Conhecimento e atitudes de enfermeiros no manejo não farmacológico da dor em recém nascidos internados em unidades de média e alta complexidade.

Abstract

Pain is one of the first marks of human existence. In recent decades, it has been proven that the newborn (NB) has anatomical, neurochemical and functional conditions for the perception, integration and response to pain, despite the immaturity in the inhibitory mechanisms. Pain is recurrent in newborns in the Neonatal Unit (UN), with different manifestations and impacts, requiring nurses to look trained, humanized and multidimensional. The objective is to analyze, together with the national scientific literature, evidence on the knowledge and attitudes employed by nurses working in medium and high complexity units for the non-pharmacological management of pain in newborns. It is an Integrative Review, with a qualitative approach, applied nature, descriptive objective and bibliographic procedures. It follows a review protocol with construction in well-defined stages. The publications were searched in the computerized databases MEDLINE, LILACS and BDENF, via VHL, by intercrossing the descriptors cataloged in DeCS and MeSH Pain, Newborn, Pain Management, Neonatal Nursing, using the Boolean operator “AND”. The inclusion and exclusion criteria were applied and an instrument was used to expand the methodological rigor. The data were analyzed by thematic category according to the model proposed by Bardin. The search resulted in 163 and 15 articles that met the established criteria were analyzed. Nurses recognize that the NB is capable of feeling pain, however, they consider only potentially invasive and sensory environmental procedures as potentially painful procedures. They do not recognize the consequences of pain for the newborn, nor pain assessment methods, nor do they use scales. Most never assess pain and when they do, they do it through subjectivity and intuition, based mainly on altered crying, without standardization. Just over half of nurses practice non-pharmacological measures for pain management, especially sweet solutions, non-nutritive sucking and Kangaroo method, justified in the view of the newborn. Family participation is not encouraged, there is a lack of communication between the teams and registration in the medical record. Limiting factors of the nurse's performance in the BU are individual, team, institutional and family. Facilitating factors were the foundations of Nursing. Changes in the academic training of nurses are required, development of permanent education programs at the BU, implementation of protocols and scales for the prevention and control of neonatal pain, standardization and systematization of care.