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In many situations, central venous catheters (CVCs), inserted by central or peripheral venipuncture, do not progress, even after performing some movement of the shoulder, head, and neck. This integrative review aimed to verify the scientific evidence about maneuvers to facilitate the advancement of CVCs in the clavicular region and/or shoulder in adult, pediatric, and neonatal patients. Primary studies with available electronic abstracts, independent of idiom or publication year, for which results showed aspects related to descriptions of maneuvers for CVC advancement in the clavicular region and shoulder, were included in the review. The sample included 6 studies published from 1989 to 2020 in CINAHL, Cochrane, Lilacs, Medline/PubMed, SCIELO, and Scopus databases. Maneuvers of the shoulder, arm, neck, and head facilitate CVC advancement in the shoulder and clavicular region. However, most of the studies analyzed were performed in adults. More research is needed on CVC advancement in pediatric and neonatal populations.

Objectives: to evaluate the effect of music applied within ten and 15 minutes, combined with swaddling, on behavioral (facial action) and physiological (heart rate) responses to pain in fullterm newborns, before and during venipuncture for blood sampling. Methods: a randomized, triple-blind, clinical trial with 52 rooming in infants randomly assigned to four groups of 13: Experimental 1 (music [ten minutes] plus swaddling), Experimental 2 (music [15 minutes] plus swaddling), Control 1 (no music [ten minutes] plus swaddling), and Control 2 (no music [15 minutes] plus swaddling). Pain was measured using the Neonatal Facial Coding System in the basal and procedural moments. Results: experimental 2 group showed high pain absence (p < 0.05); low heart rate mean (p < 0.0001) in the basal and procedural (antisepsis, puncture, blood squeezing/aspiration, compression) moments. Conclusions: neonates who listened to 15 minutes of music plus swaddling showed a greater absence of facial pain actions. Objetivos: avaliar o efeito da música aplicada em 10 e 15 minutos, combinada ao swaddling, na resposta comportamental à dor (ação facial) e fisiológica (frequência cardíaca) dos recémnascidos a termo, antes e durante a punção venosa para coleta de sangue. Métodos: ensaio clínico randomizado, triplo cego, conduzido em alojamento conjunto com 52 recémnascidos, divididos aleatoriamente em quatro grupos de 13: Experimental 1 (música [10 minutos], swaddling), Experimental 2 (música [15 minutos], swaddling), Controle 1 (sem música [10 minutos], swaddling) e Controle 2 (sem música [15 minutos], swaddling). A dor foi medida utilizando o Neonatal Facial Coding System nos momentos Basal e Procedimento. Resultados: o grupo Experimental 2 mostrou maior ausência de dor (p

Objective: to compare pain scores in term newborns submitted to music and swaddling interventions during venipuncture. Methods: pilot study of a clinical trial, carried out with 11 newborns in rooming-in care who received venipunctures. The newborns were randomly allocated into two groups: Experimental (20 minutes of music + swaddling) and Control (swaddling). Newborns were filmed and pain was assessed by the Neonatal Facial Coding System at baseline, procedure, and initial recovery phases. Results: the Experimental Group at baseline, procedure (antisepsis, puncture, and milking), and recovery showed less pain reactions and lower heart rate mean and variation (p

Objective: to assess pain in preterm newborns and to compare the neonatal and therapeutic variables with the total scores of the Neonatal Facial Coding System of preterm newborns submitted to arterial puncture exposed to music and 25% oral glucose. Method: a comparative study with 48 recordings of preterm newborns - Group 1, music (26); Group 2, glucose 25% (22) - individually analyzed by three trained nurses, after Kappa of at least 80%. Results: the variables and the pain scores of the groups did not present statistical significance (p < 0.05) according to the Neonatal Facial Coding System. 80.8% of the preterm infants in Group 1 had a higher quantitative score ≥ 3 in the neonatal variables (gender, type of delivery), and therapeutic variables (type of oxygen therapy, place of hospitalization, type of puncture). Conclusion: There was no difference when comparing the music and glucose 25% groups and the variables studied. RESUMEN Objetivo: evaluar el dolor en recién nacidos prematuros y comparar las variables neonatales y terapéuticas con las puntuaciones totales del Neonatal Facial Coding System de los recién nacidos prematuros sometidos a una punción arterial expuestos a la música y glucosa al 25% por vía oral. Método: estudio comparativo con 48 fi lmaciones de los recién nacidos prematuros divididos en el Grupo 1 - música (26) y el Grupo 2 - glucosa al 25% (22). Las fi lmaciones fueron analizadas individualmente por tres enfermeras capacitadas después de coefi ciente Kappa de al menos 80%. Resultados: las variables y puntuaciones de dolor de los grupos no fueron estadísticamente signifi cativas (p

Objective: to compare the pain response of preterm newborns submitted to arterial puncture who received musical intervention with those who received 25% glucose intervention. Methods: randomized, double-blind clinical trial; the sample consisted of 48 videos of preterm infants of the experimental group (music, n= 6), who listened to music for 10 minutes, and the control group (25% glucose, n=22), who received 25% glucose two minutes before puncture. The pain was evaluated by the Neonatal Facial Coding System at moments: Baseline, Treatment, Painful, Recovery 1 and Recovery 2. Results: there were similarities between groups at the moments Baseline, Recovery 1 and 2. A statistically significant difference was observed at the moment Treatment (p=0.014), Painful (p=0.029) for the control group. Conclusion: 25% glucose differed from music when comparing the pain response in the Treatment and Painful moments. razilian Registry of Clinical Trials: UTN: U1111-1123-4821. Objetivo: comparar resposta de dor de recém-nascidos pré-termo submetidos à punção arterial que receberam intervenção musical com os que receberam intervenção de glicose 25%. Métodos: ensaio clínico randomizado, duplo cego, amostra de 48 vídeos de prematuros dos grupos, Experimental (música, n=26), ouviu música por 10 minutos e; Controle (glicose 25%, n=22), recebeu glicose 25% dois minutos antes da punção. A dor foi avaliada pela Neonatal Facial Coding System n os momentos: Basal, Tratamento, Doloroso, Recuperação 1 e Recuperação 2. Resultados: houve semelhanças entre grupos nos momentos Basal, Recuperação 1 e 2. Constatou-se diferença estatisticamente significante no momento Tratamento (p=0,014), Doloroso (p=0,029) para grupo Controle. Conclusão: glicose 25% diferiu da música ao se comparar a resposta de dor nos momentos Tratamento e Doloroso. Registro Brasileiro de Ensaio Clínico: UTN: U1111-1123-4821.

ResumoObjetivoAnalisar, em artigos científicos, os métodos utilizados para avaliação da dor em recém‐nascidos.Fontes dos dadosEstudo de revisão integrativa de artigos publicados de 2001 a 2012, realizado nas bases: Scopus, PubMed, CINAHL, LILACS e Cochrane. A amostra constitui‐se de 13 artigos, todos com níveis de evidência 5.Síntese dos dadosConstataram‐se pelo menos 29 escalas de avaliação de dor em recém‐nascidos disponíveis em publicações cientificas, sendo 13 unidimensionais e 16 multidimensionais, que contemplam recém‐nascidos pré‐termo e a termo, para avaliação de dor aguda e prolongada.ConclusãoCom base nas características das escalas, não se pode eleger a mais adequada, pois a escolha dependerá da idade gestacional, do tipo de estímulo doloroso e do contexto em que o recém‐nascido se apresenta. Sugere‐se a utilização de escalas unidimensionais ou multidimensionais, porém, estas devem ser validadas e confiáveis.AbstractObjectiveTo analyze studies on methods used to assess pain in newborns.Data sourcesIntegrative review study of articles published from 2001 to 2012, carried out in the following databases: Scopus, PubMed, CINAHL, LILACS and Cochrane. The sample consisted of 13 articles with level of evidence 5.Data synthesis29 pain assessment scales in newborns, including 13 one‐dimensional and 16 multidimensional, that assess acute and prolonged pain in preterm and full‐term infants were available in scientific publications.ConclusionBased on the characteristics of scales, one cannot choose a single one as the most appropriate scale, as this choice will depend on gestational age, type of painful stimulus and the environment in which the infant is inserted. It is suggested the use of multidimensional or one‐dimensional scales; however, they must be reliable and validated.

OBJECTIVE: to analyze the total Premature Infant Pain Profile scores of premature infants undergoing arterial puncture during music and 25% glucose interventions, and to assess their association with neonatal and therapeutic variables.METHOD: a randomized clinical trial with 80 premature infants; 24 in the Experimental Group 1 (music), 33 in the Experimental Group 2 (music and 25% glucose), 23 in the Positive Control Group (25% glucose). All premature infants were videotaped and a lullaby was played for ten minutes before puncture in Experimental Groups 1 and 2; 25% glucose administered in Experimental Group 2 and the Positive Control Group two minutes before puncture.RESULTS: 60.0% of premature infants had moderate or maximum pain; pain scores and intervention groups were not statistically significant. Statistically significant variables: Experimental Group 1: head and chest circumference, Apgar scores, corrected gestational age; Experimental Group 2: chest circumference, Apgar scores, oxygen therapy; Positive Control group: birth weight, head circumference.CONCLUSION: neonatal variables are associated with pain in premature infants. Brazilian Registry of Clinical Trials: UTN: U1111-1123-4821.

Objective: evaluating the effects of using a flipchart as an educational intervention in improving maternal self-efficacy inbreastfeeding. Methods: a quasi-experimental study with 41 postpartum women: Intervention Group (n = 20) and ControlGroup (n = 21) of a public hospital. The intervention consisted of implementing the flipchart “I can breastfeed my baby” inthe immediate postpartum and were contacted by telephone after 15 days. For both groups, Breastfeeding Self-Efficacy Scale-Short Form was applied at baseline and after 30 days. Results: before the intervention, the intervention group was 75% withhigh self-efficacy and 71% of the mothers in the control group of had high self-efficacy. It was found that after educationalintervention, all the mothers in the intervention group showed high self-efficacy, while the percentage remained similar tobefore in the control group (76%). Conclusion: the flipchart had a positive effect on the elevation of self-efficacy in nursingmothers.

Objective: to identify the key competence domains defined in the Galway Consensus Conference Statement present in assistive technologies to promote the health of blind adults. Methods: integrative review carried out in the Latin American and Caribbean Health Sciences Literature, SCOPUS, Cumulative Index to Nursing and Allied Health Literature, and Medical Publications portal. After application of inclusion criteria, the sample consisted of 10 articles. Eight competencies for health promotion were analyzed: Catalyzing change, Leadership, Assessment of needs, Planning, Implementation, Advocacy, and Partnerships. Results: the competences Catalyzing change and Partnerships prevailed, present in all articles. No study approached the Leadership and Advocacy. Conclusion: the competences Catalyzing change, Assessment of needs, Planning, Implementation, Evaluation and Partnerships were observed in technologies for promoting the health of blind adults. Objetivo: identificar os domínios das competências essenciais definidos na Declaração de Consenso de Galway presentes em tecnologias assistivas para promoção da saúde de adultos cegos. Métodos: revisão integrativa realizada nas bases de dados Literatura Latino-Americana em Ciências de Saúde, SCOPUS, Cumulative Index to Nursing and Allied Health Literature, e portal Publicações Médicas. Após aplicação dos critérios de inclusão, a amostra constituiu de 10 artigos. Analisou-se oito competências para promoção da saúde: Catalisar mudança, Liderança, Avaliação das necessidades, Planejamento, Implementação, Advocacia e Parcerias. Resultados: as competências Catalisar mudança e Parcerias prevaleceram, sendo identificadas em todos os artigos. Nenhum estudo trabalhou a competência de Liderança e Advocacia. Conclusão: contemplou-se as competências Catalisar mudança, Avaliação das necessidades, Planejamento, Implementação, Avaliação e Parcerias em tecnologias para promoção da saúde de adultos cegos.

Aim: To analyze the verbal and nonverbal communication of nursing professionals with newborns during arterial punctures and calcaneus, from the perspective of health promotion. Method: A descriptive study, conducted in March 2012, which considered 27 interactions involving nurses and newborns. Results: data were organized into two themes: verbal communication of nursing professionals before, during and after the painful procedure, and nonverbal communication during the painful procedure according to the Proxemics Theory. Newborns showed professionals expressions of tranquility and crying through nonverbal communication. However, the nurses continued using verbal communication prior to the pain of such procedures. Conclusion: The nurses investigated established effective verbal or nonverbal communication to newborns. Such an attitude promotes holistic and humane care in the hospital setting, with a focus on health promotion.

The objective of this study was to analyze the proxemic communication between nursing team and the newborn hospitalized in the Neonatal Intensive Care Unit (NICU). It is a descriptive, exploratory study carried out in a Public Hospital in July 2009, in Fortaleza- Ceará. The sample consisted of 44 interactions involving newborns and nursing workers. For data analysis, it was used the proxemic theory, which deals with the spatial behavior of man in the communication process. It was observed in the interactions that the warmth and caring touch were the most frequent contact behaviors, and appropriate eye contact and tone of voice were predominant. It was concluded that the nursing team should be aware of the importance and influence of non-verbal signs on the communication during nursing care with newborns. O objetivo do estudo foi analisar a comunicação proxêmica entre a equipe de enfermagem e o recém-nascido (RN) de risco internado na Unidade de Terapia Intensiva Neonatal (UTIN). Trata-se de estudo descritivo, exploratório, desenvolvido em um hospital público, em julho de 2009, Fortaleza-Ceará. A amostra constituiu-se de 44 interações, envolvendo RNs e profissionais de enfermagem. Para análise dos dados obtidos, adotou-se a Teoria Proxêmica, que trata do comportamento espacial do homem no processo comunicativo. Observaram-se, nas interações, que o aconchego e o toque carinhoso foram comportamentos de contatos mais frequentes, que predominou o contato visual e o tom de voz adequado. Conclui-se que a equipe de enfermagem deve ter consciência quanto à importância e influência dos signos não-verbais emitidos na comunicação durante a assistência de Enfermagem junto aos neonatos. objetivo de este estudio fue analizar la comunicación proxémica entre el equipo de enfermería y el recién nacido (RN) de riesgo hospitalizado en la Unidad de Cuidado Intensivo Neonatal (UCIN). Se trata de estudio descriptivo, exploratorio, desarrollado en un hospital público, en julio del 2009, Fortaleza, Ceará. La muestra consistió de 44 interacciones abarcando RN y profesionales de enfermería. Para el análisis de los datos obtenidos, hemos adoptado la Teoría Proxémica, que trata del comportamiento espacial del hombre en el proceso de comunicación. Se observaron, en las interacciones, que la calidez y el toque cariñoso fueron comportamientos de contacto más frecuentes, que predominó el contacto visual y el tono de voz adecuado. Se concluye que el equipo de enfermería debe tener consciencia acerca de la importancia y la influencia de los signos no verbales emitidos en la comunicación durante la asistencia de Enfermería junto a los recién nacidos. DESCRIPTORS: Comunicación; Enfermería; Recién Nacido; Unidades de Terapia Intensiva; Grupo de Enfermería.

Proxemic communication between undergraduate nursing students and newborns is essential for effective nurse assistance between the binomial. It aimed to characterize the proxemic communication between undergraduate nursing students and newborns. Exploratory-descriptive study carried out at the neonatal medium care unit (NMCU) of a public hospital of Fortaleza-Ceara-Brazil, from November/2009 to May/2010. The subjects were 22 students and 22 newborns. Two ways of interaction between students and newborns were described: face to face (12), sideways (10). Students adopted personal (12), social (8), intimate (2) distance. Students showed expression of tranquility (15), smile (4), tranquility and smile (2), indifference (1). While the newborns presented expression of tranquility (13), cry (7), indifference (2). Twenty-one students looked at the newborns, six spoke quietly, eleven normally, five remained in silence. The proxemic factors allow assessing the communication in NMCU, improving the students' assistance to newborns.