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.