A Study to Assess the Effectiveness of Foot Massage on Pain and Physiological Parameters During Heel Lancing Among Term Neonates in a Selected Hospital at Odisha

Abstract

Background: Pain is a common and a universal sensation for children and adult. Every child has his or her own perception of pain. Routine procedure like heel lancing is the most frequent painful medical procedure during neonatal period. A fundamental principle of medical care is “do not hurt” but “do not harm” since pain is harmful to children, the care givers are committed in preventing harm to their patients. Pain is a major source of distress for children and their families as well as health care providers. Foot massage technique is one of the methods which inhibit the transmission of pain along the ascending fibers by closing gate pathways during heel lancing. Objectives: 1. To assess the level of pain during heel lancing among term neonates in control group. 2. To assess the level of pain after foot massage during heel lancing among term neonates among experimental group. 3. To assess the physiological parameters after heel lancing among term neonates in control group. 4. To assess the physiological parameters after foot massage during heel lancing among term neonates in experimental group. 5. To find the correlation between level of pain and physiological parameters after foot massage during heel lancing among term neonates in experimental group. Setting and Design: A quantitative research approach with quasi - experimental research design was adopted for the study. 60 neonates were selected by purposive sampling as samples from NICU of Christian hospital Bissam cuttack Odisha. Material and Methods: For the present study the instrument used for data collection includes: 1. Structured questionnaire to assess the socio-demographic variables. 2. Neonatal/infant pain scale (NIPS) to assess level of pain during heel lancing. 3. Duration of cry to assess level of pain during heel lancing. 4. Portable neonatal/infant pulse oximetry to assess physiological parameters i.e., heart rate and oxygen saturation. Results: To evaluate the effectiveness of foot massage on duration of cry during heel lancing among term Neonates, un paired ‘t’ test was computed which shows that the calculated ‘t’ value is 3.32 at df 58 at the level of 0.05 significance which is greater than the table value. This depicts that there is a significant difference in the duration of cry between control group and experimental group. This indicated that the foot massage technique was effective on duration of cry during heel lancing among Neonates. To evaluate the effectiveness of foot massage on oxygen saturation after heel lancing among term neonates, unpaired ‘t’ test was computed which depicts that the calculated ‘t’ value is -4.91 at df 58 at the level of 0.05 which is less than the table value. This depicts that there is no significant difference in the oxygen saturation between control group and experimental group. This shows that the foot massage technique was not effective on oxygen saturation during heel lancing among term neonates. Karl Pearson’s correlation co-efficient was computed which shows that there is significant correlation between neonatal infant pain score and heart rate. Statistical analysis interprets that the calculated ‘r’ value of experimental group is 0.06 which shows that there is moderately positive correlation between neonatal infant pain score and heart rate during heel lancing in neonates. Karl Pearson’s correlation co-efficient was computed which shows that there is significant correlation between neonatal infant pain score and oxygen saturation. Statistical analysis interprets that the calculated ‘r’ value of experimental group is -0.13 which shows that there is moderately negative correlation between neonatal infant pain score and oxygen saturation during heel lancing in neonates.