Identification of the preterm neurobehavioral signs by the staff in Neonatal Intensive Care Unit (NICU)

Abstract

INTRODUCTION: In response to external stimuli intrinsic to the neonatal intensive care unit (NICU), the preterm infant exhibits neurobehavioral signs of avoidance cues or approach behavior. These signs offer tips to the professionals about their interventions. The correct modulation of stimuli leads to a better biological, social and emotional development of preterm infant and the care professionals must be prepared to perceive and evaluate these signs. OBJECTIVE: Investigate the level of identification by NICU professionals, of the neurobehavioral signs of avoidance cues and approach behavior, exhibited by preterm infants and analyze the factors that influence the acquisition of the knowledge about these signs. METHODOLOGICAL PROCEDURES: The data were collected through the applications of The Checklist of The Assessment of the Preterm Infants' Behavior (APIB) (ALS & cols., 1982) to the NICU professionals' and through the analysis of the responses to the open questions included in the instrument. The quantitative data were analyzed by frequency count and the qualitative data by content analysis. RESULTS: Forty-five professionals answered the checklist, 80% from the nursery assistant level and 20% from the graduated level. From the 16 signs of avoidance cues and from the 17 signs of approach behaviors present in the APIB Checklist, the graduate level professionals observed tree signs of avoidance cues and seven signs of approach behavior more than the nursery assistant professionals observed. Through the qualitative analysis, it was verified that the correct identifications of the preterm infants' signs by the professionals is influenced by factors such as a heavy load of work, subtlety of the signs showed by babies, professional experience and the need of continued education.