Document Type : original article


1 Educator, Department of Pediatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Student, Research Committee, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.

3 Pediatrics Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

4 MSc Student of Neonatal Intesive Care Unit Nursing, Department of Pediatric Nursing and Student Research Committee, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.


The most common cause of admission to neonatal intensive care units (NICU) is respiratory distress syndrome. One of the respiratory assistance methods is using nasal continuous positive airway pressure (CPAP). Regarding the importance of pain control which is one of the major priorities in neonatal nursing care, this study aimed to evaluate the effect of body position on pain due to nasal CPAP in premature neonates.
Materials and Methods
In this cross-over clinical trial, 50 premature neonates who were receiving nasal CPAP admitted to the NICU of Imam Reza Hospital, Kermanshah, Iran, were included. The neonates were randomly placed at three body positions (fetal, supine, and prone positions). Pain was measured by Astrid Lindgren Children’s Hospital Pain Scale Neonates (ALPS-Neo) pain assessment scale. The collected data were analyzed using the SPSS software (Version 22.0).
Significant difference existed regarding pain of nasal CPAP among body positions (p< 0.001). Mean (SD) pain was 5.15 (0.822) in fetal position, 6.260 (0.747) in prone position and 7.326 (0.792) in supine position.
Body positioning in premature neonates under nasal CPAP in NICU can be effective as a non-pharmacologic method in alleviating pain due to nasal CPAP. Among the studied positions, the lowest pain score was seen in fetal position.