Yenidoğanda Hepatit-B Aşısı Sırasında Uygulanan Nazik İnsan Dokunuşu, Kanguru Bakımı ve Emzirmenin Ağrı Düzeyi, Ağlama Süresi ve Fizyolojik Parametrelere Etkisi: Randomize Kontrollü Çalışma

Abstract

The Effects of Gentle Human Touch, Kangaroo Care, and Breastfeeding on Pain, Crying Duration, and Physiological Parameters in Newborns During Hepatitis B Vaccination: A Randomized Controlled Trial This study aims to examine and compare the effectiveness of Gentle Human Touch (GHT), Kangaroo Care (Skin-to-Skin Contact), and Breastfeeding methods in newborns before, during, and after Hepatitis B vaccination in terms of pain, crying duration, and physiological parameters. Ethical committee approval, institutional permission, and parental consent were obtained for the study. The study was conducted with a randomized controlled experimental design at Kırşehir Training and Research Hospital. The newborns were divided into three groups: Gentle Human Touch (n=40), Kangaroo Care (n=40), and Breastfeeding (n=40). The infants included in the groups were selected with similar gestational age and birth weight variables (p >0.05). A total of 120 healthy newborns with a gestational age of 38–42 weeks and birth weight of 2000 grams or more were included. Data were collected using a demographic information form for mothers and infants, the Neonatal Infant Pain Scale (NIPS), heart rate, oxygen saturation levels, and crying duration measurements. During Hepatitis B vaccination, Gentle Human Touch and Breastfeeding were applied for a total duration of 5 minutes. Pain scores (NIPS), crying duration, and physiological changes were measured before, during, and after the vaccination. Differences among the groups were analyzed using Shapiro-Wilk normality test, Kruskal-Wallis test, One-Way ANOVA, Tukey HSD test, and Chi-square test. There were significant differences between the groups in terms of NIPS scores, crying duration and peak heart rate during and after the intervention (p<0.05). In the newborns who received Gentle Human Touch, the NIPS score was the lowest (5.55 ± 0.90), crying duration was the shortest (0.09 ± 0.02), heart rate was the most stable (150.48 ± 13.51) and oxygen saturation was the highest (96.73 ± 1.21) during the intervention. In the Kangaroo Care group, the NIPS score was 6.35 ± 0.73, crying duration was 0.14 ± 0.03 min, heart rate was 159.23 ± 13.81 beats/min and oxygen saturation was 95.55 ± 1.43 during the intervention. In the breastfeeding group, the NIPS score was the highest (6.83 ± 0.44) and crying duration was the longest during the intervention. (0.19 ± 0.03 ), heart rate was the highest (168.33 ± 14.18 ) and oxygen saturation was the lowest (95.45 ± 1.13).

The findings indicated that Gentle Human Touch was the most effective non- pharmacological intervention in reducing vaccine-induced pain in newborns. Therefore, it

is recommended that healthcare professionals and nurses integrate non-pharmacological pain management strategies into clinical practice.