A Report on Reduction of Pain During Immunization by Oral Glucose

This report investigates the effectiveness of administering oral glucose solutions to reduce pain during infant immunization. The study employs a semi-experimental design to assess the analgesic properties of 25% and 75% sucrose solutions on infants aged 16 to 19 months, comparing them against a control group receiving sterile water. Data was collected through videotaping and analyzed to measure crying times and pain scales. The simple random sampling technique ensured unbiased group allocation. The results indicated high statistical significance, suggesting that oral sucrose solutions can effectively reduce pain during immunization. The findings can be generalized to pediatric departments and immunization centers, offering a potential solution to improve adherence to immunization schedules and reduce needle phobia in children. Desklib provides access to this report along with a wealth of other solved assignments and past papers to support student learning.

Running head: Reduction of pain during immunization
1
Reduction of pain during immunization by administration of oral glucose
Name
Institutional affiliation

Reduction of pain during immunization 2
1. Background of the study
a. The unpleasant nature of the pain associated with childhood immunization is the main
concern in the study. Pain causes distress, anxiety and fear among children and their
parents during immunization. These negatively affect adherence to immunization
schedules making them skip some vaccinations. In addition, the fear and anxiety
negatively impact the health-seeking behaviour in children both when they are still young
and when they grow up into adults (McNair, (2013). Needle phobia is just one of the
results of the pain associated with the immunization procedures (McMurty et al. 2015).
b. Majority of the studies carried out to address the same issue did not show any Significant
differences when Oral sucrose solution was used before immunization procedures and
when it was not used (Dilli, 2009). The results obtained from these studies pointed out a
reduction in crying time of infants under oral sucrose. The results were however not
deemed significant owing to the lower concentrations of the sucrose solutions used and
the small sample sizes used.
c. The study is important and significant in establishing a solution to the pain that
accompanies immunization. The study seeks a lasting solution that will see improved
adherence to immunization schedules by infants with the help of their parents, and
improve their health seeking behaviour.
2. Overview of the research design
a. The main aim of the research was to ascertain whether administering 2 ml of a 25%
sucrose or a 75% sucrose solution reduces the crying time of infants and an
established pain scale. The study was to establish whether an oral sucrose solution has

Reduction of pain during immunization 3
analgesic properties to infants and if there are, what concentration is required for
optimal effect.
b. A semi-experimental research design was employed in this study. Also called a field
experiment, it's a design that examines an intervention (administration of oral sucrose
solutions in this case) in a real-life situation as opposed to laboratory experiments.
c. The main characteristics of a semi-experimental research design (field experiment)
include:
i. It examines interventions in the natural world like administration
of oral sucrose to infants to observe its effect on pain.
ii. Subjects or participants are generally randomized just like in
laboratory experiments.
iii. The design offers a higher external validity because results are
obtained from the real world.
iv. The design also suffers a likelihood of contamination since it’s
more difficult to control variables with precision in the field.
d. The design chosen has the ability to yield results from administration of the oral
sucrose solutions to infants, this being a field experiment. It’s also best suited in
comparing the results obtained from participants under different concentrations of
sucrose owing to its ability to randomize the participants. It enabled the researchers to
analyze the analgesic properties of sucrose under different concentrations and when it
was not used.
3. Sampling
a. The infants who participated in the study had the following characteristics:

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i. All infants who participated in the study were born at term
ii. They were born with a normal birth weight
iii. They were otherwise healthy with no other preexisting health conditions
iv. The had routine standard child care
v. They were aged between sixteen and nineteen months
b. Six hundred and ninety-four healthy children and infants who were receiving regular
vaccinations at the health centre were chosen and randomized. However, only 537 infants
had their results analyzed. The criteria that were used to include them in the study and
leave 157 out was based on whether the infants were born of normal birth weight, born at
term, healthy and had received only routine good child care. The 157 infants did not meet
one or more of the above four criteria.
c. It is important to have all the above criteria identified recruiting participants to avoid
recording and analyzing results from unqualified subjects. It’s also not necessary to waste
time and resources on participants whose results will be affected by other variables hence
yielding invalid results that cannot be used to make generalizations. This also to make
sure that recruits are representative of the general population.
d. Simple random sampling is used to group the participants into three categories. The first
category was given 25% sucrose solutions, the second group 75% sucrose solutions and
the last group, a sterile water solution. The third group was, therefore, the control group.
e. The sampling technique (simple random sampling) used ensured there was no bias in
selecting participants who received the sterile water or the different concentrations of
sucrose solutions. Every subject had an equal chance of falling into any group. This was
appropriate in making valid conclusions about the analgesic properties of oral sucrose.

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4. Data collection
a. The data in the study was collected by videotaping. The videos recorded were later
analyzed to extract the ‘crying time” of every participant. The duration of crying from the
infants was then recorded in tables according to their respective groups. The ages and
genders of the infants had been recorded earlier before the immunization procedures
began.
b. Mothers sat with their infants, holding them with their hands. Nurses handled them as
usual. They ensured the infants were fully awake as the procedure was being carried out.
The nurse administered the 2 ml of the random solution that had been prepared earlier by
a pharmacist. Two minutes later, the oral polio vaccine was administered first followed
by the other injectable vaccines in the left and right deltoid areas. The whole procedure
was recorded on video.
c. Videotaping was the perfect procedure for recording data in this study. It's more accurate
to measure the crying times on video record since a computer can be used to improve
accuracy. It would have been tedious for a human to measure the duration of crying with
a stop-watch which is subject to human error. This fits a study aimed to obtain and
compare the crying times of infants as a measure of pain reduction during immunization.
d. The advantages of videotaping were that it reduced the errors that could have resulted
from manually obtaining crying times, the method was suitable for obtaining information
from infants without interfering with them and it was also able to store the information
for future reference at the same time. The method is, however, costlier and requires some
expertise to record and extract information from it (Albuquerque, 2014).

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e. Alternative methods that the researchers could have chosen include voice recording and
observation as opposed to video recording.
5. Data analysis and results
a. The data collected was recorded in tables and subjected to statistical analysis. Various
tests such as the mean crying times, mean age and variance tests were done on the results
and recorded side by side for the three groups.
b. Statistical analysis of the figures obtained in the tables was the most appropriate way of
analyzing the data. Researchers were able to obtain mean crying times and compare them
to the three groups. This being a quantitative steady a statistical quantitative analysis
method was justified.
c. The researchers reported that their analysis was trustworthy since they used basic proven
scientific methods to analyze. With the proper analysis and high significance that was
obtained from the study analysis, and how correctly the standard procedures were
followed during the study, the researchers concluded that the study was rigorous.
d. The researchers described the results as having a high statistical significance. This is due
to a larger sample size that was used compared to the previous studies.
e. These results can be generalized in several other populations or settings. These include
pediatric departments in other hospitals with infants aged 16 to 19 years and other
immunization centres across the world. This is because the results were representative of
the rest of the infants within the same age bracket.

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References
Albuquerque, U. P., Ramos, M. A., de Lucena, R. F. P., & Alencar, N. L. (2014). Methods and
techniques used to collect ethnobiological data. In Methods and techniques in
Ethnobiology and Ethnoecology (pp. 15-37). Humana Press, New York, NY.
El-Magd, A. N. A., Ali, B. A. E. M., El-Kreem, H. E. A., & Mohammed, N. T. (2014). Effect of
oral Sucrose administration on reducing the infantile sensation of pain during obligatory
immunizations at Minia City
Farkas, C., Solodiuk, L., Taddio, A., Franck, L., Berberich, F. R., LoChiatto, J., & Solodiuk, J.
C. (2015). Publicly Available Online Educational Videos Regarding Pediatric Needle
Pain. The Clinical journal of pain, 31(6), 591-598.
Friedrichsdorf, S. J., Postier, A., Eull, D., Weidner, C., Foster, L., Gilbert, M., & Campbell, F.
(2015). Pain outcomes in a US children’s hospital: a prospective cross-sectional
survey. Hospital pediatrics, 5(1), 18-26.
Karlsson, K., Rydström, I., Nyström, M., Enskär, K., & Englund, A. C. D. (2016). Consequences
of needle-related medical procedures: A hermeneutic study with young children (3–7
years). Journal of Pediatric Nursing: Nursing Care of Children and Families, 31(2),
e109-e118.
McMurtry, C. M., Riddell, R. P., Taddio, A., Racine, N., Asmundson, G. J., Noel, M., ... & Shah,
V. (2015). Far from “just a poke”: common painful needle procedures and the
development of needle fear. The Clinical journal of pain, 31(Suppl 10), S3.

Reduction of pain during immunization 8
McNair, C., Yeo, M. C., Johnston, C., & Taddio, A. (2013). Non-pharmacological Management
of Pain During Common Needle Puncture Procedures in Infants. Clinics in
Perinatology, 40(3), 493-508.
McCall, J. M., DeCristofaro, C., & Elliott, L. (2013). Oral sucrose for pain control in non-
neonate infants during minor painful procedures. Journal of the American Association of
Nurse Practitioners, 25(5), 244-252.
Shah, V., Taddio, A., McMurtry, C. M., Halperin, S. A., Noel, M., Riddell, R. P., & Chambers,
C. T. (2015). Pharmacological and combined interventions to reduce vaccine injection
pain in children and adults: systematic review and meta-analysis. The Clinical journal of
pain, 31(Suppl 10), S38.
Sullivan, J. R. (2012). Skype: An appropriate method of data collection for qualitative
interviews? The Hilltop Review, 6(1), 10.
Weerahandi, S. (2013). Exact statistical methods for data analysis. Springer Science & Business
Media.
Zhou, F., Shefer, A., Wenger, J., Messonnier, M., Wang, L. Y., Lopez, A., ... & Rodewald, L.
(2014). Economic evaluation of the routine childhood immunization program in the
United States, 2009. Pediatrics, 133(4), 577-585.