Rastreio auditivo neonatal universal: Primeiro ano de experiência no Hospital da Ordem do Carmo

A surdez constitui a forma mais comum das doenças sensoriais, afetando milhões de pessoas em todo o mundo. A privação da audição, pode provocar um atraso significativo na linguagem, interferindo no desenvolvimento global da criança. A implementação de programas de Rastreio Auditivo Neonatal Universal (RANU) tornam-se, deste modo, fundamentais para uma verdadeira intervenção precoce. Só um diagnóstico precoce da surdez infantil permite evitar e/ou minimizar alterações ao nível linguístico, cognitivo, social e emocional da criança bem como da respetiva família. O objetivo deste estudo foi caracterizar o ponto da situação de doze meses de implementação do Rastreio Auditivo Neonatal Universal no Hospital da Ordem do Carmo. A amostra do estudo é constituída por 367 recém-nascidos, que nasceram no Hospital da Ordem do Carmo no período compreendido entre Junho de 2006 e Junho de 2007. Foi realizado o rastreio da surdez, recorrendo às Otoemissões Acústicas por Produtos de Distorção, a todos os recém-nascidos atrás mencionados. Todos os dados recolhidos foram tratados estatisticamente, com a garantia da sua total confidencialidade. Após o tratamento estatístico, verificou-se que a percentagem de Recém-Nascidos que passaram o rastreio foi igual a 82,6 e a percentagem de Recém-Nascidos que “falharam” o rastreio foi de 17,4. O número de falsos positivos foi igual a 64. Todos eles passaram no reteste da segunda fase. Em síntese, a conclusão principal deste estudo é a de que o Rastreio Auditivo Neonatal Universal é de extrema importância, e deve ser implementado em todos os recém-nascidos, preferencialmente antes da alta hospitalar.

Neonatal palliative care attitude scale : development of an instrument to measure the barriers to and facilitators of palliative care in neonatal nursing

OBJECTIVE The aim of this research project was to obtain an understanding of the barriers to and facilitators of providing palliative care in neonatal nursing. This article reports the first phase of this research: to develop and administer an instrument to measure the attitudes of neonatal nurses to palliative care. METHODS The instrument developed for this research (the Neonatal Palliative Care Attitude Scale) underwent face and content validity testing with an expert panel and was pilot tested to establish temporal stability. It was then administered to a population sample of 1285 neonatal nurses in Australian NICUs, with a response rate of 50% (N 645). Exploratory factor-analysis techniques were conducted to identify scales and subscales of the instrument. RESULTS Data-reduction techniques using principal components analysis were used. Using the criteria of eigenvalues being 1, the items in the Neonatal Palliative Care Attitude Scale extracted 6 factors, which accounted for 48.1% of the variance among the items. By further examining the questions within each factor and the Cronbach’s of items loading on each factor, factors were accepted or rejected. This resulted in acceptance of 3 factors indicating the barriers to and facilitators of palliative care practice. The constructs represented by these factors indicated barriers to and facilitators of palliative care practice relating to (1) the organization in which the nurse practices, (2) the available resources to support a palliative model of care, and (3) the technological imperatives and parental demands. CONCLUSIONS The subscales identified by this analysis identified items that measured both barriers to and facilitators of palliative care practice in neonatal nursing. While establishing preliminary reliability of the instrument by using exploratory factor-analysis techniques, further testing of this instrument with different samples of neonatal nurses is necessary using a confirmatory factor-analysis approach.

Screening for drugs in oral fluid : illicit drug use and drug driving in a sample of urban and regional Queensland motorists

Police services in a number of Australian states and overseas jurisdictions have begun to implement or consider random road-side drug testing of drivers. This paper outlines research conducted to provide an estimate of the extent of drug driving in a sample of Queensland drivers in regional, rural and metropolitan areas. Oral fluid samples were collected from 2657 Queensland motorists and screened for illicit substances including cannabis (delta 9 tetrahydrocannibinol [THC]), amphetamines, ecstasy, and cocaine. Overall, 3.8% of the sample (n = 101) screened positive for at least one illicit substance, although multiple drugs were identified in a sample of 23 respondents. The most common drugs detected in oral fluid were ecstasy (n = 53), and cannabis (n = 46) followed by amphetamines (n = 23). A key finding was that cannabis was confirmed as the most common self-reported drug combined with driving and that individuals who tested positive to any drug through oral fluid analysis were also more likely to report the highest frequency of drug driving. Furthermore, a comparison between drug vs. drink driving detection rates for one region of the study, revealed a higher detection rate for drug driving (3.8%) vs. drink driving (0.8%). This research provides evidence that drug driving is relatively prevalent on Queensland roads, and may in fact be more common than drink driving. This paper will further outline the study findings’ and present possible directions for future drug driving research.