Fatores que interferem no reconhecimento por adultos da expressão facial de dor no recém-nascido

Balda, Rita de Cássia Xavier; Almeida, Maria Fernanda Branco de; Peres, C.; Guinsburg, Ruth

doi:10.1590/s0103-05822009000200007

Cited by 16 publications

(12 citation statements)

References 30 publications

(69 reference statements)

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“…The disagreement found among parents, nurse technicians and pediatricians on the presence and the intensity of pain and distress in infants supports the findings of previous studies reporting differences in the assessment of pain by adult observers regarding adults, children and neonates as a function of particular personal, professional, and emotional traits of the observers [12,17,18]. The three groups of adults were different in their general characteristics: parents were slightly younger than health professionals and had significantly less years of education.…”

Section: Discussionsupporting

confidence: 83%

Perception of pain and distress in intubated and mechanically ventilated newborn infants by parents and health professionals

2014

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BackgroundAn understanding of perceptions of parents and health caregivers who assist critically ill neonates is necessary to comprehend their actions and demands. Therefore this study aim to analyze the agreement among parents, nurse technicians and pediatricians regarding the presence and intensity of pain and distress in mechanically ventilated and intubated newborn infants.MethodsCross-sectional study comprising 52 infants and 52 trios of adults composed of one parent, one nurse technician, and one pediatrician who all observed the same infant. All infants were intubated and under mechanical ventilation and were not handled during the observations. Each newborn was simultaneously observed by the trio of adults for 1 minute to evaluate the presence of pain and distress. The intensity of pain and distress that the adults believed was felt by the infants was marked in a visual analogical scale. Adults’ agreement about the simultaneous presence of pain and distress in each infant was analyzed by marginal homogeneity and Cochran tests. The agreement about the intensity of pain and distress in each infant was studied by Bland-Altman plot and intraclass correlation coefficient (ICC).ResultsThe assessments of pain and distress were heterogeneous in all three investigated groups of adults as determined by the results of a Bland-Altman plot. The presence of distress was more frequently reported compared with pain (marginal heterogeneity, p < 0.01). The pain and distress scores in each adult group were not correlated as shown by ICC [parents, 0.36 (95% CI: 0.01-0.63); nurses 0.47 (0.23-0.66); pediatricians, 0.46 (0.22-0.65)].ConclusionsAdults systematically underscore pain in comparison to distress in mechanically ventilated newborns, without recognizing the association between them.

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Section: Discussionsupporting

confidence: 83%

Perception of pain and distress in intubated and mechanically ventilated newborn infants by parents and health professionals

2014

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“…The use of the movement of the face is therefore problematic in taking therapeutic decisions. In addition to this, it is known that changes in facial expression can occur in response to acute painful stimuli, but it is not known what happens in the event of a prolonged or repetitive stimulus 1,12 .…”

Section: Discussionmentioning

confidence: 99%

O recem-nascido com dor: atuacao da equipe de enfermagem

et al. 2013

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Estudo quantitativo, descritivo e transversal realizado com profissionais de enfermagem que atuam em neonatologia nos três hospitais de Alfenas-MG. Objetivou descrever as formas de avaliação de dor do recém-nascido utilizadas pela equipe de enfermagem e analisar a prática da enfermagem quanto ao manejo da dor do neonato. A coleta de dados foi feita por meio de formulário semiestruturado, de agosto a setembro de 2008, com 42 profissionais. A análise foi feita pelo software SPSS utilizando estatística descritiva e teste de correlação. Os entrevistados acreditam que o recém-nascido é capaz de sentir dor e a avaliam por meio de alterações fisiológicas e comportamentais, e que não há utilização de escalas de avaliação álgica padronizadas nas instituições. Para o manejo, realizam intervenções farmacológicas e não farmacológicas. Há necessidade de capacitar os profissionais, contribuindo para a avaliação e o manejo da dor, e promovendo o cuidado integral ao neonato.

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“…Diversos fatores, como idade, sexo, raça, religião, estado civil, nível socioeconômico e tradições culturais, podem influenciar a avaliação da dor neonatal pelos profissionais de saúde (18,31,35,36,41) . A influência da idade do avaliador na percepção do fenômeno doloroso do neonato é um tema controverso (36) .…”

Section: Experiência Do Profissional Em Lidar Com a Dorunclassified

Fatores que influenciam a prática do profissional de saúde no manejo da dor do recém-nascido

Maia

Coutinho

2011

Rev. paul. pediatr.

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RESUMOObjetivo: Apresentar revisão sobre as principais variáveis que podem influenciar as ações e as atitudes dos profissionais de saúde no manejo adequado da dor no período neonatal.Fontes dos dados: Pesquisa bibliográfica, nas bases de dados Medline, SciELO e Lilacs, entre 1995 e 2009, restrita aos artigos escritos em inglês e português. Foram utilizados os seguintes descritores: "dor", "Terapia Intensiva Neonatal" e "profissional de Saúde". Avaliaram-se 88 artigos, sem seleção pelo desenho, sendo incluídos os 55 mais relevantes e recentes.Síntese dos dados: Os estudos confirmaram que o manejo da dor no neonato pelos profissionais de saúde é inadequado. Essa prática pode estar relacionada aos seguintes fatores: conhecimento insuficiente quanto à fisiopatologia da dor; não utilização de métodos de avaliação; falta de normatização sistemática ou protocolos; e falha na comunicação e incorporação da teoria na prática diária por parte da equipe multiprofissional. São acrescidos ainda os fatores subjetivos, pessoais e profissionais, que podem interferir na avaliação e no tratamento da dor no recém-nascido.Conclusões: Os obstáculos para um manejo adequado da dor são multifatoriais e o conhecimento das atitudes e crenças das equipes de saúde que trabalham com neonatos é muito importante. Há necessidade de investimentos na capacitação, formação e sensibilização dos profissionais acerca do controle e do tratamento da dor, com o intuito de proporcionar um cuidado mais humanizado ao neonato.Palavras-chave: dor; terapia intensiva neonatal; pessoal de Saúde. ABSTRACTObjective: To perform a literature review on the main variables associated with in the actions and attitudes of healthcare professionals regarding pain management during the neonatal period.Data sources: Bibliographic search of Medline, SciELO and Lilacs databases for articles published in English and Portuguese between 1995 and 2009, using the descriptors "pain", "Neonatal Intensive Care" and "health personnel". Among 88 articles, the 55 more recent and relevant ones were included.Data synthesis: The studies confirmed that neonatal pain management by healthcare professionals is inadequate. This may be related to insufficient knowledge regarding the physiopathology of pain; lack of systematic guidelines on pain assessment and management and failure in communication and incorporation of knowledge into the clinical practice by health professionals. Moreover, there are individual and professional subjective factors that may affect pain evaluation and treatment in newborns.Conclusions: There are multiple obstacles to adequate neonatal pain management. Understanding the attitudes and beliefs of healthcare teams is important to assess and heat neonatal pain. There is a need for investments on the qualification and awareness of healthcare professionals regarding pain control in order to provide humanized neonatal care.

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Fatores que interferem no reconhecimento por adultos da expressão facial de dor no recém-nascido

Cited by 16 publications

References 30 publications

Perception of pain and distress in intubated and mechanically ventilated newborn infants by parents and health professionals

Perception of pain and distress in intubated and mechanically ventilated newborn infants by parents and health professionals

O recem-nascido com dor: atuacao da equipe de enfermagem

Fatores que influenciam a prática do profissional de saúde no manejo da dor do recém-nascido

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