Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20240025-en
Brazilian Journal of Pain
Original Article

Knowledge of healthcare professionals about nonpharmacological pain management in the neonate in a Brazilian rooming-in: a survey study with factor analysis

Conhecimento dos profissionais de saúde sobre o manejo não farmacológico da dor neonatal em um alojamento conjunto no Brasil: estudo tipo survey com análise fatorial

Cristina Ortiz Sobrinho Valete; Carolina Perez Montenegro; Esther Angélica Luiz Ferreira

Downloads: 0
Views: 7

Abstract

BACKGROUND AND OBJECTIES: Neonatal pain management is considered one of the eight principles of neonatal care. This study aims to investigate the construct reflecting neonatal non-pharmacological pain management, in a Brazilian rooming-in unit, and identify the preferred intervention.

METHODS:: This survey study included 47 health professionals assessed through an in-person questionnaire. Factor analysis was conducted with a rotation using the Varimax method. Cronbach’s alpha was 0.78.

RESULTS: The construct comprised three factors in the following order: 1) knowledge and impact of neonatal pain on parents, 2) the benefits of pain treatment, and 3) non-pharmacological interventions. Breastfeeding is part of the first factor, revealing its particular importance. The reduction of luminosity is part of the second factor. Non-nutritive sucking with sweet solution, kangaroo position, and music therapy are part of the third factor.

CONCLUSION: The construct observed in this rooming-in identified three factors and suggests that breastfeeding is the preferred intervention to implement for non-pharmacological pain management in the neonate.

 

Keywords

Breastfeeding; Factor analysis; Newborn; Pain; Pain management

Resumo

JUSTIFICATIVA E OBJETIVOS:  O manejo da dor neonatal é considerado um dos oito princípios do cuidado neonatal. O presente estudo teve como objetivo investigar o construto que reflete o manejo não farmacológico da dor neonatal em uma unidade de alojamento conjunto brasileira e identificar a intervenção preferencial.

MÉTODOS:  Este estudo de pesquisa incluiu 47 profissionais de saúde avaliados por meio de um questionário presencial. A análise fatorial foi realizada com uma rotação usando o método Varimax. O alfa de Cronbach foi de 0,78.

RESULTADOS:  O construto foi composto por três fatores na seguinte ordem: 1) conhecimento e impacto da dor neonatal nos pais, 2) benefícios do tratamento da dor e 3) intervenções não farmacológicas. A amamentação faz parte do primeiro fator, revelando sua especial importância. A redução da luminosidade faz parte do segundo fator. A sucção não nutritiva com solução doce, a posição canguru e a musicoterapia fazem parte do terceiro fator.

CONCLUSÃO:  O construto observado neste alojamento conjunto identificou três fatores e sugere que o aleitamento materno é a intervenção preferencial a ser implementada para o controle não farmacológico da dor no recém-nascido.

Palavras-chave

Aleitamento materno; Análise fatorial; Dor; Manejo da dor; Recém-nascido

References

1 Jordan I, Martens R, Birnie KA. Don’t tell me, show me: Reactions from those with lived experience to the 2020 revised IASP definition of pain. Pediatr Neonatal Pain. 2021;3(3):119-22.

2 Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, Keefe FJ, Mogil JS, Ringkamp M, Sluka KA, Song XJ, Stevens B, Sullivan MD, Tutelman PR, Ushida T, Vader K. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-82.

3 Albuquerque A. Manual dos direitos dos pacientes. Belo Horizonte: Editora CEI; 2020.

4 Anand KJ, Hickey PR. Pain and Its Effects in the Human Neonate and Fetus. N Engl J Med. 1987;317(21):1321-9.

5 Walker SM. Long-term effects of neonatal pain. Semin Fetal Neonatal Med. 2019;24(4):101005.

6 Holm KG, Weis J, Eg M, Nørgaard B, Sixtus C, Haslund-Thomsen H, Helena Hansson, Brødsgaard A, Ragnhild Maastrup. Pain assessment and treatment in hospitalized infants, children, and young people. J Child Health Care. 2023;22:13674935231163399.

7 Shen Q, Huang Z, Leng H, Luo X, Zheng X. Efficacy and safety of non-pharmacological interventions for neonatal pain: an overview of systematic reviews. BMJ Open. 2022;12(9):e062296.

8 Ferreira EAL, Valete COS, Nassif DS, de Barros GAM. Type of delivery and pain response in full-term newborns after vitamin K administration: assessment using the COMFORT Behavior and Neonatal Facial Coding System scales. Braz J Anesthesiol. 2023;73(2):232-3.

9 Roué JM, Kuhn P, Lopez Maestro M, Maastrup RA, Mitanchez D, Westrup B, Sizun J. Eight principles for patient-centred and family-centred care for newborns in the neonatal intensive care unit. Arch Dis Child Fetal Neonatal Ed. 2017;102(4):F364-F368.

10 Valete COS, Albuquerque A, Ferreira EAL, Bruno CH, Costa GAM. Reframing neonatal care from an empathic care perspective. NCAJ. 2023;9(3):117-20.

11 Latimer MA, Johnston CC, Ritchie JA, Clarke S P, Gilin D. Factors affecting delivery of evidence-based procedural pain care in hospitalized neonates. J Obstet Gynecol Neonatal Nurs. 2009;38(2):182-94.

12 Taylor JM. Reliability. J Nurs Educ. 2021;60(2):65-6.

13 Sharma A, Minh Duc NT, Luu Lam Thang T, Nam NH, Ng SJ, Abbas KS, Huy NT, Marušić A, Paul CL, Kwok J, Karbwang J, de Waure C, Drummond FJ, Kizawa Y, Taal E, Vermeulen J, Lee GHM, Gyedu A, To KG, Verra ML, Jacqz-Aigrain ÉM, Leclercq WKG, Salminen ST, Sherbourne CD, Mintzes B, Lozano S, Tran US, Matsui M, Karamouzian M. A Consensus-Based Checklist for Reporting of Survey Studies (CROSS). J Gen Intern Med. 2021;36(10):3179-87.

14 Meek JY, Noble L. Policy statement: breastfeeding and the use of human milk. Pediatrics. 2022;150(1):e2022057988.

15 Capellini VV, Daré MF, Castral TC, Christofel MM, Leite AM, Scochi CGS. Conhecimento e atitudes de profissionais de saúde sobre avaliação e manejo da dor neonatal. Rev Eletr Enf. 2014;16(2):361-9.

16 Costa T, Rossato LM, Bueno M, Secco IL, Sposito NPB, Harrison D, Freitas JS. Conhecimento e práticas de enfermeiros acerca do manejo da dor em recém-nascidos. Rev Esc Enferm USP. 2017;51:e03210.

17 Christoffel MM, Querido DL, Silveira AL, Magesti BN, Gomes AL, Silva AC. Health professionals’ barriers in the management, evaluation, and treatment of neonatal pain. BrJP. 2019;2(1):34-8.

18 Calamy L, Walter-Nicolet E. Neonatal pain assessment practices in the maternity ward (delivery room and postpartum ward): We can improve. Arch Pediatr. 2018;25(8):476-9.

19 McNair C, Chirinian N, Uleryk E, Stevens B, McAllister M, Franck LS, Taddio A, Shah V. Effectiveness of parental education about pain in the neonatal period on knowledge, attitudes, and practices: A systematic review and meta-analysis. Paediatr Child Health. 2022;27(8):454-63.

20 Sacks E. Defining disrespect and abuse of newborns: a review of the evidence and an expanded typology of respectful maternity care. Reprod Health. 2017;14:66.

21 Ndwiga C, Warren CE, Okondo C, Abuya T, Sripad P. Experience of care of hospitalized newborns and young children and their parents: A scoping review. PLoS One. 2022;17(8):e0272912.

22 Geng X, Li G, Lu Z, Gao W, Wang L, Shen D, Zhu H, Gilmore JH. Structural and maturational covariance in early childhood brain development. Cereb Cortex. 2017;27(3):1795-807.

23 Lammertink F, van den Heuvel MP, Hermans EJ, Dudink J, Tataranno ML, Benders MJNL, Vinkers CH. Correction: early-life stress exposure and large-scale covariance brain networks in extremely preterm-born infants. Transl Psychiatry. 2022;12(1):269. Erratum for: Transl Psychiatry. 2022;12(1):256.

24 Santos J, Pearce SE, Stroustrup A. Impact of hospital-based environmental exposures on neurodevelopmental outcomes of preterm infants. Curr Opin Pediatr. 2015; 27(2):254-60.

25 Marchal A, Melchior M, Dufour A, Poisbeau P, Zores C, Kuhn P. Pain behavioural response to acoustic and light environmental changes in very preterm infants. Children (Basel). 2021;8(12):1081.

26 Akbari N, Mutlu B, Nadali J. Effect of non-nutritive sucking during heel stick procedure in pain management of term infants in the neonatal intensive care unit: a systematic review and meta-analysis. Curr Pediatr Rev. 2022;19(1):90-8.

27 Silveira ALD, Christoffel MM, Velarde LGC, Rodrigues EC, Magesti BN, Souza RO. Efeito da glicose e sucção não nutritiva na dor de prematuros na punção: ensaio clínico crossover. Rev Esc Enferm USP. 2021;55:e03732.

28 Campbell-Yeo M, Johnston CC, Benoit B, Disher T, Caddell K, Vincer M, Walker CD, Latimer M, Streiner DL, Inglis D. Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial. Pain. 2019;160(11):2580-8.

29 Zhao Y, Dong Y, Cao J. Kangaroo care for relieving neonatal pain caused by invasive procedures: a systematic review and meta-analysis. Comput Intell Neurosci. 2022;2022:2577158.

30 Maitre NL, Arnon S. Music therapy for neonatal stress and pain-music to our ears. J Perinatol. 2020;40(12):1734-5.

31 Palazzi A, Nunes CC, Piccinini CA. Music therapy and musical stimulation in the context of prematurity: a narrative literature review from 2010-2015. J Clin Nurs. 2018;27(1-2):e1-20.
 


Submitted date:
01/08/2024

Accepted date:
03/19/2024

678a651ca95395441873a576 brjp Articles

BrJP

Share this page
Page Sections