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.

摘要
研究目的：旨在阐述新生儿病房物理治疗师对疼痛的认知、疼痛评估量表的使用情况，以及减轻疼痛的相关策略。
研究方法：于2013至2015年间，对里约热内卢设有新生儿病房的医院内的物理治疗师开展访谈。访谈内容涵盖疼痛感知相关知识，从疼痛识别到护理或治疗的全流程。结果描述采用公立与私立医院对比的方式，使用费希尔精确检验（Fisher’s Exact Test）进行统计学分析，以p<0.05为差异具有统计学意义。
研究结果：本研究共走访27家医院。受访的27名物理治疗师均认可新生儿可感知疼痛，其中面部表情是被提及最多且最为熟知的疼痛体征。26%的物理治疗师认为新生儿的疼痛感知程度与成人相当。在各类评估量表中，新生儿疼痛量表（Neonatal Infant Pain Scale, NIPS）最为知名，但仅37%的病房建立了常规疼痛评估流程。静脉置管与采血是被提及最多的疼痛诱发操作，公立与私立医院在此方面无显著差异。
研究结论：参与本研究的物理治疗师在新生儿疼痛认知及疼痛评估方法方面存在知识缺口，且尚未形成包含疼痛评估的标准化护理流程。