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LETTER TO THE EDITOR01-01-2017
Dimensioning the instrumentation: Exploratory or confirmatory factor analysis?
Revista Brasileira de Enfermagem. 2017;70(2):233-234
Abstract
LETTER TO THE EDITORDimensioning the instrumentation: Exploratory or confirmatory factor analysis?
Revista Brasileira de Enfermagem. 2017;70(2):233-234
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EDITORIAL01-01-2017
Hepatites Virais: um desafio para enfermagem
Revista Brasileira de Enfermagem. 2017;70(2):231-232
Abstract
EDITORIALHepatites Virais: um desafio para enfermagem
Revista Brasileira de Enfermagem. 2017;70(2):231-232
DOI 10.1590/0034-7167.2017700201
Views0O século XX desvendou os mistérios sobre a etiologia das hepatites virais, identificando cinco agentes distintos responsáveis por essas viroses: vírus da hepatite A (HAV), vírus da hepatite B (HBV), vírus da hepatite C (HCV), vírus da hepatite D (HDV) e vírus da hepatite E (HEV). Esses vírus são responsáveis por um milhão de mortes […]See more -
EDITORIAL01-01-2017
Viral hepatitis: a challenge for nursing
Revista Brasileira de Enfermagem. 2017;70(2):231-232
Abstract
EDITORIALViral hepatitis: a challenge for nursing
Revista Brasileira de Enfermagem. 2017;70(2):231-232
DOI 10.1590/0034-7167.2017700201
Views0The 20th century unveiled the mystery of the etiology of viral hepatitis, with the identification of five different agents responsible for these infections: the hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), and hepatitis E virus (HEV). These viruses account for one million deaths every year. HBV, […]See more -
ERRATUM01-01-2017
ERRATUM
Revista Brasileira de Enfermagem. 2017;70(1):242-242
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2017;70(1):242-242
DOI 10.1590/0034-7167.20177001e01
Views0Article “Accessibility assessment of assistive technology for the hearing impaired”, with number of DOI: , published in the journal Revista Brasileira de Enfermagem, v69(5):781-7, page 781 that read:“Luciana Vieira de CaravalhoI”.[…]See more -
REVIEW01-01-2017
From silence to voice: book review
Revista Brasileira de Enfermagem. 2017;70(1):240-241
Abstract
REVIEWFrom silence to voice: book review
Revista Brasileira de Enfermagem. 2017;70(1):240-241
DOI 10.1590/0034-7167-2016-0066
Views1The book() is a translation of the original titled From silence to voice(), published by Cornell Paperbacks in 2006. Bernice Burech and Susanne Gordon are journalists and took the nursing profession as the object of study. The authors have diagnosed silence in the profession, which motivated writing a work valuing the use of all types […]See more -
REFLECTION01-01-2017
Reflections in the light of the complexity theory and nursing education
Revista Brasileira de Enfermagem. 2017;70(1):236-239
Abstract
REFLECTIONReflections in the light of the complexity theory and nursing education
Revista Brasileira de Enfermagem. 2017;70(1):236-239
DOI 10.1590/0034-7167-2016-0239
Views0See moreABSTRACT
Objective:
to reflect on nursing education, taking into account the principles of complex thinking proposed by Morin.
Method:
reflection based on the principles of the complexity theory by Edgar Morin.
Results:
the application of complexity in teaching proposes an emancipatory education based on questioning and social transformation. It comprises the education of nurses who interact with others as a characteristic of their work. It is necessary to prepare students to develop critical and reflective attitudes and actions to overcome the fragmentation and linearity of knowledge.
Conclusion:
nursing care has been based on a reductionist assistance, reflecting the Cartesian model. Thus, nursing education seeks to comprise shared knowledge and experiences so that no subject or professional overpowers another, accepting the uniqueness of professionals and patients.
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EXPERIENCE REPORT01-01-2017
Pelvic floor rehabilitation program: report of 10 years of experience
Revista Brasileira de Enfermagem. 2017;70(1):231-235
Abstract
EXPERIENCE REPORTPelvic floor rehabilitation program: report of 10 years of experience
Revista Brasileira de Enfermagem. 2017;70(1):231-235
DOI 10.1590/0034-7167-2016-0257
Views0ABSTRACT
Objective:
to relate the creation, experience of establishment and service performed in the Pelvic Floor Rehabilitation Program [(PRAP)], a project of the School of Nursing of University of Campinas (UNICAMP), developed at a health unity in Campinas, São Paulo, Brazil.
Results:
this Program appeared due to the high demand of patients with urinary incontinence (UI) and need of formation or qualification of professionals to serve those customers and multiply the actions at other health unities. Nowadays, the PRAP is in its tenth year, and it has served 102 patients with UI and other dysfunctions of the pelvic floor and lower urinary tract, qualified 480 health professionals and stimulated researches.
Conclusion:
the preventive actions of pelvic floor rehabilitation are important areas of the nurse’s performance and initiatives as the related ones contribute for the professional formation and practice based on evidences.
Keywords:Lower Urinary Tract SymptomsNursingPelvic Floor DisordersRehabilitation ServicesUrinary IncontinenceSee more
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ERRATUM01-13-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
DOI 10.1590/0034-7167.20247706e08
Views0In the article “Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(4):e20230520, Chart 1:Where it read:[…]See more -
ERRATUM01-13-2024
ERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
Abstract
ERRATUMERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
DOI 10.1590/0034-7167.20247706e06pt
Views0No artigo “Crenças e atitudes de pais ou responsáveis legais sobre a vacinação infantil: revisão de escopo”, com número DOI: , publicado no periódico Revista Brasileira de Enfermagem, 2024;77(4):e20240126, página 5:Onde se lia:[…]See more -
ORIGINAL ARTICLE01-13-2024
Indicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
- Jarbas da Silva Ziani
, - Jenifer Härter ,
- Francielle Liz Monteiro ,
- Camila Biazus Dalcin ,
- Stela Maris de Mello Padoin , [ … ],
- Cláudia Zamberlan
Abstract
ORIGINAL ARTICLEIndicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
DOI 10.1590/0034-7167-2024-0204
- Jarbas da Silva Ziani ,
- Jenifer Härter ,
- Francielle Liz Monteiro ,
- Camila Biazus Dalcin ,
- Stela Maris de Mello Padoin ,
- Marcelo Ribeiro Primeira ,
- Laís Mara Caetano da Silva Corcini ,
- Cláudia Zamberlan
Views0See moreABSTRACT
Objectives:
to compare the sociodemographic and clinical severity indicators of hospitalized people with HIV in relation to clinical outcomes and urgent hospital admission.
Methods:
a retrospective cohort study was conducted with 102 medical records of HIV-infected individuals hospitalized in a hospital in southern Brazil. In addition to descriptive analysis, Fisher’s exact test, Pearson’s Chi-square, and logistic regression were used.
Results:
the data showed a significant direct effect on severity indicators in the following variables: male sex (p=0.013), skin color (p=0.023), level of education (p=0.000), urgent admissions (p=0.000), late diagnosis (p=0.001), diabetes mellitus (p=0.001), hypertension (p=0.004), kidney disease (p=0.002), high viral load (p=0.006), CD4+ count below 200 (p=0.005), fever (p=0.016), weight loss (p=0.013), co-infection with hepatitis C (p=0.004), and mortality (p=0.007).
Conclusions:
three sociodemographic and thirteen clinical markers were identified as being associated with the risk of clinical deterioration in hospitalized people with HIV.
- Jarbas da Silva Ziani
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ORIGINAL ARTICLE01-13-2024
Nurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
- Camila Wohlenberg Camparoto ,
- Maria do Carmo Fernandez Lourenço Haddad ,
- Elen Ferraz Teston ,
- Pamela dos Reis ,
- Sonia Silva Marcon
Abstract
ORIGINAL ARTICLENurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
DOI 10.1590/0034-7167-2023-0481
- Camila Wohlenberg Camparoto ,
- Maria do Carmo Fernandez Lourenço Haddad ,
- Elen Ferraz Teston ,
- Pamela dos Reis ,
- Sonia Silva Marcon
Views1See moreABSTRACT
Objectives:
to understand the perspective of nurses on the use of telemonitoring in the management of people with type 2 diabetes mellitus and arterial hypertension in primary care.
Methods:
this qualitative research involved sixteen nurses from eight municipalities in Paraná. Data were collected between November 2022 and January 2023 through inperson or remote interviews, which were audio-recorded and subjected to content analysis.
Results:
according to the nurses, telemonitoring enhances users’ knowledge about these conditions, communication and connection with the team, and productivity. However, the lack of electronic resources and equipment, high staff turnover, low user adherence, and the limited availability of professional time present significant challenges.
Final Considerations:
the effective implementation and operation of telemonitoring in the management of people with diabetes and hypertension involve both potential benefits and barriers. It is essential to have the availability of human and technological resources, managerial support, and the commitment of professionals and users.
- Camila Wohlenberg Camparoto
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ORIGINAL ARTICLE01-13-2024
Knowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
Abstract
ORIGINAL ARTICLEKnowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
DOI 10.1590/0034-7167-2023-0424
Views0ABSTRACT
Objectives:
to investigate the knowledge, attitudes, and practices of nurses regarding blood culture collection.
Methods:
a cross-sectional study was conducted in five Brazilian public hospitals with 112 nurses. Data were collected using an adapted questionnaire and analyzed through descriptive and inferential statistics.
Results:
nurses who did not consider themselves capable of collecting blood cultures had a 72% lower chance of performing the collection at the recommended site and an 83% lower chance of using the same needle for blood inoculation into the vials. Nurses working in the emergency department had a 75% lower chance of knowing the international benchmark for blood culture contamination rates, and those with less than 5 years in the position decreased their chance of accuracy in this matter by 79%.
Conclusions:
there are gaps in the knowledge, attitudes, and practices of nurses regarding blood culture collection. Standardization of the technique, periodic education, supervision and guidance of the collection team, and process auditing are recommended coping strategies.
Keywords:Blood CultureBlood Specimen CollectionHealth Knowledge, Attitudes, PracticeNursing CareQuality of Health CareSee more
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ORIGINAL ARTICLE01-13-2024
Social representations of oncologic surgery for patients with cancer
- Rômulo Frutuoso Antunes ,
- Rachel Verdan Dib ,
- Raquel de Souza Ramos ,
- Antonio Marcos Tosoli Gomes ,
- Manassés Moura dos Santos , [ … ],
- Karen Paula Damasceno dos Santos Souza
Abstract
ORIGINAL ARTICLESocial representations of oncologic surgery for patients with cancer
Revista Brasileira de Enfermagem. 2024;77(6):e20230273
DOI 10.1590/0034-7167-2023-0273
- Rômulo Frutuoso Antunes ,
- Rachel Verdan Dib ,
- Raquel de Souza Ramos ,
- Antonio Marcos Tosoli Gomes ,
- Manassés Moura dos Santos ,
- Margarida Maria Rocha Bernardes ,
- Carolina Cristina Scrivano dos Santos ,
- Karen Paula Damasceno dos Santos Souza
Views0See moreABSTRACT
Objectives:
to analyze the social representations of patients with cancer regarding oncologic surgery.
Methods:
a qualitative study based on Social Representation Theory was conducted with 126 participants between October 2021 and May 2022 in a public hospital in Rio de Janeiro. A characterization questionnaire, free evocations of the inducing term “surgery”, and semi-structured interviews with 60 participants were applied. Data were analyzed using Microsoft Excel® and IRaMuTeQ.
Results:
the central core of the representation is composed of fear, cure, hope, and removing the disease. The analysis of interviews resulted in six classes that highlight the social changes caused by treatment as well as the need for a support network to cope with the surgical process.
Final Considerations:
the representations reflect fear and hope towards the procedure and the desire to remove the disease, thus translating the cure through surgery.
- Rômulo Frutuoso Antunes
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ORIGINAL ARTICLE01-13-2024
Evaluation of care for people with HIV in Primary Health Care: construct validation
- Clarissa Mourão Pinho ,
- Juliana da Rocha Cabral ,
- Morgana Cristina Leôncio de Lima ,
- Mônica Alice Santos da Silva ,
- Regina Celia de Oliveira , [ … ],
- Maria Sandra Andrade
Abstract
ORIGINAL ARTICLEEvaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
DOI 10.1590/0034-7167-2023-0190
- Clarissa Mourão Pinho ,
- Juliana da Rocha Cabral ,
- Morgana Cristina Leôncio de Lima ,
- Mônica Alice Santos da Silva ,
- Regina Celia de Oliveira ,
- Jael Maria de Aquino ,
- Erika Simone Galvão Pinto ,
- Maria Sandra Andrade
Views0ABSTRACT
Objectives:
to verify the construct validation of an instrument for evaluating care for people living with HIV in Primary Health Care.
Methods:
methodological study carried out in 2021 with 260 health professionals in Recife, PE. Validation based on the internal structure was carried out at this stage using exploratory and confirmatory factor analysis, and validity based on item response theory.
Results:
the validation determined the retention of five factors and 63 items. The instrument’s internal consistency and quality of fit was 0.90, the Tukey-Lewis index was 0.915 and the comparative fit index was 0.918 in the confirmatory factor analysis. The indication for the absolute majority of items is adequate fit.
Conclusions:
the instrument has construct validity, making it possible to use it to evaluate the decentralization process and care for People Living with HIV in Primary Health Care.
Keywords:Acquired Immunodeficiency SyndromeComprehensive Health CareHIVPrimary Health CareProgram EvaluationSee more
- Clarissa Mourão Pinho
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ORIGINAL ARTICLE01-10-2024
Inventory of ethical problems in mobile pre-hospital care
- Simone da Silva Oliveira ,
- Mariana Oliveira Antunes Ferraz ,
- Darci de Oliveira Santa Rosa ,
- Kátia Santana Freitas ,
- Elaine de Oliveira Souza , [ … ],
- Marisa Aparecida Amaro Malvestio
Abstract
ORIGINAL ARTICLEInventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
DOI 10.1590/0034-7167-2023-0539
- Simone da Silva Oliveira ,
- Mariana Oliveira Antunes Ferraz ,
- Darci de Oliveira Santa Rosa ,
- Kátia Santana Freitas ,
- Elaine de Oliveira Souza ,
- Deisy Vital dos Santos ,
- Marisa Aparecida Amaro Malvestio
Views0See moreABSTRACT
Objective:
to construct and validate the content of an inventory of ethical problems experienced by nurses in mobile pre-hospital care.
Method:
a psychometric approach study, developed with the following stages: (1) instrument construction through a theoretical matrix based on deliberative bioethics, scoping review and online qualitative research; (2) content validity by judges; (3) pre-testing with Mobile Emergency Care Service nurses in various Brazilian states. For content validity analysis, the Content Validity Ratio was calculated (CVR>0.45 for judges and CVR>0.35 for the target population).
Results:
the instrument had 44 items, distributed across four dimensions.
Final considerations:
the constructed instrument presented sources of evidence of content validity, providing good psychometric measurements and constituting a useful tool for nurses’ practice in the pre-hospital setting.
- Simone da Silva Oliveira
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EDITORIAL01-01-2015
Health technologies for spatial analysis and situational diagnosis of the territories: contributions to nursing
Revista Brasileira de Enfermagem. 2015;68(6):999-1000
Abstract
EDITORIALHealth technologies for spatial analysis and situational diagnosis of the territories: contributions to nursing
Revista Brasileira de Enfermagem. 2015;68(6):999-1000
DOI 10.1590/0034-7167.2015680601i
Views0In order to establish an organizational basis for work processes in primary health care geared towards a new social practice, it is important to recognize territories and their contexts, as these materialize human interactions, conflicts, health problems and human needs.In the process of recognition and situational diagnosis of territories, technologies for spatial analysis can facilitate […]See more -
EDITORIAL01-01-2015
Tecnologias em saúde para análise espacial e diagnóstico situacional dos territórios: contribuições para a enfermagem
Revista Brasileira de Enfermagem. 2015;68(6):999-1000
Abstract
EDITORIALTecnologias em saúde para análise espacial e diagnóstico situacional dos territórios: contribuições para a enfermagem
Revista Brasileira de Enfermagem. 2015;68(6):999-1000
DOI 10.1590/0034-7167.2015680601i
Views0Para a constituição de uma base organizativa dos processos de trabalho na Atenção Primária à Saúde em direção a uma nova prática social é importante o reconhecimento dos territórios e seus contextos, pois estes materializam as interações humanas, os conflitos, os problemas de saúde e necessidades humanas.Nesse processo de reconhecimento e diagnóstico situacional dos territórios, […]See more -
OFFICIAL DOCUMENT01-01-2015
CARTA DE FORTALEZA PARA A ENFERMAGEM BRASILEIRA
Revista Brasileira de Enfermagem. 2015;68(5):961-962
Abstract
OFFICIAL DOCUMENTCARTA DE FORTALEZA PARA A ENFERMAGEM BRASILEIRA
Revista Brasileira de Enfermagem. 2015;68(5):961-962
DOI 10.1590/0034-7167.2015680527
Views0APRESENTAÇÃOOs participantes do 18º Seminário Nacional de Pesquisa em Enfermagem (SENPE), promovido pela Associação Brasileira de Enfermagem (ABEn) e realizado pela ABEn Seção Ceará, aprovaram, em Sessão Plenária de Encerramento, no dia 03 de junho de 2015, a “Carta de Fortaleza para a Enfermagem Brasileira”. A ABEn vem a público divulgá-la, ao mesmo tempo em […]See more -
Delayed surgical recovery: a concept analysis
Revista Brasileira de Enfermagem. 2015;68(5):953-960
Abstract
Delayed surgical recovery: a concept analysis
Revista Brasileira de Enfermagem. 2015;68(5):953-960
DOI 10.1590/0034-7167.2015680526i
Views0See moreABSTRACT
Objective:
analyze the concept of delayed surgical recovery.
Method:
the Rodgers’ concept analysis provided the procedural mechanisms to guide the study, and an integrative review was performed to achieve the second activity of the model adopted. The PubMed, CINAHL, EMBASE and LILACS databases were selected to search for primary studies.
Results:
sixty-six primary studies were included and served as basis to construct the use and meaning of delayed surgical recovery concept. In the analysis, six attributes were outlined, which are interrelated and underpin the research concept definition. Preliminary experience was identified as the antecedent. The consequences of the concept are expressed through clinical manifestations, re-interventions, dependence on care and reduced quality of life.
Conclusion:
the definition of the concept was constructed, and the antecedents and consequents were identified. The use and meaning of the delayed surgical recovery concept point to the use of the qualifier ‘impaired’ instead of ‘delayed’.
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REVIEW01-01-2015
Total Quality Management and hospital nursing: an integrative literature review
Revista Brasileira de Enfermagem. 2015;68(5):945-952
Abstract
REVIEWTotal Quality Management and hospital nursing: an integrative literature review
Revista Brasileira de Enfermagem. 2015;68(5):945-952
DOI 10.1590/0034-7167.2015680525i
Views0See moreABSTRACT
Objective:
to identify the available evidence in the literature on Total Quality Management in nursing administration.
Method:
integrative literature review of full text articles in Portuguese, English and Spanish, published between 2000 and 2011 in the LILACS, MEDLINE, SciELO and PubMed databases.
Results:
the sample comprises 24 periodical articles grouped by the following thematic categories: Theoretical assumptions; Practical application and Quality indicators. Despite the criticism of models derived from classic administration theories, experiences of success with the deployment of TQM have already marked the health and nursing setting in Brazil.
Conclusion:
Total Quality Management in managing of nursing care has being fully used in some health institutions, while others have adopted several of its principles. Two of the twenty four articles are intervention studies, which characterizes the necessity for clinical research in this area.
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RESEARCH01-01-2015
Association between fatigue and functional capacity in patients with intermittent claudication
Revista Brasileira de Enfermagem. 2015;68(5):937-944
Abstract
RESEARCHAssociation between fatigue and functional capacity in patients with intermittent claudication
Revista Brasileira de Enfermagem. 2015;68(5):937-944
DOI 10.1590/0034-7167.2015680524i
Views0See moreABSTRACT
Objective:
to characterize fatigue and exertion fatigue in patients with intermittent claudication (IC), and to test their association with sociodemographic and clinical variables, walking capacity and level of physical activity.
Method:
forty-nine participants (66.6 years; 70% male) were studied. Validated questionnaires were used to assess fatigue (DUFS), exertion fatigue (DEFS), level of physical activity (BASIC) and walking capacity (WIQ).
Results:
participants had substantial fatigue (DUFS = 20.4+8.8) and substantial exertion fatigue (DEFS = 20.4+10.8). There was an association between the DUFS and marital status (p = 0,008). There was a statically significant association between DEFS with scores of the BASIC (r = .331; p = .02) and among DEFS with WIQ domains – walking distance (r=.359; p = .011) and climbing stairs (r=.331; p = .02).
Conclusion:
patients with IC have fatigue and exertion fatigue. Exertion fatigue might compromise the engagement of these patients in physical activity, one of the main components of IC treatment.
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RESEARCH01-01-2015
Body mobilization for prevention of pressure ulcers: direct labor costs
Revista Brasileira de Enfermagem. 2015;68(5):930-936
Abstract
RESEARCHBody mobilization for prevention of pressure ulcers: direct labor costs
Revista Brasileira de Enfermagem. 2015;68(5):930-936
DOI 10.1590/0034-7167.2015680523i
Views0See moreABSTRACT
Objective:
to calculate the average total cost (ATC) on the direct labor costs (DLC) of nursing professionals in body mobilization of patients for the prevention of pressure ulcers.
Method:
this is a quantitative, exploratory and, descriptive research. We observed 656 preventive mobilizations and we calculated the cost by multiplying the time spent by professionals at a unitary DLC.
Results:
ATC with DLC for each Unit corresponded to: Medical Clinic R$ 5.38 for bed turning, R$ 5.26 for seating positions, R$ 5.55 for walking aid; Surgical Clinic R$ 2.42 for bed turning, R$ 2.30 for seating positions, R$ 2.96 for walking aid and Intensive Care Unit R$ 8.15 for bed turning, R$ 7.57 for seating positions, R$ 15.32 for walking aid.
Conclusion:
the knowledge generated can support management related to costs of human resources needed to efficiently and effectively nursing care.
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RESEARCH01-01-2015
The mobilization of nurses for the non-interruption of nursing residence
Revista Brasileira de Enfermagem. 2015;68(5):923-929
Abstract
RESEARCHThe mobilization of nurses for the non-interruption of nursing residence
Revista Brasileira de Enfermagem. 2015;68(5):923-929
DOI 10.1590/0034-7167.2015680522i
Views0See moreABSTRACT
Objective:
To analyze the strategies employed by nurses to maintain the nursing residence program at the Ophir Loyola Hospital and discuss the potential effects of this interruption on the state of Pará.
Method:
Social-historic research. Data were collected through primary sources, written documents, and oral testimonial; the secondary sources used were manuals and articles that approached the topic in question. The theoretical reference was based on the French sociologist Pierre Bourdieu’s ideas about the concepts of cultural, social, and symbolic capital, in addition to the habitus and field concepts.
Results:
During the nurses’ mobilization there was a strong political influence on the development of the crisis and the interruption of the nursing residence Program at the Ophir Loyola Hospital, with implications for the nurses’ qualifications and the health care delivered to the societyof Pará.
Conclusion:
The analysis showed the prevalence of partisan political interests at the expense of social interests, culminating in the interruption of the nursing residency.
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