NCT05079594

Brief Summary

The heel blood procedure for newborn screening is done for almost all babies within the first 48 hours of birth. It is stated that non-pharmacological methods in reducing pain during the heel blood collection process are simple, effective, free, and very cost-effective. Studies have shown that auditory interventions (such as mother's voice, white noise) used in invasive procedures distract the infant and create a cognitive strategy for pain control. According to this information, one aim of the study is to determine the effect of the mother's voice and white noise, which are non-pharmacological methods, on the comfort level of the baby in the heel blood procedure. It is thought that especially acute painful procedures applied to infants will reduce the level of stress and anxiety in parents. Another aim of this study is to determine the effect of a mother's voice and white noise, which are non-pharmacological methods, on the state anxiety levels of mothers in the heel blood collection process.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
60

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Mar 2021

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 15, 2021

Completed
7 months until next milestone

First Submitted

Initial submission to the registry

October 4, 2021

Completed
11 days until next milestone

First Posted

Study publicly available on registry

October 15, 2021

Completed
3 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 15, 2022

Completed
1 day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 16, 2022

Completed
Last Updated

December 5, 2023

Status Verified

December 1, 2023

Enrollment Period

10 months

First QC Date

October 4, 2021

Last Update Submit

December 3, 2023

Conditions

Keywords

white noisepainMother's voicepain managementnewborn

Outcome Measures

Primary Outcomes (1)

  • CONFORTneo Scale

    The Neonatal Comfort Behavior Scale consists of 7 items: muscle tone, alertness, facial tension, calmness/agitation, body movements, respiratory response, and crying. Since "respiratory response" was scored in infants connected to mechanical ventilator and "crying" was scored in spontaneously breathing infants, the total score was calculated over 6 items. The lowest score that can be obtained from the Newborn Comfort Behavior Scale is 6, and the highest score is 30.On this scale, if the total score of the scale is between 6-13, the baby is comfortable. If the total score is between 14-30, the baby has pain or distress and needs interventions to relieve him.

    1 year

Secondary Outcomes (4)

  • Heart rate peak

    1 year

  • Oxygen saturation

    1 year

  • Crying time

    1 year

  • State Anxiety Scale score

    1 year

Study Arms (3)

Routine Care Group

NO INTERVENTION

Before the application, the families will be informed by the researcher and the 'Informed Consent Form' will be signed. After the heel blood procedure, when the baby starts to cry, comfort will be provided with gentle touches. For ethical reasons, routine care will be provided when the baby cries.

White Noise

EXPERIMENTAL

Since white noise is a humming and continuous monotonous sound, it is similar to the sound in the womb. It will be explained that this sound is very similar to the sound that the baby hears in the mother's womb by making the white noise recordings listen to the mothers who will have their babies listen to white noise. by Orhan Osman; Dr. From the album 'Kolik', which was created by making use of the album 'The Happiest Baby' prepared by Harvey Karp, which consists only of uterus sounds; The song 'Don't Let Your Baby Cry, PT.2' will be played to babies. In addition, infants will be excluded from the study even though they meet the criteria, if they are not sedated, the procedure takes more than 2 minutes, the procedure is disrupted because someone enters the room loudly, or the mother changes the baby's position.

Other: White noise

Mother Voice

EXPERIMENTAL

Auditory responses, fetal age 26-28. It develops in the auditory cortex and brain stem in weeks. Hearing is one of the first senses a fetus develops and is 24-33. can recognize and remember the mother's voice after weeks. The fetus memorizes the musical characteristics of the mother's voice, like tone, by listening to it. It is stated that newborns exposed to their own mother's voice have a lower heart rate, higher sucking rate, a more relaxed appearance, and less crying and body movements.

Other: Mother voice

Interventions

Five minutes before the procedure, the mother's voice recording will be played to the baby and the speaker will be placed 30 cm away from the baby. The baby's comfort level will be evaluated by the researcher using the "Neonatal Comfort Behavior Scale" 2 minutes before the procedure begins. Physiological values of the baby will be noted by the researcher 1 minute before the procedure.As soon as the heel blood procedure is completed, the baby's physiological values and comfort level will be noted by the "Newborn Comfort Behavior Scale" by the researcher. After the procedure, the recording will continue to be played until the baby's mother's voice returns to the basal values. Physiological values and comfort levels of the baby will be noted by the researcher 1 minute and 2 minute after the procedure. 2 minutes after the procedure, the baby's comfort level will be evaluated by the researcher using the "Neonatal Comfort Behavior Scale".

Mother Voice

Before Operation The decibel meter will be set to an average of 50-60 dB and the speakers will be played at a distance of 30 cm. Intervention in this group will be made at the elevation. White noise will be played five minutes before the procedure.The baby's comfort level and physiological values will be evaluated by the researcher using the "Neonatal Comfort Behavior Scale" 2 minutes before the procedure begins. Order of Operation As soon as the heel blood procedure is completed, the baby's physiological values and comfort level will be noted by the "Newborn Comfort Behavior Scale" by the researcher. Post-Processing After the procedure, white noise will continue to be listened to until the baby's physiological values return to basal values. Physiological values and baby's comfort level of the baby will be noted by the researcher 1 minute and 2 minute after the heel blood collection is completed.

White Noise

Eligibility Criteria

Age1 Hour - 1 Month
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17)

You may qualify if:

  • Newborns whose postnatal age is between 1-5 days,
  • newborns born between gestational weeks,
  • Healthy newborns,
  • Babies of mothers without diabetes,
  • Newborns who were not given any opioid and non-opioid drugs before the application,
  • Newborns who have been fed at least 30 minutes ago,
  • Newborns without any painful interventions other than vitamin K and Hepatitis B injections will be included.
  • Mothers who can speak and understand Turkish,
  • The mothers and their babies who accepted to participate in the study and whose written consent form was obtained from them will be included in the study.

You may not qualify if:

  • Connected to a mechanical ventilator,
  • Having a neurological disorder,
  • Congenital anomaly,
  • Having hyperglycemia,
  • Having undergone a surgical procedure,
  • Substance addicted mother and her baby,
  • If the lancet cannot be inserted and removed at once, the baby will be excluded from the study.
  • Infants, despite meeting the criteria, will be excluded from the study if the heel blood collection takes more than 2 minutes in total, the procedure is disrupted by someone entering the room loudly, or the mother changes the position of the baby.
  • Mothers with a special condition that will cause difficulties in understanding and perception will be excluded from the study.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Akdeniz University

Kepez, Antalya, Turkey (Türkiye)

Location

Related Publications (10)

  • Axelin A, Anderzen-Carlsson A, Eriksson M, Polkki T, Korhonen A, Franck LS. Neonatal Intensive Care Nurses' Perceptions of Parental Participation in Infant Pain Management: A Comparative Focus Group Study. J Perinat Neonatal Nurs. 2015 Oct-Dec;29(4):363-74. doi: 10.1097/JPN.0000000000000136.

    PMID: 26505851BACKGROUND
  • Benoit B, Campbell-Yeo M, Johnston C, Latimer M, Caddell K, Orr T. Staff Nurse Utilization of Kangaroo Care as an Intervention for Procedural Pain in Preterm Infants. Adv Neonatal Care. 2016 Jun;16(3):229-38. doi: 10.1097/ANC.0000000000000262.

    PMID: 27148835BACKGROUND
  • Benoit B, Martin-Misener R, Latimer M, Campbell-Yeo M. Breast-Feeding Analgesia in Infants: An Update on the Current State of Evidence. J Perinat Neonatal Nurs. 2017 Apr/Jun;31(2):145-159. doi: 10.1097/JPN.0000000000000253.

    PMID: 28437305BACKGROUND
  • Campbell-Yeo M, Fernandes A, Johnston C. Procedural pain management for neonates using nonpharmacological strategies: part 2: mother-driven interventions. Adv Neonatal Care. 2011 Oct;11(5):312-8; quiz pg 319-20. doi: 10.1097/ANC.0b013e318229aa76.

    PMID: 22123399BACKGROUND
  • Cong X, Delaney C, Vazquez V. Neonatal nurses' perceptions of pain assessment and management in NICUs: a national survey. Adv Neonatal Care. 2013 Oct;13(5):353-60. doi: 10.1097/ANC.0b013e31829d62e8.

    PMID: 24042143BACKGROUND
  • Cong X, McGrath JM, Delaney C, Chen H, Liang S, Vazquez V, Keating L, Chang K, Dejong A. Neonatal nurses' perceptions of pain management: survey of the United States and China. Pain Manag Nurs. 2014 Dec;15(4):834-44. doi: 10.1016/j.pmn.2013.10.002. Epub 2014 Feb 6.

    PMID: 24508269BACKGROUND
  • Franck LS, Oulton K, Bruce E. Parental involvement in neonatal pain management: an empirical and conceptual update. J Nurs Scholarsh. 2012 Mar;44(1):45-54. doi: 10.1111/j.1547-5069.2011.01434.x. Epub 2012 Feb 16.

    PMID: 22339845BACKGROUND
  • Harrison D, Larocque C, Bueno M, Stokes Y, Turner L, Hutton B, Stevens B. Sweet Solutions to Reduce Procedural Pain in Neonates: A Meta-analysis. Pediatrics. 2017 Jan;139(1):e20160955. doi: 10.1542/peds.2016-0955. Epub 2016 Dec 16.

    PMID: 27986905BACKGROUND
  • Karakoc A, Turker F. Effects of white noise and holding on pain perception in newborns. Pain Manag Nurs. 2014 Dec;15(4):864-70. doi: 10.1016/j.pmn.2014.01.002. Epub 2014 Feb 20.

    PMID: 24559599BACKGROUND
  • Kahraman A, Gumus M, Akar M, Sipahi M, Bal Yilmaz H, Basbakkal Z. The effects of auditory interventions on pain and comfort in premature newborns in the neonatal intensive care unit; a randomised controlled trial. Intensive Crit Care Nurs. 2020 Dec;61:102904. doi: 10.1016/j.iccn.2020.102904. Epub 2020 Jul 9.

MeSH Terms

Conditions

Acute PainPainAgnosia

Condition Hierarchy (Ancestors)

Neurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and SymptomsPerceptual DisordersNeurobehavioral ManifestationsNervous System Diseases

Study Officials

  • Uğur Gül

    Akdeniz Universitesi, Akdeniz University Faculty of Nursing

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Research Assistant

Study Record Dates

First Submitted

October 4, 2021

First Posted

October 15, 2021

Study Start

March 15, 2021

Primary Completion

January 15, 2022

Study Completion

January 16, 2022

Last Updated

December 5, 2023

Record last verified: 2023-12

Data Sharing

IPD Sharing
Will not share

The identity of the patient will not be shared to ensure confidentiality.

Locations