Abstract
This systematic literature review evaluated the methodological quality of studies measuring noise in neonatal intensive care units. A manual and also electronic search in the Medline, Scielo, Lilacs, BDENF, WHOLIS, BDTD, Science Direct, NCBI and Scirus databases resulted in 40 studies that met the criterion "measuring noise in neonatal units and/or incubators". Experts in neonatology and acoustics validated the critical analysis instrument, which obtained a mean = 7.9 (SD=1.3). The inter-observer reliability in 18 articles resulted in an Intra-class correlation coefficient (ICC) of 0.89 (CI 0.75-0.95). The quality indicators were 50% better in those studies that measured noise only in the unit's environment and associated measuring strategies to the physical area. The results showed great methodological variability, which hindered comparability and raised the probability of bias. The conditions required to ensure internal and external validity were observed in few studies.
Highlights
The use of technology to care for newborns has improved survival though it has transformed neonatal intensive care units (NICU) into very noisy places[1,2]
The instrument that evaluated the studies included in the review displayed satisfactory face validity[14] (79%)
It was reliable in relation to inter-observer variability according to Intra-class correlation coefficient (ICC) values, except in Module II, in which difficulties characterizing the neonatal environment were found
Summary
The use of technology to care for newborns has improved survival though it has transformed neonatal intensive care units (NICU) into very noisy places[1,2]. Noise in these places can affect newborns, increasing their heart rate and respiratory frequency, dropping their oxygen saturation, diminishing the duration of their sleep state and hindering their ability to stay in a deep sleep state, and causing alterations in their motor activity[3,4]. Health organizations and experts have tried to establish guidelines limiting the levels of noise in NICUs. WHO recommends that noise in hospital facilities should not exceed 30 dB(A)(5). The Brazilian standard NBR 10152, approved by the Brazilian Technical Standards Association (ABNT)
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