The Effectiveness of 4s’s Techniques To Physiological And Crying Duration Of Newborn

The Effectiveness of 4s’s Techniques To Physiological And Crying Duration Of Newborn

Erni Setiyorini
Pediatric Nursing STIKes Patria Husada Blitar
Blitar, Indonesia, 085645646666


For a hospital birth, there are numerouse routine procedures,  such as injection, blood sampling procedures and many other   which can administered. The procedures made newbon uncomfortable by pain then have impact to short and long term. Newborn express their pain in defferent  ways. Previous study  have  shown that newborn who experience many painful procedures may show changes to their behaviour in later childhood. The purpose of this study was determine the effect of 4s’s techniques on physiological responses and duration of crying after venous blood sampling.
We conducted a prospective, post test only control group design. Newborn consist of 46 samples, were divided   into 2 group, 23 samples control group with 1s’s technique and 23 samples treatment group with 4s’s technique. The data collected by accidental sampling at November 2014 by observation sheet. Data Analysis used T-Test and Wilcoxon Signed Rank Test.
Result showed that 4S’S technique had effect on physiological responses on pain (heart rate with p=0,004, respiratory rate with p=0,000, temperature with p=0,000) and on duration of crying with p=0,001).The 4s’s technique decrease pain on newborn with physiological responses indicator  and decrease length of crying.



Barr RG, et al. Effectiveness of educational  materials  designed to change knowledge and behaviors regarding crying and shaken-baby syndrome in mothers of newborns: a randomized, controlled trial. Peds.2009;123:972-80St. James- Roberts I: Distinguishing between infant fussing, crying and colic: How many phenomena? in Lester B,  Barr  R,  eds:Colic  and Excessive  Crying,  Report  of  the 105th Ross Conference on Pediatric Research, 1997, 3-14.
Fransson   AL1,   Karlsson   H,   Nilsson K.2005.  Temperature  variation in newborn babies: importance of   physical   contact   with   the mother. med/16244210.  acess  at  October 30, 2015.
Gupta S.2012. The 5s’s: Easing Baby pain after vaccine shots. pain-after-vaccine-shots/. Hatfield LA, Meyers MA, Messing TM. 2012. A systematic review of the effects of repeated painful procedures in infant: is there a potential to mitigate future pain responsivity?. 8p99. acess at October 30, 2015. Haouari N, Wood C, Griffiths G, Levene
The analgesic effect of sucrose in full term infants: a randomised controlled trial. BMJ. 1995 Jun 10;310(6993):1498–1500.   [PMC free article] [PubMed]
Henry P.R, Haubold K and Dobrzykowski T.M. 2004. Pain in the Healthy Full-Term Neonate: Efficacy and Safety of Interventions. ticle/481612 acess at Nopember 2015. Hockenberry   MJ   &   Wilson   D.2007. Wong’s nursing care of infants and childrens (8ted). St. Louis: Mosby Elsevier. Karp  H.2012.Happiest  baby  on  the block. Gramedia: Jakarta. Kartikawati D.2011. Buku ajar dasar–dasar kegawatdaruratan. Jakarta: Salemba Medika. Khurana S, Hall R.W, Anand KJS. 2005.
Treatment of Pain and Stress in the Neonate. http://neoreviews.aappublications. org/content/6/2/e76. acess at October 30, 2015. Medical Education Division, Brookside Associates .2007.Lesson 4: vital signs. oducts/Nursing_Fundamentals_II/ lesson_4_Section_1A.htm.   acess at october 15, 2015. Page GG.2004. Are there long – term consequences of pain in newborn in newborn or very yaoung infants. Acess at October 30,2015. Rollman  GB,  Abdel-Shaheed  J, Gillespie JM, Jones KS. 2003. Does past pain influence current pain:  biological  and psychosocial models of sex differences. n%20et%20al%20%20Past%20pa in%20Eur%20J%20Pain.pdf.
Acess at October 30, 2015. Setiyorini E. 2015. The effect of 4S’s technique to physiological and behavioral responses on newborn.  Proceeding  Book  The 1st International Nursing Confrence STIKes Hang Tuah Surabaya, June 6, 2015. Sexton S and Natale R. 2009. Risk and benefits of pacifiers. acess at October 15, 2015.
Wintiyah.2014. Pengaruh Swaddling, side position, sushing dan swinging (4S’s) terhadap durasi tangisan bayi paska prosedur pengambilan darah di Ruang Edelweis RS Ngudi Waluyo Wlingi. Skripsi. STIKes Patria Husada Blitar.
Wong DL, dkk. 2009. Buku Ajar Keperawatan Pediatrik, Ed. 6, Vol.1. Alih Bahasa Agus Sutarna dkk. Jakarta: EGC. Williams   SM, et al. 1996. Sudden Infant Death Syndrome: Insulation from Bedding and Clothing and its Effect Modifiers.  International  Journal of Epidemiology; 25, 366-75.