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ORIGINAL ARTICLE10-06-2023
Quality of health care in Primary Care: perspective of people with Diabetes Mellitus
Revista Brasileira de Enfermagem. 2023;76(5):e20230008
Abstract
ORIGINAL ARTICLEQuality of health care in Primary Care: perspective of people with Diabetes Mellitus
Revista Brasileira de Enfermagem. 2023;76(5):e20230008
DOI 10.1590/0034-7167-2023-0008
Views0See moreABSTRACT
Objectives:
to identify how people with diabetes assess the care offered by Primary Care teams.
Methods:
a cross-sectional study based on structured interviews with the application of the Patient Assessment of Chronic Illness instrument to people with Type 2 Diabetes Mellitus. Data were submitted to statistical analysis.
Results:
451 individuals participated in the study, more than half aged 60 years or older (64.0%); 63.9% had been diagnosed for more than five years; and 23.9% used insulin. The average score obtained was 2.5, which indicated little involvement in self-care and low support for the care of the chronic condition by the Family Health Strategy team, and was higher among women and people with a partner.
Conclusions:
people with diabetes consider that they do not receive individualized treatment, with dialogue and discussion for setting goals, and that they are not prepared for self-managing their health condition.
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ORIGINAL ARTICLE10-06-2023
Ethical problems in nursing teleconsultations for people living with HIV during the Covid-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220754
Abstract
ORIGINAL ARTICLEEthical problems in nursing teleconsultations for people living with HIV during the Covid-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220754
DOI 10.1590/0034-7167-2022-0754
Views0See moreABSTRACT
Objectives:
to understand the ethical problems experienced by primary health care nurses in using nursing teleconsultations for people living with the human immunodeficiency virus during the coronavirus pandemic.
Methods:
qualitative research, anchored in Constructivist Grounded Theory. Data was collected between July and September 2020, with 17 participants.
Results:
the first category highlights the ethical problems in conducting teleconsultations, managing high demand, communication barriers, and risks related to data security. The second emphasizes the potential of teleconsultations in communication and access, by generating changes in the work process and the use of protocols to guide clinical practice.
Conclusions:
nurses’ work in digital mode requires professional qualification, with a view to stimulating reflection on teleconsultation practice, ethical-moral deliberation and combating stigma, and also adopting data security-centered conduct.
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Ethical dilemmas and illicit acts in nursing: reflections on the legal (dis)order
Revista Brasileira de Enfermagem. 2023;76:e20220558
Abstract
Ethical dilemmas and illicit acts in nursing: reflections on the legal (dis)order
Revista Brasileira de Enfermagem. 2023;76:e20220558
DOI 10.1590/0034-7167-2022-0558
Views0See moreABSTRACT
Objectives:
to reflect on aspects of the legal system that involve situations of ethical dilemmas and illegal acts applied in legal proceedings related to nursing professionals.
Methods:
theoretical-reflective essay anchored in conceptions issued by a Brazilian nursing class body, based on technical opinions, in articulation with examples extracted from judges of the Superior Court of Justice.
Results:
the legal sources demonstrated the need to support nursing practices through a due and clear understanding of the notions addressed. Indeed, ethical dilemmas linked to professional practice usually refer to the psychological impact of having to act differently from what feels morally, ethically, or professionally appropriate.
Final Considerations:
the reflection was guided by conceptual and legal issues involving nursing practice, pointing to the need to monitor the effects of legal disorder caused by current legislation, which may have implications for the legal security of professionals.
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ORIGINAL ARTICLE10-06-2023
Nursing students’ professional values for reinforcing the professional identity
Revista Brasileira de Enfermagem. 2023;76:e20220338
Abstract
ORIGINAL ARTICLENursing students’ professional values for reinforcing the professional identity
Revista Brasileira de Enfermagem. 2023;76:e20220338
DOI 10.1590/0034-7167-2022-0338
Views0ABSTRACT
Objectives:
to understand the nursing students’ professional values in different Brazilian universities and verify a correlation between the “Professional Value” and the sociodemographic variables.
Methods:
quantitative, cross-sectional, and descriptive study conducted through an electronic questionnaire with a Professional Values Scale (NPVS-3). Participants were Nursing students of all semesters from three universities – two in the Southeast region and one in the North region.
Results:
of the 337 participating Nursing students, 282 were female. The Caring dimension presented the highest score (mean=46.61), and Professionalism, the lowest score (mean=34.65). A statistically significant association was detected between the Caring dimension, “university where is attending,” and “gender.”
Conclusions:
the results indicate the Caring dimension as the one containing the most scored professional values since the nurses’ training, and the relation of those values in such dimension is more significant in the female sample.
Keywords:Code of EthicsKnowledge ManagementNursing EthicsNursing StudentsRole of the Nursing ProfessionalSee more -
EDITORIAL09-25-2023
Artificial intelligence as an ally in Brazilian nursing: challenges, opportunities and professional responsibility
Revista Brasileira de Enfermagem. 2023;76(3):e760301
Abstract
EDITORIALArtificial intelligence as an ally in Brazilian nursing: challenges, opportunities and professional responsibility
Revista Brasileira de Enfermagem. 2023;76(3):e760301
DOI 10.1590/0034-7167.2023760301
Views0The current state of nursing in Brazil presents complex challenges and opportunities that require innovative solutions. In this context, artificial intelligence (AI) emerges as a promising tool to address these challenges and seize opportunities. In particular, natural language processing models, such as OpenAI’s ChatGPT, demonstrate the potential to be valuable resources for nurses at all […]See more -
EDITORIAL09-25-2023
A inteligência artificial como aliada na enfermagem brasileira: desafios, oportunidades e responsabilidade profissional
Revista Brasileira de Enfermagem. 2023;76(3):e760301
Abstract
EDITORIALA inteligência artificial como aliada na enfermagem brasileira: desafios, oportunidades e responsabilidade profissional
Revista Brasileira de Enfermagem. 2023;76(3):e760301
DOI 10.1590/0034-7167.2023760301pt
Views0O estado atual da enfermagem no Brasil apresenta desafios e oportunidades complexas que requerem soluções inovadoras. Nesse contexto, a inteligência artificial (IA) surge como uma ferramenta promissora para enfrentar esses desafios e aproveitar as oportunidades. Em particular, os modelos de processamento de linguagem natural, como o ChatGPT da OpenAI, demonstram potencial para serem recursos valiosos […]See more -
ORIGINAL ARTICLE09-18-2023
Vaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity
Revista Brasileira de Enfermagem. 2023;76(4):e20220734
Abstract
ORIGINAL ARTICLEVaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity
Revista Brasileira de Enfermagem. 2023;76(4):e20220734
DOI 10.1590/0034-7167-2022-0734
Views0See moreABSTRACT
Objective:
to analyze vaccination coverage spatial distribution in children under one year old and the socioeconomic factors associated with meeting the recommended goals in Minas Gerais.
Methods:
an ecological study, carried out in 853 municipalities in the state. Pentavalent, poliomyelitis, meningococcal conjugate, yellow fever, rotavirus, and 10-valent pneumococcal conjugate vaccination coverage were analyzed. Scan statistics and multiple logistic regression were performed to identify spatial clusters and factors associated with meeting coverage goals.
Results:
spatial analysis revealed clusters with risk of low coverage for all vaccines. Number of families with per capita income of up to 1/2 wage, Minas Gerais Social Responsibility Index and percentage of the poor or extremely poor population were associated with meeting the established goals.
Conclusions:
the results are useful for designing interventions regarding the structuring of vaccination services and the implementation of actions to increase vaccination coverage in clusters with less propensity to vaccinate.
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ORIGINAL ARTICLE09-04-2023
Impact of an educational intervention on standard precautions during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(4):e20220750
Abstract
ORIGINAL ARTICLEImpact of an educational intervention on standard precautions during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(4):e20220750
DOI 10.1590/0034-7167-2022-0750
Views0See moreABSTRACT
Objective:
To evaluate the impact of an educational intervention on the knowledge of nursing professionals regarding standard precautions.
Methods:
This is an almost experimental study conducted with 100 nursing professionals. Data collection was performed using a sociodemographic characterization instrument and the Standard Precautions Knowledge Questionnaire. The educational intervention was based on five moments, where the approach to questions with less than 70% accuracy was intensified.
Results:
There was a significant difference between the scores of healthcare professionals before (16.20 ± 1.51) and after (16.90 ± 1.31) the educational intervention (W=3.336; p < 0.05). Regarding knowledge about hand hygiene after glove use, an increase in knowledge from 83% to 93% was obtained.
Conclusions:
A positive effect on the professionals’ knowledge was recorded, demonstrating advances regarding the strengthening of already acquired knowledge and the understanding of new knowledge.
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ORIGINAL ARTICLE09-24-2022
Nurses’ performance in palliative care: spiritual care in the light of Theory of Human Caring
Revista Brasileira de Enfermagem. 2022;75(1):e20210029
Abstract
ORIGINAL ARTICLENurses’ performance in palliative care: spiritual care in the light of Theory of Human Caring
Revista Brasileira de Enfermagem. 2022;75(1):e20210029
DOI 10.1590/0034-7167-2021-0029
Views1See moreABSTRACT
Objectives:
to analyze nurses’ role in assisting patients in palliative care, with emphasis on the spiritual dimension, in the light of Theory of Human Caring.
Methods:
this is an exploratory, qualitative study, carried out in a hospital in João Pessoa, Paraíba, between August and December 2019, with 10 nurses. For data collection, semi-structured interviews were used. For analysis, we opted for content analysis.
Results:
the spiritual dimension of care is contemplated by several religious and spiritual practices. These are respected and encouraged by nurses, although there is difficulty in providing care for the spiritual dimension.
Final Considerations:
nurses have attitudes consistent with Jean Watson’s Theory and apply the Caritas Process elements during assistance to patients’ spiritual dimension in palliative care.
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ERRATUM01-15-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
DOI 10.1590/0034-7167.20247701e01
Views1In the article “The ethics of nursing care for transgender people”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 3):e20220797, in authorship:Where it read:[…]See more -
ORIGINAL ARTICLE04-14-2023
Guide for Systematization of Care and Nursing Process: educational technology for professional practice
Revista Brasileira de Enfermagem. 2023;76:e20210975
Abstract
ORIGINAL ARTICLEGuide for Systematization of Care and Nursing Process: educational technology for professional practice
Revista Brasileira de Enfermagem. 2023;76:e20210975
DOI 10.1590/0034-7167-2021-0975
Views1ABSTRACT
Objective:
to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process.
Methods:
applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout.
Results:
the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges.
Final considerations:
the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.
Keywords:Educational TechnologyNursing ProcessNursing RecordsProfessional PracticeStandardized Nursing TerminologySee more -
ORIGINAL ARTICLE03-27-2023
Adaptation and validation of an adult patient classification instrument with emphasis on the family dimension
Revista Brasileira de Enfermagem. 2023;76(2):e20220530
Abstract
ORIGINAL ARTICLEAdaptation and validation of an adult patient classification instrument with emphasis on the family dimension
Revista Brasileira de Enfermagem. 2023;76(2):e20220530
DOI 10.1590/0034-7167-2022-0530
Views1ABSTRACT
Objectives:
to adapt and validate an instrument for classifying adult patients that emphasizes the family support network in the demand for nursing care.
Methods:
methodological study, carried out in three phases: adaptation of an instrument considering the reality of adult patients; content validation with seven experts and assessment of measurement properties (construct validity and internal consistency) with 781 hospitalized patients.
Results:
in content validation, the indicators reached the values established for the Content Validity Index (0.85-1.00). In the confirmatory factor analysis, the 11 indicators were distributed in three domains and presented average variance extracted and factor loading greater than 0.5. Composite reliability was greater than 0.7.
Conclusions:
the present study adapted and made available, with evidence of validity and reliability, an instrument for classifying adult patients that considers the family support network in the demand for nursing care.
Keywords:Factor AnalysisFamilyHospital Organization and AdministrationPatient-Centered CareValidation StudiesSee more -
Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
Abstract
Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
DOI 10.1590/0034-7167-2020-0422
Views1See moreABSTRACT
Objective:
To identify and map the technological tools of information and communication to support the teaching learning process in Nursing teaching courses.
Methods:
This is a scoping review whose search was carried out in seven databases and in grey literature. After an initial analysis of the selection, 88 texts were read integrally, and 29 made up the final sample.
Results:
Virtual learning environment and object, simulation, hypermedia, and software or cellphone applications were the tools the nursing professors used the most. Studies highlight that the application of technology was important in the teaching-learning process, since it encouraged teaching based on safe care, motivating and developing abilities/competences, supported on significant, effective, flexible, and autonomous learning.
Conclusion:
The contribution of the technology for nursing formation stands out, but it should be highlighted that its employment must be critical, reflective, based on pedagogical theories and developed by trained professors.
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ORIGINAL ARTICLE03-19-2021
Mobile application of the Terminology Subset for Coping with Domestic Violence Against Children
Revista Brasileira de Enfermagem. 2021;74:e20200287
Abstract
ORIGINAL ARTICLEMobile application of the Terminology Subset for Coping with Domestic Violence Against Children
Revista Brasileira de Enfermagem. 2021;74:e20200287
DOI 10.1590/0034-7167-2020-0287
Views1See moreABSTRACT
Objective:
to describe the development of a mobile application for the International Classification Terminology Subset for Nursing Practice for Coping with Domestic Violence Against Children.
Methods:
an applied research of technological development, based on the Analysis, Design, Development, Implementation and Evaluation model and on the terminological subset based on the Theory of Nursing Praxis Intervention in Collective Health framework.
Results:
the application is divided into: 1) “Definition”: characterizes the phenomenon of violence against children; 2) “Assistance”: electronic record of nursing care; 3) “Diagnosis Consultation”; 4) “Intervention Consultation”: nursing diagnoses, outcomes, and interventions related to children and their families, subdivided into Strengthening and Weariness group.
Final considerations:
built from scientific research, the application has the potential to support nursing care, presenting, in an organized and systematic manner, nursing diagnoses, outcomes, and interventions, in addition to enabling the registration of cases under monitoring.
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ORIGINAL ARTICLE06-14-2024
Validity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
Abstract
ORIGINAL ARTICLEValidity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
DOI 10.1590/0034-7167-2023-0195
Views1See moreABSTRACT
Objectives:
to describe the validity process of the TBApp mobile application for self-care management for people with tuberculosis linked to Primary Health Care.
Methods:
methodological research developed with ten expert judges, carried out virtually. The application was assessed in relation to content and technology quality in seven domains (objectivity; structure and appearance; relevance; functionality; reliability; usability; and efficiency), using an instrument with a Likert scale.
Results:
TBApp was considered valid, relevant, functional, reliable and effective by expert judges. The objectives, structure and presentation and relevance domains presented an overall Content Validity Index of 0.93, and the functionality, reliability, usability and efficiency domains presented characteristics and sub-characteristics values greater than 0.80.
Conclusions:
TBApp is a creative and innovative tool that can be used by people with TB and disseminated in the scientific community.
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ORIGINAL ARTICLE10-01-2022
Self-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
Abstract
ORIGINAL ARTICLESelf-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
DOI 10.1590/0034-7167-2020-1257
Views1INTRODUCTIONChronic non-communicable diseases are the main causes of death and health problems in the world, causing about 41 million deaths each year, which corresponds to approximately 71% of all deaths. Among these diseases, diabetes mellitus has stood out due to the increase in its incidence and prevalence().Estimates indicate that 463 million people live with diabetes […]See more
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EXPERIENCE REPORT04-09-2020
Implementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
Abstract
EXPERIENCE REPORTImplementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
DOI 10.1590/0034-7167-2018-0421
Views0See moreABSTRACT
Objectives:
to present the nurses’ experience with technological tools to support the early identification of sepsis.
Methods:
experience report before and after the implementation of artificial intelligence algorithms in the clinical practice of a philanthropic hospital, in the first half of 2018.
Results:
describe the motivation for the creation and use of the algorithm; the role of the nurse in the development and implementation of this technology and its effects on the nursing work process.
Final Considerations:
technological innovations need to contribute to the improvement of professional practices in health. Thus, nurses must recognize their role in all stages of this process, in order to guarantee safe, effective and patient-centered care. In the case presented, the participation of the nurses in the technology incorporation process enables a rapid decision-making in the early identification of sepsis.
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ORIGINAL ARTICLE06-27-2019
Caring for the carer: quality of life and burden of female caregivers
Revista Brasileira de Enfermagem. 2019;72(3):728-736
Abstract
ORIGINAL ARTICLECaring for the carer: quality of life and burden of female caregivers
Revista Brasileira de Enfermagem. 2019;72(3):728-736
DOI 10.1590/0034-7167-2018-0334
Views0See moreABSTRACT
Objective:
To assess the quality of life and the burden of female caregivers.
Method:
Descriptive, cross-sectional, quantitative study carried out with 224 informal caregivers from March to July 2016. Three instruments were used: a characterization form for the caregiver, the WHOQOL-Bref questionnaire and the Zarit Burden Interview. The following tests were used: Cronbach’s Alpha, Kolmogorov-Smirnov, Kruskal-Wallis, Spearman and Mann-Whitney.
Results:
The mean age of caregivers was 51.8 years with a standard deviation of 13.7. They were predominantly married, had a low income and low level of education, were first-degree relatives, had been providing care for one to five years and presented some pathology. The associations of quality of life that presented statistical significance were: income, marital status, number of people living with the caregiver and time of care.
Conclusion:
The burden was negatively correlated with QOL, that is, the greater the burden, the more impaired will be the life of these caregivers.
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REVIEW03-24-2021
Development of clinical competence in nursing in simulation: the perspective of Bloom’s taxonomy
Revista Brasileira de Enfermagem. 2021;74(1):e20200135
Abstract
REVIEWDevelopment of clinical competence in nursing in simulation: the perspective of Bloom’s taxonomy
Revista Brasileira de Enfermagem. 2021;74(1):e20200135
DOI 10.1590/0034-7167-2020-0135
Views0See moreABSTRACT
Objectives:
to investigate the scientific evidence on the use of Bloom’s taxonomy for developing competence in nursing professionals and students in clinical simulation.
Methods:
integrative review of the National Library of Medicine (NLM), National Institutes of Health (NIH), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Web of Science and SCOPUS databases, using the Rayyan application.
Results:
a total of 871 studies were identified; four composed the sample. The development of clinical competence occurred through the coordination of knowledge, skills, and attitudes. To develop the cognitive domain, the objectives of knowledge and comprehension of the Bloom’s taxonomy were mobilized. The psychomotor domain required development of the skills demanded by the proposed clinical care. The affective domain was developed through will and motivation to learn.
Conclusions:
it is possible to develop clinical competence in nursing by adopting Bloom’s taxonomy in each phase of clinical simulation.
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ORIGINAL ARTICLE06-27-2019
Package of menthol measures for thirst relief: a randomized clinical study
Revista Brasileira de Enfermagem. 2019;72(3):600-608
Abstract
ORIGINAL ARTICLEPackage of menthol measures for thirst relief: a randomized clinical study
Revista Brasileira de Enfermagem. 2019;72(3):600-608
DOI 10.1590/0034-7167-2018-0057
Views0See moreABSTRACT
Objective:
To evaluate the effectiveness of the menthol package (lip hydration and ice popsicles) compared to a package of non-menthol measures (lip hydration and ice popsicles) as a way to relieve thirst in patients in the Anesthetic Recovery Room.
Method:
Randomized and parallel trial study, with 120 patients randomized patients in an experimental group – menthol measurements (n=59) and control group – measures without menthol (n = 61).
Results:
There was a significant (p<0.05) decrease in intensity, hydration, dryness and taste in the oral cavity between the three moments of assessment/intervention in the two groups. The difference was significant in the experimental group for thirst intensity at the second assessment/intervention point (p<0.05) after a single administration of the menthol package.
Conclusion:
There was a reduction in thirst intensity in both groups. Patients who received menthol packages showed a significant decrease in intensity after a single evaluation/intervention time. NCT: 02869139.
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EDITORIAL03-27-2020
Coronavirus 2020
Revista Brasileira de Enfermagem. 2020;73(2):e2020n2
Abstract
EDITORIALCoronavirus 2020
Revista Brasileira de Enfermagem. 2020;73(2):e2020n2
DOI 10.1590/0034-7167-2020730201
Views0Emerging and reemerging infectious diseases are constant challenges for public health worldwide. Recent cases of pneumonia of unknown cause in Wuhan, China, have led to the discovery of a new type of Coronavirus (2019-nCoV), which are enveloped RNA viruses, commonly found in humans, other mammals and birds, capable of causing respiratory, enteric, hepatic, and neurological […]See more -
ORIGINAL ARTICLE12-04-2020
Pressure injury related to the use of personal protective equipment in COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200670
Abstract
ORIGINAL ARTICLEPressure injury related to the use of personal protective equipment in COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200670
DOI 10.1590/0034-7167-2020-0670
Views0See moreABSTRACT
Objective:
To describe the prevalence and factors associated with pressure injuries related to the use of personal protective equipment during the COVID-19 pandemic.
Methods:
Cross-sectional study conducted using an instrument made available in social networks with 1,106 health professionals. The data were analyzed using descriptive statistics and compared, considering pvalue < 0.05.
Results:
There was a prevalence of 69.4% for pressure injuries related to the use of personal protective equipment, with an average of 2.4 injuries per professional. The significant factors were: under 35 years of age, working and wearing personal protective equipment for more than six hours a day, in hospital units, and without the use of inputs for protection.
Conclusion:
Pressure injuries related to the use of medical devices showed a high prevalence in this population. The recognition of the damage in these professionals makes it possible to advance in prevention strategies.
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ORIGINAL ARTICLE12-13-2019
Accessibility of children with special health needs to the health care network
Revista Brasileira de Enfermagem. 2019;72:65-71
Abstract
ORIGINAL ARTICLEAccessibility of children with special health needs to the health care network
Revista Brasileira de Enfermagem. 2019;72:65-71
DOI 10.1590/0034-7167-2017-0899
Views0See moreABSTRACT
Objective:
To know how children with special health needs access the health care network.
Method:
This is a qualitative research of descriptive-exploratory type, developed using semi-structured interviews mediated by the Talking Map design. Participants were 19 family caregivers of these children in two Brazilian municipalities. Data were submitted to inductive thematic analysis.
Results:
Difficulties were mentioned from the diagnosis moment to the specialized follow-up, something represented by the itinerary of the c hild and his/her family in the search for the definition of the medical diagnosis and the access to a specialized professional; a gap between the children’s needs and the care offered was observed in primary health care.
Conclusion:
The access of children with special health needs is filled with obstacles such as slowness in the process of defining the child’s diagnosis and referral to a specialist. Primary health care services were replaced by care in emergency care units.
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