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The evaluation of procedural pain within the laboratory screening of newborns.
PELENKOVÁ, Radka
Pain in newborns is nowadays considered a coherent, commonly used term. Pain in newborns can be diagnosed and then successfully treated through evaluation methods adjusted to the age of a child. Correct evaluation and treatment of pain are fundamental needs of every individual including newborns. Newborn screening is active and full-area searching of congenital or heredetary diseases and their disorders in the preclinical state, before they can become apparent. Laboratory screening, which we will focus on in this work, is made by taking capillary blood of newborn. Capillary blood is taken from the heel and different tools can be used. Our aim was to find out, if there are any differences between the newborn pain using two different tools. Second aim was to find out, if there are any differences between the difficulty of blood sampling using two different tools. The third aim was to map benefits and disadvantages of the two tools from the point of view of the staff. Quantitative and qualitative survey was used for the research. The investigation of the quantitative survey was realized by the method of observation of the blood sample collection and evaluation of pain according to the NFCS scale. The observation took place in Nemocnice České Budějovice a.s. and Nemocnice Tábor a.s. Verification of the hypotheses were made by statistical test called t-test. Alltogether 48 blood sample collections were observed, 24 made with lancet and 24 made with tenderfoot. The qualitative survey took place in the form of individual semi-standardized interviews with the staff of the neonatology department. The interviews were manually transcribed and subsequently analyzed. We divided the interviews into individual categories and subcategories, on the basis of which clear diagrams were created. Based on observation and statistical elaboration, the hypothesis H1 was verified - There are differences in pain intensity when taking blood from the heel using different tools. It was find that the tool tenderfoot is more suitable than lancet for lower pain intensity. The hypothesis H2 was declined - There are no differences in the difficulty of the blood sample colection from the heel using different tools. From the staff's point of view, tenderfoot has many positives, its only negatives are economical and ecological effect. Nurses find tenderfoot easier to use and they also consider safety for children and staff to be one of the main benefits. Based on the research results, the use of tenderfoot can be recommended to healthcare facilities due to the ease of the blood sample collection and lower pain intensity despice higher financial costs. The aim of healthcare should be primarily the comfort of the newborn during the blood sample collection.
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