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Effect of repeated Kangaroo Mother Care on repeated procedural pain in preterm infants: A randomized controlled trial.
Int J Nurs Stud. 2015 Jul; 52(7):1157-65.IJ

Abstract

BACKGROUND

Preterm infants' repeated exposure to painful procedures may lead to negative consequences. Thus, non-pharmacological pain management is essential due to medication side effects. Kangaroo Mother Care, which aims at offering human care to neonates, has been established for the treatment of a single painful procedure, but the effectiveness of Kangaroo Mother Care across repeated painful procedures is unknown.

OBJECTIVE

To test the effectiveness of repeated Kangaroo Mother Care on repeated heel-stick pain in preterm neonates.

DESIGN

Randomized controlled trial.

SETTING

Level III Neonatal Intensive Care Unit at a large teaching hospital in northeast China.

METHOD

Preterm infants (gestational age less than 37 weeks) (n=80) were recruited and randomly assigned using a random table format to either an incubator group (n=40) or Kangaroo Mother Care group (n=40). Pain assessments were carried out during four routine heel stick procedures. For the first heel stick, preterm infants in each group received no intervention (routinely stayed in incubator). During the next three heel sticks, the infants in Kangaroo Mother Care group received heel sticks during Kangaroo Mother Care, while infants in the incubator group received heel sticks in incubator. The procedure of each heel stick included 3 phases: baseline, blood collection and recovery. Crying, grimacing and heart rate in response to pain were evaluated at each phase across four heel sticks by three trained independent observers who were blinded to the purpose of the study. Data were analyzed by analysis of variance (ANOVA), with repeated measures at different evaluation phases of heel stick.

RESULTS

75 preterm infants completed the protocol. Between-group comparison revealed that preterm infants' heart rate was significantly lower, and the duration of crying and facial grimacing were both significantly shorter in the Kangaroo Mother Care group (n=38) than the incubator group (n=37) from the blood collection phase to recovery phase during repeated heel sticks. No significant within-group difference was found in heart rate between the baseline phase and recovery phase through repeated heel sticks for Kangaroo Mother Care group. In contrast, the incubator group experienced significant within group differences in heart rate between baseline and recovery through repeated heel sticks.

CONCLUSION

The effect of repeated Kangaroo Mother Care analgesia remains stable in preterm infants over repeated painful procedures. Given the many invasive procedures that are part of clinical care in preterm infants and most mothers preferred to provide comfort for their infants during painful procedures, Kangaroo Mother Care may be a safe analgesic alternative in preterm infants in whom it is feasible.

Authors+Show Affiliations

School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China. Electronic address: bpn456@163.com.Binzhou Medical University Hospital, Binzhou, China.Binzhou Medical University Hospital, Binzhou, China.Binzhou Medical University Hospital, Binzhou, China.School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25912524

Citation

Gao, Haixia, et al. "Effect of Repeated Kangaroo Mother Care On Repeated Procedural Pain in Preterm Infants: a Randomized Controlled Trial." International Journal of Nursing Studies, vol. 52, no. 7, 2015, pp. 1157-65.
Gao H, Xu G, Gao H, et al. Effect of repeated Kangaroo Mother Care on repeated procedural pain in preterm infants: A randomized controlled trial. Int J Nurs Stud. 2015;52(7):1157-65.
Gao, H., Xu, G., Gao, H., Dong, R., Fu, H., Wang, D., Zhang, H., & Zhang, H. (2015). Effect of repeated Kangaroo Mother Care on repeated procedural pain in preterm infants: A randomized controlled trial. International Journal of Nursing Studies, 52(7), 1157-65. https://doi.org/10.1016/j.ijnurstu.2015.04.006
Gao H, et al. Effect of Repeated Kangaroo Mother Care On Repeated Procedural Pain in Preterm Infants: a Randomized Controlled Trial. Int J Nurs Stud. 2015;52(7):1157-65. PubMed PMID: 25912524.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of repeated Kangaroo Mother Care on repeated procedural pain in preterm infants: A randomized controlled trial. AU - Gao,Haixia, AU - Xu,Guihua, AU - Gao,Honglian, AU - Dong,Rongzhi, AU - Fu,Hongjie, AU - Wang,Danwen, AU - Zhang,Heng, AU - Zhang,Hua, Y1 - 2015/04/09/ PY - 2014/11/07/received PY - 2015/03/29/revised PY - 2015/04/03/accepted PY - 2015/4/28/entrez PY - 2015/4/29/pubmed PY - 2016/2/27/medline KW - Crying KW - Heart rate KW - Kangaroo-Mother Care Method KW - Pain KW - Preterm infants SP - 1157 EP - 65 JF - International journal of nursing studies JO - Int J Nurs Stud VL - 52 IS - 7 N2 - BACKGROUND: Preterm infants' repeated exposure to painful procedures may lead to negative consequences. Thus, non-pharmacological pain management is essential due to medication side effects. Kangaroo Mother Care, which aims at offering human care to neonates, has been established for the treatment of a single painful procedure, but the effectiveness of Kangaroo Mother Care across repeated painful procedures is unknown. OBJECTIVE: To test the effectiveness of repeated Kangaroo Mother Care on repeated heel-stick pain in preterm neonates. DESIGN: Randomized controlled trial. SETTING: Level III Neonatal Intensive Care Unit at a large teaching hospital in northeast China. METHOD: Preterm infants (gestational age less than 37 weeks) (n=80) were recruited and randomly assigned using a random table format to either an incubator group (n=40) or Kangaroo Mother Care group (n=40). Pain assessments were carried out during four routine heel stick procedures. For the first heel stick, preterm infants in each group received no intervention (routinely stayed in incubator). During the next three heel sticks, the infants in Kangaroo Mother Care group received heel sticks during Kangaroo Mother Care, while infants in the incubator group received heel sticks in incubator. The procedure of each heel stick included 3 phases: baseline, blood collection and recovery. Crying, grimacing and heart rate in response to pain were evaluated at each phase across four heel sticks by three trained independent observers who were blinded to the purpose of the study. Data were analyzed by analysis of variance (ANOVA), with repeated measures at different evaluation phases of heel stick. RESULTS: 75 preterm infants completed the protocol. Between-group comparison revealed that preterm infants' heart rate was significantly lower, and the duration of crying and facial grimacing were both significantly shorter in the Kangaroo Mother Care group (n=38) than the incubator group (n=37) from the blood collection phase to recovery phase during repeated heel sticks. No significant within-group difference was found in heart rate between the baseline phase and recovery phase through repeated heel sticks for Kangaroo Mother Care group. In contrast, the incubator group experienced significant within group differences in heart rate between baseline and recovery through repeated heel sticks. CONCLUSION: The effect of repeated Kangaroo Mother Care analgesia remains stable in preterm infants over repeated painful procedures. Given the many invasive procedures that are part of clinical care in preterm infants and most mothers preferred to provide comfort for their infants during painful procedures, Kangaroo Mother Care may be a safe analgesic alternative in preterm infants in whom it is feasible. SN - 1873-491X UR - https://www.unboundmedicine.com/medline/citation/25912524/Effect_of_repeated_Kangaroo_Mother_Care_on_repeated_procedural_pain_in_preterm_infants:_A_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0020-7489(15)00107-8 DB - PRIME DP - Unbound Medicine ER -