{"id":25791,"date":"2025-04-28T17:44:24","date_gmt":"2025-04-28T17:44:24","guid":{"rendered":"https:\/\/www.ucf.edu\/pegasus\/?p=25791&post_type=story"},"modified":"2025-05-05T18:20:04","modified_gmt":"2025-05-05T18:20:04","slug":"pains-silent-signals","status":"publish","type":"story","link":"https:\/\/www.ucf.edu\/pegasus\/pains-silent-signals\/","title":{"rendered":"Pain’s Silent Signals"},"content":{"rendered":"
It\u2019s been more than 30 years since Martin Schiavenato \u201907PhD <\/strong>tried to comfort a newborn girl in the neonatal intensive care unit (NICU) in Tallahassee, Florida. She was born with a genetic disorder where the epithelial tissue that protects all internal and external surfaces of the body is missing. Her skin sloughed off. The simplest touch caused pain, but she had no way to communicate the extent of it.<\/p>\n \u201cThe memory is seared into my mind,\u201d Schiavenato says.<\/p>\n A trained nurse, he vividly remembers taking 12-hour overnight shifts with the little girl. He couldn\u2019t swaddle her. He couldn\u2019t give her a pacifier. He couldn\u2019t even change her diaper without causing pain.<\/p>\n \u201cEverything you want to do for an infant, instinctually and therapeutically, you couldn\u2019t do,” says Schiavenato, who is now an associate professor at Gonzaga University. “We were left to give her morphine, which can cause permanent damage when the brain is still developing. I kept telling myself, \u2018We should have a way to assess pain for patients who can\u2019t verbalize it.\u2019 No matter how short that little girl\u2019s life would be, I wanted to make it count. That\u2019s how my long journey began.\u201d<\/p>\n The journey led him on a route rarely followed, from bedsides in the NICU to UCF where he joined the university\u2019s first-ever cohort of doctoral nursing<\/a> students aiming to be among the less than 1% of nurses in the U.S. who have Ph.D.s. Schiavenato chose a track in innovative technologies. He took courses in engineering and collaborated with computer science students, driven by the desire to create something tangible rather than theoretical \u2014 a path made possible by UCF\u2019s interdisciplinary work in health and human performance<\/a>. For his dissertation, he researched signals that might indicate the severity of pain among patients who are unable to report it for themselves.<\/p>\n People with dementia, for example. Or babies.<\/p>\n \u201cA patient\u2019s inability to verbalize how much pain they\u2019re in will directly affect our ability to treat it with precision. I knew that I needed to develop a device somehow.\u201d \u2014 Martin Schiavenato \u201907PhD<\/strong><\/p><\/blockquote>\n Schiavenato\u2019s tireless work reached its most recent milestone when Aster DM Healthcare chose him as one of 10 finalists from among a pool of 78,000 entries for the prestigious 2024 Aster Guardians Global Nursing Award. If he needed a boost of inspiration, he drew it from the award ceremony in India. There, Schiavenato met a man from rural Papua New Guinea who spends two days crossing rivers and mountains to reach patients. He spoke with people from regions in Africa where the infant mortality rate is among the highest in the world. <\/p>\n Turns out, the inspiration was mutual.<\/p>\n \u201cThe honorees understood what I\u2019m doing and why,\u201d Schiavenato says. \u201cThere\u2019s always something tugging at my heart \u2014 always<\/em>.\u201d<\/p>\n Schiavenato received similar encouragement from mentors and colleagues during his time at UCF. He\u2019d spend days and nights at Winnie Palmer Hospital observing newborns reacting to heel sticks, a blood testing method. That\u2019s where he began to note a consistency in facial expressions, especially in the lower jaw. The natural grimace became Schiavenato\u2019s first building block. Next, he gathered evidence of infants in distress raising one hand to the forehead and splaying the fingers. Over time, he investigated heart-rate variability among newborns and added his findings to create a composite pain score.<\/p>\n \u201cThese three signals \u2014 facial expression, finger splaying and heart rate variability \u2014 tell us each baby\u2019s story of pain,\u201d Schiavenato says.<\/p>\n