This is a convergent care study with the aim to build, together with the nursing staff, a proposal for care protocol based on non-pharmacological methods for discomfort and pain management in newborns admitted to a neonatal intensive care unit. The study was carried out in a neonatal intensive care unit of a university hospital with 16 nursing staff professionals. Data were collected in two stages: first, a reflective-educational process was performed and, afterwards, a participant observation during the different work shifts of the nursing staff. The care protocol proposal will enable the standardization of care strategies for pain management in newborns using non-pharmacological methods. Furthermore, it will contribute to provide better care in the neonatal unit, reducing pain and discomfort experienced during hospitalization, as well as resulting in fewer consequences and better quality of life for the newborns and their families.

The present text discusses the creation of a health care model for older adults. The population aging arising from Brazil's new demographic and epidemiological reality, a relatively recent phenomenon, requires innovative and efficient responses. This article presents a proposal for care that emphasizes low intensity instances of care, focusing on health promotion, prevention, and the coordination of care. Integrated models aim to solve the problem of fragmented and poorly coordinated care in our current health systems, and the more health professionals know about a patient's history, the better the results. This is how resolutive models of care should function. A low intensity care unit, an epidemiological assessment, a client portfolio, with a doctor and nurse and a few gerontologists on staff, and a social center will make the difference. There will also be a high quality information system, including medical records that cover clinical and social characteristics. Everything is available via cloud computing and the cell phones of the doctors and clients, and high levels of technology and performance based pay for doctors make a further difference. In short, a higher quality, more resolutive and cost-effective care model is our aim. A contemporary care model for older adults should seek coordinated care, greater quality and the reduction of costs 211 Citation: Veras R, Cordeiro R. A contemporary care model for older adults should seek coordinated care, greater quality and the reduction of costs. Int J Fam Commun Med. 2019;3(5):210-214. Citation: Veras R, Cordeiro R. A contemporary care model for older adults should seek coordinated care, greater quality and the reduction of costs. Int J Fam Commun Med. 2019;3(5):210-214.

RESUMOObjetivo: promover um processo de reflexão junto à equipe de enfermagem sobre o manejo do desconforto e da dor em recém-nascido (RN). Método: pesquisa convergente-assistencial realizada em uma unidade neonatal do sul do Brasil. Os participantes foram 16 profissionais da equipe de enfermagem. A coleta de dados ocorreu nos meses de outubro e novembro de 2012, através de grupos de reflexão sustentados pelo referencial teórico da Pedagogia Libertadora. Resultados: da prática educativa, emergiram três categorias: os estímulos ambientais provocam dor e desconforto no RN; procedimentos invasivos como principais causadores da dor em RN; e a enfermagem reconhece os sinais álgicos no bebê. Conclusão: os resultados demonstram a preocupação dos profissionais de saúde com a identificação da dor, a necessidade de minimizar os estímulos ambientais e a importância do uso de medidas não farmacológicas e farmacológicas, principalmente durante os procedimentos invasivos, evitando implicações no desenvolvimento neuropsicomotor do recém-nascido. Palavras-chave: Dor; recém-nascido; neonatologia; enfermagem.ABSTRACT Objective: to engage nursing staff in thinking about management of discomfort and pain in newborn babies. Method: this convergentcare study was conducted in a neonatal unit in southern Brazil. The participants were 16 members of a nursing team. Data was collected during October and November 2012, through focus groups underpinned by the theory of Liberation Pedagogy. Results: from that practical educational activity three categories emerged: environmental stimuli cause pain and discomfort in the newborn; invasive procedures are the main causes of pain in the neonatal unit; and nurses recognize the signals of babies' pain. Conclusion: the results demonstrate health professionals' concern with identifying pain, the need to minimize environmental stimuli and the importance of using pharmacological and non-pharmacological measures, mainly during invasive procedures, to avoid effects on the psychomotor development of the newborn. Keywords: Pain; infant, newborn; neonatology; nursing. RESUMENObjetivo: promover un proceso de reflexión, junto con el equipo de enfermería, sobre la gestión del malestar y dolor del recién nacido. Método: investigación convergente asistencial se realizó en una unidad neonatal en el sur de Brasil. Los participantes fueron 16 profesionales del equipo de enfermería. Los datos fueron recolectados durante los meses de octubre y noviembre de 2012, a través de grupos de reflexión con el apoyo del marco teórico de la Pedagogía Libertadora. Resultados: de la práctica educadora, han surgido tres categorías: los estímulos ambientales le provocan dolor y malestar al recién nacido; procedimientos invasivos como los principales causadores de dolor al recién nacido y la enfermería reconoce las señales álgicas en el bebé. Conclusión: los resultados demuestran la preocupación de los profesionales de salud con la identificación del dolor, la necesidad de minimizar los estímulos ambientales y la importancia del uso...