Effectiveness of Breastfeeding on reduction of pain level during Immunization among infants in selected Primary Health Centre at Rajkot

 

Ms Jadav Vibhuti M¹, Mr Sam K Prasad², Mr Jeenath Justin Doss K³

¹M.Sc. Nursing (II^nd Year), Shri Anand Institute of Nursing, Rajkot, Gujarat.

²HOD- Child Health Nursing, Shri Anand Institute of Nursing, Rajkot, Gujarat.

³Principal, Shri Anand Institute of Nursing, Rajkot, Gujarat.

 

ABSTRACT:

Child is a precious gift which has lot of potentials within, which can be the best resource for the nation if raised and molded in a good manner. Healthy children can become healthy citizens constituting healthy nation. The study was conducted to assess the effect of breastfeeding on reduction of pain level during immunization among infants at selected primary health centre, Rajkot. The research design used for the present study was quasi-experimental non- equivalent control group post test only design. By using non-probability purposive sampling technique for 60 samples were selected and effectiveness of breastfeeding on pain level during immunization was assessed by faces pain scale-revised (FPS-R). Breastfeeding given to experimental group during vaccination process and level of pain was assessed after vaccination, whereas in control group samples were assessed level of pain without giving breastfeeding. The obtained data was analyzed using ‘t’ test. The mean score of experimental and control group was 3.47 and 7.2 and the standard deviation was 2.12 and 1.83 respectively with mean difference of 3.73. The calculated ‘t’ test value 7.32 was less than the table value at 0.05 level of significance. Hence, it was concluded that provision of breastfeeding during immunization was effective to reduce the level of pain among infants.

 

 

 

INTRODUCTION:

Pain is “an unpleasant sensory and emotional experience associated with actual of potential tissue damage, or described in terms of such damage” according to the International Association for the Study of Pain.¹ The International Association further states that, “pain is subjective. Each individual learns the application of the word through experiences related to in early life.”

 

This definition emphasizes the individually of each person’s pain response and the importance of pain experiences, especially those in early life, in shaping that response. Thus, a child experience during painful medical procedures likely plays a significant role in shaping that individuals pain responses to future events.²

Pain is a perception that is often overlooked in the infant population, especially with regard to immunizations. Immunization injections are the most common painful medical procedures experienced during childhood, causing substantial distress for children, their families and health care workers.³ Evidence has shown that infants do perceive and remember pain, demonstrating heightened pain response to other painful procedures later in life. So painful experience in infants should be anticipated and prevented as much as possible.⁴

 

NEED OF THE STUDY:

Routine vaccination is an inherent part of the health care delivery system as it is the most effective health intervention in reducing the morbidity and mortality due to “vaccine preventable diseases”⁵ Immunizations are performed repeatedly throughout infancy and childhood, with the number steadily increasing overtime. In addition to causing acute pain, repeated immunization can lead to preprocedural anxiety, needle fears and health care avoidance behaviors. Further vaccine administration may also be resisted⁶ contributing to the risk of resurgence of vaccine-preventable diseases.⁷

 

According to the current centres for disease control and prevention (CDC) guidelines, infants 18 months and younger are scheduled to receive a total of 27 required immunizations, including the oral rotavirus vaccine. These infants typically receive 18 of these immunizations between birth and 6 months and may receive 1 to 6 immunizations with each well-child visit.⁸

 

The investigator, while attending well baby clinic, found that the intra muscular vaccine causes so much distress and pain to the children as well as to the parents. The investigator felt the need for application of systematic, easily available and effective distraction to reduce the pain perception of infants. In the present study the investigator plans to use breast feeding as an intervention to reduce pain perception among infants during immunization.

 

OBJECTIVES:

The objectives of the study are:

·       To assess the level of pain perceived by infants during immunization.

·       To determine the effectiveness of breastfeeding in reducing pain during immunization among infant.

·       To find out the association between the pain level among infants with their selected demographic variables.

 

HYPOTHESIS:

H₁:   There will be significant difference between the pain levels among infants.

H₂: There will be significant association between the pain levels among infants with their selected demographic variables.

 

MATERIALS AND METHODS:

Research Design:

Quasi-experimental (Non-equivalent control group post-test only) design.

 

 

Setting of the study:

The investigator conducted study at Khirasara primary health centre of Lodhika taluka at Rajkot district.

 

Population:

The population for the present study was infants with age group from 0 months to 12 months.

 

Sample:

It includes infants undergoing immunization.

 

Sample size:

The sample size for the present study will be consists of 60 infants (30 experimental and 30 control group infants).

 

Sampling Technique:

Non-probability purposive sampling technique will be used to select the sample.

 

Data analysis plan:

The collected data was analyzed using both descriptive and inferential statistics.

 

FINDINGS:

Major study findings includes,

 

Findings related to demographic variables of the study

·       Out of 60 subjects 10(33.3%) from experimental group and control group are in the age group of 3-6 months and 0-3 months respectively.

·       From 60 samples 16(53.3%) are male and 14(46.7%) are female from experimental group whereas 17(56.7%) are male and 13(43.3%) are female in control group.

·       As regard to weight 16(53.3) from experimental group and 18(60%) from control group are having 4-6 kg of weight.

·       13(43.3%) from experimental and control group are having 50-65 cm of height.

·       Majority of samples i.e. 21(70%) from experimental group and 18(%) from control group are from joint family 22(73.3%) from experimental group.

·        23(76.7%) from control group were previously exposed to any vaccine.

·       12(40%) infants from experimental and 10(33.3%) infants from control group have one sibling.

 

The calculated ‘t’ is 7.32 and the tabulated ‘t’ is 2.00 with df 58 at p<0.05 level which is highly significance.

       

The study shows that the calculated chi square value is less than tabulated value at the level of 0.05 for all the selected demographic variables except weight, which shows there is significant association between effectiveness of breastfeeding and selected demographic variables.

 

CONCLUSION:

The present study which clearly shows that there was a significant difference in pain perception during vaccination among infants between experimental and control groups. The main conclusion from this present study is that samples from selected primary health centre of Khirasara, Rajkot had shown reduction on pain level after immunization due to breastfeeding. Thus, breastfeeding technique of pain reduction is proved to be one of the best methods of pain level reduction among infants during and after immunization.

 

REFERENCES:

1.        Shabeer P Basheer & S. Yaseen Khan. A Consise Textbook of Advanced Nursing Practice.2^nd edition;168.

2.        Kelly D. Young, MD, MS, paediatric procedural pain, volume 45, mo.2: February 2005:89-90

3.        Jacobson RM et al, Vaccine Research Group Making Vaccines more acceptable-methods to prevent and minimize pain and other common adverse events associated with vaccine. Asian Journal of nursing research and education. 2001; 19:2418-27.

4.        Cheryl T, Lindberg CE. Breastfeeding as a Pain Intervention When Immunizing Infants. Journal for Nurse Practitioners 2010;6(4):287-95.

5.        Reis EC et al. Effective pain reduction for multiple immunization injections in young infants. Archives pediatric adolescent medicine 2003;157;1:1115-1120.

6.        Madlon Kay DJ, Harper PG. Too many shots? Parents, nurse and physician attitudes towards multiple simultaneous childhood vaccinations. Archives of Family Medicine. 1994;3 :610-3[PubMed]

7.        Askew GL, Finelli L, Lutz J, DeGraaf J, Siegel B, Spitalny K. Beliefs and practices regarding childhood vaccination among urban paediatric providers in New Jercy, The paediatrics.2000;96:889-92[PubMed]

8.        Amali Arumaikani. Rajiv Gandhi University of Health Sciences. Effectiveness of breast feeding on reduction of pain related behaviours among infants during immunization. April 2013.

 

 

 

 

Received on 02.09.2019         Modified on 23.09.2019

Accepted on 12.10.2019      ©A&V Publications All right reserved