Kadriye GÜL, Deniz AKYILDIZ
Mediterranean Nursing and Midwifery - 2026;6(2):99-109
Objective: This study aimed to identify factors associated with pain and crying duration during the heel-stick procedure for the Guthrie test in term newborns. Method: Conducted in Adıyaman, Türkiye, from July to December 2022, this cross-sectional study used the Neonatal Infant Pain Scale to measure pain before (Phase1), during (Phase2), and after (Phase3) the procedure. Pain and crying were recorded via video for subsequent analysis, and ambient noise levels were measured using a decibel meter. Results: A total of 187 term newborns were included in the study. According to the results of multiple linear regression analysis, the main factors associated with increased pain levels during the procedure (Phase2) were the use of a syringe needle, longer blood collection duration, a higher number of individuals present in the room, and elevated noise levels. In the post-procedural phase (Phase3), the number of heel punctures and the duration of the procedure were found to be significant contributors to increased pain. Crying duration was positively associated with blood sampling from both heels, number of punctures, procedure time, environmental noise level, number of individuals present, and the pain scores in both Phase2 and Phase3. These findings indicate that increases in these factors significantly elevate both pain intensity and crying duration in newborns. Conclusion: Pain levels and crying duration in newborns increased with procedural factors such as needle type, number of punctures, use of both heels, and sampling duration, as well as environmental factors like room occupancy and noise level.
