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Identification of pain in neonates: the adults’ visual perception of neonatal facial features

Journal of Perinatology volume 41, pages 2304–2308 (2021)Cite this article

Subjects

Abstract

Objective

To verify the visual attention of adults when assessing neonatal pain.

Study design

143 adults (59% health professionals) evaluated 20 pictures (2 pictures of 10 neonates’ faces: at rest; during a painful procedure). Tobii-TX300 tracked the participants’ eyes movement. For each picture, adults scored pain intensity (0 = no pain; 10 = maximum). Latent classes analysis was applied by cognitive diagnosis models—GDINA with two attributes (knowledge of pain presence/absence). Variables associated with belonging to the class of adults that correctly identified pictures of newborns with/without pain were identified by logistic regression.

Results

To identify neonatal pain, adults look at the mouth, eyes, and forehead in facial pictures. The latent class analysis identified four classes of adults: those that identify painful/painless neonates (YY-Class; n = 80); only painful neonates (n = 28); only painless neonates (n = 34) and none (n = 1). Being a health professional (OR: 2.29; 95% CI: 1.16–4.51), and each look at the nasolabial furrow (2.07; 1.19–3.62) increased the chance of belonging to the YY-class.

Conclusions

Being a health professional and the visual fixation at the nasolabial furrow helped to identify the presence/absence of neonatal pain.

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Fig. 1: Image of the newborn: Areas of interest.

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Acknowledgements

We thank Fundação de Amparo à Pesquisa de São Paulo (FAPESP) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) for the financial support. Fundação de Amparo à Pesquisa do Estado de São Paulo—Fapesp—Grant Nos. 2012/50157-0 and 2018/13076-9. The funder did not participate in the work.

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Authors and Affiliations

  1. Division of Neonatal Medicine, Department of Pediatrics at Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

    Marina Carvalho de Moraes Barros, Giselle Valério Teixeira da Silva, Juliana do Carmo Azevedo Soares, Tatiany Marcondes Heiderich, Rita de Cassia Xavier Balda & Ruth Guinsburg

  2. Image Processing Laboratory, Department of Electrical Engineering, Centro Universitario FEI, São Bernardo do Campo, São Paulo, Brazil

    Carlos Eduardo Thomaz, Lucas Pereira Carlini, Rafael Nobre Orsi & Pedro Augusto Santos Orona Silva

  3. Epidemiology and Biostatistics, Department of Preventive Medicine at Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

    Adriana Sanudo & Solange Andreoni

Authors
  1. Marina Carvalho de Moraes Barros
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Contributions

MCMB, CET, and RG: responsible for conception and design of the study, data analysis and interpretation, and writing the manuscript. GVTS, JCAS, TMH, and RCXB: responsible for study design, patient screening and enrollment, data collection, data analysis and interpretation, and for revising the manuscript. LPC, RNO, and PASOS: responsible for study design, data collection, data analysis and interpretation, and for revising the manuscript. AS and SO: responsible for the statistical data analysis and writing the manuscript.

Corresponding author

Correspondence to Marina Carvalho de Moraes Barros.

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The authors declare no competing interests.

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Barros, M.C.d.M., Thomaz, C.E., da Silva, G.V.T. et al. Identification of pain in neonates: the adults’ visual perception of neonatal facial features. J Perinatol 41, 2304–2308 (2021). https://doi.org/10.1038/s41372-021-01143-1

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