Neonatal Pain: Characterization of the Physiotherapist’s Perception in the Neonatal Intensive Care Unit

Abstract

Objective: To describe the perception of physiotherapists in neonatal units regarding pain, the use of measurement scales and strategies that minimize pain. Methods: Interviews were conducted with physiotherapists in hospitals with neonatal units between 2013 and 2015 in Rio de Janeiro. The questions concerned the knowledge of the feeling of pain, from its recognition to its care or treatment. The description of the results was done by comparing public and private hospitals (Fisher’’s Exact exact Testtest), considering p<0.05 as significant. Results: 27 hospitals were visited. All the professionals interviewed (n=27) stated that the newborns feel pain, with facial expression being the most cited and known sign for pain. 26% of physiotherapists believe that newborns experience pain at the same magnitude as adults. Among the scales, the Neonatal Infant Pain Scale (NIPS) was the most well known, but only 37% of the units had routine pain assessment protocols. IV cannulation and blood collection were the most mentioned procedures as a cause of pain and there was no difference between public and private hospitals. Conclusions: There is a gap in the knowledge about neonatal pain and how to evaluate it among the participating physiotherapists, with no systematization of care routines involving this assessment.

Non-pharmaceutical intervention and pain management situation for neonatal analgesia

“…Among the painful procedures, venepuncture and blood collection were considered the most common procedures that cause pain. 44 Neonates received few pain relief measures during hospitalization in NICUs. 45 An investigation in Brazil showed that in those preterm infants investigated, daily average painful interventions were 5.37, while the neonates with invasive ventilation were most exposed to painful procedures (71.2%), but only 44.9% received pain relief interventions.…”

Percepção do enfermeiro diante da dor no neonato prematuro

“…Os neonatos prematuros são neurologicamente imaturos, mais suscetíveis aos efeitos danosos dos procedimentos dolorosos, o que justifica a importância do manejo da dor no período neonatal (Barandouzi et al, 2020). Já se sabe que essa falha no manejo da dor favorecerá alterações no desenvolvimento durante a primeira infância, exercendo efeitos prejudiciais permanentes nestas crianças, especialmente nos prematuros extremos, desde alterações no neurodesenvolvimento ou mesmo as síndromes metabólicas (Miatello et al, 2019;Gimenez et al, 2020).…”

“…Partindo dessa visão holística, a dor pode ser identificada e cuidada de forma que minimize os traumas que o paciente, neonato ou idoso, possa sentir, favorecendo o seu tratamento de forma mais humana. Por ser a dor única e subjetiva, torna-se mais difícil de ser avaliada no RN, pois existe uma ausência de capacidade de verbalização e experiências prévias de dor, que levariam a comparação e descrição dessa sensação (Gimenez et al, 2020) Atualmente, a dor é considerada como quinto sinal vital, assim para sua mensuração nos neonatos as expressões faciais são consideradas, juntamente com o uso de instrumentos que possam verificar o desconforto, propondo, assim, intervenções eficazes. Perceber e intervir a sensação dolorosa, proporcionará conforto e ajudará a promoção do bem-estar do prematuro (Gimenez et al, 2020;Bottega et al, 2010).…”

Massage for pain relief in newborns submitted to puncture: systematic review

“…Thus, these matters are extremely important for the multidisciplinary team, especially nurses, as they generate sensitivity when observing changes that are considered, by many professionals, as a challenge during the assessment, treatment and pain relief in newborns, in order to enable humanized care (8,(11)(12)(13)(14) .…”