Percepção dos profissionais de saúde sobre a importância da posição prona no desenvolvimento neuropsicomotor de recém-nascidos em Unidades de Terapia Intensiva Neonatais da região Sul do Brasil

• Ano de defesa: 2019
• Autor(a) principal: Martinello, Micheli [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Musculoskeletal Development; Early Intervention; Prone Position; Body Position; Newborn; Intensive Care Units; Neonatal; Desenvolvimento Musculoesquelético; Intervenção Precoce; Posição Prona; Posicionamento Terapêutico; Recém-Nascido; Unidade De Terapia Intensiva Neonatal
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7967073; https://repositorio.unifesp.br/handle/11600/59867

Introduction: Considering neonatal care in relation to maturation processes and adverse musculoskeletal conditions, the alternation of decubitus provides comfort to the newborn (RN), with greater body organization and being able to reduce the levels of stress and pain, in the Neonatal Intensive Care Unit (NICU). Objective: To identify the perception of health professionals about the importance and indication of the prone position in the DNPM, and to identify the use of the prone posture, according to the physiotherapeutic assistance, for NB in NICU of the Southern Region of Brazil. Methods: A cross-sectional study was carried out with health professionals working in the NICU of Southern Brazil (Paraná, Santa Catarina and Rio Grande do Sul) between December 2015 and May 2018. The information was collected through a standardized questionnaire, applied to the head of the NICU and to the following members of the unit's multiprofessional team: doctors, nurses and physiotherapists. Descriptive analysis, Chi-square test, Student's t-test, Mann-Whitney test and logistic regression were performed using the ENTER method. It was considered statistically significant when p <0.001. Results: 51 NICUs were included, totaling 438 professionals interviewed (180 nurses, 154 physicians and 104 physiotherapists); the mean age of the interviewees was 37.5 years ± 9.23 and the average experience time in the area was 11 years (SD: 8.6). Regarding the professional qualification of the participants, 87.3% reported having specialization and 12.7% attended postgraduate courses. There was a positive correlation between the affirmative response of the professionals regarding the interference of the prone position in the DNPM and the indication of this posture in the NICU (OR: 2.455, p <0.001, 95% CI), being that the presence of the professional physiotherapist increases the chance of indication of the prone position (p <0.001, 95% CI). However, 73.1% of physiotherapists reported limitations in their insertion in services, often related to aspects external to the clinical condition of the newborn as lack of exclusive and / or full-time professionals in the NICU (75%) and a reduced number of professionals (33.6%). Conclusion: According to the perception of the professionals interviewed, the indication of the prone position in the NICU is associated with considering their interference in the NPMD of infants and the presence of a physiotherapist in the unit. The use of the prone position was positively related to the presence of a protocol for this posture, whereas the lack of the exclusive and/or integral physical therapist, and the disproportion between the demand and number of professionals, may have contributed to the limited alternation of position during the hospitalization of the infant.