Research Article
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Effect of Heel Warming with a Thermofor at Two Different Temperatures Before Heel Stick Sampling in Healthy Term Neonates on Total Crying and Procedure Durations: A Randomized Controlled Trial

Year 2023, , 739 - 746, 01.10.2023
https://doi.org/10.31067/acusaglik.1331629

Abstract

Purpose: The purpose of this research is to determine the effect of heel warming with a thermofor at two different temperatures before heel stick sampling in healthy term neonates on total crying and procedure durations.
Methods: This study was a randomized controlled trial. The sample for the research comprised 120 healthy term neonates with heel stick sampling performed by the same nurse. Neonates were randomized into control (n = 40), heel warming with a thermofor containing warm water (n = 40) and heel warming with a thermofor containing hot water (n = 40) three groups. In the study, to determine the efficacy of the heel warming intervention, neonates were recorded for six minutes before heel stick sampling and five minutes after heel puncture with a video camera.
Results: In the study, both the total procedure duration and total crying duration were statistically significantly shorter in the group with heel warming with hot water compared to the control group (KW = 6.088, p = 0.016; KW = 7.611, p = 0.006, respectively). However, in the group with heel warming with warm water, there was no significant difference in terms of total crying and procedure durations compared to both the control group and the group with heel warming using hot water (p> 0.05).
Conclusion: Before heel stick sampling in healthy term neonates, warming the heel with a thermofor containing hot water is effective in shortening the total crying and procedure durations.

Supporting Institution

No external or intramural funding was received.

Project Number

None

Thanks

The author would like to thank all participants in this study.

References

  • Cirik VA, Gül U, Kihtir Z, Arayici S, Efe E, Çakmak H, et al. The effect of using maternal voice, white noise, and holding combination interventions on the heel stick sampling. J Pediatr Nurs. 2023;70:1–11.
  • Erdim L, Zengin N, Karaca B. Investigation of the preanalytical process practices in primary care in Istanbul regarding the newborn screening tests. Turkish J Biochem. 2023;48(1):12–8.
  • Peng H, Yin T, Yang L, Wang C, Chang Y, Jeng M. Non-nutritive sucking , oral breast milk , and facilitated tucking relieve preterm infant pain during heel-stick procedures : A prospective , randomized controlled trial. Int J Nurs Stud [Internet]. 2018;77(October 2017):162–70. Available from: https://doi.org/10.1016/j.ijnurstu.2017.10.001
  • Yin T, Yang L, Lee T, Li C, Hua Y, Liaw J. Development of atraumatic heel-stick procedures by combined treatment with non-nutritive sucking, oral sucrose, and facilitated tucking: a randomised controlled trial. Int J Nurs Stud [Internet]. 2015;52(8):1288–99. Available from: http://dx.doi.org/10.1016/j.ijnurstu.2015.04.012
  • KarabıyıkOğurlu Ö, TuralBüyük E, Yildizlar O. The effect of warm compression applied before heel lance on pain level, comfort level and procedure time in healthy term newborns: a randomized clinical trial. J Midwifery Reprod Heal. 2019;8(3):2276–83.
  • Gao H, Li M, Gao H, Xu G, Li F, Zhou J, et al. Effect of non-nutritive sucking and sucrose alone and in combination for repeated procedural pain in preterm infants: a randomized controlled trial. Int J Nurs Stud [Internet]. 2018;83:25–33. Available from: https://doi.org/10.1016/j.ijnurstu.2018.04.006
  • Shu S, Lee Y, Hayter M, Wang R. Efficacy of swaddling and heel warming on pain response to heel stick in neonates: A randomised control trial. J Clin Nurs. 2014;23(21–22):3107–14.
  • Brummelte S, Grunau RE, Chau V, Poskitt KJ, Brant R, Vinall J, et al. Procedural pain and brain development in premature newborns. Ann Neurol. 2012;71(3):385–96.
  • Dinçer S, Yurtçu M, Günel E. Pain in newborns and nonpharmacologic treatment procedures. Selcuk Med J. 2011;27(1):46–51.
  • Güven Ş, Çalbayram N. The effect of Helfer skin tap technique on hepatitis B vaccine intramuscular injection pain in neonates : a randomized controlled trial. Explore. 2023;19:238–42.
  • Hockenberry M, Wilson D. Wong’s Nursing Care of Infants and Children. 11th ed. Hockenberry M, Wilson D, editors. Mosby; 2019. 1424 p.
  • Pazarcikci F, Efe E. Atraumatic care methods in childhood vaccination. Int Ref J Gynaecol Dis Matern Child Heal. 2017;9:62–77.
  • Buyuk E. The effect of local application of heat before heel lancing procedure on duration of crying and procedure. Int J Caring Sci. 2018;11(3):1526–30.
  • Balcı S, Dur S, Özdemir S, Kavuncuoglu S. The effect of two different lancets and heel warming on duration of crying and procedure time during blood sampling: A randomized controlled study. J Neonatal Nurs J. 2021;27:426–31.
  • Avcin E, Kucukoglu S. The effect of breastfeeding, kangaroo care, and facilitated tucking positioning in reducing the pain during heel stick in neonates. J Pediatr Nurs [Internet]. 2021;61:410–6. Available from: https://doi.org/10.1016/j.pedn.2021.10.002
  • Folk LA. Guide to capillary heelstick blood sampling in infants. Adv Neonatal Care. 2007;7(4):171–8.
  • Aydin D, İnal S. Effects of breastfeeding and heel warming on pain levels during heel stick in neonates. Int J Nurs Pr. 2019;25:1–8.
  • Mir M, Benham Vashani H, Sadeghi T, Boskabadi H, Khorshahi A. Effects of Yakson therapeutic touch and heel warming on pain caused by heel stick procedure, vital signs, and cry duration in full-term neonates. Evid Based Care. 2018;8(2):49–57.
  • Dur S, Balcı S. Assessing neonatal pain, duration of crying and procedure time following use of automatic or manual heel lances: a randomized controlled study. J Trop Pediatr. 2018;64:488–94.
  • Barker DP, Willetts B, Cappendijk VC, Rutter N. Capillary blood sampling: Should the heel be warmed? Arch Dis Childhood-Fetal Neonatal Ed. 1996;74(2):139–40.
  • Hassan Z, Shah M. Scald injury from the Guthrie test: should the heel be warmed? Arch Dis Childhood-Fetal Neonatal Ed. 2005;90:533–4.
  • Ray R, Godwin Y, Shepherd A. Convective burn from use of hairdryer for heel warming prior to the heel prick test - a case report. BMC Pediatr. 2011;11(1):30.
  • Sapkota PS, Bhandari SS, Karn BK. Efficacy of heel warming on pain response to heel stick in neonates. J Nepal Paediatr Soc. 2021;41(1):48–53.
  • Janes M, Pinelli J, Landry S, Downey S. Comparison of capillary blood sampling using an automated incision device with and without warming the heel. J Perinatol. 2002;22(2):154–8.
Year 2023, , 739 - 746, 01.10.2023
https://doi.org/10.31067/acusaglik.1331629

Abstract

Project Number

None

References

  • Cirik VA, Gül U, Kihtir Z, Arayici S, Efe E, Çakmak H, et al. The effect of using maternal voice, white noise, and holding combination interventions on the heel stick sampling. J Pediatr Nurs. 2023;70:1–11.
  • Erdim L, Zengin N, Karaca B. Investigation of the preanalytical process practices in primary care in Istanbul regarding the newborn screening tests. Turkish J Biochem. 2023;48(1):12–8.
  • Peng H, Yin T, Yang L, Wang C, Chang Y, Jeng M. Non-nutritive sucking , oral breast milk , and facilitated tucking relieve preterm infant pain during heel-stick procedures : A prospective , randomized controlled trial. Int J Nurs Stud [Internet]. 2018;77(October 2017):162–70. Available from: https://doi.org/10.1016/j.ijnurstu.2017.10.001
  • Yin T, Yang L, Lee T, Li C, Hua Y, Liaw J. Development of atraumatic heel-stick procedures by combined treatment with non-nutritive sucking, oral sucrose, and facilitated tucking: a randomised controlled trial. Int J Nurs Stud [Internet]. 2015;52(8):1288–99. Available from: http://dx.doi.org/10.1016/j.ijnurstu.2015.04.012
  • KarabıyıkOğurlu Ö, TuralBüyük E, Yildizlar O. The effect of warm compression applied before heel lance on pain level, comfort level and procedure time in healthy term newborns: a randomized clinical trial. J Midwifery Reprod Heal. 2019;8(3):2276–83.
  • Gao H, Li M, Gao H, Xu G, Li F, Zhou J, et al. Effect of non-nutritive sucking and sucrose alone and in combination for repeated procedural pain in preterm infants: a randomized controlled trial. Int J Nurs Stud [Internet]. 2018;83:25–33. Available from: https://doi.org/10.1016/j.ijnurstu.2018.04.006
  • Shu S, Lee Y, Hayter M, Wang R. Efficacy of swaddling and heel warming on pain response to heel stick in neonates: A randomised control trial. J Clin Nurs. 2014;23(21–22):3107–14.
  • Brummelte S, Grunau RE, Chau V, Poskitt KJ, Brant R, Vinall J, et al. Procedural pain and brain development in premature newborns. Ann Neurol. 2012;71(3):385–96.
  • Dinçer S, Yurtçu M, Günel E. Pain in newborns and nonpharmacologic treatment procedures. Selcuk Med J. 2011;27(1):46–51.
  • Güven Ş, Çalbayram N. The effect of Helfer skin tap technique on hepatitis B vaccine intramuscular injection pain in neonates : a randomized controlled trial. Explore. 2023;19:238–42.
  • Hockenberry M, Wilson D. Wong’s Nursing Care of Infants and Children. 11th ed. Hockenberry M, Wilson D, editors. Mosby; 2019. 1424 p.
  • Pazarcikci F, Efe E. Atraumatic care methods in childhood vaccination. Int Ref J Gynaecol Dis Matern Child Heal. 2017;9:62–77.
  • Buyuk E. The effect of local application of heat before heel lancing procedure on duration of crying and procedure. Int J Caring Sci. 2018;11(3):1526–30.
  • Balcı S, Dur S, Özdemir S, Kavuncuoglu S. The effect of two different lancets and heel warming on duration of crying and procedure time during blood sampling: A randomized controlled study. J Neonatal Nurs J. 2021;27:426–31.
  • Avcin E, Kucukoglu S. The effect of breastfeeding, kangaroo care, and facilitated tucking positioning in reducing the pain during heel stick in neonates. J Pediatr Nurs [Internet]. 2021;61:410–6. Available from: https://doi.org/10.1016/j.pedn.2021.10.002
  • Folk LA. Guide to capillary heelstick blood sampling in infants. Adv Neonatal Care. 2007;7(4):171–8.
  • Aydin D, İnal S. Effects of breastfeeding and heel warming on pain levels during heel stick in neonates. Int J Nurs Pr. 2019;25:1–8.
  • Mir M, Benham Vashani H, Sadeghi T, Boskabadi H, Khorshahi A. Effects of Yakson therapeutic touch and heel warming on pain caused by heel stick procedure, vital signs, and cry duration in full-term neonates. Evid Based Care. 2018;8(2):49–57.
  • Dur S, Balcı S. Assessing neonatal pain, duration of crying and procedure time following use of automatic or manual heel lances: a randomized controlled study. J Trop Pediatr. 2018;64:488–94.
  • Barker DP, Willetts B, Cappendijk VC, Rutter N. Capillary blood sampling: Should the heel be warmed? Arch Dis Childhood-Fetal Neonatal Ed. 1996;74(2):139–40.
  • Hassan Z, Shah M. Scald injury from the Guthrie test: should the heel be warmed? Arch Dis Childhood-Fetal Neonatal Ed. 2005;90:533–4.
  • Ray R, Godwin Y, Shepherd A. Convective burn from use of hairdryer for heel warming prior to the heel prick test - a case report. BMC Pediatr. 2011;11(1):30.
  • Sapkota PS, Bhandari SS, Karn BK. Efficacy of heel warming on pain response to heel stick in neonates. J Nepal Paediatr Soc. 2021;41(1):48–53.
  • Janes M, Pinelli J, Landry S, Downey S. Comparison of capillary blood sampling using an automated incision device with and without warming the heel. J Perinatol. 2002;22(2):154–8.
There are 24 citations in total.

Details

Primary Language English
Subjects Primary Health Care
Journal Section Research Article
Authors

Fahriye Pazarcıkcı 0000-0002-3249-299X

Ayşe Aydınlı 0000-0001-5150-838X

Project Number None
Early Pub Date September 20, 2023
Publication Date October 1, 2023
Submission Date July 23, 2023
Published in Issue Year 2023

Cite

EndNote Pazarcıkcı F, Aydınlı A (October 1, 2023) Effect of Heel Warming with a Thermofor at Two Different Temperatures Before Heel Stick Sampling in Healthy Term Neonates on Total Crying and Procedure Durations: A Randomized Controlled Trial. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 14 4 739–746.