Comparison of mother’s therapeutic touch and voice stimulus in reduce pain in premature infants undergoing invasive procedures

Published: 20 May 2021
Abstract Views: 2426
PDF: 622
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


  • Defi Efendi Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java; Neonatal Intensive Care Unit, Universitas Indonesia Hospital, Depok, West Java, Indonesia.
  • Nining Caswini Pediatric Special Care Unit, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
  • Reisy Tane Faculty of Nursing, Health Institute Deli Husada Deli Tua, Deli Tua, North Sumatera, Indonesia.
  • Maria Dyah Kurniasari College of Nursing, Taipei Medical University, Taipei, Taiwan; Faculty of Medicine and Health Science, Universitas Kristen Satya Wacana, Salatiga, Central of Java, Indonesia.
  • Huda Mega Hasanul College of Nursing, Taipei Medical University, Taipei, Taiwan.
  • Raudha Ilmi Farid Neonatal Intensive Care Unit, Universitas Indonesia Hospital, Depok, West Java, Indonesia.

Invasive procedures commonly cause recurring pain in preterm infants. Noninvasive pain management is an essential part of nursing intervention in the Neonatal Intensive Care Unit (NICU). The study’s aim is to identify the impact of touch therapy on pain in premature infants undergoing invasive treatments. The method was a quasi- experiment with 63 premature infants. The premature infants were classified into four groups: i) Mother’s touch Therapy (MTT), ii) Mother’s Voice Stimulus (MVS), iii) a combination of MTT and MVS, and iv) routine care. The observed infants’ pain scores were determined through a multiple regression model using the Generalized Estimating Equation (GEE) method. The GEE test showed that the combination of touch and sound therapy significantly reduced pain in premature infants undergoing invasive measures (p<0.05). A combined application of MTT and MVS is the most effective in reducing pain scores in infants undergoing invasive procedures and thus, can used safely as part of nursing intervention in the NICU.

Cruz MD, Fernandes AM, Oliveira CR. Epidemiology of painful procedures performed in neonates: a systematic review of observational studies. Eur J Pain 2016;20:489-98. DOI:

Johnston C, Campbell-Yeo M, Disher T, et al. Skin-to-skin care for procedural pain in neonates. Cochrane Database Syst Rev 2017;2:CD008435. DOI:

Qiu J, Jiang YF, Li F, et al. Effect of combined music and touch intervention on pain response and β-endorphin and cortisol concentrations in late preterm infants. BMC Pediatr 2017;17:38. DOI:

Korja R, Latva R, Lehtonen L. The effects of preterm birth on mother-infant interaction and attachment during the infant’s first two years. Acta Obstet Gynecol Scand 2012;91:164-73. DOI:

Montirosso R, Provenzi L, Calciolari G, et al. Measuring maternal stress and perceived support in 25 Italian NICUs. Acta Paediatr 2012;101:136-42. DOI:

Kaffashi F, Scher MS, Ludington-Hoe SM, Loparo KA. An analysis of the kangaroo care intervention using neonatal EEG complexity: a preliminary study. Clin Neurophysiol 2013;124:238-46. DOI:

Jefferies AL, Canadian Paediatric Society, Fetus and Newborn Committee. Kangaroo care for the preterm infant and family. Paediatr Child Health 2012;17:141-6. DOI:

Segers E, Ockhuijsen H, Baarendse P, et al. The impact of family centred care interventions in a neonatal or paediatric intensive care unit on parents’ satisfaction and length of stay: a systematic review. Intensive Crit Care Nurs 2019;50:63-70. DOI:

Pillai Riddell RR, Racine NM, Gennis HG, et al. Non-pharmacological management of infant and young child procedural pain. Cochrane Database Syst Rev 2015;2015:CD006275. DOI:

Paixão MJG. Breastfeeding for procedural pain in infants beyond the neonatal period. Clin Nurse Spec 2018;32:116-7. DOI:

Field T. Touch for socioemotional and physical well-being: a review. Dev Rev 2010;30:367-83. DOI:

Hanley MA, Coppa D, Shields D. A practice-based theory of healing through therapeutic touch: advancing holistic nursing practice. J Holist Nurs 2017;35:369-81. DOI:

Bijari BB, Iranmanesh S, Eshghi F, Baneshi MR. Gentle human touch and yakson: the effect on preterm’ s behavioral reactions. ISRN Nurs 2012;2012:750363. DOI:

Alipour Z, Eskandari N, Ahmari Tehran H, et al. Effects of music on physiological and behavioral responses of premature infants: a randomized controlled trial. Complement Ther Clin Pract 2013;19:128-32. DOI:

Gargano G, Nuccini F. Maternal voice and preterm infants development. Ital J Pediatr 2015;41:A14. DOI:

Neal DO, Lindeke LL. Music as a nursing intervention for preterm infants in the NICU. Neonatal Netw 2008;27:319-27. DOI:

Malarvizhi G, Vatsa M, Roseline M, et al. Inter-rater reliabilty of neonatal infant pain scale (NIPS) as a multidimensional behavioral pain tool. Journal of Health and Allied Sciences NU 2012;02:26-30. DOI:

Cignacco E, Hamers JP, van Lingen RA, et al. Pain relief in ventilated preterms during endotracheal suctioning: a randomized controlled trial. Swiss Med Wkly 2008;138:635-45.

Oktaviani E, Rustina Y, Efendi D. Facilitated tucking effective to pain relief on the preterm infants in perinatal unit in Jakarta. Jurnal Keperawatan Indonesia 2018;21:9-16. DOI:

Hartley KA, Miller CS, Gephart SM. Facilitated tucking to reduce pain in neonates: evidence for best practice. Adv Neonatal Care 2015;15:201-8. DOI:

Krueger C. Exposure to maternal voice in preterm infants: a review. Adv Neonatal Care 2010;10:13-8. DOI:

Williamson S, McGrath JM. What are the effects of the maternal voice on preterm infants in the NICU? Adv Neonatal Care 2019;19:294-310. DOI:

Honda N, Ohgi S, Wada N, et al. Effect of therapeutic touch on brain activation of preterm infants in response to sensory punctate stimulus: a near-infrared spectroscopy-based study. Arch Dis Child Fetal Neonatal Ed 2013;98:F244-8. DOI:

Picciolini O, Porro M, Meazza A, et al. Early exposure to maternal voice: effects on preterm infants development. Early Hum Dev 2014;90:287-92.. DOI:

Efendi, D. ., Caswini, N., Tane, R., Kurniasari, M. D., Hasanul, H. M., & Farid, R. I. (2021). Comparison of mother’s therapeutic touch and voice stimulus in reduce pain in premature infants undergoing invasive procedures. La Pediatria Medica E Chirurgica, 43(s1).


Download data is not yet available.