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PainNCT05606458

The Effect of Multisensory Stimulation on Baby's Pain and Mother's Anxiety During Heel Blood Collection

A study testing İntervention Group in people with Pain, run by Uludag University at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Newborn screening programs are preventive health services that have a significant place in public health programs in developed and developing countries worldwide. For these scans, heel blood is taken from the newborn, and the heel blood collection procedure applied for diagnostic purposes is one of the most common… Read more about this study

Who is it for?
Ages 38 to 42 weeks
Conditions the study is for
Pain
What is being tested?
İntervention Group
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteTurkey (Türkiye)
Study dates
25 Jul 2019to 25 Jan 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 38 to 42 weeks
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Being a term baby with a gestational age of 38-42 GH
  • The birth weight of 2500 g or more
  • Having a baby for whom only heel blood sampling will be performed
  • Babies with a 5th-minute Apgar score of 7 and above
  • Having a baby who did not receive any painful stimuli until 30 minutes before the intervention
  • The criteria for the parent's willingness to participate in the study are sought.

Who cannot join

  • Babies receiving muscle relaxants, analgesics, and sedation will not be included in the study.
  • Voluntary refusal of parents to take heel blood

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Uludag University

    Bursa, Nilufer, 16059

Other trials in Turkey (Türkiye)

About this study

Official title: The Effect of Multisensory Stimulation Applied by the Mother to Her Infant During the Heel Blood Collection Procedure on the Infant's Pain and Mother's State Anxiety: A Randomized Controlled Trial

Newborn screening programs are preventive health services that have a significant place in public health programs in developed and developing countries worldwide. For these scans, heel blood is taken from the newborn, and the heel blood collection procedure applied for diagnostic purposes is one of the most common painful procedures applied to the newborn. Pharmacological and non-pharmacological pain management may be necessary to reduce and minimize pain during painful procedures in the neonatal intensive care unit. One of the non-pharmacological applications applied during acute procedural pain in the newborn is sensorial saturation, which consists of multisensory stimulation (sensitive touch, massage, auditory, visual, sense of taste, and smell). This study aimed to examine the effect of multisensory stimulation applied by the mother during the heel blood collection procedure in newborns on reducing pain and to evaluate the effects of family-centered practice on the state anxiety of mothers. This study was carried out as a randomized controlled, experimental study. Ethical approval was obtained before starting the study. In addition, written informed consent was obtained from the families of the newborns in the control and intervention groups. The study population consisted of newborns born in a hospital in Turkey between July 2019 and January 2020, and whose heel blood was taken for routine metabolic screening by the Ministry of Health. The sample group consisted of 80 randomly assigned newborns, 40 in the intervention group and 40 in the control group. Newborn mothers in the intervention group gave their babies multisensory stimulation(speech, touch, breastfeeding, eye contact, maternal skin odor) before, during, and after the procedure. The newborns in the control group underwent routine heel blood sampling in the baby room under a radiant heater. The Neonatal Infant Pain Scale (NIPS) was used for pain assessment. The NIPS score was evaluated by the researcher before the procedure, during the procedure, and 1 minute after the procedure. The State Anxiety Inventory was used to measure the mother's anxiety. The state of anxiety of the mothers in each group was evaluated before and after the procedure.

Read the detailed description

Sensory stimuli can be easily realized with the active cooperation of the mother and, based on family-centered care, can help parents feel that they are playing an active role in their baby's care by being involved in their baby's care and can have positive effects on reducing the pain and stress of the baby during the heel blood collection process.As far as we know, there is no study in the literature investigating the effectiveness of multisensory stimulation applied by the mother during the heel blood collection procedure in reducing both the baby's pain and the mother's anxiety. It is thought that our study will provide new evidence to nursing care, that more than one sensory stimulus will be provided by the mother, will increase the baby's sense of confidence and reduce pain, contribute to the importance of family-centered care, and will be useful to support the results of the current study. This study aimed to examine the effect of multisensory stimulation applied by the mother during the heel blood collection procedure in newborns on reducing pain and to evaluate the effects of family-centered practice on the state anxiety of mothers.Before starting work, S.B.U. Ethical approval was obtained from the Süreyyapaşa Chest Diseases and Thoracic Surgery Clinical Research Ethics Committee. To start the research after the ethics committee's approval, T.C. Permissions were obtained from the Istanbul Provincial Health Directorate and the Istanbul Tuzla State Hospital management. In addition, written informed consent was obtained from the families of the newborns in the control and intervention groups. The research population consisted of all newborns born in Tuzla State Hospital in Turkey/Istanbul between July 2019 and January 2020 and whose infants were taken for routine metabolic screening by the Ministry of Health. The sample group consisted of 80 randomly assigned newborns, 40 in the intervention group and 40 in the control group. Randomization was provided according to the order of the procedure. The first newborn control group and the second newborn intervention group were formed. The newborns whose heel blood will be taken every day of the week during working hours continued from where they left off according to the order of the procedure. Before the procedure, the necessary materials were prepared, and the heel blood sheet information was filled in. The mothers of the babies whose heel blood was taken were informed about the heel blood screening and the research. The form containing the identification information of the baby and the mother was filled out. Before the procedure, the mother was asked to fill out the State Anxiety Scale (in both groups, the baby was with the mother). The newborns in the control group were taken to an open bed under a radiant heater, leaving the mother's side for routine heel blood collection applied in the hospital. First of all, the foot of the baby, who was taken to an open bed under a radiant heater, was warmed in the hands of the nurse for one minute, the area where the baby's heel blood would be taken was determined, the baby's heel was wiped with 70% alcohol with the help of a sponge and waited for it to dry, then heel lance was performed. The procedure was completed after the relevant sections on the pre-prepared heel blood sheet were filled with blood. A light touch was provided if necessary for the routine comfort of the baby for ethical reasons. The mothers of the babies whose heel blood was taken in the intervention group were informed about the steps of the procedure and the multisensory stimulation they would give to their babies (mother's voice, touching, breastfeeding, eye contact, mother's skin smell). The baby was started to be breastfed before the procedure and continued until the end of the evaluation period (1st stimulus). The mother supported her baby's back and bottom with one hand. He started to touch by positioning the thumb of the other hand to prevent the baby's nose from being blocked and the other fingers of the same hand to touch the baby's face (2nd stimulus). The mother started to talk with her baby in a gentle but firm tone, sometimes using sentences (words, lullabies, songs, etc.) that she wanted to increase the volume of her baby (3rd stimulus). Talking was started before the procedure and continued until the end of the evaluation period. The mother was in the baby's sight (4th stimulus). Clothes were removed as much as possible for the smell of the mother's skin (5th stimulus). After the baby's foot in the mother's lap was warmed in the nurse's hand for one minute, the area where the baby's heel blood would be taken was determined. After the baby's heel was wiped with 70% alcohol and a sponge and waited for it to dry, heel lance was performed. The procedure was completed after the relevant sections on the pre-prepared heel blood sheet were filled with blood. If the baby stopped sucking at any time during the procedure, the baby was placed back on the breast and the procedure continued from where it had left off. In the study, the data of the baby and the mother was prepared by the researcher mother's age, mother's occupation, gestational week of the baby, birth weight, gender, mode of delivery, etc.), the "Neonatal Infant Pain Scale (NIPS)" scale, which will be used in the assessment of the baby's pain, and the questionnaire form of the State Anxiety Scale to measure the mother's anxiety was used. NIPS score was evaluated by the researcher before the procedure, during the procedure, and 1 minute after the procedure. The State Anxiety Scale was administered to the mother before and after the procedure. The researcher calculated state anxiety scale scores.

Conditions
Pain
Keywords
Neonatal, Heel Lance, Multisensory stimulation, Family Centered Care, NIPS, Sensorial Saturation(SS)
Medical subject headings
Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • İntervention GroupBehavioural

    Before the procedure, the baby was started to be breastfed (1st stimulus). The mother supported her baby's back and bottom with one hand. He started to touch by positioning the thumb of the other hand to prevent the baby's nose from being blocked, and the other fingers of the same hand to touch the baby's face (2nd stimulus). The mother started to talk to her baby with a gentle tone of voice, sometimes using sentences (lullaby, song, etc.) that she wanted to increase the volume of her voice (3rd stimulus). The mother was in the baby's sight (4th stimulus). Clothes were removed as much as possible for the smell of the mother's skin (5th stimulus). The baby's foot in the mother's arms was warmed in the nurse's hand for a minute. The area was determined, and the baby's heel was wiped with 70% alcohol. It was expected to dry. Heel piercing was performed while the stimuli continued. Heel blood was taken. When the evaluation period is complete, the process is over.

Study groups in NCT05606458
Study groupRoleWhat they receive
Control GroupNo interventionThe baby who met the inclusion and exclusion criteria underwent routine heel blood sampling at the hospital. First of all, the foot of the baby, who was taken to an open bed under a radiant heater, was warmed in the nurse's hand for one minute, the area where the baby's heel blood would be taken was determined, the baby's heel was wiped with 70% alcohol with the help of a sponge and waited for it to dry, then heel lance was performed. The procedure was completed after the relevant sections on the pre-prepared heel blood sheet were filled with blood. A light touch was provided if necessary for routine comfort of the infant for ethical reasons.
İntervention GroupExperimentalTheir mothers gave a multisensory stimulus to the newborns in the mother's room. 1. Stimulus: Breast milk, breastfeeding (sense of taste) 2. Stimulus : Maternal touch (sense of touch) 3. Stimulus: Mother's voice (hearing sense) 4. Stimulus: Maternal eye contact (sense of sight) 5. Stimulus: Mother skin smell (sense of smell)
Receives: Behavioral: İntervention Group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Neonatal Infant Pain Scale (NIPS)

    The Neonatal Infant Pain Scale (NIPS) was used for pain assessment. The primary outcome was the pain score assessed with the NIPS scale, a validated and widely used tool to measure procedural pain in infants. NIPS is a measurement tool that includes five behavioral groupings (facial expression, crying, movements of arms and legs, state of alertness) and one physiological parameter (respiration pattern). Of the indicators, only crying is scored between 0 and 2, while the other indicators are scored as 0 or 1. Evaluation results in a possible total score between 0 and 7. A high score indicates an increase in the severity of pain. NIPS was evaluated before the procedure, during the procedure, and at the 1st minute after the procedure.

    Measured: Pre-procedure.

  2. Neonatal Infant Pain Scale (NIPS)

    The Neonatal Infant Pain Scale (NIPS) was used for pain assessment. The primary outcome was the pain score assessed with the NIPS scale, a validated and widely used tool to measure procedural pain in infants. NIPS is a measurement tool that includes five behavioral groupings (facial expression, crying, movements of arms and legs, state of alertness) and one physiological parameter (respiration pattern). Of the indicators, only crying is scored between 0 and 2, while the other indicators are scored as 0 or 1. Evaluation results in a possible total score between 0 and 7. A high score indicates an increase in the severity of pain. NIPS was evaluated before the procedure, during the procedure, and at the 1st minute after the procedure.

    Measured: During the procedure

  3. Neonatal Infant Pain Scale (NIPS)

    The Neonatal Infant Pain Scale (NIPS) was used for pain assessment. The primary outcome was the pain score assessed with the NIPS scale, a validated and widely used tool to measure procedural pain in infants. NIPS is a measurement tool that includes five behavioral groupings (facial expression, crying, movements of arms and legs, state of alertness) and one physiological parameter (respiration pattern). Of the indicators, only crying is scored between 0 and 2, while the other indicators are scored as 0 or 1. Evaluation results in a possible total score between 0 and 7. A high score indicates an increase in the severity of pain. NIPS was evaluated before the procedure, during the procedure, and at the 1st minute after the procedure.

    Measured: 1st minute after the procedure.

  4. State-Trait Anxiety Scale

    The State-Trait Anxiety Inventory consists of two separate forms containing a total of 40 items. The State Anxiety Scale consists of 20 questions. Scoring the State Anxiety Inventory; According to the severity of the emotions, they are answered as (1) none, (2) a little, (3) a lot, and (4) completely. There are direct (straight) and reversed statements in the scales. Direct statements are negative emotions. Inverted expressions are positive emotions. The State Anxiety Scale has ten reversed statements (items 1, 2, 5, 8, 10, 11, 15, 16, 19, and, 20). Total score; It is found by subtracting the total score of positive statements from the total score of negative statements and adding 50, which is the constant value for this scale. Total score: "0-19 points" are considered as no anxiety, "20-39 points" as mild anxiety, "40-59 points" as moderate anxiety, "60-79 points" as severe anxiety, and "80 and above" as panic.

    Measured: Pre-procedure

  5. State-Trait Anxiety Scale

    The State-Trait Anxiety Inventory consists of two separate forms containing a total of 40 items. The State Anxiety Scale consists of 20 questions. Scoring the State Anxiety Inventory; According to the severity of the emotions, they are answered as (1) none, (2) a little, (3) a lot, and (4) completely. There are direct (straight) and reversed statements in the scales. Direct statements are negative emotions. Inverted expressions are positive emotions. The State Anxiety Scale has ten reversed statements (items 1, 2, 5, 8, 10, 11, 15, 16, 19, and, 20). Total score; It is found by subtracting the total score of positive statements from the total score of negative statements and adding 50, which is the constant value for this scale. Total score: "0-19 points" are considered as no anxiety, "20-39 points" as mild anxiety, "40-59 points" as moderate anxiety, "60-79 points" as severe anxiety, and "80 and above" as panic.

    Measured: İmmediately after the procedure

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Nov 2022
  2. Study start25 Jul 2019
  3. Primary completion25 Jan 2020
  4. Study completion25 Jan 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
80 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05606458
Sponsor's protocol ID
UludagUniversity/AKKAYAGUL
Status last verified
Nov 2022
First submitted
25 Oct 2022
Last updated
4 Nov 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Akkaya-Gul A, Ozyazicioglu N, Celikboya-Kabadayi E. Multisensory stimulation by mothers: impact on neonatal pain and maternal anxiety during heel blood collection: a randomized controlled trial. J Perinatol. 2026 Apr;46(4):569-576. doi: 10.1038/s41372-025-02436-5. Epub 2025 Oct 6.

    PubMed 41053317

Questions about this trial

What is this clinical trial studying?

A study testing İntervention Group in people with Pain, run by Uludag University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Neonatal Infant Pain Scale (NIPS) (time frame: Pre-procedure.). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05606458, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Nov 2022.

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