The effects of cold application in reduction of acut pain due to injection of vaccination in children

Immunization is an important strategy for disease prevention. But, vaccination is located in the first rank in the painful/stressful processes. Which is one of the nonpharmacological methods, cold application is an important tool for pain reduction. This is a randomized controlled trial, which is conducted for investigating the effect of 45 seconds cold application before DaBT-IPA-Hib(Diphtheria, acellular pertussis, tetanus, inactivated polio, Haemophlius İnfluenzae type b) vaccination on pain in 18-24 months healthy children. While 39 children were taken for intervention(cold application) group, 37 children were taken for control group. Randomization was carried out by gender and age. Vaccine injections were administered by the same nurse during the study to ensure the results reliability. Monitoring of children's pain and cry were observed by the same observer nurse. All children in control and intervention groups stayed in the parent's lap during the vaccine injection. Silence was provided during one minute after vaccine injection and it was not allowed any intervention to appease children. Cold application was administered at the upper one-third of the thigh and the front portion of the vastus lateralis muscle during 45 seconds by the researcher. Vaccine injection was administered immediately after the cold application. The routine vaccination procedures were implemented for the children in the control group. There were no significant differences between the intervention and control groups in terms of the average of FLACC pain scores and FLACC pain levels before vaccine injection (p>0.05). The average of FLACC pain scores during vaccine injection of the control group (7.43±1.17) were significantly higher than the intervention group (4.69±1.15 ) (p<0.05). The FLACC pain levels during vaccine injection of the intervention group were significantly lower than the control group(p<0.05). The crying time during vaccine injection of the intervention group were lower than the control group, but there were no significant differences between two groups (p>0.05). The average of FLACC pain scores after vaccine injection of the control group were significantly higher than the intervention group (p<0.05). It was found that 45 seconds cold application to (DaBT-IPA-Hib) vaccine injection area decreases pain in 18-24 months healthy children. It is suggested that new studies should be implemented which include cold application and using other techniquies.