Comunicação cinésica do recém-nascido sob influência do manuseio e ruidos em uma unidade neonatal

Abstract

The kinesics capture of newborns admitted to Neonatal Units (NUs) is necessary for a care based on humanization. The objective was to assess the kinesics of newborns in a NU, related to the handling of health professionals and noise produced in the Unit, according to Birdwhistell (1985). Descriptive exploratory study of quantitative approach carried out at NU in a public hospital of Fortaleza-CE, Brazil. The sample consisted of 20 newborns who were daily filmed from July to September 2010. In the first phase of data collection medical records were analyzed, in the second the newborns were filmed six hours a day, divided in the morning, afternoon and evening. The results revealed that most of the newborns were between 30.1 and 34 gestational weeks, 4 to 15 days old, were born weighing between 1,000g and 1,499g, male, with a diagnosis of prematurity and were resuscitated with O2 inhalation. The main source of noise in all day shifts was the trash can, an average of 84.5 times in the morning, 86 in the afternoon and 78.9 in the evening. The infusion pump presented a higher average length of noise in the morning and evening (14.4 and 16.1 minutes, respectively), and the incubator in the evening (36.1 minutes). The handling most performed in average on every shift was the organization: morning, 2.7 times; afternoon, 3.1 and evening, 2.4. The organization added more time of performance, on average, in the morning (12.1 minutes); in the afternoon prevailed diaper change (10.6 minutes) and in the evening diet (7 minutes). Before the hit the kinesics most adopted by the newborn was the flexion motion (230), during was the shock (48) and after the flexion motion again (276). A statistically significant correlation between the type of kinesics and the profile characteristics of the newborn was verified: the noise of the trash can produced an inverse relation between the hit and gestational age (p=0.024, r=-0.871), birth weight (p=0.024, r=-0.871) and assessment weight (p=0.024, r=-0.871). Before, during and after handling the orogastric probe, the flexion motion was more present, with the following values, respectively: 36 times, 169 times, 44 times. Also, the flexion motion prevailed before, during and after diet administration with the following values, respectively, 15 times, 149, 15. A statistically significant correlation occurred with the diet administration between the kinesics and the newborn profile: morning - the flexion motion was more observed in newborns with oldest chronological age (p=0.034, r=0.744); afternoon - the suction movement was more observed in newborns with oldest chronological age (p=0.023, r=0.822) and weight during the evaluation (p=0.049, r=0.757); evening - the shock movement was more detected in newborns with oldest gestational (p=0.002, r=-0.998) and chronological age (p=0.047, r=0.760). Following this line of thought all the noise and handling captured were assessed concerning the same factors described above. It was concluded that the newborn, through kinesics reveals by signs like facial expression, body movements, crying and state of consciousness and activity, expresses his emotions and communicates how he feels.