title: The recognition of facial expression of pain in full-term newborns by parents and health professionals.
abstract: OBJECTIVE
  To determine whether adults can recognize neonatal facial expression of pain.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Neonatal intensive care unit, nursery, and outpatient clinic of one university hospital and one private hospital in São Paulo, Brazil.
  
  
  METHODS
  Four hundred five adults divided into 2 groups: health and nonhealth professionals.
  
  
  METHODS
  The faces of 3 healthy full-term newborns who needed glucose screening were photographed at rest and during light exposure, heel rubbing, and heel puncture. A series of adults answered a questionnaire on personal and professional data and then they analyzed for 1 minute each of the 3 sets of pictures to answer the following question: "In which picture of this set do you think that the baby is feeling pain?"
  
  
  METHODS
  Number of correct answers for the 3 sets of photographs shown to the adults.
  
  
  RESULTS
  Seventy-four percent of the health professionals and 86% of the nonhealth professionals indicated correctly the picture with facial expressions of pain in at least 2 of the 3 sets. Regarding which picture was picked out by the interviewee, 94% of the health professionals and 92% of the nonhealth professionals indicated the picture taken during the heel puncture in set 1. The same observation was made by 53% and 54% of the health professional and by 68% and 66% of the nonhealth professional interviewees for sets 2 and 3, respectively.
  
  
  CONCLUSIONS
  Facial expression of pain represents an effective neonatal communication tool. However, the health professional group achieved a lower level of recognition of neonatal facial expressions of pain. Factors related to the personal and professional characteristics of the adults interviewed probably contributed to this result.
authors.affiliation: Department of Neonatal Medicine, Federal University of São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil.
authors.forename: R d
authors.initials: Rd
authors.lastname: Xavier Balda
authors.forename: R
authors.initials: R
authors.lastname: Guinsburg
authors.forename: M F
authors.initials: MF
authors.lastname: de Almeida
authors.forename: C d
authors.initials: Cd
authors.lastname: Peres
authors.forename: M H
authors.initials: MH
authors.lastname: Miyoshi
authors.forename: B I
authors.initials: BI
authors.lastname: Kopelman
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003463:Cues; D005149:Facial Expression; D005260:Female; D006801:Humans; D007231:Infant, Newborn / Q000502:physiology* / Q000523:psychology; D016014:Linear Models; D008297:Male; D015588:Observer Variation; D010146:Pain / Q000175:diagnosis* / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods*; D010290:Parents / Q000523:psychology*; D010564:Personnel, Hospital / Q000523:psychology*; D010781:Photography; D011795:Surveys and Questionnaires