OBJETIVO: Verificar o nível de ruído da Unidade de Terapia Intensiva Neonatal e identificar suas fontes. MÉTODOS: Estudo quantitativo, descritivo e exploratório, conduzido em uma Unidade de Terapia Intensiva Neonatal de São Paulo. A coleta de dados ocorreu de abril a maio de 2005, utilizando um dosímetro para 96 horas de registro do nível de pressão sonora e 9 horas de observação, para identificar as fontes de ruído. RESULTADOS: Registrou-se Leq entre 61,3 a 66,6 dBA, sendo maior nos dias do final de semana. Os valores dos picos variaram de 90,8 a 123,4 dBC, sendo mais elevados no período noturno. As principais fontes foram: alarme dos ventiladores, dos oxímetros, conversa entre profissionais e pais e outros. CONCLUSÃO: Considerando os efeitos deletérios do nível elevado de ruído sobre neonatos e equipe de saúde, os resultados demonstram a necessidade de intervenções em algumas rotinas e na conduta dos profissionais e familiares.

Background: Peak sound levels during sleep can compromise the development of hospitalized infants. Quiet time is a strategy implemented in neonatal units to promote the sleeping of neonates by reducing noise levels, luminosity, and handling during particular periods of the day. Purpose: To determine the impact of quiet time on reducing sound levels and increasing total sleep time. Methods: This longitudinal study was conducted at a neonatal intermediate care unit with a convenience sample of 12 premature infants. Four times per day, 60-minute quiet times were provided in the neonatal unit. Sleep-awake states and sound levels were evaluated during quiet times as well as 60 minutes before and afterward. Polysomnography was used for sleep-awake state assessment, and a noise dosimeter was used to check sound levels every 24 hours. Results: The preterm infants had a corrected gestational age of 35.0 ± 1.5 weeks and weighed 1606.0 ± 317.8 g. Total sleep time was highest during quiet time (P = .005). Premature infants remained awake for longer following quiet times (P = .005). There was also a reduction in sound level during quiet times compared with the other time frames (P = .006). No statistically significant relationship was found between total sleep time and sound levels more than 24 hours. Implications for Practice: Quiet time is a nursing intervention that should be implemented in all neonatal units. Implications for Research: Future research should use a greater sample size and other factors that influence sleep should be further investigated.

Pinheiro EM, Silva MJP, Ângelo M, Ribeiro CA. The meaning of interaction between nursing professionals and newborns/families in a hospital setting. Rev Latino-am Enfermagem 2008 novembro-dezembro; 16(6):1012-8. This study aimed to understand the meaning of the nursing team's communication with newborns and families during care delivered in a neonatal unit and also to develop a theoretical model. Symbolic Interactionism andHargie's model were used as theoretical and Grounded theory as the methodological reference framework. The study was carried out at the nursery of a hospital in São Paulo, SP, Brazil. The study sample was composed of three nurses and four nursing auxiliaries. The theoretical model Being mediated by the strength of motivation was based on findings and revealed the role the nursing professionals' motivation played during interactions with newborns and families. The conclusion is that more humanized interactions with newborns and familiesresult from the nursing professionals' motivation. Research has showed that an infant's hospitalization process is a stressing experience for parents and that it is very difficult for them to be apart from their child (3)(4) . DESCRIPTORS: communication; newborn; motivation; nursing EL SIGNIFICADO DE LA INTERACCIÓN DE LAS PROFESIONALES DE ENFERMERÍA CON EL RECIÉN NACIDO/FAMILIA DURANTE LA HOSPITALIZACIÓNInterpersonal METHODThe theoretical reference frameworks for this study were Symbolic Interactionism (SI) The methodological reference adopted to guide data collection and analysis was Grounded theory. It aims to describe concepts that emerge from data and interpret the relation between these concepts, allowing for the construction of theoretical models (9) .(Before collecting data, permission from the Research Ethics Committee was obtained and ethical criteria Communicating with the newborn and family describes the professionals' movement towards the family and newborn. When they begin interaction through care, they establish a goal. Moved by their motivation, nurses and auxiliaries perform actions

The goal was to identify sound pressure level (SPL) at the neonatal intensive care unit (NICU) and inside the incubator of a teaching hospital of a public university from São Paulo -SP, Brazil. SPL inside the NICU and the incubator were measured using four dosimeters in January/2010. SPL at the NICU varied from 52.6 dBA to 80.4 dBA and inside the incubator, from 45.4 dBA to 79.1 dBA. SPL both at the NICU and inside the incubator are above the recommended values, but levels were higher at the NICU than inside the incubator.Although there are some specific factors related to SPL inside the incubator, the NICU and incubator acoustic features present a system: an increase/decrease in SPL at the NICU usually tends to increase/decrease SPL inside the incubator. The study points to the need for simultaneous monitoring of SPL at the NICU and inside the incubator. Evidenciou-se que tanto o NPS da UTIN como o do interior da incubadora estão acima dos recomendados, sendo mais altos na UTIN do que na incubadora. Embora haja alguns fatores específicos relacionados ao NPS no interior da incubadora, perfis acústicos da UTIN e da incubadora são como sistema: elevação/redução do NPS da UTIN, geralmente, tende a elevar/reduzir o NPS no interior da incubadora. Portanto, pode-se concluir que o presente estudo aponta para a importância do monitoramento simultâneo dos NPS da UTIN e do interior da incubadora.Descritores: Ruído; Terapia Intensiva Neonatal; Enfermagem Neonatal; Humanização da Assistência; Recém-Nascido. Ruido en la Unidad de Terapia Intensiva Neonatal y en el interior de la incubadoraSe tuvo por objetivo identificar el nivel de presión sonora (NPS) de la Unidad de Terapia Intensiva Neonatal (UTIN) y del interior de la incubadora de un hospital escuela de una universidad pública de Sao Paulo-SP, Brasil. El NPS de la UTIN y de la incubadora fueron obtenidos por cuatro dosímetros en enero de 2010. El NPS de la UTIN varió entre 52,6 dBA y 80,4 dBA y el del interior de la incubadora fue de 45,4dBA a 79,1dBA. Tanto el NPS de la UTIN como el del interior de la incubadora son mayores que lo que recomendado, siendo más altos en la UTIN que en la incubadora. A pesar de que existen algunos factores específicos relacionados al NPS en el interior de la incubadora, los perfiles acústicos de la UTIN y de la incubadora son como un sistema, es decir: la elevación/reducción del NPS de la UTIN generalmente tiende a elevar/reducir el NPS en el interior de la incubadora.Se concluye que muy importante la monitorización simultánea del NPS de la UTIN y del interior de la incubadora.Descriptores: Ruido; Cuidado Intensivo Neonatal; Enfermería Neonatal; Humanización de la Atención.

RESUMOO obje vo deste estudo foi verifi car o conhecimento e a percepção de profi ssionais de Unidade de Terapia Intensiva Neonatal (UTIN) sobre as repercussões do ruído ao neonato, família e profi ssionais, antes da implementação de um programa educa vo. Trata--se de uma pesquisa descri va, quan ta va, realizada em Unidade de Terapia Intensiva Neonatal de um hospital de São Paulo, com 101 profi ssionais. Foram u lizados: ques onário para a coleta de dados, e os testes de Qui-quadrado e t de Student para a associação entre as variáveis. Os profi ssionais idenfi caram a UTIN como muito ruidosa (44,9%), perceberam os efeitos desse ruído durante e após a jornada de trabalho (67,4%) e u lizaram estratégias para amenizá-lo. Embora os profi ssionais desconheçam a legislação sobre o ruído no ambiente hospitalar, iden fi caram repercussões para si, recém-nascido e família. Os resultados apontaram para a necessidade de orientar a equipe quanto à legislação, prevenção de ruído e reorganização das prá cas assistenciais e estrutura

Considering advancements in data collection methods, we explore the use of videotaping in qualitative research. This bibliographical study aims at developing reflections on the possibilities of using videotapes in research and at providing material to researchers. The video is used as an instrument of data collection and generation. We mention technical aspects, such as the utilization of a mobile or fixed camera. By means of the latter, the authors report their experience, emphasizing compliance with the neutrality principle and the possibility of editing the images obtained as a means of generating new data. The authors highlight that it was possible to detect contradictions between discourse and behavior through the use of videotaping and interviews. The authors also discuss the ethical principles set by CNS Resolution 196/96 and other ethical questions, whose solutions should be based on the agreement between researchers and subjects.

Objective:To compare the total sleep time of premature infant in the presence or absence of reducing sensory and environmental stimuli in the neonatal unit. Method: Longitudinal study in a Neonatal Intermediate Care Unit of a public hospital in Sao Paulo. The sample consisted of 13 premature infants. We used polysomnograph and unstructured observation for data collection. We analyzed 240 and 1200 minutes corresponding to the periods of the presence and absence of environmental management, respectively. Data were compared in proportion to the total sleep time in the two moments proposed by the study. Results: The total sleep time in periods without environmental management was on average 696.4 (± 112.1) minutes and with management 168.5 (± 27.9) minutes, proportionally premature infant slept an average of 70.2% during periods with no intervention and 58.0% without management (p=0.002). Conclusion: Reducing stimulation and handling of premature infant environment periods was effective to provide greater total sleep time. DESCRIPTORS INTRODUCTIONThe estimate of premature births in Brazil is about 9.8% of the 2,913.160 births registered in 2011 (1) . Due to prematurity, the proportion of premature infants (PI) may require hospitalization in a neonatal unit, which is commonly characterized as in environment that has high sensory stimuli overload for the newborn, additionally, there is a need for frequent management for invasive and painful procedures (2)(3)(4)(5) . The characteristics of the neonatal unit environment and care provided to premature infants according to the institutional routines can reduce the total sleep time leading them to consequent deprivation, which can be constituted in morbidity factor, especially when the gestational age is low and the length of hospital stay is long (2,4,6) . Many studies show that sleep deprivation of premature infants in the neonatal unit can lead to worsening of clinical status and delay hospital discharge, besides that, it could trigger behavioral disorders in adulthood (4,(7)(8) . PI present sleep with polyphasic pattern that are classified into three stages: active, quiet and indeterminate sleep (3,7,(9)(10) . The different stages of sleep are essential for the homeostasis of premature infants, because they establish relations with important physiological and neurological activities (3,9) . In the quiet sleep, decreased basal metabolic rate occurs, which promotes replenishment of energy reserves as well as promote cellular repair, in the active sleep brain activation occurs, which is essential for the structural maturation of the central nervous system (10)(11) . It is noteworthy that the indeterminate sleep cannot be considered as quiet or active, it is characterized as the transition between these two types of sleep patterns (12) . Mitigating possible harmful effects of care provided to hospitalized newborns is one of the actions that should be prioritized by professionals working towards recovery (13) . In this context, the developmental care aims at reduc...

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