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

• Published in: Journal of perinatology Vol. 41; no. 9; pp. 2304 - 2308
• Main Authors: Barros, Marina Carvalho de Moraes, Thomaz, Carlos Eduardo, da Silva, Giselle Valério Teixeira, do Carmo Azevedo Soares, Juliana, Carlini, Lucas Pereira, Heiderich, Tatiany Marcondes, Orsi, Rafael Nobre, Balda, Rita de Cassia Xavier, Silva, Pedro Augusto Santos Orona, Sanudo, Adriana, Andreoni, Solange, Guinsburg, Ruth
• Format: Journal Article
• Language: English
• Published: United States Nature Publishing Group 01.09.2021
• Subjects: Adult; Adults; Attention; Cognitive ability; Diagnosis; Diseases; Eye (anatomy); Facial expression; Forehead; Furrows; Health aspects; Humans; Infant, Newborn; Infants (Newborn); Logistic Models; Medical personnel; Neonates; Newborn babies; Pain; Pain - diagnosis; Pain in children; Pain Measurement; Pediatric research; Physiological aspects; Pictures; Psychological aspects; Visual Perception; Brazil
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/s41372-021-01143-1

To verify the visual attention of adults when assessing neonatal pain. 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. 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. Being a health professional and the visual fixation at the nasolabial furrow helped to identify the presence/absence of neonatal pain.