Light level in neonatal intensive care units: repercussions on neonatal health

Abstract

The development of the hospitalized newborn and the impacts of the environment are very important aspects within the neonatal scope, considered as relevant themes for the establishment of methods to reduce harm to these individuals. It is known that the environment of neonatal intensive care units in all its complexity does not favor the neurodevelopment of preterm infants. Among the factors that interfere in the neonatal development of neonates, it is identified that the continuous exposure to light is one of the components that lead to deficiencies in this process, also influencing sleep and activity patterns, clinical improvement, weight gain and diet progression. In order to reduce the harmful effects of the environment, some neonatal units perform the control of stimuli, with reduced noise, luminosity and manipulation of the newborn, called environmental management. In addition, they perform tissue coverage in incubators to reduce light, favor the environment for sleep and induce the circadian cycle. Through a practical reflection, the need to clinically evaluate such environmental stimuli, more specifically those that generate effects in the sleep-wake cycle, is understood as it is understood that sleep is essential for physical, mental and emotional development. This descriptive study aims to identify the levels of illuminance in neonatal intensive care units that perform or not periods of environmental management. In order to mimic the environment in which newborns are exposed during hospitalization in neonatal units, the sample will be composed by the measurement of the illuminance inside the incubator, incubator with photo protection and in acrylic crib. Unoccupied furniture will be positioned randomly in two locations, according to proximity to the natural light source. Variables related to the architectural structure of the unit (type of lighting, window and shutter structure, distance between furniture and light source) and environmental (environmental management and daytime period) variables will be evaluated. To obtain the records of the light level, a dosimeter will be used, positioned at the height of the eyes of the newborns, registering every 60 seconds for 24 hours. The data collection will begin after the science and agreement of the study institutions and the approval of the Research Ethics Committee of the university. The recorded data will be transferred to the computer, stored in databases and submitted to statistical analysis by SPSS 17.0 for Windows software. Quantitative variables will be presented by mean and standard deviation, median, minimum and maximum values. In order to compare the means of the illuminance levels, according to the different positions and types of furniture, t test, Anova or Fisher's exact tests will be used according to the parametric or non-parametric nature of the distribution, according to the method proposed by Kolmogorov-Smirnov. Statistically significant findings will be considered, those with a type I error probability of less than 5%.