The effect of voice applications on pain in premature infants: A systematic review

Premature babies have difficulty expressing pain. Premature infants show pain with physiological or behavioral symptoms. Neonatal nurses use pharmacological and non-pharmacological methods in the management of pain. SES applications, which are one of the non-pharmacological methods, have become widespread in intensive care units in recent years. This study was planned to see the effect of this prevalence in the last 20 years (2003-2022) and to determine the effect of sound applications on pain in premature babies. In the research conducted in 16 databases with keywords, 9301 articles were reached. When the selection was made according to the inclusion criteria among these articles, 17 articles were included in the study. 46.9% of the studies obtained were conducted in Turkey, 17.7% in China, 11.8% in Iran, 5.9% in Taiwan, 5.9% in Lebanon, 5.9% in Japan and 5.9% in Australia. 58.8% of the studies used a single audio application and a single experimental group, while 41.2% used more than one audio application and experimental group. There were 19 sound interventions in a total of 28 experimental groups. 26% of the audio interventions used were determined as white noise, 16% as mother's voice, 21% as lullaby, 10.7% as heartbeat, 21% as music and 5.3% as intrauterine sounds. As a result of the studies, the positive effect rate of the sound interventions applied was found to be 88.2%, while the negative or non-effective studies were determined to be 11.8%. As a result, positive results were obtained by seeing an increase in SpO2 value, stabilization of heart rate, decrease in respiratory rate and shortening of crying time in addition to pain assessment in studies. The methods determined to have positive results in the management of pain are recommended to be used in neonatal intensive care units.