The Effect of the Helfer Technique in the Facilitated Position on Pain Caused by Hepatitis B Vaccine Injection in Term Infants: A Randomized Clinical Trial

Articles in Press

Document Type : original article

Authors

1 Student Research Committee School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Nursing and Midwifery Care Research Center, Department of Pediatric Nursing, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/jpp.2026.95093.5637

Abstract

Background: Vaccine-induced pain is a common concern in infancy. Non-pharmacological methods, such as the Helfer technique and facilitated positioning are safe, simple, and cost-effective alternatives for pain management. This study aimed to evaluate the individual and combined effects of these methods on vaccination-induced pain in term infants.
Methods: This four-arm randomized clinical trial was conducted between January and April 2025 at Imam Reza Hospital in Iran. A total of 192 term infants were randomly assigned to one of four groups: Helfer technique, facilitated positioning, combined Helfer technique and facilitated positioning, or a control group (n=48 per group). Pain was assessed during and one minute after vaccination using the Neonatal Infant Pain Scale (NIPS).              
Results: The mean NIPS scores during vaccination were 4.65 ± 0.89 (Helfer), 4.88 ± 1.09 (facilitated positioning), 3.71 ± 0.98 (combined), and 5.54 ± 1.08 (control). Analysis of variance revealed significant differences among the groups (P = 0.03). Bonferroni post hoc tests indicated that the Helfer technique significantly reduced pain compared to the control group (P = 0.01), while facilitated positioning alone did not show a statistically significant difference (P = 0.07). The combined approach of the Helfer technique and facilitated positioning resulted in the lowest pain scores, demonstrating a significant reduction compared to the control group (P = 0.03) and suggesting a potential synergistic effect.
Conclusion: The combined use of the Helfer technique and facilitated positioning was more effective in reducing vaccination-induced pain in term infants than either intervention alone. These simple, safe, and low-cost nonpharmacological methods may be recommended for pain management during infant vaccination.

Keywords

References

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Journal of Pediatric Perspectives

Articles in Press, Accepted Manuscript
Available Online from 30 May 2026

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