Jurnal Keperawatan Indonesia, Volume 21 No.1, Maret 2018, hal 9-16
pISSN 1410-4490, eISSN 2354-9203
DOI: 10.7454/jki.v21i1.539

FACILITATED TUCKING EFFECTIVE TO PAIN RELIEF
ON THE PRETERM INFANTS IN PERINATAL UNIT
IN JAKARTA
Eva Oktaviani1*, Yeni Rustina2, Defi Efendi2
1. Nursing Major of Health Polytechnic of Ministry of Health Lubuklinggau, Palembang, 31626, Indonesia
2. Faculty of Nursing Universitas Indonesia, Depok 16424, Indonesia
*E-mail: nersevaoktaviani@gmail.com

Abstract
The majority of preterm infants require a long period of hospitalization in intensive care units, which often necessitates
those undergoing painful procedures, including blood collection. This study aims to identify the effectiveness of facilitated
tucking on pain responses, including physiological parameters and the duration of crying during blood collection. The
study design is quasi-experimental, employing a nonequivalent control group pretest-posttest approach. The study
involves 40 infants, selected by the consecutive sampling technique and assigned into two groups: an intervention group
(n= 20), which received facilitated tucking during blood collection, and a control group (n= 20), which did not receive
facilitated tucking. The General Linear Model+post hoc, Mann-Whitney, and independent t-test were applied to analyze
the data. The results suggest that there was a significant difference in the mean of the pulse, oxygen saturation, and
duration of crying between the two groups during blood collection. The duration of crying in the intervention group was
shorter than in the control group. Facilitated tucking was effective in relieving pain and the duration of crying during
blood collection, and could be implemented as part of the developmental care process to promote pain management in
infants.
Keywords: developmental care, facilitated tucking, pain, preterm infants
Abstrak
Mayoritas bayi prematur akan mengalami perawatan yang lama di ruang intensif, sehingga terpapar sejumlah prosedur
menyakitkan berulang yang menimbulkan respon nyeri salah satunya pengambilan darah. Tujuan dari penelitian ini untuk
mengidentifikasi pengaruh penerapan facilitated tucking terhadap respon nyeri berupa parameter fisiologis dan lama
menangis selama dilakukan pengambilan darah. Desain penelitian adalah quasi experimental dengan nonequivalent
control group pretest-posttest design. Empat puluh bayi pada sampel penelitian dibagi menjadi dua kelompok; kelompok
intervensi (n= 20) dengan facilitated tucking dan kelompok kontrol (n= 20) tanpa facilitated tucking, diambil secara
consecutive sampling. Analisis menggunakan uji General Linear Model+post hoc, Mann-Whitney, dan Independent TTest. Ada perbedaan signifikan rerata frekuensi nadi, saturasi oksigen, dan lama menangis antara kedua kelompok selama
pengambilan darah. Lama menangis pada kelompok intervensi menjadi lebih singkat. Facilitated tucking efektif
mengurangi nyeri dan lama menangis selama pengambilan darah. Facilitated tucking dapat diterapkan sebagai bagian dari
asuhan perkembangan untuk mendukung program pengendalian nyeri pada neonatus.
Kata kunci: asuhan perkembangan, bayi prematur, facilitated tucking, nyeri

Background
Preterm infants require long periods of special
care in neonatal intensive care units due to the
prematurity of their body functions and anatomy
(Jaberi & Raksana, 2017; Johnston, Fernandes,

& Campbell-Yeo, 2011; Lawn et al., 2013). The
condition puts babies at risk from distress and
from the various painful procedures they need
to undergo as part of routine care (Brummelte,
et al., 2012). Arterial or venous blood collection
and heel pricks are among the procedures which

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Jurnal Keperawatan Indonesia, Vol. 21, No. 1, Maret 2018, hal 9-16

they frequently undergo during their hospital
stay (Johnston et al., 2011). Repeated invasive
procedures are pain-provoking stimuli. Pain is
acute stress, which may lead to short and longterm complications as it occurs during critical
periods (Kostovic & Judas, 2010; Marchant,
2014; Page, 2004). Short-term complications
include changes in physiological parameters (tachycardia, desaturation and tachypnea), behaviors and metabolism (Kostovic & Judas, 2010).
Long-term complications from persistent and
uncontrolled pain include the altered development of the central nervous system, heightened
pain sensitivity, impaired regulation of stress
hormones (cortisol), and changes in the hypothalamus-pituitary-adrenal (HPA) axis (Walker,
2013). Another long-term complication is immunocompromised (Page, 2004).
Preterm infants have a mature pain pathway;
however, they perceive pain for a longer period
due to the immaturity of their descending
pathway of pain (Hatfield, 2014). Therefore, it
is essential to implement pain management to
enhance infants’ ability to cope with it and to
promote their growth and development. The extent and complexity of consequences resulting
from hospitalization stress require nurses to take
more effective and efficient non-pharmacological approaches with fewer side effects. The
pharmacological approach to relieving pain in
infants is reported to result in harmful side effects,
including respiratory depression, apnea, bradycardia, hypotension, desaturation, airway obstruction, and hypersalivation (Lago et al., 2009).
Non-pharmacological approaches that have been
proven to be effective in relieving pain and stress
in preterm infants include non-nutritive sucking,
kangaroo mother care, provision of oral sucrose,
music therapy, swaddling, and facilitated tucking (Martin, Dias, Enumo, & de Paula, 2013).
A study by Reyhani, Aemmi, Mohebbi, and
Boskabadi (2014) reported that facilitated tucking during venipuncture might reduce pain responses in preterm infants, as indicated by the
shorter duration of crying in the intervention
group. The facilitated tucking position is des-

cribed as a sub-type of the nesting procedure,
positioning infants in the middle or closer by
holding their upper and lower extremities in a
flexion position in both of the examiner’s hands
(Kucukoglu, Kurt, & Aytekin, 2015).
Behaviors demonstrated by infants in pain include avoidance (infants withdraw their extremities away from pain stimuli), aggression (tachycardia, desaturation, and increased muscle
tone), postural or expression changes, and alarm
(crying) (Bellieni, 2012). Developmental care
in neonatal care units aims to reduce physiological and psychological distress in order to
promote nerve development in preterm infants.
This care includes positioning and touch, such
as facilitated tucking, which provides comfort
throughout a painful procedure (Fernandes,
Campbell-Yeo, & Johnston, 2011).
In Indonesia, no studies have addressed the application of facilitated tucking in preterm infants
with non-invasive ventilation, and its impact
on two pain responses during blood collection,
namely physiological parameters and behavior,
thus emphasizing the need conduct such research.
This study aims to identify the effectiveness of
facilitated tucking on relieving pain by evaluating two pain responses, namely heart rate and
oxygen saturation, and duration of crying in preterm infants during blood collection.

Method
The study design was quasi-experimental, employing a nonequivalent control group pretestposttest approach. The study involved 40 preterm infants admitted to several hospitals in
Jakarta, all of whom were selected through the
consecutive sampling technique and assigned to
intervention and control groups which each
comprised 20 infants. The inclusion criteria included preterm infants with a gestational age of
28-36 weeks and non-invasive ventilation, and
who were undergoing arterial or venous blood
collection; the exclusion criteria included infants
with congenital and neurological defects, those
with hemodynamic instability, and infants who

Oktaviani, et al., Facilitated Tucking Effective to Pain Relief on the Preterm Infants in Perinatal Unit in Jakarta

11

had been prescribed with analgetic or sedative
medication.

group, who were provided with standard care
(without facilitated tucking).

The intervention group was given facilitated
tucking three minutes prior to the puncture,
during the puncture, and three minutes following it, while the control group was provided
with standard care during blood collection.
Facilitated tucking was applied by facilitating
infants in a physiological flexion position by
fixing one hand on the posterior part of their
head and hand, while the other hand fixating the
buttocks and flexed the extremities. This position resembles a flexed fetal-type position in the
womb.

The study was granted administrative approval
and conducted by complying with research ethics.
Ethical clearance was issued by the Ethical Committee of the Faculty of Nursing of Universitas
Indonesia.

Pain responses were evaluated by assessing
physiological parameters including alteration in
pulse rate and oxygen saturation, which were
documented at their highest points before, during, and after the puncture, and behavioral response (crying duration), whose length was measured in seconds by a stopwatch. The evaluation
of the physiological parameters and crying duration was compared with that of the control

Results
The findings are presented based on the type of
analysis. The majority of the infants were male
(67.5%), applied with CPAP (Continuous Positive Airway Pressure) (62.5%), with an average birth weight of 1411.6 grams, and an average weight of 1481.6 grams during the data
collection. The average gestational age was 31.8
weeks and the average age was 10.1 days. The
test of homogeneity revealed that both groups
were homogeneous. The participant characteristics are shown in Table 1.
Figure 1 shows that the control group, who were
not provided with facilitated tucking, had their

Table 1. Participant Characteristics in the Intervention and Control Groups
Group
Total

Male
Female

n (%)
27 (67.5)
13 (32.5)

n (%)
14 (70)
6 (30)

No Facilitated
Tucking
n(%)
13 (65)
7 (35)

Mechanical ventilation NIV
CPAP
HFN
Optiflow

3 (7.5)
25 (62.5)
10 (25)
2 (5)

1 (5)
13 (65)
4 (20)
2 (10)

2 (10)
12 (60)
6 (30)
-

0.428

Mean (SD)

Mean (SD)

Mean (SD)

p, Ind t-test

Birth weight (grams)

1411.6 (395.2)

1507.5 (388.0)

1315.80 (388.1)

0.788

Current weight
(grams)
Gestational age
(weeks)
Chronological age
(days)

1481.6 (369.5)

1556.5 (377.7)

1406.85 (354.8)

0.204

31.5 (1.96)

31.8 (2.0)

31.25 (1.9)

0.516

10.1 (9.8)

9.4 (8.2)

10.80 (11,4)

0.660

Characteristic
Gender

Facilitated Tucking

p, x2
1,000

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Jurnal Keperawatan Indonesia, Vol. 21, No. 1, Maret 2018, hal 9-16

Table 2. Means of Pulse, Oxygen Saturation, and Crying Duration in the Intervention and Control Groups
Characteristic

Stage of
Puncture

Pulse

Before
During
After

SaO2

Before
During
After

Crying duration

Group
Facilitated Tucking
No Facilitated Tucking
Mean
SD
Range
Mean
SD
Range
145.30
14.183
120-168
156.10
19.371
100-187
156.55
21.182
125-205
180.80
24.827
148-250
147.30
14.579
124-170
165.55
17.209
130-195

0.053*
0.002
0.001

96.10
95.80
95.90
63.65

0.753**
0.036
0.032
0.002***

3.567
2.931
2.931
46.226

86-100
86-99
86-99
8-170

96.05
92.35
94.05
127.35

3.137
4.069
2.892
68.753

89-100
86-99
88-98
20-240

p

Note: *General Linear Model+post hoc; **Mann-Whitney; ***Independent T-Test

200

Pulse (x/minute)

190
180.8
180
170
160

165.55
156.2

156.1

147.3

145.45

150

Control
140
Intervention

130
120

Before Puncture (3 minutes)

During Puncture

After Puncture (3 minutes)

Figure1. The difference in Mean of Pulse between Intervention and Control Group

98
97

SaO2(%)
97
96

96

96

96
95

94

94
93

92

92

Control

91

Intervention

90
Before Puncture (3 minutes)

During Puncture

After Puncture (3 minutes)

Figure 2. The difference in Mean of Oxygen Saturation between Intervention and Control Group

Oktaviani, et al., Facilitated Tucking Effective to Pain Relief on the Preterm Infants in Perinatal Unit in Jakarta

highest pulse rate during puncture, and that this
group had an overall higher pulse rate than the
intervention group. The corresponding rate of the
intervention group, which did receive facilitated tucking, immediately returned to its earlier
rate following the puncture. Table 2 indicates
that there was a significant difference in the mean
of the pulse between the two groups during and
after the puncture (p= 0.002; p= 0.001, p<α).
Figure 2 suggests that the lowest oxygen saturation of the control group was during puncture.
It also indicates that oxygen saturation after the
puncture returned to its former value faster in
the intervention group than in the control group.
The intervention group also demonstrated higher overall oxygen saturation than the control
group. Table 2 shows a significant difference in
the mean of changes in oxygen saturation between both groups during and after puncture (p=
0.036: p= 0.032, p <α).
Table 2 also shows a comparison of the crying
duration; the group which received facilitated
tucking had a shorter duration than the group
that did not receive it. The analysis results suggest a significant difference in crying duration
between the two groups (p= 0.002, p <α).

Discussion
Infants may have a higher pulse rate and lower
oxygen saturation as responses to stress during
blood collection procedures (Bellieni, 2012).
The study findings indicate that there was a
significant difference in the means of pulse and
oxygen saturation during and after puncture between the group which received facilitated tucking and that which did not. This finding corresponds with that of Reyhani, Mohebi, Boskabadi,
Gholami, and Ghanbarabadi (2012), who reported that there was a significant difference in
pulse rate and oxygen saturation in a group
which had been provided with facilitated tucking during blood collection (p= 0.001). A study
conducted by Sundaram, Shrivastava, Pandian,
and Singh (2013) also revealed a significantly
lower pulse rate during a 120-second relaxation

13

phase in infants who had received facilitated
tucking during blood collection by heel stick.
Our study findings suggest that the pulse and
oxygen saturation of the group provided with
facilitated tucking returned more quickly to
their earlier valued than those of the control
group. Diego, Field, and Hernandez-Reif (2009)
state that touch and positioning may facilitate
an infant’s physiological stability, as they increase parasympathetic activities during the
relaxation phase. This claim is supported by
Ramada, Almeida, and Cunha’s (2013) study,
which revealed that therapeutic touch promoted
relaxation, reduced vital signs, and affected the
basal metabolism rate in infants. Liaw, et al.
(2012) reported that the application of facilitated tucking during the heel prick procedure
assisted in stabilizing physiological functions
and behaviors in premature neonates. Facilitated tucking helps simultaneous skin contact in
the postural position, which results in a synergistic effect on pain and stabilization of the motoric and autonomic nervous system, leading to
lower levels of stress (Cignacco et al., 2012).
Lower stress in infants will promote their growth
and development.
Premature infants have not fully developed their
ability to make a flexion action independently
in response to pain, which prevents them from
using a self-comforting strategy to adapt to stressful and painful conditions. Facilitated tucking
assists preterm infants in maintaining their movements, which leads to stability of the autonomic physiological function (Naeni, Mohagheghi,
Peyrovi, & Mehran, 2014). Smith (2012) explains
that providing touch for infants is beneficial for
promoting physiological and regulation stability, by maintaining the pulse rate within the
normal range and improving sleep quality. The
analgetic effect of touch may also be described
through the oxytocinergic mechanism and mediation of C fiber through sensory stimuli (Hatfield,
2014; Ramada et al., 2013).
Crying is a major behavioral response to pain
(Kostandy et al., 2008). Infants cry in response

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Jurnal Keperawatan Indonesia, Vol. 21, No. 1, Maret 2018, hal 9-16

to inconveniences, including pain. Pain in hospitalized preterm infants commonly results from
numerous invasive procedures, such as blood
collection, and facilitated tucking is a non-pharmacological approach to relieving this pain during blood collection. The study findings indicate that the infants in the intervention group
had a shorter duration of crying during blood
collection than those in the control group. This
result is in line with Liaw et al.’s (2012) study,
which reported that there was a significantly
shorter duration of crying in a group of premature infants who were provided with oral
sucrose, non-nutritive sucking and facilitated
tucking during the heel stick procedure than in
a group who were provided with standard care.
Sundaram et al. (2013) also reported lower
levels of pain in preterm infants who were provided with facilitated tucking during the heel
stick procedure. A combination of facilitated
tucking and music also reduced pain levels significantly and shortened the duration of crying
in their intervention group (68.5 seconds) in
comparison with the control group (105 seconds)
(Zubaidah & Naviati, 2015). The analysis revealed the homogeneity of both groups, so it
can be assumed that infants’ physiological and
behavioral responses during blood collection
were affected by facilitated tucking. Facilitated
tucking is a type of therapeutical touch; touch is
therapeutical modality which facilitates relaxation, promotes movement, enhances reflexes,
and reduces anxiety and crying (Chhugani &
Sarkar, 2014).
A study conducted by Brummelte et al. (2012)
claimed that infants with repeated and uncontrolled pain stimulation might lose their white
matter fractional anisotropy and subcortical gray
matter area of the brain. Such circumstances
may lead to permanent brain damage in motoric
and cognitive functions. Therefore, accurate pain
assessment and appropriate pain management
will provide advantages for preterm neonates,
as they offer clear instructions for intervention.
The fetal tucking position reduces an infant’s
body surface, which maintains energy expen-

diture. Reducing lighting, controlling noises,
and positioning are part of the developmental
care that aims to enhance infants’ energy and
adaptation to pain stimuli (Kucukoglu et al.,
2015).
The implication of the study is enriches nursing
interventions, especially in perinatal units. In
order to improve the quality of nursing care,
perinatology nurses may apply facilitated tucking as part of the developmental care and pain
management of neonates during blood collection. The intervention serves to reduce the risk
of short and long-term consequences resulting
from repeated painful procedures in premature
infants. Chronic pain may result in weaker immune systems in neonates (Page, 2004).
The main limitation of this study was the limited number of samples involved. Only 40 participants were involved; however, the statistical
analysis indicates significant differences in pulse rate, oxygen saturation and crying duration
during blood collection between the intervention and control groups. Moreover, the study
did not apply various standardized instruments
to evaluate pain in neonates.

Conclusion
The study results suggest that facilitated tucking is effective in relieving pain in premature
infants during blood collection. This is indicated by the relatively constant changes in pulse
and oxygen saturation and the shorter duration
of crying during blood collection in the group
which was provided with facilitated tucking.
Further study should be conducted with a higher number of samples and application of various
aspects of developmental care. A study with a
clinical trial design should be conducted, applying standardized instruments for better results
so that it can be used as a reference for hospital
policies. Health facilities should enrich their
pain management procedures through evidencebased practices by applying facilitated tucking
as part of the standardized pain management

Oktaviani, et al., Facilitated Tucking Effective to Pain Relief on the Preterm Infants in Perinatal Unit in Jakarta

procedures for neonates. Nurses and other healthcare providers should also develop their skills
in neonatal pain management (HM, NN, INR).

Acknowledgments
The authors would like to express their gratitude to the Pediatric Nursing Department of the
Faculty of Nursing of Universitas Indonesia,
and to the board, head nurse, physicians, and
nurses in the Perinatology Unit of RSUPN
Ciptomangunkusumo, who provided support
during the data collection.

Reference
Bellieni, C.V. (2012). Pain assessment in human
fetus and infant. The American Association of
Pharmaceutical Scientist Journal, 14 (3),
456–446. doi: 10.1208/s12248-012-9354
Brummelte, S., Grunau, R.E., Chau, V., Poskitt,
K.J., Brant, R., Vinal, J………. Miller, S.P.
(2012). Procedural pain and brain development in premature newborns. American
Neurological Association, 71, 385–396. doi:
10.1002/ana.22267
Cignacco, E.L., Sellam, G., Stoffel, L., Gerull, R.,
Nelle, M., Anand, K.J.S., & Engberg, S.
(2012). Oral sucrose and “facilitated tucking”
for repeated pain relief in preterms: A
randomized Controlled Trial. Pediatrics, 129
(2), 299–308. doi: 10.1542/peds.2011-1879
Chhugani, M., & Sarkar, S. (2014). Therapeutic
touch modalities and premature neonates’s
health outcome: A literature review. Neonatal Biology, 3 (148), 1–3. doi. 10.4172/
2167-0897.1000148
Diego, M.A., Field, T., & Hernandez-Reif, M.
(2009). Procedural pain heart rate responses
in massaged preterm infants. Infants
Behavioural Development, 32 (2), 226–229.
doi: 10.1016/j.infbeh.2008.12.001
Fernandes, A., Campbell-Yeo, M., & Johnston,
C.C. (2011). Procedural pain management for
neonates using non-pharmacological strategies:
Part 1: Sensorial interventions. Advances in

15

Neonatal Care, 11 (4), 235–241.doi: 10.1097
/ANC.0b013e318225a2c2
Hatfield, L.A. (2014). Neonatal pain: What’s age
got to do with it? Surgical Neurology International, 5 (13), s479–s489. doi: 10.4103/
2152-7806.144630
Jaberi, E., & Raksana, M. (2017). A study on
preterm births during 2013-2015, shiraz, iran.
Journal of Obstetrics and Gynaecology, 38
(1), 22–26. doi: 10.1080/01443615.2017.132
2565
Johnston, C.C., Fernandes, A.M., & Campbell-Yeo,
M. (2011). Pain in neonates is different. Pain,
152 (3), S63–S73. doi: 10.1016/j.pain.2010.
10.008
Konstandy, R., Xiaomei, C., Abouelfettoh, A.,
Bronson, C., Stankus, A., & Ludington, S.M.
(2008). Effect of kangaroo skin care (skin
contact) on crying response to pain in preterm
neonates. Pain Management of Nursing, 9
(2), 55–65. doi: 10.1016/j.pmn.2007.11.004
Kostovic, I., & Judas, M. (2010). The development
of the subplate and thalamocortical connections in the human fetal brain. Acta Paediatrica,
99 (8), 1119–1127. doi: 10.1111/j.1651-222
7.2010.01811.x
Kucukoglu, S., Kurt, S., & Aytekin, A. (2015). The
effect of the facilitated tucking position in
reducing vaccination-induced pain in newborns. Italian Journal of Pediatrics, 41, 61.
http://doi.org/10.1186/s13052-015-0168-9
Lago, P., Garetti, E., Merazzi, D., Pieragostini, L.,
Ancora, G., Pirelli, A., & Bellieni, C. V.
(2009). Guidelines for procedural pain in the
newborn. Acta Paediatrica (Oslo, Norway:
1992), 98 (6), 932–939. http://doi.org/10.
1111/j.1651-2227.2009.01291.x
Lawn, J.E., Davaidge, R., Paul, V.K., Xylander,
S.V., Johson, J.D.G., Costello, A. ......
Molyneux, L. (2013). Born too soon: Care for
the preterm baby. Reproductive Health, 10
(1), 1–19. doi: 10.1186/1742-4755-10-S1-S5
Liaw, J.J., Yang, L., Lee, C.M., Fan, H.C., Chang,
Y.C., & Cheng, L.P. (2012). Effects of

16

Jurnal Keperawatan Indonesia, Vol. 21, No. 1, Maret 2018, hal 9-16

combined use of non-nutritive sucking, oral
sucrose, and facilitated tucking on infant behavioural states across heel-stick procedures:
A prospective, randomized controlled trial.
International Journal of Nursing Studies, 50
(7), 883–894. doi: 10.1016/j.ijnurstu.2012.
08.021
Marchant, A. (2014). Neonatal do not feel pain: A
critical review of the evidence. Bioscience
Horizons, 7, 1–9. doi: 10.1093/biohorizons/
hzu006
Martin, S.W., Dias, F.S., Enumo, S.R.F., & de
Paula, K.M.P. (2013). Pain assessment and
control by nurses of neonatal intensive care
unit. Revista do Instituto de Medicina Tropical
de Sao Paulo, 14 (1), 21–26.doi: 10.1590/
S1806-00132013000100006
Naeni, M.A., Mohagheghi, P., Peyrovi, H., &
Mehran, A. (2014). The effect of facilitated
tucking during endotracheal suctioning on
procedural pain in preterm neonates: A
randomized controlled crossover study.
Global Journal of Health Science, 6 (4),
278–284. doi: 10.5539/gjhs.v6n40278
Page, G.G. (2004). Are there long-term consequences of pain in newborn or very young infants?
The Journal of Perinatal Education, 13 (3),
10–17. http://doi.org/10.1624/105812404X1
725
Ramada, N.C.O., Almeida, F.A., & Cunha, M.L.R.
(2013). Therapeutic touch: influence on vital
signs of newborns. Einstein, 11 (4), 421–425.

http://doi.org/10.1590/S1679-450820130004
00003
Reyhani, T., Aemmi, S.Z., Mohebbi, T., &
Boskabadi, H. (2014). The effect of facilitated
tucking (FT) during venipuncture on duration
of crying in preterm infants. International
Journal of Pediatrics, 12 (2), 431–435.
Reyhani, T., Mohebbi, T., Boskabadi, H., Gholami,
H., & Ghanbarabadi, G.V. (2012). The effect
of facilitated tucking during venipuncture on
pain and physiological parameters in preterm
infants. Evidence Based Care Journal, 2 (2),
47–55. doi: 10.22038/EBCJ.2012.399
Smith, J.R. (2012). Comforting touch in the very
preterm hospitalized infant: An integrative
review. Advances in Neonatal Care, 12 (6),
349–365. doi: 10.1097/ANC.0b013e3182609
3ee
Sundaram, B., Shrivastava, S., Pandian, J.S., &
Singh, V.P. (2013). Facilitated tucking on
pain in pre-term newborns during neonatal
intensive care: A single blinded randomized
controlled cross-over pilot trial. Journal of
Pediatric Rehabilitation Medicine, 6 (1),19–
27. doi: 10.3233/PRM-130233
Zubaidah, Z., & Naviati, E. (2015). Pengaruh
facilitated tucking dan musik terhadap respon
nyeri bayi prematur ketika pengambilan
darah. Jurnal Keperawatan Soedirman, 10
(2), 94–104. http://dx.doi.org/10.20884/1.jks.
2015.10.2.603