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- ItemSomente MetadadadosInfluência da duração do contato pele a pele sobre o sono e parâmetros fisiológicos de recém-nascidos pré-termo(Universidade Federal de São Paulo (UNIFESP), 2020-11-26) Pinto, Claudia Machado Alves [UNIFESP]; Avelar, Ariane Ferreira Machado [UNIFESP]; Universidade Federal de São PauloIntroduction: Improving the sleep-wake pattern and stabilizing the vital signs of preterm newborns (PTNB) are benefits related to skin-to-skin contact with their mother or father, with a positive impact on brain development, maturation and repair , behavioral, cognitive and motor of the newborn. However, the duration of skin-to-skin contact is still not clearly established in order to achieve the expected positive results during hospitalization and discharge of PTNB. Objective: To investigate the influence of the duration of skin-to-skin contact on sleep and physiological parameters of preterm newborns and the maternal and neonatal characteristics that may interfere with the duration of this contact. Casuistry and method: Cross-sectional study, developed with preterm newborns, weighing less than 2,000 grams and able to perform skin-to-skin contact (CPP) at the Conventional Neonatal Intermediate Care Unit of a public maternity hospital in the Western Brazilian Amazon. The convenience sample consisted of 36 PTNB and 30 mothers. Data collection took place from April to October 2018. Sociodemographic, reproductive and obstetric maternal, biological and neonatal vitality variables, those related to skin-to-skin contact and their duration, physiological and behavioral parameters were investigated. The physiological parameters of newborns (NB) were recorded before, during and after a single session of skin-to-skin contact, and the mother's temperature was recorded before and after. The behavioral responses presented by the newborns during the CPP were filmed in real time, and the predominant state of the behavior was recorded at the end of each 10-second recording period. The differentiation of the sleep-wake states of PTNBs was performed based on the definitions of an accepted observational biobehavioral assessment method and classified as sleep, wakefulness and transition. Results: Skin-to-skin contact occurred for a median time of 2.12 hours (1st quartile: 1.65; 3rd quartile: 2.99), with newborns between 26 and 31 weeks of gestational age and weight between 980 and 2,000 grams at birth. Most mothers (55.6%) remained in CPP for more than 2 hours. Statistically significant differences were identified in the respiratory rate of the PTNB and maternal axillary temperature between the values before and after the CPP and the neonatal heart rate before the end of the CPP (p⦤0.05). With regard to behavior, the duration of CPP did not significantly influence the sleep time of PTNB, but it was possible to observe that NBs who stayed in contact longer spent more time sleeping. Conclusion: our study was unable to identify the effect of CPP duration on sleep in this sample of preterm newborns. Monitoring the behavioral state for a longer period can provide significant insights. As for the physiological parameters, the CPP promoted an increase in the neonatal respiratory rate and maternal axillary temperature after contact and the heart rate of the newborns at the end of the contact.
- ItemAcesso aberto (Open Access)Manipulação de recém-nascidos prematuros e a influência sobre o sono(Universidade Federal de São Paulo (UNIFESP), 2017-02-24) Maki, Maria Takahashi [UNIFESP]; Avelar, Ariane Ferreira Machado [UNIFESP]; http://lattes.cnpq.br/8919300907658980; http://lattes.cnpq.br/6770686589576590; Universidade Federal de São Paulo (UNIFESP)Premature birth leads to prolonged hospitalization of the neonate and consequent excessive manipulation during this period, leading to fragmentation and sleep deprivation with probable future developmental impairment. Observational and correlational study aimed at identifying performed manipulations in preterm infants (PNF) and evaluating the influence on total sleep time, wakefulness and sleep patterns.Using direct observation, filming and 24-hour polysomnography of hospitalized PTNB infants in a neonatal intermediate care unit of a University Hospital of São Paulo. The sample consisted of clinically stable PTNB, 1722,92(±215,32)grams, infants maintained in a double wall incubator with positive otoacoustic emission test. Descriptive statistics and the nonparametric Friedman test, Pearson correlation coefficient, Spearman and Linear Regression analysis with statistical significance of p≤0.05 was used for the data analysis. Twelve female PTNB, with a mean of 1722,92(±215,32)grams, with low weight, individually handled 176.4 (± 37.9) on average during the 24 hours were evaluated. The manipulations occurred mainly for monitoring, followed by therapeutics / diagnosis, hygiene and comfort and feeding. It was observed that 58% of the manipulations were due to the hospitalization. Regarding the sleep variables, we found that PTNBs remained predominantly in quiet sleep (38.4%), followed by wakefulness (37.6%), active sleep (31.2%), and undetermined sleep (30.4%) , Remaining longer (95.5 ± 31.57) minutes in QS in night 1, followed by AS (76.25 ± 34.79) in the evening period, US (73.29 ± 14.94) and vigil time(140.83 ± 43.74) in night 2. No statistically significant differences were found between direct manipulations (r = 0.158 and p = 0.623) and the environment (r = 0.226 and p = 0.479) with total sleep time P> 0.05). Thus, the results of the study reinforce the importance of care aimed at the behavioral signs of prematurity and the grouping of activities in order to provide an environment that favors the adequate development of early birth and the need for hospitalization in neonatal units.
- ItemSomente MetadadadosMeasurement of family-centered care perception and parental stress in a neonatal unit(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2016) Balbino, Flávia Simphronio [UNIFESP]; Ferreira Gomes Balieiro, Maria Magda [UNIFESP]; Mandetta, Myriam Aparecida [UNIFESP]Objective: to evaluate the effects of the implementation of the Patient and Family-Centered Care Model on parents and healthcare perceptions and parental stress. Method: a quasi-experimental study developed in a neonatal unit of a university hospital in the municipality of Sao Paulo, Brazil, with the implementation of this model of care. Data collection were performed by two sample groups, one using non-equivalent groups of parents, and another using equivalent groups of healthcare professionals. The instruments Perceptions of Family-Centered Care-Parent Brazilian Version, Perceptions of Family-Centered Care-Staff Brazilian Version and Parental Stress Scale: Neonatal Intensive Care Unit, were applied to 132 parents of newborns hospitalized and to 57 professionals. Results: there was a statistically significant improvement in the perceptions of the parents in most items assessed (p <= 0,05) and for the staff in relation to the family welcome in the neonatal unit (p = 0.041) and to the comprehension of the family's experience with the infant's hospitalization (p = 0,050). There was a reduction in the average scores of parental stress, with a greater decrease in the Alteration in Parental Role from 4,2 to 3,8 (p = 0,048). Conclusion: the interventions improved the perceptions of parents and healthcare team related to patient and family-centered care and contributed to reducing parental stress.
- ItemSomente MetadadadosMimetização in vitro da prática transfusional em neonatos: influência do tipo de cateter e da irradiação de concentrados de hemácias sobre marcadores de hemólise(Universidade Federal de São Paulo (UNIFESP), 2019-11-28) Orsi, Kelly Cristina Sbampato Calado [UNIFESP]; Avelar, Ariane Ferreira Machado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: In transfusion practice in neonates, predominantly irradiated red blood cell (RBC) are administered by smaller caliber catheters due to small diameter and vascular fragility of neonates. The literature does not define precisely whether the mechanical action of the devices on the RBC, as well as the irradiation process can influence on occurrence of harmful hemolysis levels to newborn´s health. Objectives: To evaluate the effect of RBC irradiation on hemolysis marker levels; to compare the levels of irradiated and non-irradiated RBC hemolysis markers after in vitro infusion by peripheral intravenous catheter (PIV), umbilical catheter and peripheral inserted central catheter (PICC); to verify the influence of the infusion method on hemolysis markers administered in vitro in PIV. Materials and methods: Experimental study conducted in laboratory under controlled temperature and humidity conditions. Data collection occurred after approval of the ethical merit (nº 3,116,300) .Irradiated and non-irradiated RBC type A+ conserved in CPDA-1, with maximum 7 days of storage, were used. RBC was randomly administered in triplicate by syringe pump at 10 ml/h velocity, in 24 Gauge PIV, 2 French PICC and , 5Fr umbilical catheter, and gravitational method only on 24G PIV. Aliquots were collected directly from the RBC bag - M1, after manual filling of the infusion system (syringe and extension tube)-M2 and after infusion by catheters -M3. The hemolytic markers analyzed were: hemolysis degree (%), hematocrit - Ht (%); total hemoglobin - Hbt (g / dl); free hemoglobin - Hbl (g / dl); potassium - K (mmol / l) and lactate dehydrogenase - LDH (U / L). 360 aliquots were analyzed and levels of 1800 irradiated and non-irradiated RBC hemolysis markers were identified. The mean storage time of RBC were 4.9 (± 2.1) days Descriptive and inferential analysis were used and, according to the nature of the variables, the Mann – Whitnney, Wilcoxon, Kruskall Wallis, and / or Student's T tests, p <0.05, were applied. Results: Irradiated RBC presentes higher potassium levels 25,40±7,19) than non irradiated (18,92± 4,83) (p<0,001). CIVP have no influence in hemolysis markers, in both blood types. After umbilical cateter infusion we noted incremente in Hbl [0,04±0,01 to 0,05±0,02g/dl]; Ht [69,60±5,84 to 75,60±4,29%]; K [17,95±19,69 to 19,69±3,30] of RBc non irradiated, and Ht [65,80±5,96 to 68,20±7,46%]; e LDH [118,73(107,93-82,13) to 146,01(113,33-irradiated RBC, and Hbl [0,03±0,01 to 0,04± 0,02g/dl] e grau de hemólise [0,04±0,01 to 0,05±0,02g/dl] (p=0,020) on irradiated RBC. The gravitational infusion influenced on incremente of Hbl [0,03±0,02 to 0,05±0,02g/dl], Ht [72,00(70,00-73,00) to74,00(72,00-74,5)%], K [26,27±5,19 to 30,2±4,23] e LDH [118,73(107,93-223,96) to 159,20(122,77-236,10)U/L] of irradiated RBC.Conclusion: Red blood cell irradiation had an influence on potassium and LDH levels, and in vitro infusion with CCIP and umbilical catheter resulted in significant changes in the levels of some hemolysis markers, regardless of the type of blood evaluated. In the infusion of irradiated and non-irradiated RBC by PIV, the gravitational method caused greater variation of hemolysis markers when compared to the syringe infusion pump. The levels of hemolysis markers identified, regardless of blood type, catheter or infusion method, do not suggest clinical repercussions in the neonate and are safe for transfusion therapy.
- ItemAcesso aberto (Open Access)Noise at the Neonatal Intensive Care Unit and inside the incubator(Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2011-10-01) Pinheiro, Eliana Moreira [UNIFESP]; Guinsburg, Ruth [UNIFESP]; Nabuco, Marco Antonio de Araujo; Kakehashi, Tereza Yoshiko [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Instituto Nacional de Metrologia, Normalização e Qualidade IndustrialThe goal was to identify sound pressure level (SPL) at the neonatal intensive care unit (NICU) and inside the incubator of a teaching hospital of a public university from São Paulo - SP, Brazil. SPL inside the NICU and the incubator were measured using four dosimeters in January/2010. SPL at the NICU varied from 52.6 dBA to 80.4 dBA and inside the incubator, from 45.4 dBA to 79.1 dBA. SPL both at the NICU and inside the incubator are above the recommended values, but levels were higher at the NICU than inside the incubator. Although there are some specific factors related to SPL inside the incubator, the NICU and incubator acoustic features present a system: an increase/decrease in SPL at the NICU usually tends to increase/decrease SPL inside the incubator. The study points to the need for simultaneous monitoring of SPL at the NICU and inside the incubator.
- ItemAcesso aberto (Open Access)Nurses Knowledge about the Insertion Procedure for Peripherally Inserted Central Catheters in Newborns(Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2010-04-01) Lourenço, Solange Antonia; Ohara, Conceicao Vieira da Silva [UNIFESP]; Hospital do Coração Pediatric Intensive Care Unit; Universidade Federal de São Paulo (UNIFESP)The right to practice the Peripherally Inserted Central Catheter (PICC) technique, mainly in neonatal intensive care units, was achieved by nursing and consists of efforts that lead to a new challenge: the improvement of the practice of this procedure. This study determined and evaluated the theoretical and practical knowledge acquired by nurses in qualification courses concerning aspects of PICC line insertion in the case of newborns. This descriptive and quantitative study used a questionnaire with nine questions to collect data. The study population was composed of 40 nurses qualified to insert a PICC line in newborns. According to the conceptual knowledge scale established for this study, the results reveal that the nurses have inadequate knowledge concerning the studied aspects, indicating the need for nurses to constantly update and improve their knowledge about this practice so as to better the quality of care delivered to newborns.
- ItemAcesso aberto (Open Access)Parental role conflict: the nursing diagnosis in mothers of hospitalized newborns(Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2013-04-01) Carmona, Elenice Valentim [UNIFESP]; Vale, Ianê Nogueira do; Ohara, Conceicao Vieira da Silva [UNIFESP]; Abrão, Ana Cristina Freitas de Vilhena [UNIFESP]; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To verify if mothers of newborns hospitalized recognize the defining characteristics of parental role conflict as representative of that experience. METHODS: A cross-sectional and descriptive study, developed in a neonatal unit of a public teaching hospital in the state of São Paulo. The sample consisted of 100 women who assigned scores of 1 to 5 to the defining characteristics of the diagnosis, where 1 meant not at all characteristic and 5 meant completely characteristic of what I am experiencing. RESULT: Of the total sample, 96 women self-identified with the diagnosis. The most prevalent defining characteristics were: anxiety, mother expresses concern(s) in relation to changes in maternal role; verbalizes feelings of frustration, reports concern about family and fear. Women who were with their children less often during hospitalization had a higher number of defining characteristics. CONCLUSION: There was a high prevalence of the defining characteristics of the studied diagnosis, suggesting the relevance of the topic and the need for further studies to be developed in the neonatal unit.
- ItemAcesso aberto (Open Access)Percepção materna quanto aos filhos recém-nascidos hospitalizados(Associação Brasileira de Enfermagem, 2014-10-01) Carmona, Elenice Valentim; Vale, Ianê Nogueira Do; Ohara, Conceicao Vieira da Silva [UNIFESP]; Abrão, Ana Cristina Freitas de Vilhena [UNIFESP]; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)Cross-sectional descriptive study conducted in the neonatal unit of a public teaching hospital in the state of São Paulo, Brazil, which aimed to determine the perceptions of mothers about their newborns hospitalized children. The sample consisted of 100 women questioned, through the Neonatal Perception Inventory Broussard, about how much trouble was expected to be presented by babies of the general unit, on behaviors such as crying; feeding; regurgitate or vomit; evacuate; sleep and have a routine. Then, the same questions were repeated about their own babies. Ninety mothers considered their children with fewer difficulties than other babies at the unit. Younger women and mothers of infants with higher weights tended to consider their children with more difficulty. The Inventory is easy to apply and may be useful in the evaluation of mother-child interaction, although its result cannot be considered in isolation.
- ItemAcesso aberto (Open Access)Self-efficacy scale for the establishment of good relationships with families in neonatal and pediatric hospital settings(Univ Sao Paolo, 2017) Cruz, Andreia Cascaes [UNIFESP]; Angelo, Margareth; dos Santos, Bernardo PereiraObjective: The purpose of this study was to develop and test the psychometric properties of the Self-efficacy Scale for the Establishment of Good Relationships with Families in Neonatal and Pediatric Hospital Settings. Method: Methodological study grounded on self-efficacy theory was conducted in three phases: conceptual and operational definition (review of the literature and interviews with the target population), content validity (opinion of five experts e three clinical nurses), and exploratory factor analysis and internal consistency reliability (cross-sectional survey with a valid sample of 194 nurses). Results: A ten-point Likert scale with 40-item was designed and one item was excluded after review by experts. Three factors emerged from the exploratory factor analysis. The Cronbach's alpha for all items was 0.983 with item-total correlations in the range 0.657 to 0.847. Cronbach's alpha value if item deleted were less than or equal to 0.983. Conclusion: The final version of the scale demonstrated psychometric adequacy. It is a useful tool to be administered in the clinical, educational and research nursing fields to measure nurses' self-efficacy beliefs concerning the establishment of good relationships with families.
- ItemAcesso aberto (Open Access)Tradução, adaptação cultural e validação para a língua portuguesa da Parenteral Stress Scale:Neonatal Intensive Care Unit (PSS:NICU)(Universidade Federal de São Paulo (UNIFESP), 2009-06-24) Souza, Sandra Regina de [UNIFESP]; Dupas, Giselle [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introdução: a internação de um recém-nascido na Unidade de Terapia Intensiva Neonatal (UTIN) é um acontecimento inesperado e assustador com o qual os pais não estavam preparados para lidar.Esse evento, que gera sofrimento na família, traz para os profissionais da saúde uma demanda de cuidado, cujo intuito é amenizar as repercussões dessa hospitalização no cotidiano da família. Como enfermeira neonatologista, a autora percebe o estrese dos pais no ambiente neonatal e a necessidade de instrumentos objetivos para identificá-lo e para elaborar as intervenções de enfermagem. No Brasil não encontramos um instrumento para avaliar este tipo de estresse. A escala Parenteral Stress Scale Neonatal Intensive Care Unit(PSS:NICU) é um instrumento desenvolvido por Margaret S. Milles nos Estados Unidos, cuja finalidade é avaliar esse tipo de estresse, tem sido utilizado em vários países. Objetivo: fazer a tradução, a adaptação cultural e a validação da PSS:NICU na língua portugues. Método: fora, utilizadas as etapas de tradução e adaptação cultural proposta Guillemin et al.(1993) que incluem tradução, retradução, análise por um comitê de revisores e preteste da escala. Foi reaizada também análise da confiabilidade por meio do teste e reteste e da consistência interna. Foi feita a validação clínica da versão da escala PSS:NICU na língua portuguesa a uma amostra de 163 país em dois hospitais no Estado de São Paulo.Resultados: a escala na língua portuguesa foi prestada e o nível de compreensão dela foi considerado adequado. A investigação da confiabilidade mostrou boa consistência interna na aplicação a pais brasileiros.Os valores obtidos dos coeficientes de correlação intraclasse ficaram em torno de 0,70, mostrando-se uma boa estabilidade entre as duas avaliações. A análise fatorial pelo método de componentes principais utilizou os mesmos critérios da escala original, com rotação Varimax, que apresentaram grau de variância adequado de 57,9%.Os escores de estresse dos pais foram de 2,3(pouco estressante) na subescala "sons e imagens"; 2,9(moderadamente estressante)na subescala "aparência e comportamento do bebê" e 3,7(muito estressante) na subescala "alteração papel de pais" na métrica 1(Nível de Ocorrência de Estresse")e 2,2; 2,6 e 3,4(pouco, moderadamente e muito estresse) respectivamente na métrica 2(Nível Geral de Estresse").Conclusão: a PSS:NICU na versão em português é uma ferramenta válida e confiável para avaliar o estresse de pais na Unidade de Terapia Intensiva Neonatal.