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RESEARCH01-01-2017
Validation of an instrument regarding nursing intervention in patients in vasoactive therapy
Revista Brasileira de Enfermagem. 2017;70(3):453-460
Abstract
RESEARCHValidation of an instrument regarding nursing intervention in patients in vasoactive therapy
Revista Brasileira de Enfermagem. 2017;70(3):453-460
DOI 10.1590/0034-7167-2016-0254
Views0See moreABSTRACT
Objective:
to validate the content of a Standard Operational Procedure, regarding nursing interventions in emergency patients treated with vasoactive drugs.
Method:
methodological study, carried out from December 2015 to January 2016. Content validity was determined by 16 experts (13 nurses, 2 pharmacists and one biomedical scientist), who judged it through a four-point Likert scale. The items were evaluated in terms of: feasibility, objectivity, simplicity, clearness, pertinence and accuracy. The Content Validity Index was applied, accepting the value ≥ 0.90.
Results:
two rounds of evaluation were required to achieve the minimum index. The items were reviewed regarding writing, dilution, indication and replacement interval. The instrument was validated with 33 items and with total Content Validity Index of 0.99.
Conclusion:
the instrument was considered appropriate, fractionally and globally, for nursing care for the patient treated with vasoactive drugs in emergency, in a safe and reliable way.
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01-01-2017
Nursing in cardiology: state of the art and frontiers of knowledge
Revista Brasileira de Enfermagem. 2017;70(3):451-452
Abstract
Nursing in cardiology: state of the art and frontiers of knowledge
Revista Brasileira de Enfermagem. 2017;70(3):451-452
DOI 10.1590/0034-7167.2017700301
Views0Heart diseases lead the group of clinical disorders with higher rates of hospitalization and mortality and present a progressive increase in incidence due to population ageing, simultaneously to the development of new health therapies and technology. DATASUS() estimated a cost of nearly 700 million Reais for the country’s health care system in 2015, only for […]See more -
01-01-2017
Enfermagem em cardiologia: estado da arte e fronteiras do conhecimento
Revista Brasileira de Enfermagem. 2017;70(3):451-452
Abstract
Enfermagem em cardiologia: estado da arte e fronteiras do conhecimento
Revista Brasileira de Enfermagem. 2017;70(3):451-452
DOI 10.1590/0034-7167.2017700301
Views0As doenças cardíacas lideram o grupo das desordens clínicas de maiores taxas de hospitalização e mortalidade, além de apresentarem um progressivo aumento da incidência na população devido ao envelhecimento concomitante ao desenvolvimento das terapias e tecnologias em saúde. Uma estimativa obtida pelo DATASUS() acusa um gasto onerado ao sistema de saúde do país, no ano […]See more -
REFLECTION01-01-2017
Nursing care in early childhood: contributions from intersubjective recognition
Revista Brasileira de Enfermagem. 2017;70(2):446-450
Abstract
REFLECTIONNursing care in early childhood: contributions from intersubjective recognition
Revista Brasileira de Enfermagem. 2017;70(2):446-450
DOI 10.1590/0034-7167-2016-0319
Views0See moreABSTRACT
Objective:
to understand the elements composing intersubjective recognition that are relevant for nursing care in early childhood in favor of comprehensive child development.
Method:
reflexive study based on the Honnethian concept of intersubjective recognition in the dimensions of affection, defense of rights, and social esteem.
Results:
nursing knowledge and practices, permeated by the intersubjective recognition in the mentioned dimensions, contribute to the dynamism of interpersonal relations, the production of co-responsibility, and shared construction of health care in early childhood, with benefits to comprehensive development.
Conclusion:
a successful coordination of the three intersubjective dimensions enables the expansion of the understanding on childhood and nursing care in child health in the field of human development promotion, covering affection, defense of rights, and social esteem in the established relationships with future positive individual and social possibilities.
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REFLECTION01-01-2017
Hand hygiene as a caring practice: a reflection on professional responsibility
Revista Brasileira de Enfermagem. 2017;70(2):442-445
Abstract
REFLECTIONHand hygiene as a caring practice: a reflection on professional responsibility
Revista Brasileira de Enfermagem. 2017;70(2):442-445
DOI 10.1590/0034-7167-2016-0189
Views0See moreABSTRACT
Hand hygiene represents a fundamental nursing care practice and is traditionally considered the most important and effective measure in the prevention and control of healthcare-related infections. However, studies indicate that adherence to the procedure is unsatisfactory throughout the world, and show low adherence rates. In a context in which patient safety stands out as a priority, this text submits refl ections about professional responsibility when not adhering to hand hygiene practices, and ethical aspects related to this conduct.
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REFLECTION01-01-2017
Systematization of nursing care and the formation of professional identity
Revista Brasileira de Enfermagem. 2017;70(2):436-441
Abstract
REFLECTIONSystematization of nursing care and the formation of professional identity
Revista Brasileira de Enfermagem. 2017;70(2):436-441
DOI 10.1590/0034-7167-2016-0515
Views0See moreABSTRACT
The aim of this study is to explore arguments that broaden the understanding of possible links between the organization of nursing care and the structuring of professional identity. For that purpose, some aspects related to these themes are addressed, highlighting issues regarding differences in the concepts of the organization of nursing care and the nursing process, as well as the performance of this activity and its possible impact on the establishment of its relationship with the professional identity. Emphasis is given to the need to stimulate the debate on the subject by nursing professionals involved in the training of human resources and the provision of care, as well as in class entities, in order to deepen understanding of these concepts as significant elements for strengthening our professional identity.
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REFLECTION01-01-2017
Brazilian method for the development terminological subsets of ICNP®: limits and potentialities
Revista Brasileira de Enfermagem. 2017;70(2):430-435
Abstract
REFLECTIONBrazilian method for the development terminological subsets of ICNP®: limits and potentialities
Revista Brasileira de Enfermagem. 2017;70(2):430-435
DOI 10.1590/0034-7167-2016-0308
Views1See moreABSTRACT
Reflection on the limits and potentialities of a Brazilian method for the development of terminological subsets of ICNP®,(International Classification for Nursing Practice) based on the correlation between this method and international methods. This issue has been debated by the International Council of Nurses (ICN). Although the council propose a guideline for elaboration, they encourage and reinforce the use of various perspectives and processes in the development of subsets. Brazilian Nursing needs to propose a method and deepen reflections on the use of terminological subsets of ICNP® in the reality of the country. The development of subsets in Brazil is considered incipient and the proposed method needs to be used and deepened in order to spread the use of terminology through the application of subsets.
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EXPERIENCE REPORT01-01-2017
Focus group on qualitative research: experience report
Revista Brasileira de Enfermagem. 2017;70(2):424-429
Abstract
EXPERIENCE REPORTFocus group on qualitative research: experience report
Revista Brasileira de Enfermagem. 2017;70(2):424-429
DOI 10.1590/0034-7167-2016-0091
Views1See moreABSTRACT
Objective:
to report the experience of applying the focus group technique for production of data in qualitative research.
Method:
four group sessions were held from May to June 2015, with the participation of professionals from the public sector of PHC and from specialized service.
Results:
the way focus group was developed is described in steps: planning, recruitment, ambience, group sessions, and evaluation.
Conclusion:
we highlight that the focus group, as a technique to produce data in collective space, can contribute not only to the construction of knowledge in Nursing, but also to the research approach with the assistance practice.
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ORIGINAL ARTICLE12-04-2023
Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
Abstract
ORIGINAL ARTICLEBurnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
DOI 10.1590/0034-7167-2022-0684
Views0See moreABSTRACT
Objectives:
to analyze the association between burnout and the perception of the ethical climate in nursing professionals in the covid-19 Intensive Care Unit and the relationship with the organization of work from the perspective of managers of these units.
Methods:
mixed method study conducted in three university hospitals in southern Brazil from December 2021 to March 2022. A cross-sectional study was developed with 110 nursing professionals, followed by an exploratory-descriptive study through semi-structured interviews with six managers. Descriptive and analytical statistics and discursive textual analysis were used.
Results:
the prevalence of burnout was 10% and the perception of negative ethical climate was 24.5%. The association between burnout and ethical climate revealed overload and fatigue during working hours, related to tension, fear, and stress that emerged from the consequences of the organization and relations of work in the covid-19 Intensive Care Unit.
Conclusions:
there was an association between burnout and ethical climate and elements of the work organization.
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ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
DOI 10.1590/0034-7167.20247701e03
Views2In the article “Nurses in the labor market: professional insertion, competencies and skills”, with DOI number: , published in Revista Brasileira de Enfermagem, 2017;70(6):1220-6, on page 1225:Include before REFERENCES:[…]See more -
ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
DOI 10.1590/0034-7167.20247702e06
Views2In the article “Is there scientific relevance to the plot of films and documentaries about eating disorders?”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(1):e20220547, page 7:Where it read:[…]See more -
ORIGINAL ARTICLE07-29-2024
Educational technology for multidisciplinary training for managing waiting lists for elective patients
Revista Brasileira de Enfermagem. 2024;77(3):e20230299
Abstract
ORIGINAL ARTICLEEducational technology for multidisciplinary training for managing waiting lists for elective patients
Revista Brasileira de Enfermagem. 2024;77(3):e20230299
DOI 10.1590/0034-7167-2023-0299
Views1See moreABSTRACT
Objectives:
to construct and assess an educational technology for managing patient waiting lists for multidisciplinary training.
Methods:
study supported by Instructional Design – ADDIE model, whose stages of construction of educational technology were developed in the form of a multi-professional training course. Its respective content assessment was carried out by a committee of experts from 2021 to 2022. The analysis occurred based on the proportion of content adequacy with 95% Confidence Interval.
Results:
seventeen products were created as educational technology learning objects: five storyboards; four videos; three comic books; two pedagogical action plans; a mind map; and a YouTube® playlist. Nine experts assessed content adequacy, which reached 0.89.
Conclusions:
this educational technology contributes to the performance of professionals who manage waiting lists by reducing inequalities, alleviating differences, in addition to promoting equity in care and good health for patients in the Brazilian Health System.
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REVIEW11-22-2024
Spirituality and religiosity in children, adolescents and their families in a vulnerable context: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230425
Abstract
REVIEWSpirituality and religiosity in children, adolescents and their families in a vulnerable context: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230425
DOI 10.1590/0034-7167-2023-0425
Views1See moreABSTRACT
Objective:
to map evidence in the literature on the spirituality and religiosity of children, adolescents and their families in social vulnerability.
Methods:
this is a scoping review based on the JBI methodology, with the search without delimiting the time period, in English, Portuguese and Spanish, in the Virtual Health Library, PubMed, Embase, Cochrane Library, Scopus and Web of Science databases.
Results:
twenty-two studies were identified. The most studied population were adolescents, followed by children and their families. Regarding the setting, the context of vulnerability related to the low socioeconomic level experienced by these populations was highlighted. Furthermore, spirituality and religiosity were considered important for coping, social support, purpose and strength.
Conclusion:
there is an influence of spirituality and religiosity in the lives of children, adolescents and families, being a protective factor and a source of comfort, playing essential tools for living in context.
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ORIGINAL ARTICLE12-13-2024
Stress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
Abstract
ORIGINAL ARTICLEStress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
DOI 10.1590/0034-7167-2023-0542
Views1See moreABSTRACT
Objectives:
to analyze stress from the perspective of nursing workers caring for people with COVID-19 in a public hospital in the Recôncavo region of Bahia.
Methods:
this is an exploratory qualitative study, conducted through semi-structured interviews. The data were analyzed using word clouds, similarity trees, and content analysis.
Results:
nursing workers were exposed to stress while attending to patients with COVID-19. The reported stressors in the workplace included: work overload, lack of planning, speed in performing tasks, fatigue, lack of participation in decision-making, lack of support from management, technological changes, excessive responsibility without preparation, interpersonal conflicts, and professional undervaluation.
Conclusions:
exposure to these stressors leads to emotional exhaustion and demotivation, which were intensified during the COVID-19 pandemic.
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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
Views2See moreABSTRACT
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.
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ORIGINAL ARTICLE01-10-2024
Inventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
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
Views1See 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.
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ORIGINAL ARTICLE09-16-2019
Tuberculosis: health care and surveillance in prisons
Revista Brasileira de Enfermagem. 2019;72(5):1304-1310
Abstract
ORIGINAL ARTICLETuberculosis: health care and surveillance in prisons
Revista Brasileira de Enfermagem. 2019;72(5):1304-1310
DOI 10.1590/0034-7167-2018-0260
Views0See moreABSTRACT
Objective:
To identify tuberculosis-related health care and surveillance actions in Prison Health Units.
Method:
Cross-sectional study, of quantitative, exploratory and descriptive character. We visited 13 Teams of Prison Health, and nurses and technicians were interviewed regarding epidemiological surveillance instruments, physical structure and materials.
Results:
Search for respiratory symptoms in admission was reported by 6 (46.2%) of the teams, and the smear microscopy was the most requested test. The Logbook of Respiratory Symptoms and the Logbook for Monitoring Tuberculosis Cases were used in 7 (53.8%) institutions. Two of them (15.4%) had a location for sputum collection and 1 (7.7%) had a radiographer. The Directly Observed Therapy was reported in 7 (53.8%) units.
Conclusion:
Health care actions related to the search for respiratory symptoms and Directly Observed Therapy should be expanded, as well as surveillance actions and recording in official documents of the National Tuberculosis Control Program.
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ORIGINAL ARTICLE06-27-2019
Patient safety incidents identified by the caregivers of hospitalized children
Revista Brasileira de Enfermagem. 2019;72(3):707-714
Abstract
ORIGINAL ARTICLEPatient safety incidents identified by the caregivers of hospitalized children
Revista Brasileira de Enfermagem. 2019;72(3):707-714
DOI 10.1590/0034-7167-2018-0484
Views0See moreABSTRACT
Objective:
to analyze patient safety incidents identified by caregivers of hospitalized children.
Method:
a qualitative, exploratory-descriptive study was carried out with 40 caregivers of children hospitalized in three hospital institutions in the city of Porto Alegre, Rio Grande do Sul State, Brazil, from April to December 2016. Semi-structured, recorded and transcribed interviews were carried out in their entirety, submitted to a thematic analysis using the NVivo 11.0 software.
Results:
reports related to falls, infant feeding, patient/caregiver identification, medication process, communication, hand hygiene and hygiene of the hospital environment, spread of diseases, relations between caregivers and professionals and care processes/procedures were all cited.
Final considerations:
communication and the relations among caregivers and professionals are the main contributory factors for patient safety incidents, interfering with the quality of care. The participation of caregivers and engagement in child care may be strategies to be developed to promote a safety culture.
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ORIGINAL ARTICLE07-31-2020
Maternal and child health care: adequacy index in public health services
Revista Brasileira de Enfermagem. 2020;73:e20170757
Abstract
ORIGINAL ARTICLEMaternal and child health care: adequacy index in public health services
Revista Brasileira de Enfermagem. 2020;73:e20170757
DOI 10.1590/0034-7167-2017-0757
Views0See moreABSTRACT
Objectives:
to analyze the adequacy of maternal and child-care in prenatal care, childbirth and the puerperal period, in the public health service.
Methods:
longitudinal study carried out in a city in Paraná with 357 puerperal women in a public maternity ward, outpatient clinic for immediate puerperal return and home visit 42 days postpartum. Four care domains were grouped (1 – Prenatal, 2 – Maternity, 3 – Immediate puerperal return, 4 – Late puerperal return). Mean, median, standard deviation and coefficient of variance were calculated considering adequate assistance when ≥ 70%; and inadequate, inferior.
Results:
lowest suitability average in Domain 3 (39.37%) and highest for Domain 4 (74.82%); median of 50.00% at 3 and 76.90% at 4. The largest standard deviation, in Domain 3 (25.18%); and high coefficient of variance for 1 and 3.
Conclusions:
in maternal and child follow-up, rates close to adequate in maternity care and higher in late puerperal return, meanwhile prenatal and immediate puerperal return were below the recommended in the health care network.
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ORIGINAL ARTICLE09-16-2019
Temporal trend of leprosy in a region of high endemicity in the Brazilian Northeast
Revista Brasileira de Enfermagem. 2019;72(5):1356-1362
Abstract
ORIGINAL ARTICLETemporal trend of leprosy in a region of high endemicity in the Brazilian Northeast
Revista Brasileira de Enfermagem. 2019;72(5):1356-1362
DOI 10.1590/0034-7167-2018-0682
Views0See moreABSTRACT
Objective:
to analyze the temporal trend and epidemiological patterns of leprosy indicators in Sobral, a municipality countryside of the state of Ceará, from 2001 to 2016.
Method:
a time series study based on data from the Department of Informatics of the Unified Health System. The time trend analysis was performed using the join point regression model.
Results:
There were 2,220 new cases of leprosy in Sobral from 2001 to 2016. Of these, 158 (7.2%) in children younger than 15 years of age, the proportion of new male cases was 52.8% (1,162), cases with grade 2 were 7.0% (156), and proportion of cases diagnosed by contact examination 5.7% (126).
Final considerations:
leprosy remains hyperendemic in adults and children, demonstrating the character of neglected disease. Analysis of the temporal trend allowed to verify that the instability in the detection coefficients, reflect operational problems in the organization of the services
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ORIGINAL ARTICLE09-30-2020
Organizational culture, authentic leadership and quality improvement in Canadian healthcare facilities
Revista Brasileira de Enfermagem. 2020;73:e20190732
Abstract
ORIGINAL ARTICLEOrganizational culture, authentic leadership and quality improvement in Canadian healthcare facilities
Revista Brasileira de Enfermagem. 2020;73:e20190732
DOI 10.1590/0034-7167-2019-0732
Views0See moreABSTRACT
Objective:
To investigate relationships among flexible and hierarchical organizational cultures, quality improvement domains, and authentic leadership competencies in Canadian healthcare facilities.
Method:
Observational cross-sectional study conducted in Alberta, Canada. Nurse managers (n=226) completed a survey including validated measures of organizational culture, quality improvement and authentic leadership. Data were analyzed using descriptive statistics, Spearman’s correlation coefficient and Chi-squared test (p<0.05).
Results:
Quality improvement through accreditation is related to organizational culture and authentic leadership. We saw a propensity for participants who reported working in a more flexible culture also reported greater quality improvement implementation and authentic leadership practices.
Conclusion:
This study assessed and reported the relationships between flexible organizational cultures, quality improvement through the accreditation process, and authentic leadership practices of healthcare managers. Flexible organizational cultures influence the adoption of authentic leadership, participatory management model and also improves quality.
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04-14-2021
COVID-19 patients in prone position: validation of instructional materials for pressure injury prevention
Revista Brasileira de Enfermagem. 2021;74:e20201185
Abstract
COVID-19 patients in prone position: validation of instructional materials for pressure injury prevention
Revista Brasileira de Enfermagem. 2021;74:e20201185
DOI 10.1590/0034-7167-2020-1185
Views0See moreABSTRACT
Objective:
to perform the content and face validation of a checklist and a banner on pressure injury prevention in patients in prone position.
Method:
this is a methodological study of content and face validation with 26 nurses with specialization. Professionals assessed the checklist and the banner in relation to clarity, theoretical relevance, practical relevance, relation of the figures to the text and font size. The Content Validity Index was calculated for each item, considering one with a value equal to or greater than 0.8 as valid.
Results:
all the actions described in the checklist and in the banner had a Content Validity Index greater than 0.80, with standardization of verbal time and esthetic adjustments in the banner’s layout, as suggested.
Conclusions:
the checklist and the banner were validated and can be used in clinical practice to facilitate pressure injury preventions in patients in prone position.
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03-19-2021
Production and validation of educational technology on nursing care for syphilis prevention
Revista Brasileira de Enfermagem. 2021;74:e20190694
Abstract
Production and validation of educational technology on nursing care for syphilis prevention
Revista Brasileira de Enfermagem. 2021;74:e20190694
DOI 10.1590/0034-7167-2019-0694
Views0See moreABSTRACT
Objectives:
Validate script and storyboard of a video for educational intervention on nursing care for the prevention and management of syphilis.
Methods:
Methodological design study, with quantitative analysis approach. The content and appearance of the educational video script and storyboard was validated by a committee of experts on the subject and video. They were considered validated from the agreement of 78%, calculated by means of the Content Validity Index.
Results:
There were suggestions, which were analyzed; and, where relevant, the script and storyboard were changed. The degree of agreement among the expert judges on the subject obtained a Content Validity Index (CVI) of 100%, while, with the technical experts in video, all the questions in the educational material obtained the percentage above the recommended minimum of 78%.
Conclusion:
The validated video is an important technological production and could be used in the context of health care.
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REVIEW03-09-2020
Singular therapeutic project in mental health: an integrative review
Revista Brasileira de Enfermagem. 2020;73(2):e20180508
Abstract
REVIEWSingular therapeutic project in mental health: an integrative review
Revista Brasileira de Enfermagem. 2020;73(2):e20180508
DOI 10.1590/0034-7167-2018-0508
Views0See moreABSTRACT
Objectives:
to analyze the Singular Therapeutic Projects’ characteristics in mental health care used to assist the subject with psychological distress.
Methods:
it is an Integrative Literature Review study conducted in July 2017. The following databases used to collect the data were LILACS, MEDLINE and BDENF. After applying the inclusion and exclusion criteria, 12 articles were selected.
Results:
there was divergence between what was recommended by the Ministry of Health for PTS elaboration with that described in the studies analyzed. Emphasis is placed on the low participation and co-responsibility between team/user in PTS elaboration, excessive referrals to specialized mental health services, fragmentation of knowledge within the multidisciplinary team, and difficulty sharing and discussing information about cases.
Final considerations:
it is pointed out the need to adapt PTS elaboration, and its respective steps, to the needs of each individual.
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