Research Article
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The Effect of the Use of Black and White Flashcards on Acute Pain Levels in Infants

Year 2023, Volume: 23 Issue: 3, 285 - 291, 24.10.2023

Diler Yılmaz , Nejla Canbulat Şahiner , Zübeyde Ezgi Erçelik

https://doi.org/10.26650/jchild.2023.1327823

Abstract

Objective: Vaccination practices are one of the most painful procedures in infancy, creating anxiety and distress for both infants and their parents. This study was planned to determine the effect of black and white flashcards on the level of acute pain infants feel during vaccination applications.
Materials and Methods: The sample of this prospective randomized controlled trial comprised 119 infants who were brought to the family health center for the 2nd and 3rd dose of the combined 5-vaccine and who met the inclusion criteria. The data were obtained using the information form, which included descriptive characteristics of the baby and family, and the FLACC pain assessment tool.
Results: The mean pain scores of the infants (2.76 ± 2.06) in the black and white flashcard group were significantly lower than those of the control group (4.61 ± 2.00) (p < 0.01). Additionally, there was statistically no significant difference between the total durations of crying and the periods of the infants between initial crying and calming down in both the experimental and control groups (p>0.05).
Conclusion: We concluded that the use of black and white flashcards during the vaccination practices was efficient. In line with these results, we recommend that nurses use black and white flashcards, an easily applicable method, to decrease the pain sensitivity of infants during vaccine applications.

Keywords

pain vaccination distraction

Supporting Institution

Bandırma Onyedi Eylul University Scientific Research Projects Coordination Unit, Bandırma

Project Number

BAP-19-1004-003

Thanks

The authors thank the parents and babies for participating.

References

  • Bozkurt G. Immune system and immunization. In: Genç RE, Özkan H editors. Newborn Health and Diseases Book for Midwives. Istanbul, Türkiye: Nobel Medical Bookstore, 2016:393. google scholar
  • Özümit D. Investigation of validity and validity of Turkish attitudes to the foreign affairs. [master’s thesis]. İzmir: İzmir Kâtip Çelebi University, Health Science Institue, 2019. google scholar
  • Santo Fontes V, Nunes Ribeiro CJ, Neves Dantas RA, Oliveira Ribeiro MC. Pain relief strategies during immunization. Br J Pain. Sao Paulo. 2018;1(3):270-3. google scholar
  • Gad RF, Dowling DA, Abusaad FE, Bassiouny MR, Abd El Aziz MA. Oral Sucrose Versus Breastfeeding in Managing Infants’ Immunization-Related Pain: A Randomized Controlled Trial. MCN Am J Matern Child Nurs. 2019;44(2):108-114. doi:10.1097/ NMC.0000000000000512 google scholar
  • Gennis H, Pillai Riddell R, O’Neill MC, Katz J, Taddio A, Garfield H, et al. Parental Psychological Distress Moderates the Impact of a Video Intervention to Help Parents Manage Young Child Vaccination Pain. J Pediatr Psychol. 2018;43(10):1170-1178. doi:10.1093/jpepsy/jsy058 google scholar
  • Derebent E, Yigit R. Pain in newborn: Assesment and management. Cumhuriyet University School of Health Journal 2006;10(2):41-48. google scholar
  • Srouji R, Ratnapalan S, Schneeweiss S. Pain in children: assessment and nonpharmacological management. Int J Pediatr. 2010;2010:474838. doi:10.1155/2010/474838 google scholar
  • Inal S, Canbulat N. Using of distraction methods on procedural pain management of pediatric patients. Journal of Current Pediatrics 2015;13(2):116-21. google scholar
  • Göl İ, Altuğ Özsoy S. Evidence-Based applications to reduce pain in vaccine injections. Turkiye Klinikleri J Public Health Nurs-Special Topics 2017b;3(1):39-45. google scholar
  • WHO. Reducing pain at the time of vaccination: WHO position paper, September 2015-Recommendations. Vaccine. 2016;34(32):3629-3630. doi:10.1016/j.vaccine.2015.11.005 google scholar
  • Kassab M, Hamadneh S, Nuseir K, ALmomani B, Hamadneh J. Factors Associated With Infant Pain Severity Undergoing Immunization Injections. J Pediatr Nurs. 2018;42:e85-e90. doi:10.1016/j.pedn.2018.04.002 google scholar
  • Taddio A, Appleton M, Bortolussi R, Chambers C, Dubey V, Halperin S, et al. Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline (summary). CMAJ. 2010;182(18):1989-1995. doi:10.1503/cmaj.092048 google scholar
  • Caglar S, Büyükyılmaz F, Coşansu G, Çağlayan S. Effectiveness of ShotBlocker for Immunization Pain in Full-Term Neonates: A Randomized Controlled Trial. J Perinat Neonatal Nurs. 2017;31(2):166-171. doi:10.1097/JPN.0000000000000256 google scholar
  • Nieto Garda A, Berbel Tornero O, Monleon Sancho J, Alberola-Rubio J, Lopez Rubio ME, Pico Sirvent L. Evaluacion del dolor en ninos de 2, 4 y 6 meses tras la aplicacion de metodos de analgesia no farmacologica durante la vacunacion [Evaluation of pain in children of 2, 4 and 6 months after the application of non-pharmacological analgesia methods during vaccination]. An Pediatr (Engl Ed). 2019;91(2):73-79. doi:10.1016/j. anpedi.2018.10.002 google scholar
  • Shahid R, Benedict C, Mishra S, Mulye M, Guo R. Using iPads for distraction to reduce pain during immunizations. Clin Pediatr (Phila). 2015;54(2):145-148. doi:10.1177/0009922814548672 google scholar
  • Harrison D, Wilding J, Bowman A, Fuller A, Nicholls SG, Pound CM, et al. Using YouTube to Disseminate Effective Vaccination Pain Treatment for Babies. PLoS One. 2016;11(10):e0164123. Published 2016 Oct 3. doi:10.1371/journal.pone.0164123 google scholar
  • Şıktaş Ö, Uysal G. The Effect of Buzzy Application on Pain Level During Vaccine Injection in Infants. J Nurs Care Qual. 2023;38(1):E9-E15. doi:10.1097/NCQ.0000000000000656 google scholar
  • Güngör T, Öztürk Şahin Ö. Analysis of two non-pharmacological pain management methods for vaccine injection pain in infants: A randomized controlled trial. Bebeklerde aşı enjeksiyonu ağrısında iki non-farmokolojik ağrı yönetim metodu: Randomize kontrollü bir çalışma. Agri. 2021;33(1):15-22. doi:10.14744/ agri.2020.54289 google scholar
  • Ozdemir FK, Tüfekci FG. The effect of using musical mobiles on reducing pain in infants during vaccination. J Res Med Sci. 2012;17(7):662-667. google scholar
  • Chen J. Beyond black and white: heibaika, neuroparenting, and lay neuroscience. BioSocieties 2021;16:70-87. google scholar
  • Koç T, Gözen D. The Effect of Foot Reflexology on Acute Pain in Infants: A Randomized Controlled Trial. Worldviews Evid Based Nurs. 2015;12(5):289-296. doi:10.1111/wvn.12099 google scholar
  • Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23(3):293-297. google scholar
  • http://mesmerised.com.au/product/baby-flashcards/ Accessed 03 March 2020. google scholar
  • Pancekauskaite G, Jankauskaite L. Paediatric Pain Medicine: Pain Differences, Recognition and Coping Acute Procedural Pain in Paediatric Emergency Room. Medicina (Kaunas). 2018;54(6):94. Published 2018 Nov 27. doi:10.3390/medicina54060094 google scholar
  • Özdemir A, Kürtüncü M. Use of distraction techniques on during the invasive processes of pediatric patients. SSTB International Refereed Academic Journal of Sports, Health and Medical Sciences 2017;24:48-60. google scholar
  • Chad R, Emaan S, Jillian O. Effect of virtual reality headset for pediatric fear and pain distraction during immunization. Pain Manag. 2018;8(3):175-179. doi:10.2217/pmt-2017-0040 google scholar
  • Modanloo S, Stacey D, Dunn S, Choueiry J, Harrison D. Parent resources for early childhood vaccination: An online environmental scan. Vaccine. 2019;37(51):7493-7500. doi:10.1016/j.vaccine.2019.09.075 google scholar
  • Bekar P, Efe E. Effects of mother-sung lullabies on vaccination-induced infant pain and maternal anxiety: A randomized controlled trial. J Pediatr Nurs. 2022;65:e80-e86. doi:10.1016/j. pedn.2022.03.003 google scholar
  • Vaziri F, Khosropoor M, Hidari M, Pourahmad S, Morshed Behbahani B, Saki F. The Effect of Aromatherapy by Lavender Oil on Infant Vaccination Pain: a Double Blind Randomized Controlled Trial. J Caring Sci. 2019;8(1):17-21. Published 2019 Mar 1. doi:10.15171/jcs.2019.003 google scholar
  • Gedam DS, Verma M, Patil U, Gedam S. Effect of distraction technique during immunization to reduce behaviour response score (FLACC) to pain in toddlers. J Nepal Paediatr Soc. 2013;33(1):25-30. google scholar
  • Göl İ, Altuğ Özsoy S. Effects of Rapid Vaccine Injection Without Aspiration and Applying Manual Pressure Before Vaccination on Pain and Crying Time in Infants. Worldviews Evid Based Nurs. 2017;14(2):154-162. doi:10.1111/wvn.12206 google scholar
  • Karakuş Türker T. Comparing the effects of kangaroo care and breastfeeding in reducing the pain due to hepatitis B vaccination in newborns [master’s thesis]. İstanbul: Istanbul University, Health Science Institue, 2018. google scholar

Siyah Beyaz Dikkati Başka Yöne Çekme Kartlarının Bebeklerin Hissedilen Akut Ağrı Düzeyine Etkisi

Year 2023, Volume: 23 Issue: 3, 285 - 291, 24.10.2023

Diler Yılmaz , Nejla Canbulat Şahiner , Zübeyde Ezgi Erçelik

https://doi.org/10.26650/jchild.2023.1327823

Abstract

Amaç: Aşı uygulamaları, bebeklik dönemindeki ağrı ve en acı verici prosedürlerden biri olup hem bebekler hem de ebeveynleri için endişe ve sıkıntı yaratıcı durumdur. Araştırma; aşı uygulamaları sırasında kullanılan siyah beyaz dikkati başka yöne çekme kartlarının bebeklerde hissedilen akut ağrı düzeyine etkisini belirlemek amacı ile planlandı.
Gereç ve Yöntem: Randomize kontrollü araştırmanın örneklemini aile sağlığı merkezine 5’li karma aşının 2. veya 3. dozu için başvuran vaka seçim kriterlerine uyan toplam 119 (dikkati başka yöne çekme grubu (n=60), kontrol grubu (n=59)) bebek oluşturdu. Veriler bebek ve ailenin tanıtıcı özelliklerini içeren bilgi formu ve FLACC ağrı değerlendirme ölçeği kullanılarak elde edildi.
Bulgular: Dikkati başka yöne çekme yönteminin uygulandığı grupta yer alan yenidoğanların (2.76 ± 2.06) işlemsel ağrı puan ortalamaları kontrol grubuna (4.61 ± 2.00) göre anlamlı derecede düşüktü (p < 0.01). Hem deney hem de kontrol grubunda yer alan yenidoğanların toplam ağlama süreleri ile ilk sakinleşme süreleri arasında istatiksel yönden anlamlılık bulunmadı (p>0.05).
Sonuç: Sonuç olarak, aşı uygulamaları sırasında hissedilen ağrıyı azaltmada dikkati başka yöne çekme kartlarının etkili olduğu belirlendi. Bu sonuçlar doğrultusunda; bebeklerin aşı uygulamaları sırasında ağrıya hassasiyetini azaltmak için kolay uygulanabilir bir yöntem olarak dikkati başka yöne çekme kartlarının hemşireler tarafından kullanımı önerilmektedir.

Keywords

ağrı aşılama dikkati başka yöne çekme

Project Number

BAP-19-1004-003

References

  • Bozkurt G. Immune system and immunization. In: Genç RE, Özkan H editors. Newborn Health and Diseases Book for Midwives. Istanbul, Türkiye: Nobel Medical Bookstore, 2016:393. google scholar
  • Özümit D. Investigation of validity and validity of Turkish attitudes to the foreign affairs. [master’s thesis]. İzmir: İzmir Kâtip Çelebi University, Health Science Institue, 2019. google scholar
  • Santo Fontes V, Nunes Ribeiro CJ, Neves Dantas RA, Oliveira Ribeiro MC. Pain relief strategies during immunization. Br J Pain. Sao Paulo. 2018;1(3):270-3. google scholar
  • Gad RF, Dowling DA, Abusaad FE, Bassiouny MR, Abd El Aziz MA. Oral Sucrose Versus Breastfeeding in Managing Infants’ Immunization-Related Pain: A Randomized Controlled Trial. MCN Am J Matern Child Nurs. 2019;44(2):108-114. doi:10.1097/ NMC.0000000000000512 google scholar
  • Gennis H, Pillai Riddell R, O’Neill MC, Katz J, Taddio A, Garfield H, et al. Parental Psychological Distress Moderates the Impact of a Video Intervention to Help Parents Manage Young Child Vaccination Pain. J Pediatr Psychol. 2018;43(10):1170-1178. doi:10.1093/jpepsy/jsy058 google scholar
  • Derebent E, Yigit R. Pain in newborn: Assesment and management. Cumhuriyet University School of Health Journal 2006;10(2):41-48. google scholar
  • Srouji R, Ratnapalan S, Schneeweiss S. Pain in children: assessment and nonpharmacological management. Int J Pediatr. 2010;2010:474838. doi:10.1155/2010/474838 google scholar
  • Inal S, Canbulat N. Using of distraction methods on procedural pain management of pediatric patients. Journal of Current Pediatrics 2015;13(2):116-21. google scholar
  • Göl İ, Altuğ Özsoy S. Evidence-Based applications to reduce pain in vaccine injections. Turkiye Klinikleri J Public Health Nurs-Special Topics 2017b;3(1):39-45. google scholar
  • WHO. Reducing pain at the time of vaccination: WHO position paper, September 2015-Recommendations. Vaccine. 2016;34(32):3629-3630. doi:10.1016/j.vaccine.2015.11.005 google scholar
  • Kassab M, Hamadneh S, Nuseir K, ALmomani B, Hamadneh J. Factors Associated With Infant Pain Severity Undergoing Immunization Injections. J Pediatr Nurs. 2018;42:e85-e90. doi:10.1016/j.pedn.2018.04.002 google scholar
  • Taddio A, Appleton M, Bortolussi R, Chambers C, Dubey V, Halperin S, et al. Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline (summary). CMAJ. 2010;182(18):1989-1995. doi:10.1503/cmaj.092048 google scholar
  • Caglar S, Büyükyılmaz F, Coşansu G, Çağlayan S. Effectiveness of ShotBlocker for Immunization Pain in Full-Term Neonates: A Randomized Controlled Trial. J Perinat Neonatal Nurs. 2017;31(2):166-171. doi:10.1097/JPN.0000000000000256 google scholar
  • Nieto Garda A, Berbel Tornero O, Monleon Sancho J, Alberola-Rubio J, Lopez Rubio ME, Pico Sirvent L. Evaluacion del dolor en ninos de 2, 4 y 6 meses tras la aplicacion de metodos de analgesia no farmacologica durante la vacunacion [Evaluation of pain in children of 2, 4 and 6 months after the application of non-pharmacological analgesia methods during vaccination]. An Pediatr (Engl Ed). 2019;91(2):73-79. doi:10.1016/j. anpedi.2018.10.002 google scholar
  • Shahid R, Benedict C, Mishra S, Mulye M, Guo R. Using iPads for distraction to reduce pain during immunizations. Clin Pediatr (Phila). 2015;54(2):145-148. doi:10.1177/0009922814548672 google scholar
  • Harrison D, Wilding J, Bowman A, Fuller A, Nicholls SG, Pound CM, et al. Using YouTube to Disseminate Effective Vaccination Pain Treatment for Babies. PLoS One. 2016;11(10):e0164123. Published 2016 Oct 3. doi:10.1371/journal.pone.0164123 google scholar
  • Şıktaş Ö, Uysal G. The Effect of Buzzy Application on Pain Level During Vaccine Injection in Infants. J Nurs Care Qual. 2023;38(1):E9-E15. doi:10.1097/NCQ.0000000000000656 google scholar
  • Güngör T, Öztürk Şahin Ö. Analysis of two non-pharmacological pain management methods for vaccine injection pain in infants: A randomized controlled trial. Bebeklerde aşı enjeksiyonu ağrısında iki non-farmokolojik ağrı yönetim metodu: Randomize kontrollü bir çalışma. Agri. 2021;33(1):15-22. doi:10.14744/ agri.2020.54289 google scholar
  • Ozdemir FK, Tüfekci FG. The effect of using musical mobiles on reducing pain in infants during vaccination. J Res Med Sci. 2012;17(7):662-667. google scholar
  • Chen J. Beyond black and white: heibaika, neuroparenting, and lay neuroscience. BioSocieties 2021;16:70-87. google scholar
  • Koç T, Gözen D. The Effect of Foot Reflexology on Acute Pain in Infants: A Randomized Controlled Trial. Worldviews Evid Based Nurs. 2015;12(5):289-296. doi:10.1111/wvn.12099 google scholar
  • Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23(3):293-297. google scholar
  • http://mesmerised.com.au/product/baby-flashcards/ Accessed 03 March 2020. google scholar
  • Pancekauskaite G, Jankauskaite L. Paediatric Pain Medicine: Pain Differences, Recognition and Coping Acute Procedural Pain in Paediatric Emergency Room. Medicina (Kaunas). 2018;54(6):94. Published 2018 Nov 27. doi:10.3390/medicina54060094 google scholar
  • Özdemir A, Kürtüncü M. Use of distraction techniques on during the invasive processes of pediatric patients. SSTB International Refereed Academic Journal of Sports, Health and Medical Sciences 2017;24:48-60. google scholar
  • Chad R, Emaan S, Jillian O. Effect of virtual reality headset for pediatric fear and pain distraction during immunization. Pain Manag. 2018;8(3):175-179. doi:10.2217/pmt-2017-0040 google scholar
  • Modanloo S, Stacey D, Dunn S, Choueiry J, Harrison D. Parent resources for early childhood vaccination: An online environmental scan. Vaccine. 2019;37(51):7493-7500. doi:10.1016/j.vaccine.2019.09.075 google scholar
  • Bekar P, Efe E. Effects of mother-sung lullabies on vaccination-induced infant pain and maternal anxiety: A randomized controlled trial. J Pediatr Nurs. 2022;65:e80-e86. doi:10.1016/j. pedn.2022.03.003 google scholar
  • Vaziri F, Khosropoor M, Hidari M, Pourahmad S, Morshed Behbahani B, Saki F. The Effect of Aromatherapy by Lavender Oil on Infant Vaccination Pain: a Double Blind Randomized Controlled Trial. J Caring Sci. 2019;8(1):17-21. Published 2019 Mar 1. doi:10.15171/jcs.2019.003 google scholar
  • Gedam DS, Verma M, Patil U, Gedam S. Effect of distraction technique during immunization to reduce behaviour response score (FLACC) to pain in toddlers. J Nepal Paediatr Soc. 2013;33(1):25-30. google scholar
  • Göl İ, Altuğ Özsoy S. Effects of Rapid Vaccine Injection Without Aspiration and Applying Manual Pressure Before Vaccination on Pain and Crying Time in Infants. Worldviews Evid Based Nurs. 2017;14(2):154-162. doi:10.1111/wvn.12206 google scholar
  • Karakuş Türker T. Comparing the effects of kangaroo care and breastfeeding in reducing the pain due to hepatitis B vaccination in newborns [master’s thesis]. İstanbul: Istanbul University, Health Science Institue, 2018. google scholar
There are 32 citations in total.

Details

Primary Language English
Subjects Podiatry
Journal Section Research Articles
Authors

Diler Yılmaz 0000-0003-4043-0411

Nejla Canbulat Şahiner 0000-0003-3322-5372

Zübeyde Ezgi Erçelik 0000-0001-6872-6949

Project Number BAP-19-1004-003
Publication Date October 24, 2023
Published in Issue Year 2023 Volume: 23 Issue: 3

Cite

APA Yılmaz, D., Canbulat Şahiner, N., & Erçelik, Z. E. (2023). The Effect of the Use of Black and White Flashcards on Acute Pain Levels in Infants. Journal of Child, 23(3), 285-291. https://doi.org/10.26650/jchild.2023.1327823
AMA Yılmaz D, Canbulat Şahiner N, Erçelik ZE. The Effect of the Use of Black and White Flashcards on Acute Pain Levels in Infants. Journal of Child. October 2023;23(3):285-291. doi:10.26650/jchild.2023.1327823
Chicago Yılmaz, Diler, Nejla Canbulat Şahiner, and Zübeyde Ezgi Erçelik. “The Effect of the Use of Black and White Flashcards on Acute Pain Levels in Infants”. Journal of Child 23, no. 3 (October 2023): 285-91. https://doi.org/10.26650/jchild.2023.1327823.
EndNote Yılmaz D, Canbulat Şahiner N, Erçelik ZE (October 1, 2023) The Effect of the Use of Black and White Flashcards on Acute Pain Levels in Infants. Journal of Child 23 3 285–291.
IEEE D. Yılmaz, N. Canbulat Şahiner, and Z. E. Erçelik, “The Effect of the Use of Black and White Flashcards on Acute Pain Levels in Infants”, Journal of Child, vol. 23, no. 3, pp. 285–291, 2023, doi: 10.26650/jchild.2023.1327823.
ISNAD Yılmaz, Diler et al. “The Effect of the Use of Black and White Flashcards on Acute Pain Levels in Infants”. Journal of Child 23/3 (October 2023), 285-291. https://doi.org/10.26650/jchild.2023.1327823.
JAMA Yılmaz D, Canbulat Şahiner N, Erçelik ZE. The Effect of the Use of Black and White Flashcards on Acute Pain Levels in Infants. Journal of Child. 2023;23:285–291.
MLA Yılmaz, Diler et al. “The Effect of the Use of Black and White Flashcards on Acute Pain Levels in Infants”. Journal of Child, vol. 23, no. 3, 2023, pp. 285-91, doi:10.26650/jchild.2023.1327823.
Vancouver Yılmaz D, Canbulat Şahiner N, Erçelik ZE. The Effect of the Use of Black and White Flashcards on Acute Pain Levels in Infants. Journal of Child. 2023;23(3):285-91.
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