Effects of Musical Stimulation During Retinopathy Examination on Pain and Comfort Levels of Premature Infants: A Randomized Controlled Study

ABSTRACT Background: Retinopathy of Prematurity (ROP) examination is a procedure associated with pain, discomfort, and physiological changes in premature newborns. Purpose: Explore effects of exposure to different types of auditory stimulation during ROP examination on pain, comfort, and physiological parameters of premature infants. Methods: The study was conducted in the neonatal intensive care unit between January 2023 and June 2024. A stratified randomization method was used for sample selection, and a total of 75 premature infants participated. Intervention comparisons included a rain stick (n = 25), white noise (n = 25), and control (n = 25). The sound of a rain stick is often considered musical. Premature infants in the intervention groups were exposed to the rain stick or white noise 3 minutes before, during the entire ROP examination, and 3 minutes after. The infants in the control group underwent routine ROP examination and nursing care. Results: Neonatal Pain Agitation and Sedation Scale and comfort scores were significant in the rain stick group than in the white noise and control groups before, during, and after the examination. In both the rain stick and white noise groups, mean SpO 2 and peak heart rate differed significantly between during- and post-procedure measurements ( P < .05). Implications for Practice and Research: Musical stimulation, as a noninvasive and accessible intervention, can be used in neonatal intensive care unit care to reduce pain and enhance infant comfort. Neonatal nurses may safely integrate gentle auditory stimuli into routine care. Future studies should determine optimal music types, durations, and methods, and evaluate their long-term and cross-cultural effects to support standardized neonatal music therapy practices.