The effect of pain, stress and comfort of developmental supporting positions during the heel lance in premature i̇nfants

Aim: In this study, premature newborns was conducted to determine of the effect of baby's pain, stress and comfort during heel lance of surrounded by the developmental supportive position. Method: This research is an experimental study pre-test and post-test pattern in a single group. The study data were collected with 'İnfant Information Form, Patient Follow-up Form, Comfort-Neo Scale and Neonatal Infant Pain Scale (NIPS). During the heel lance procedure is given 3rd day in supine and 4th day on the prone position in infants. Positions are given using linen or towels. Premature infant given position was monitored for 30 minutes.Then heel lance has started. The premature neonates have been recorded by the camera during heel lance procedure. The videos are evaluated using scales by two specialists (observer) in postprocedural. In addition, pre-procedure, during the procedure and post-procedure oxygen saturation and heart rate were recorded. Also criying time was recorded. Saliva samples were taken prior to 5 second and after 30 second heel lancing. Saliva samples were frozen at -80 ° C after centrifugation. After the data collection process is finished that the saliva were saliva analyzed with Salımetrıcs Cortizol Elisa Kits and Salımetrıcs Melatonin Eliza Kit. The data evaluation was carried out with Power analizi, Shapiro-Wilk analizi, Wilcoxon Test, McNemar Test, Mann-Whitney U Test, Kruskal-Wallis Test, İnterclass Correlation Coefficient (ICC). Result: Oxygen saturation at intraprocedure were significantly lower in the prone position and non-significant mean differences in heart rate (p>0.05). Shorter duration of crying (P = .014) were observed for prone position. The mean NIPS score, YKDÖ score, pain forecast score and distress forecast score for premature neonates who were prone position during the procedure was significantly lower than the score for infants in the supine position each for the two observers (p<0.000). Also, the level of salivary cortisol had significantly increased in the prone position, but non-significant mean differences in the level of salivary melatonin between positions. Conclusion: Prone position has an effect reducing pain, enhancing comfort and reducing stress in preterm newborns and can be used as a non-pharmacological method for pain relief. Keywords: premature infants; pain; comfort; stres; cortisol levels; melatonin levels.