The Effect of 3 Different Auditory Applications on Newborn Heel Prick Procedure

NCT ID: NCT06167551

Last Updated: 2023-12-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-01

Study Completion Date

2024-11-01

Brief Summary

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In pain management of neonates in interventional applications, health professionals should be able to evaluate pain, reduce or eliminate pain. Pharmacologic and nonpharmacologic methods are used in pain management. Pharmacological, opioid analgesics, sedatives and local anesthetics are used. Nonpharmacologic methods include breastfeeding, giving pacifiers, oral sucrose, music, massage, therapeutic touch and nesting, positioning such as fetal positioning, wrapping, kangaroo care, rocking and cradling.

Music makes positive changes in oxygen saturation level and peak heart rate values and reduces stress and pain. Classical music with light rhythmic emphasis and steady rhythm accompanied by a simple human voice or a single instrument, music performed by female vocalists (mother's voice, lullabies with female voice) and white noise similar to intrauterine sounds are among the types of music that have a positive effect on newborns.

This study was planned as a randomized controlled experimental design to compare the lullaby, classical music and white noise song by the mother to the newborn before and during heel prick blood collection with the control group and to determine which application gives superior results to the newborn's pain level, crying time and physiological parameters.

Detailed Description

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In pain management of newborns in interventional applications, health professionals should be able to evaluate pain and reduce or eliminate pain. Pharmacological and non-pharmacological methods are used in the management of pain. Non-pharmacological methods: practices such as breastfeeding, giving a pacifier, giving oral sucrose, listening to music, massage, therapeutic touching and nesting, positioning the fetus such as wrapping, giving kangaroo care, rocking and holding.

The newborn's response to sound often leads to changes in breathing and heart rate. Mild to moderate sounds (55-75 dB), such as speech and music, cause a decrease in heart rate and create an orientation response. Music makes positive changes in oxygen saturation level and heart rate peak values, and also reduces stress and pain. Arnon et al. determined that letting newborns in intensive care listen to music has a positive effect on reducing pain and anxiety, making it easier for newborns to fall asleep and increasing their sleep quality. Classical music with a light rhythmic emphasis and constant rhythm accompanied by a simple human voice or a single instrument, music performed by female vocalists (mother's voice, lullabies with a female voice) and white noise similar to intrauterine sounds are among the types of music that have a positive effect on newborns.

Heel prick pricking in newborns causes pain, which results in increased blood pressure and pulse rate, decreased SpO2, and crying. For this reason, this study was designed as a randomized controlled experimental design to compare the classical music and white noise and lullaby applications to the newborn before and during heel blood collection with the control group and to determine which application provides superior results on the newborn's pain level, crying duration and physiological parameters.

Research Purpose and Type This research was planned as a randomized controlled experimental design to compare the lullaby, classical music and white noise aplications to the newborn during the heel prick prick procedure with the control group.

Research Variables Independent variables; Lullaby your mother sings, white noise, classical music Dependent variables; Heart rate peak (HRV), oxygen saturation (SpO2), NIPS score, NIAPAS score, crying duration.

Place and Time to Conduct the Research The research will be carried out between February 2024 and June 2024 in the Neonatal Intensive Care Unit of Gaziantep Cengiz Gökçek Gynecology and Children's Hospital.

The population of the research It will create term newborns born at 38-42 weeks of gestation in the Neonatal Intensive Care Unit of Gaziantep Cengiz Gökçek Gynecology and Children's Hospital between February 2024 and June 2024. Postpartum 24-72. These are the newborns whose heel blood will be taken during Sample; The sample number of the study was determined by power analysis. The thesis study, which evaluated the effect of different auditory interventions on pain in heel blood collection in newborns, was taken as an example. According to the NIPS pain assessment scale used in the study, the average score of the results during the procedure was 4.26±2.16 in the 1st experimental group, 4.81±2.18 in the 2nd experimental group, 5.02±2.00 in the 3rd experimental group, and 5.93±1.32 in the control group. In this study, it was anticipated that the NIPS score average difference would have a large effect size (.95 large effect), with a 5% alpha margin of error (two-sided) and 80% power, and in the calculation of the number of samples made in the G\*Power (3.1.9.2.) program, each It was determined that 20 babies should be included in a group, 80 babies in total. Considering that there may be sample loss for any reason during the research, the aim is to reach 96 newborns (24 babies in each group) by increasing the number of babies by 20% and using statistical parametric analysis methods.

The sample will be randomly selected from the study population. In the study, randomization will be performed using the URN method, which is considered equivalent to the full randomization method. Although this method is shown as UD, it includes two parameters, α and β. These represent balls of two different colors (for example: red and white). α can be white or red, while β will be the exact opposite of the chosen ball colour. One of the balls is chosen randomly, and if the selected ball is white, the subject is assigned to the α group, and if it is red, the subject is assigned to the β group. This selection process is repeated to determine which group the subject will be in.

In the research, the red ball will be the mother's lullaby (intervention group 1), the yellow ball will be white noise (intervention group 2), the blue ball will be classical music (intervention group 3), and the white ball will be the control group. When there is a baby in the clinic that meets the sample selection conditions, these balls prepared by the researcher will be placed in an invisible, dark-colored bag and a random nurse working in the ward will be able to make the selection without seeing it. Which group the baby will be placed in will be determined by the color of the ball coming out of the bag, and the babies will be distributed randomly to the groups.

Conditions

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Newborn Pain

Keywords

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newborn heel prick music pain care

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Comparison of 3 different auditory applications with the control group during heel prick collection in newborns.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Outcome Assessors
The baby's crying time will be monitored and recorded. KTA and SpO2 will be recorded by the researcher during blood collection. Pain assessment of the babies will be made by two independent neonatal nurses other than the researcher. Both observers must have worked in the clinic for at least 5 years.

Analysis of the data will be done by an independent analyst, not by researchers.

Study Groups

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mother lullaby group

group listening to mother's lullaby

Group Type EXPERIMENTAL

mother lullaby group

Intervention Type OTHER

mother's lullaby: the mother will be made to sing her own lullaby 5 minutes before the heel prick.

white noise group

group listening to white noise

Group Type EXPERIMENTAL

white noise group

Intervention Type OTHER

white noise: 5 minutes before taking heel prick blood, white noise will be started to be played on an MP3 player with white noise. The MP3 player will be placed in the crib where the baby lies, at the baby's bedside, at least 20 cm away from the baby's head. After the MP3 player is turned on, the sound level will be measured at the baby's ear level with a decibel meter and adjusted so that it does not exceed 70 decibels.

classical music group

group listening to classical music

Group Type EXPERIMENTAL

classical music group

Intervention Type OTHER

classical music: 5 minutes before heel prick, classical music will be started to be played from the MP3 player with white noise. The MP3 will be placed inside the crib where the baby lies, at the baby's bedside, at least 20 cm away from the baby's head. After the MP3 player is turned on, the sound level will be measured at the baby's ear level with a decibel meter and adjusted so that it does not exceed 70 decibels.

Control group

No intervation

Group Type OTHER

Contol Group

Intervention Type OTHER

No intervation

Interventions

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mother lullaby group

mother's lullaby: the mother will be made to sing her own lullaby 5 minutes before the heel prick.

Intervention Type OTHER

white noise group

white noise: 5 minutes before taking heel prick blood, white noise will be started to be played on an MP3 player with white noise. The MP3 player will be placed in the crib where the baby lies, at the baby's bedside, at least 20 cm away from the baby's head. After the MP3 player is turned on, the sound level will be measured at the baby's ear level with a decibel meter and adjusted so that it does not exceed 70 decibels.

Intervention Type OTHER

classical music group

classical music: 5 minutes before heel prick, classical music will be started to be played from the MP3 player with white noise. The MP3 will be placed inside the crib where the baby lies, at the baby's bedside, at least 20 cm away from the baby's head. After the MP3 player is turned on, the sound level will be measured at the baby's ear level with a decibel meter and adjusted so that it does not exceed 70 decibels.

Intervention Type OTHER

Contol Group

No intervation

Intervention Type OTHER

Other Intervention Names

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No intervation

Eligibility Criteria

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Inclusion Criteria

* The newborn must be between 38-42 weeks and weigh appropriately for his/her week (Appropriate Gestational Age - AGA),
* Not taking any analgesic, sedative or anticonvulsant medication for at least 6 hours before,
* Feeding at least 1 hour before,
* No fever,
* Not receiving oxygen therapy,
* Not receiving antibiotic treatment
* No congenital anomalies
* Not next to the bed or under the heater
* Not receiving phototherapy,
* Not being connected to a mechanical ventilator

Exclusion Criteria

* Presence of congenital anomaly,
* Having a chest tube inserted,
* Intracranial bleeding,
* Presence of anomaly that may cause deafness
* Those with a history of epileptic seizures will be excluded.
* The patient's family refuses to participate in the study.
Minimum Eligible Age

24 Hours

Maximum Eligible Age

72 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Namik Kemal University

OTHER

Sponsor Role lead

Responsible Party

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Zeynem YILDIRIM BALKAN

Dr. Lecturer and Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Serap BALCI, PHD

Role: STUDY_DIRECTOR

ISTANBUL UNİVERSİTY CERRAHPAŞA

Central Contacts

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Zeynem YILDIRIM BALKAN, PHD

Role: CONTACT

Phone: +905073190958

Email: [email protected]

Serap ÖZDEMİR, PHD

Role: CONTACT

Phone: +905375438610

Email: [email protected]

References

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Arnon S, Shapsa A, Forman L, Regev R, Bauer S, Litmanovitz I, Dolfin T. Live music is beneficial to preterm infants in the neonatal intensive care unit environment. Birth. 2006 Jun;33(2):131-6. doi: 10.1111/j.0730-7659.2006.00090.x.

Reference Type BACKGROUND
PMID: 16732778 (View on PubMed)

Balcı, S. (2006). Beyaz Gürültünün Kolikli Bebeklerde Etkisi. Marmara Üniversitesi Sağlık Bilimleri Enstitüsü Çocuk Sağlığı ve Hastalıkları Hemşireliği Anabilim Dalı. Yüksek Lisans Tezi. İstanbul, Türkiye.

Reference Type BACKGROUND

Balcı, S., Dur, Ş., Özdemir, Ş., & Kavuncuoğlu, S. (2021). The effect of two different lancets and heel warming on duration of crying and procedure time during blood sampling: A randomized controlled study. Journal of Neonatal Nursing, 27(6), 426-431.

Reference Type BACKGROUND

Derebent, E., & Yiğit, R. (2008). Yenidoğanda Non-Farmakolojik Ağrı Yönetimi. Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi, 22(2), 113.

Reference Type BACKGROUND

Gilad, E., & Arnon, S. (2010). The role of live music and singing as a stress-reducing modality in the neonatal intensive care unit environment. Music and Medicine, 2(1), 18-22

Reference Type BACKGROUND

Gooding, L. F. (2010). Using music therapy protocols in the treatment of premature infants: An introduction to current practices. The arts in Psychotherapy, 37(3), 211-214

Reference Type BACKGROUND

İmseytoğlu, D., & Yıldız, S. (2012). YENİDOĞAN YOĞUN BAKIM ÜNİTELERİNDE MÜZİK TERAPİ. Florence Nightingale Journal of Nursing, 20(2), 160-165.

Reference Type BACKGROUND

Kanbur BN, Mutlu B, Salihoglu O. Validity and reliability of the Neonatal Infant Acute Pain Assessment Scale (NIAPAS) in Turkish: prospective study. Sao Paulo Med J. 2021 Jul-Aug;139(4):305-311. doi: 10.1590/1516-3180.2020.0721.R1.23122020.

Reference Type BACKGROUND
PMID: 34346962 (View on PubMed)

Uyar M, Akin Korhan E. [The effect of music therapy on pain and anxiety in intensive care patients]. Agri. 2011 Oct;23(4):139-46. doi: 10.5505/agri.2011.94695. Turkish.

Reference Type BACKGROUND
PMID: 22290677 (View on PubMed)

Standley, J. M. (2012). A discussion of evidence-based music therapy to facilitate feeding skills of premature infants: The power of contingent music. The arts in Psychotherapy, 39(5), 379-382.

Reference Type BACKGROUND

Other Identifiers

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TNKU-Z.BALKAN-1

Identifier Type: -

Identifier Source: org_study_id