Discussion
taste of breast milk, ’ pain, pain
This study showed that during and after blood sampling, the changes in the infants’ pain were significant among the study groups. So that during the blood sampling, the pain intensity of the infants in the ear muffs group with the eye shield group, the ear muffs group with the control group, and the eye shield plus ear muffs group were significantly different from each of the other groups. After blood sampling, there was a significant difference between the infants’ pain in the intervention and the control groups. This difference can be explained by the fact that controlling sound and light as two physical stimuli have an effect on the changes in the Electroencephalogram of infants, and by reducing disturbing physical stimuli, pain responses in these infants can be reduced [Wu et al. showed in their study that the pain caused by blood sampling in infants receiving the smell and taste of breast milk was less than in the group of infants under routine care [In another study conducted by Alemdar and Ozdemir [Similarly, Mater et al. investigated the effect of eye shield compared to massage on premature infants’ response to pain during venipuncture. The results showed a significant difference between the pain intensity in the eye shield group, the massage group, and the control group during and after venipuncture. However, massage significantly reduced infants’ pain compared to eye shield [Our study showed that heart rate changes were significant among the studied groups during and after blood sampling. In other words, there was a significant difference between the heart rate of infants during blood sampling in the eye shield and the control groups, the ear muffs and the control groups, and the eye shield plus ear muffs group and the eye shield, ear muffs, and the control groups. Abujarir et al.‘s study in Qatar showed that using ear muffs in the NICU had a positive effect on the infants’ vital signs. That is, during routine activities in the NICU, the heart rates in the group of infants with ear muffs were lower than that of infants without ear muffs [According to the findings of this study, the percentage of blood oxygen saturation of infants during the intervention in the ear muffs and the ear muffs plus eye shield was significantly different from the control group. Furthermore, the percentage of saturated oxygen after the intervention in the eye shield, ear muffs, and eye shield plus ear muffs groups significantly differed from that of the control group. Abujarir et al.‘s study showed that using ear muffs in NICU infants was associated with a significant increase in oxygen saturation level [One of the strengths of the present study is its randomized clinical trial design with a control group and the approach of applying non-pharmacological pain management in infants, which is rarely conducted. One of the limitations of this study is the presence of extra ward noise during the morning shift due to the alarms of devices and equipment and the crowding of personnel and students in the ward, which may affect newborns’ physiological indicators. Another limitation of the study was the slight difference in the pain score before the intervention in the groups. Although this difference was not statistically significant, it is suggested to conduct studies with a larger sample size in the future.