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Comparative Study
. 2025 Aug 16;25(1):623.
doi: 10.1186/s12887-025-05979-w.

The effect of tactile versus auditory stimulation on reducing pain associated with invasive procedures among preterm neonates at NICUs

Entsar Shehata Mohammed  1 , Seham Mohammed Elmwafie  2 , Fatma Sayed Abdelaziz Mohamed  3 , Safaa Salah Ismail  4
Affiliations
Comparative Study

The effect of tactile versus auditory stimulation on reducing pain associated with invasive procedures among preterm neonates at NICUs

Entsar Shehata Mohammed et al. BMC Pediatr. .

Abstract

Background: Preterm neonates often undergo invasive procedures during the period spent in neonatal intensive care units (NICUs), yet their ability to deal with pain is limited due to their immature nervous systems. Managing pain efficiently in this age is crucial, as recurrent or improperly controlled pain can have over-time influences on their neurological and physiological development. The study aimed to determine the effect of tactile versus auditory stimulation on reducing pain associated with invasive procedures among preterm neonates at NICUs. The study hypothesized that preterm neonates who receive tactile stimulation will exhibit lower pain scores than those who receive auditory stimulation.

Methods: A comparative (three-group) quasi-experimental design included 90 preterm neonates divided equally into three groups (tactile stimulation group = 30, auditory stimulation group = 30, and control group = 30) at NICU affiliated with Beni-Suef University Hospital. Neonatal Infant Pain Scale (NIPS) was utilized four times: before, during, immediately after, and after five minutes of each invasive procedure to collect data between March and August 2024.

Results: During the invasive procedure, preterm neonates in the tactile stimulation group showed the lowest mean scores across pain indicators, including facial expression (0.30 ± 0.466), breathing pattern (0.37 ± 0.490), arm movement (0.53 ± 0.507), leg movement (0.43 ± 0.504), state of arousal (0.70 ± 0.450), cry (0.63 ± 0.615), oxygen saturation (0.37 ± 0.490), and heart rate (0.60 ± 0.498). The total NIPS mean score was highest in the control group (8.47 ± 1.196), indicating severe pain, followed by the auditory stimulation group (5.57 ± 1.431), indicating moderate pain, and lowest in the tactile stimulation group (3.50 ± 1.225), indicating mild pain. A statistically significant difference in NIPS scores was observed among the three groups during and after the procedure (p < 0.05), while no significant difference was found before the procedure (p > 0.05).

Conclusion: Both tactile and auditory stimulation can significantly reduce pain scores in preterm neonates undergoing painful invasive procedures and are effective in improving physiological stability and neurobehavioral outcomes of premature neonates.

Implications to practice: NICUs should involve tactile and auditory stimulation interventions in the routine nursing care for hospitalized preterm neonates as safe and effective non-pharmacological techniques of pain management. So, replicating the study in other geographical settings is essential, to generalize findings to different settings.

Keywords: Auditory stimulation; Invasive procedures; Pain; Preterm neonate; Tactile stimulation.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All methods were carried out in compliance with the applicable guidelines and regulations outlined in the Declaration of Helsinki (October 2008). This study was carried out according to the ethical guidelines provided by the Ethical Scientific Research Committee of the Faculty of Nursing at Helwan University and was approved under committee session number 351072023. Formal consent was obtained from the administration of hospitals where the study was conducted before the beginning of the study. The aim of the study was explained to the parents, and their consent was obtained. Additionally, they were assured that they are allowed to withdraw from the study at any time without a specific reason. The participants were also informed that their information would be coded securely and utilized only for scientific purposes. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Sample of the study
Fig. 2
Fig. 2
Mean score of the NIPS throughout the procedure
See this image and copyright information in PMC

References

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