Conhecimentos e prÃticas dos profissionais de saÃde sobre o manejo da dor no perÃodo neonatal

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Introduction: Despite greater knowledge regarding pain, newborns continue to be exposed to invasive procedures without the use of analgesics in neonatal intensive care units. Most physicians are incapable of assessing and treating pain in newborns due to a failure to incorporate current knowledge into their medical routine. The attitudes of neonatologists often do not reflect current evidence regarding pain in this age group. Objectives: 1- Perform a literature review to assess variables that influence the actions and attitudes of healthcare professionals in clinical practice; 2- Compare the practices reported to those used by physicians regarding pain management in neonatal intensive care units. Methods: A literature review was carried out on the topic using the MEDLINE, SciElo and LILACS databases for studies published between 1995 and 2008, employing the descriptors âPainâ, âNeonatal Intensive Careâ and âHealthcare Professionalsâ. For the original article, a descriptive, crosssectional study was carried out, with an analytical component, through questionnaires applied for the physicians, casual workers and / or persons on duty, in the period of January the May of 2007. In order to compare the information provided by physicians with the routine medical practice of the services, there were used data of a study inquiry six months before, in the same services, entitled âPain management and the systematic use of analgesics in neonatologyâ. Two stages took place in different periods to lessen it influences of the interrogation on the conducts of the interviewed ones. Results: A number of studies demonstrate that healthcare professionals are nearly always incapable of identifying and treating pain in newborns. There are multiple obstacles to the adequate management of neonatal pain, including insufficient knowledge and training, a lack of systematic norms and subjective factors such as personal influences or previous professional experience. In the original study, the reported use of analgesics was greater than that actually used for the treatment of newborns in situations of pain such as enterocolitis (p<0.02), postoperative period (p<0.01), oro-tracheal intubation (p<0.01) and mechanical ventilation (p<0.01). Statistically significant differences were also found for the use of opioids, benzodiazepines and the association of these drugs. The study also demonstrated that, although all the healthcare professionals report that newborns feel pain, there was a lack of knowledge on the part of the interviewees regarding the clinical and pharmacological aspects of analgesics in the neonatal period. Conclusion: The physicians evaluated in the present study know that newborns feel pain, but demonstrate a lack of knowledge regarding important clinical and pharmacological aspects for adequate pain management in newborns. Despite advances in pain management, neonatologists have not yet incorporated such advances into their routine practice. In order to reduce the distance between knowledge and practice, awareness on the part of healthcare professionals is needed with regard to the importance of minimizing pain in this period of life. Thus, training is needed for these healthcare professionals regarding pain management, along with the implantation of norms and protocols in the services studied in order to improve routine practices and provide assistance in the quest for more humanized neonatal care

ASSUNTO(S)

pain healthcare professional pediatria neonatal intensive care dor â terapia intensiva neonatal profissional de saÃde

ACESSO AO ARTIGO

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