The effect of Helfer skin tap technique on hepatitis B vaccine intramuscular injection pain in neonates: A randomized controlled trial

Effects of the Helfer skin tap technique and Buzzy® application on the levels of pain and fear experienced by children during vaccination: A randomized controlled trial

PURPOSE

Vaccination is an invasive procedure that causes pain. Uncontrolled pain negatively affects all aspects of life, including health. This study aimed to determine the effects of the Helfer skin tap technique and Buzzy® application on the levels of pain and fear experienced by 4-year-old children during measles-mumps-rubella (MMR) vaccination.

METHODS

This study adopted a randomized controlled experimental design. The study sample consisted of 96 children (Helfer skin tap technique group: n = 32, Buzzy® group: n = 32, control group: n = 32) who received MMR vaccination. Children in the Buzzy® and Helfer skin tap technique groups received their respective interventions before and after vaccine injection, while children in the control group received routine vaccine injection.

RESULTS

Based on the parents' and nurse's observations, the pain and fear scores after vaccine injection were lowest in the Buzzy® group and highest in the control group. Based on the children's assessments, the pain scores after vaccine injection were lower in the Buzzy® group than in the Helfer skin tap technique group.

CONCLUSION

Buzzy® application and the Helfer skin tap technique have beneficial effects on children's pain and fear during MMR vaccination. Buzzy® application is more effective in reducing pain and fear during vaccine injection in children than the Helfer skin tap technique.

PRACTICE IMPLICATIONS

Nurses can increase the comfort of children by reducing pain during vaccination using Buzzy®.

The Effect of Grasp Reflex Stimulation on Pain During Vaccine Administration

BACKGROUND

The administration of vaccination, being an invasive procedure, can induce considerable pain in preterm infants.

OBJECTIVE

This study was conducted to evaluate the effect of grasp reflex stimulation on pain and crying time during hepatitis B vaccine administration in infants.

METHODS

This parallel randomized controlled trial was conducted between November 1, 2022, and April 1, 2023, at the Neonatal Intensive Care Unit of a public hospital in Turkey. The study included preterm infants whose parents provided both verbal and written consent. The control group (n = 31) underwent a routine vaccination procedure, while the experimental group (n = 28) underwent grasp reflex stimulation in addition to the routine vaccination procedure. Data were collected through the infant information form, stopwatch, and Premature Infant Pain Profile Scale-Revised (PIPP-R) form.

RESULTS

The mean PIPP-R score during the procedure was 11.67 ± 2.05 in the experimental group and 15.51 ± 1.36 in the control group (P ≤ .001). After the procedure, the mean PIPP-R score was 10.89 ± 2.06 in the experimental group and 14.67 ± 1.55 in the control group (P ≤ .001). The mean duration of crying was 19.57 ± 6.17 in the experimental group and 27.12 ± 6.19 in the control group (P ≤ .001). The mean PIPP-R and crying time of the control group were higher.

CONCLUSION

Grasp reflex stimulation applied to preterm infants during vaccine administration decreased pain and crying time during and after the procedure. Grasp reflex stimulation can be applied as a care approach for procedures that may cause pain in infants and may help calm infants as part of pain management in nursing.

IMPLICATIONS FOR PRACTICE AND RESEARCH

The results of this study provide new information to the literature regarding the impact of grasp reflex stimulation on pain and the duration of crying induced by the hepatitis B vaccine in preterm infants. To our knowledge, this is the first study to confirm the effectiveness and feasibility of grasping reflex stimulation in hepatitis B vaccine administration in preterm infants. This study may contribute to future evidence-based studies. Grasping reflex stimulation can be tried as a parent-provided intervention in younger or older infants or in those who are critically ill.

Effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection: An open-label randomized controlled study

BACKGROUND

Intramuscular injections, which children frequently experience during hospitalization, are one of the most significant causes of pain. Pain control is an important part of care. Therefore, it is necessary to provide practical methods in the field of nursing care to reduce injection-related pain.

AIM

This study aimed to determine the effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection.

METHOD

This randomized controlled clinical study (NCT05250804) was conducted in a pediatric emergency department between January and July 2022. A total of 64 children aged 4-10 years were randomly divided into two groups: 32 children in the Helfer skin tap group (HG), and 32 children in the control group (CG). Data were collected using the Wong-Baker FACES Pain Rating Scale, the Child Anxiety Scale-State, and the Child Fear Scale.

RESULTS

After the intramuscular injection, children in the HG had significantly lower levels of pain, anxiety, and fear than those in the CG, with mean scores of 3.25±1.50 versus 5.18±1.51, 5.87±1.56, versus 6.23±1.46, and 1.68±0.53 versus 3.15±0.76, respectively (p<0.001 for all scores).

CONCLUSION

The Helfer skin tap technique has positive effects on pain, anxiety, and fear in children during intramuscular injection. This technique can be used by nurses to reduce the pain, anxiety, and fear felt by children receiving an intramuscular injection.