Material & Methods
Following approval by the Ethics Committee of
the University of Welfare and Rehabilitation
Sciences and informed consent from the parents,
data were collected from 100 healthy newborns
delivered at Shariati hospital in Bandar Abbas
City (Iran). Inclusion criteria were birth weight
between 2500 and 4000 grams, age of birth 2 to
24 hours, Apgar Scores of at least 7 at 1 minute,
estimated gestational age of at least 37 weeks,
heart rate between 100 and 160 per minute, blood
02 saturation ≥95% and no known congenital
anomalies. Exclusion criteria were caesarean
section, administration of a vaccination or any
injection, birth trauma, ill neonate and drug abuse
by the mother in pregnancy. The neonates were
randomly assigned to intervention and control
groups. The number of samples in each group
was 50. Demographic characteristics were
essentially homogenous between the 2 groups
(Table 1). Mean birth weight was 3083.2 grams
(SD= 258.3) and 3142.2 (SD=242.3) in
intervention and control groups respectively.
Data were collected in a quiet room in the
nursery. The infants were brought to a quiet, alert state at the start of data collection. Control
infants were wrapped in their receiving blanket
and placed on their side in their respective
bassinets. Mothers, whose infants had been
assigned to receive contact, changed into a
hospital gown that buttoned in front and returned
to their beds that had been adjusted to a 45° angle
to provide a comfortable reclining position. Then
the infant, wearing only a diaper, was then
positioned on the mother so that skin-to-skin
contact was maintained through her open gown.
Two receiving blankets were placed over the
infant’s back. The mothers then were asked to
lock their fingers, place their hands over the
blankets, and apply a slight pressure on their
infant’s back to stabilize the infant for both
procedural ease and to facilitate video recording.
The mothers were requested not to rub their
infant’s head, speak with their neonates, shake
them, or touch them before, during, or after the
injection. At this point, the experimenters left the
room for 10 minutes, so that mother and infant
could settle into a relaxed contact position. On
return, we found infants in both groups to be in a
relaxed and quiet state. So the sequence of phases
was as follows:
1. Placement of pulse oximeter (NTB195) probe
and the heart rate and blood O2 saturation
obtained before intervention.
2. Intervention. KC, 10 minutes before injection
until 3 minutes after injection.
3. Procedure. The vastus lateralis muscle was
grasped, swabbed and 0.5 ml vitamin K injected with a 30 guage needle; pressure at
the site of injection was held with a sterile
gauze. The duration of procedure was 2
minutes. To minimize variability of the
stimulus, the same nurse performed all the
injections.
4. Two minutes before, immediately and 3
minutes post-procedure data collection for
heart rate and blood 02 saturation.
Data were analyzed using SPSS for Windows.
Independent-t, Mann-Whitney and Chi-square
tests were used for analysis. Kolmogrov-Smirnov
test was used to check normality of distributions.