Objective:to determine the frequency of pain, to verify the measures adopted for pain relief during the first seven days of hospitalization in the Neonatal Intensive Care Unit and to identify the type and frequency of invasive procedures to which newborns are submitted. Method:cross-sectional retrospective study. Out of the 188 hospitalizations occurred during the 12-month period, 171 were included in the study. The data were collected from the charts and the presence of pain was analyzed based on the Neonatal Infant Pain Scale and on nursing notes suggestions of pain. For statistical analysis, the Statistical Package for the Social Sciences was used, and the significance level was set at 5%. Results:there was at least one record of pain in 50.3% of the hospitalizations, according to the pain scale adopted or nursing note. The newborns underwent a mean of 6.6 invasive procedures per day. Only 32.5% of the pain records resulted in the adoption of pharmacological or non-pharmacological intervention for pain relief. Conclusion:newborns are frequently exposed to pain and the low frequency of pharmacological or non-pharmacological interventions reinforces the undertreatment of this condition.

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El estudio tuvo como objetivo conocer la experiencia de niños y adolescentes en cuidados paliativos en el manejo diario del dolor. La investigación cualitativa fue realizada con entrevistas semi-estructuradas con seis niños entre siete y 17 años. La teoría del Desarrollo cognitivo de Piaget fue utilizada como Marco teórico y la Historia Oral como Referencial Metodológico. Cuatro temas fueron encontrados: describiendo el dolor; buscando una vida más próxima de la normalidad, a pesar del dolor y la enfermedad; utilizando varias alternativas para el control del dolor y viviendo la autoimagen perjudicada. A pesar del dolor ser un agente limitante en la vida de los niños y adolescentes, verificamos que enfrentaban el dolor diariamente y, que así mismo, tenían vida además del dolor y la enfermedad. Adicionamos, aun, la importancia de los enfermeros comprender que el eficaz manejo del dolor es esencial para una vida mas próxima de la normalidad, reduciendo su sufrimiento. DESCRIPTORES ABSTRACTA qualitative study was conducted with semi-structured interviews with the aim of understanding the experience of children and adolescents under palliative care when managing pain daily and how they describe the intensity, quality and location of pain. We used Piaget's theory of cognitive development as a theoretical framework and oral history as a methodological framework. We found four themes: describing pain; seeking a life closer to normality, despite pain and disease; using a variety of alternatives for pain control; and living with damaged physical appearance. Although pain is a limiting factor in the lives of children and adolescents, we found that they faced their daily pain and still had a life beyond pain and illness. In addition, we highlight the relevance of nurses' understanding that effective management of pain in children is essential for a normal life and less suffering.

Objectives: to identify and characterize the care provided to adolescents admitted to an emergency department due to a suicide attempt. Methods: an observational, cross-sectional, descriptive study with a retrospective approach, carried out with medical records of adolescents aged 10 to 19 admitted for suicide attempts, between January 2015 and July 2020, in an emergency department. Data were subjected to descriptive and inferential analysis. Results: eighty-eight service occurrences were identified, mainly to females, exposed to multiple risk factors. Exogenous intoxication was the main method used, occurring at home and on weekdays. There were systemic repercussions, requiring multiple interventions and hospitalizations. Only 26% of cases were notified. Conclusions: adolescents treated for suicide attempts were exposed to multiple risk factors, with intoxication as the main means used. There is concern about the underreporting of cases and the logic of clinical care and medicalization.

Objective: To understand children’s satisfaction and dissatisfaction with pain management in the pediatric emergency department. Method: Exploratory-descriptive qualitative study performed with children between 6 and 12 years of age and use of semi-structured interviews and thematic analysis of data. Results: Nineteen children were interviewed. The results were organized in two themes: Theme 1 - Satisfaction perceived by children regarding pain management, which included three subthemes, namely: Priority care and quick pain relief, Basic needs met and Embracement by the team; and Theme 2 - Dissatisfaction perceived by children regarding pain management, which included three subthemes: Painful procedures, Uncomfortable environment and Delay in pain relief. Conclusion: Children’s satisfaction with pain management was observed to be much more than pain relief or priority service, and also included the pediatric emergency department environment and embracement by the team. Care should be directed to children’s singularities, that is, a care built from the understanding of the experience from children’s point of view.

Facilidades e dificuldades identificadas pelas enfermeiras pediatras na aplicação dos "cartões de qualidade da dor" 3 Originais / OriginalsResumo A dor pode provocar consequências físicas e emocionais nas crianças e adolescentes. Conhecer a experiência de enfermeiras na utilização de um instrumento multidimensional e direcionado ao público infantil para avaliar a dor demanda compreender as percepções e atitudes das enfermeiras ao vivenciarem situações de dor das crianças e adolescentes. Os objetivos do estudo foram, portanto, identificar as facilidades e dificuldades das enfermeiras no que concerne ao uso de um instrumento multidimensional para avaliar a dor em crianças e adolescentes. Os dados foram coletados por meio de abordagem qualitativa, mediante entrevistas semiestruturadas com nove enfermeiras e analisados conforme a proposta do Discurso do Sujeito Coletivo. A partir dos dados obtidos pelas entrevistas, surgiram dois temas: Dificuldades e Facilidades encontradas por enfermeiras na utilização do instrumento "Cartões de Qualidade da Dor" para a avaliação da dor em crianças e adolescentes. Concluiu-se que as enfermeiras perceberam o impacto positivo dessa ferramenta no cuidado aos pacientes e suas mães e enfrentaram algumas dificuldades devido à inexperiência na utilização do instrumento. Palavras-chave: avaliação da dor; enfermagem pediátrica; criança; adolescente; instrumentos de avaliação.Abstract Pain can cause physical and emotional consequences for children and adolescents. To know the nurses' experience in the use of a multidimensional instrument and directed to children to assess pain, demand to understand the perceptions and attitudes of nurses when they experience situations of pain of children and adolescents. This study aimed to get to identify the facilities and difficulties in the utilization of these cards by the nurses. Data were collected through a qualitative approach, using recorded semi structured interviews with nine nurses and subsequently analyzed in accordance with the Collective Subject Discourse. From the data obtained in the interviews, two themes emerged: difficulties encountered by nurses and facilities in using the instrument "Pain Quality Cards" to assess pain in children and adolescents. It was concluded that the nurses realized the positive impact of this tool in patient care and their mothers and faced some difficulties due to inexperience in using such instruments.

Aos meus pais, Fátima e Dalton, pela dedicação, confiança, paciência e incondicional amor. Obrigada por me ensinar o significado da família e que família linda vocês construíram. Ao Benoni, obrigada por ser o meu amor. Seu companheirismo, dedicação para comigo e disponibilidade me ajudaram a finalizar mais esta etapa das nossas vidas. Sua disciplina e perseverança me inspiram. Aos meus queridos irmãos e amados familiares. Saibam que os tenho como incentivadores e apoiadores das minhas escolhas, obrigada por tudo e por tanto, sempre! À professora Dr a. Lisabelle Rossato. Não tenho palavras para descrever a minha gratidão pela senhora, que desde o início da minha trajetória acadêmica esteve sempre tão solícita e disposta a me ensinar. Obrigada por me receber de coração e braços abertos, entender as minhas dificuldades, me acolher em sua família e por ser um exemplo de mulher para mim. Obrigada por conduzir este trabalho com competência e paciência, apesar dos percalços no caminho. Simplesmente obrigada, Lisa! Aos amigos e colegas dos grupos de pesquisa e da pós-graduação. Não irei me arriscar em citar nomes, pois são muitos e valiosos. Obrigada pela parceria em todos os momentos e por compartilharem comigo suas vidas. Sem dúvida vocês deixaram meu caminho na pósgraduação mais leve e colorido. Muitos levarei pra vida e eles sabem quem são.

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