire form and the Neonatal Infant Pain Scale (NIPS).

Results

While the means of the total pain scores in the HSTT group were found to be 1.73 ± 2.04 during injection and 1.73 ± 0.98 after injection, in the RT group, the mean scores were 5.56 ± 0.92 during injection and 4.90 ± 1.25 after injection. The difference between the groups arising in the comparison of means of the total pain scores obtained during and after injection in HSTT and RT groups was determined to be statistically significant (p <0.05).

Conclusion

In conclusion, HSTT was proven to be effective in reducing hepatitis B vaccine intramuscular (IM) injection pain in neonates. This study demonstrates that HSTT is associated with reduced pain in newborns during hepatitis B vaccine IM injections.

Section snippetsINTRODUCTION

The International Association for the Study of Pain has defined pain as "an unpleasant sensory and emotional experience from any part of the body associated with actual or potential tissue damage". Pain is subjective. Individuals’ definition of pain is based on their previous pain experiences, and early life experiences associated with pain shape future pain responses.1

Pain transmission is mediated through A-delta (large, myelinated and fast conduction) and C (non-myelinated and slow

Study Design

The study was carried out randomized controlled trial type to determine the effect of HSTT on hepatitis B vaccine IM injection pain in neonates.

Inclusion Criteria

Various factors are effective in the perception of pain and the formation of response in the newborn.7 For this reason, neonates who were at gestational week> 37, were born by vaginal delivery in the delivery room, 5th minute Apgar score had Apgar score ≥ 9, had birth weight ≥ 2500 g, had no congenital anomalies, and had no birth asphyxia were included

RESULTS

There was no statistically significant difference between the neonates in HSTT and RT groups in terms of their birth weight, gender, gestational week, and Apgar scores (Table 1)(p >0.05).

The means of the total pain scores in the HSTT group were 1.73 ± 2.04 during injection and 1.73 ± 0.98 after injection, whereas they were 5.56 ± 0.92 during injection and 4.90 ± 1.25 after injection in the RT group. The difference between the groups found as a result of the comparison of means of the total pain

DISCUSSION

The study investigated the effect of HSTT on hepatitis B vaccine IM injection pain in neonates.

The absence of a statistically significant difference between the HSTT and RT groups indicates that the randomization between the groups was homogeneous (Table 1).

In the study, the pain level evaluated during and after hepatitis B vaccine IM injection administered using HSTT was found to be significantly lower than the pain level obtained during and after IM injection using RT (Table 2). This finding

CONCLUSION

This study proved that HSTT was effective in reducing hepatitis B vaccine IM injection pain in neonates. The finding that HSTT reduces pain in IM injection interventions should be shared with academicians and nurse clinicians. Academic nurses should include this subject in their curriculum and transfer this information to their students. In addition, nurse clinicians should be taught the HSTT method through in-service training programs and nurses should use this method in IM injection

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

CRediT authorship contribution statement

Şefika Dilek Güven: Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing, Visualization. Nazan Çalbayram: Conceptualization, Methodology, Investigation, Formal analysis, Data curation, Writing – original draft, Writing – review & editing, Visualization, Supervision, Project administration, Funding acquisition.

Acknowledgements

The authors would like to thank the families and newborns who agreed to participate in the study, and the health profession working in the Nevsehir State Hospital delivery room.

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