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ORIGINAL ARTICLE12-16-2024
Respectful care for postpartum women with sickle cell disease: a netnographic study
- Zannety Conceição Silva do Nascimento Souza
, - Luana Gabriella Pinheiro Barrêto ,
- Paulo Roberto Lima Falcão do Vale ,
- Elysangela Dittz Duarte ,
- Cristiane dos Santos Silva , [ … ],
- Evanilda Souza de Santana Carvalho
Abstract
ORIGINAL ARTICLERespectful care for postpartum women with sickle cell disease: a netnographic study
Revista Brasileira de Enfermagem. 2024;77(6):e20230545
DOI 10.1590/0034-7167-2023-0545
- Zannety Conceição Silva do Nascimento Souza ,
- Luana Gabriella Pinheiro Barrêto ,
- Paulo Roberto Lima Falcão do Vale ,
- Elysangela Dittz Duarte ,
- Cristiane dos Santos Silva ,
- Evanilda Souza de Santana Carvalho
Views1See moreABSTRACT
Objectives:
to analyze principles of respectful maternity care in narratives of postpartum women with sickle cell disease, relating them to Sustainable Development Goals.
Methods:
netnographic study, with two videos published in 2020. Deductive iconographic and thematic analysis by Respectful Maternity Care Charter, organized in MAXQDA.
Results:
principles identified were the right to: freedom from harm and ill-treatment; information, informed consent, refusal of medical procedures, and respect for their choices and preferences including companion; be considered a person from birth, with dignified and respectful treatment; health at the highest possible level; newborns being with their parents or guardians. The Sustainable Development Goals for women by 2030 were not positively contemplated in postpartum women’s experience.
Final Considerations:
it is appropriate that health workers qualify themselves to provide respectful maternity care, with qualified listening, understanding, and resolution of unique demands of postpartum women with sickle cell disease, seeking equality in care for women.
- Zannety Conceição Silva do Nascimento Souza
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12-16-2024
GerenciaDOR™: development of digital technology by nurses for the assessment of patients with chronic pain
Revista Brasileira de Enfermagem. 2024;77(6):e20240050
Abstract
GerenciaDOR™: development of digital technology by nurses for the assessment of patients with chronic pain
Revista Brasileira de Enfermagem. 2024;77(6):e20240050
DOI 10.1590/0034-7167-2024-0050
Views0See moreABSTRACT
Objectives:
to develop a digital technological solution (prototype) for assessing patients with chronic pain.
Methods:
this is a methodological and technological development study based on the Human-Centered Design framework and the principles of Patient-Centered Care. The prototype guides patients through a body diagram and directs them to an evaluation using specific instruments that address the multidimensional aspects of chronic pain.
Results:
the GerenciaDOR* project enables navigation through the Web App screens, providing access to pain assessment features up to the presentation of results.
Final Considerations:
the study describes a systematic approach to pain assessment and expands nurses’ knowledge in pain management. Additionally, it can promote the development of other digital technologies for chronic pain assessment and contribute to a multidisciplinary, patient centered treatment.
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ORIGINAL ARTICLE12-16-2024
Psychometric analysis of ProQOL-BR in nursing: building hospital safety and protection
- Frederico Marques Andrade ,
- Lanuza Borges Oliveira ,
- Igor Monteiro Lima Martins ,
- Maria Eduarda Borges Rodrigues ,
- Carla Silvana de Oliveira e Silva
Abstract
ORIGINAL ARTICLEPsychometric analysis of ProQOL-BR in nursing: building hospital safety and protection
Revista Brasileira de Enfermagem. 2024;77(6):e20240085
DOI 10.1590/0034-7167-2024-0085
- Frederico Marques Andrade ,
- Lanuza Borges Oliveira ,
- Igor Monteiro Lima Martins ,
- Maria Eduarda Borges Rodrigues ,
- Carla Silvana de Oliveira e Silva
Views0See moreABSTRACT
Objectives:
to analyze the psychometric properties of the ProQOL-BR instrument in hospital nursing professionals.
Methods:
a methodological study to validate the ProQOL-BR. Confirmatory factor analysis, assessment of local and global adjustment quality, Pearson hypothesis testing and Cronbach’s alpha internal consistency analysis were used.
Results:
a total of 490 professionals participated. The model presents adequate quality due to factor weights (λ≥ 0.40), acceptable overall fit quality and adequate chi-square ratio and degrees of freedom (χ2/g.1=2.51) for the parameters of CFI (0.923), GFI (0.902), TLI (0.914) and RMSEA (0.042). In terms of validity, it was shown to be adequate with CC=0.89. The internal consistency obtained by standardized Cronbach’s alpha was 0.761. Criterion validity was shown to be favorable with significant correlations (0.001).
Conclusions:
the instrument was validated regarding content, criteria and reliability. Three questions were removed from the original instrument, ProQOL-BR, leaving the final instrument with 25 questions.
- Frederico Marques Andrade
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REVIEW12-16-2024
Recommendations for guidelines for promoting mental health in the workplace: an umbrella review
- Evelin Daiane Gabriel Pinhatti ,
- Amanda Salles Margatho do Nascimento ,
- Regina Celia Bueno Rezende Machado ,
- Rosangela Aparecida Pimenta ,
- André Estevam Jaques , [ … ],
- Maria do Carmo Fernandez Lourenço Haddad
Abstract
REVIEWRecommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
DOI 10.1590/0034-7167-2024-0086
- Evelin Daiane Gabriel Pinhatti ,
- Amanda Salles Margatho do Nascimento ,
- Regina Celia Bueno Rezende Machado ,
- Rosangela Aparecida Pimenta ,
- André Estevam Jaques ,
- Maria do Carmo Fernandez Lourenço Haddad
Views1See moreABSTRACT
Objectives:
to summarize the recommendations of guidelines for promoting mental health in the workplace.
Methods:
an umbrella review, according to Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses methodological assumptions. Data collection was carried out in January 2021 and updated in July 2023 in the American Psychological Association, Cochrane Library, EMBASE, National Library of Medicine, and Scopus databases. Systematic reviews that assessed guidelines with recommendations for mental health care for workers were included. PROSPERO registration CRD42023461845.
Results:
four systematic reviews published between 2015 and 2018 were identified. The abstracts highlighted actions that facilitate and inhibit the recommendations as well as three categories of intervention: primary prevention – worker protection; secondary prevention – promoting workers’ mental health; and tertiary prevention – supporting, monitoring and rehabilitating workers upon returning to work.
Conclusions:
the interventions are based on prevention, promotion and early recognition, support and rehabilitation of mental health problems.
- Evelin Daiane Gabriel Pinhatti
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ORIGINAL ARTICLE12-16-2024
Analysis of omission of antimicrobial doses in Intensive Care Units
- Isabelle Ribeiro Machado ,
- Danielle de Mendonça Henrique ,
- Flávia Giron Camerini ,
- Vanessa Galdino de Paula ,
- Cintia Silva Fassarella , [ … ],
- Lucas Rodrigo Garcia de Mello
Abstract
ORIGINAL ARTICLEAnalysis of omission of antimicrobial doses in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(6):e20240102
DOI 10.1590/0034-7167-2024-0102
- Isabelle Ribeiro Machado ,
- Danielle de Mendonça Henrique ,
- Flávia Giron Camerini ,
- Vanessa Galdino de Paula ,
- Cintia Silva Fassarella ,
- Lucas Rodrigo Garcia de Mello
Views0See moreABSTRACT
Objectives:
to analyze the rate of antimicrobial dose omission in intensive care units.
Methods:
cross-sectional study carried out between March 1 and September 30, 2023, in intensive care units of a University Hospital in Rio de Janeiro.
Results:
the sample consisted of 452 prescriptions and 1467 antimicrobial doses. The dose omission rate was 4.29%. Each antimicrobial prescribed increased the chance of omission by 51%. The strategy of double-checking prescriptions helped prevent 30% of antimicrobial dose omissions (p=0.0001).
Conclusions:
monitoring the omission of antimicrobial doses can guide nursing actions to improve quality and patient safety, contributing to the prevention of medication errors, antimicrobial stewardship and the fight against antimicrobial resistance.
- Isabelle Ribeiro Machado
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ORIGINAL ARTICLE12-16-2024
Health literacy development of Primary Health Care patients: qualitative research
Revista Brasileira de Enfermagem. 2024;77(6):e20240154
Abstract
ORIGINAL ARTICLEHealth literacy development of Primary Health Care patients: qualitative research
Revista Brasileira de Enfermagem. 2024;77(6):e20240154
DOI 10.1590/0034-7167-2024-0154
Views0See moreABSTRACT
Objectives:
to identify the process of health literacy development among primary care patients, relating it to their self-care practices.
Methods:
qualitative, prospective research with 22 patients from two Family Health Strategy units. Data were obtained through individual semi-structured interviews, examined through descriptive statistics and thematic content analysis.
Results:
the results discuss how participants learn about health and how this resonates in their behaviors, culminating in two thematic categories: “Health knowledge construction”; and “Dialogue between health knowledge construction and patient care actions”.
Final Considerations:
health knowledge is developed mainly through interpersonal relationships, mediated by health professionals through bonding and communication. Community educational actions and training of health professionals in communication can promote health literacy and self-care among patients.
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ORIGINAL ARTICLE12-16-2024
Bladder ultrasound: evidence of content validity of a checklist for training nurses
- Filipe Utuari de Andrade Coelho ,
- Sabrina Martins Reigota ,
- Flávia Manfredi Cavalcanti ,
- Dejanira Aparecida Regagnin ,
- Beatriz Murata Murakami , [ … ],
- Vinícius Batista Santos
Abstract
ORIGINAL ARTICLEBladder ultrasound: evidence of content validity of a checklist for training nurses
Revista Brasileira de Enfermagem. 2024;77(6):e20230183
DOI 10.1590/0034-7167-2023-0183
- Filipe Utuari de Andrade Coelho ,
- Sabrina Martins Reigota ,
- Flávia Manfredi Cavalcanti ,
- Dejanira Aparecida Regagnin ,
- Beatriz Murata Murakami ,
- Vinícius Batista Santos
Views0See moreABSTRACT
Objectives:
to develop and analyze evidence of content validity of a checklist for training nurses in measuring bladder volume through ultrasound.
Methods:
a methodological study, consisting of three stages: literature review; instrument item preparation; and analysis of evidence of content validity. The Content Validity Index (CVI) and Gwet’s AC2 were used for content validity analyses.
Results:
the checklist consisted of 23 items. The CVIs for clarity, relevance and dimensionality were 0.99, 0.99 and 0.98 respectively, and the CVIs for Gwet’s AC2 with coefficients for clarity, relevance and dimensionality were 0.89, 0.97 and 0.95, respectively, with p<0.001.
Conclusions:
the checklist developed for training nurses in measuring bladder volume through ultrasound achieved adequate evidence of content validity, and can be used to train nurses in clinical practice and future research.
- Filipe Utuari de Andrade Coelho
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12-16-2024
A relação entre gênero, formação educacional e ambiente de aprendizagem com a ansiedade do estudante de enfermagem
- Amelia Margaretha Simbolon ,
- Jesika Sari Munthe ,
- Mikar Syah Idaman Daeli ,
- Ineke Patrisia ,
- Chriska Roully Adeline Sinaga
Abstract
A relação entre gênero, formação educacional e ambiente de aprendizagem com a ansiedade do estudante de enfermagem
Revista Brasileira de Enfermagem. 2024;77(6):e20220615
DOI 10.1590/0034-7167-2022-0615
- Amelia Margaretha Simbolon ,
- Jesika Sari Munthe ,
- Mikar Syah Idaman Daeli ,
- Ineke Patrisia ,
- Chriska Roully Adeline Sinaga
Views1See moreRESUMEN
Objetivos:
identificar las variables asociadas a la práctica clínica relacionadas con la ansiedad de los estudiantes de enfermería.
Métodos:
se utilizó un diseño descriptivo, cuantitativo, correlacional con las recomendaciones STROBE, EQUATOR. La población fue de 233 estudiantes de enfermería con una muestra de 135 personas. Los datos se recopilaron de marzo a abril de 2022 utilizando instrumentos validados.
Resultados:
la prueba de chi-cuadrado y razón de verosimilitud significativa para género, formación académica y entorno de aprendizaje son superiores a 0.05, por lo que no existe una relación significativa entre las variables y la ansiedad de los estudiantes.
Conclusiones:
los estudiantes necesitan prepararse nuevamente antes de ingresar al campo de la práctica. Investigaciones cualitativas también son necesarias.
- Amelia Margaretha Simbolon
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REVIEW09-06-2022
Religiosity and mental health as aspects of comprehensiveness in care
- Dalila de Alcântara Martins ,
- Prisca Dara Lunieres Pêgas Coêlho ,
- Sandra Greice Becker ,
- Alaidistania Aparecida Ferreira ,
- Maria Luiza Carvalho de Oliveira , [ … ],
- Leslie Bezerra Monteiro
Abstract
REVIEWReligiosity and mental health as aspects of comprehensiveness in care
Revista Brasileira de Enfermagem. 2022;75(1):e20201011
DOI 10.1590/0034-7167-2020-1011
- Dalila de Alcântara Martins ,
- Prisca Dara Lunieres Pêgas Coêlho ,
- Sandra Greice Becker ,
- Alaidistania Aparecida Ferreira ,
- Maria Luiza Carvalho de Oliveira ,
- Leslie Bezerra Monteiro
Views0See moreABSTRACT
Objective:
to understand how religiosity can influence the health of individuals diagnosed with mental disorders, based on comprehensive care.
Methods:
this is an integrative literature review, with the inclusion of articles in Portuguese, English and Spanish, between 2010 and 2018.
Results:
the critical analysis and qualitative synthesis of the 24 selected studies were categorized into two subtopics: The influence of religiosity in promoting comprehensive mental health care; Mental health versus religiosity: influencing conditions for effective access to comprehensive care.
Final considerations:
a positive influence of religiosity was identified in the lives of individuals diagnosed with mental disorders; however, evidence shows that health teams do not feel comfortable and prepared to work with religiosity as an expression of spirituality. This being one of the dimensional aspects of health, it can be inferred, on the results, the existence of this gap in the comprehensive care approach.
- Dalila de Alcântara Martins
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ORIGINAL ARTICLE06-09-2021
Professional practice in caring for maternal grief in the face of stillbirth in two countries
Revista Brasileira de Enfermagem. 2021;74(3):e20200253
Abstract
ORIGINAL ARTICLEProfessional practice in caring for maternal grief in the face of stillbirth in two countries
Revista Brasileira de Enfermagem. 2021;74(3):e20200253
DOI 10.1590/0034-7167-2020-0253
Views0See moreABSTRACT
Objective:
to understand professional care for maternal grief in the puerperium of stillbirth.
Methods:
a clinical-qualitative study with all the women who had stillbirths living in Maringá (Brazil) and participating in the Center d’Études et de Recherche in Family Intervention at the University of Quebec in Outaouais in Gatineau (Canada). Semi-structured interviews were carried out and the relevant aspects were categorized into themes.
Results:
the identified categories were: Assistance received in the puerperium with a focus on grief: hospital and outpatient environment, and Professional support in coping with maternal grief after fetal loss: with contact and memories, without contact and without memories and impossibilities of contact with the baby.
Final
considerations: the need for a multidisciplinary support and monitoring network for women who experienced fetal loss was evident. From this study, a routine of care for grief can be implemented in Brazil based on experiences in Canada.
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ORIGINAL ARTICLE05-03-2021
Implementation of a surgical safety checklist in Brazil: cross-sectional study
- Vanessa de Brito Poveda ,
- Cassiane de Santana Lemos ,
- Simone Garcia Lopes ,
- Márcia Cristina de Oliveira Pereira ,
- Rachel de Carvalho
Abstract
ORIGINAL ARTICLEImplementation of a surgical safety checklist in Brazil: cross-sectional study
Revista Brasileira de Enfermagem. 2021;74(2):e20190874
DOI 10.1590/0034-7167-2019-0874
- Vanessa de Brito Poveda ,
- Cassiane de Santana Lemos ,
- Simone Garcia Lopes ,
- Márcia Cristina de Oliveira Pereira ,
- Rachel de Carvalho
Views0See moreABSTRACT
Objective:
to identify the implementation process of the World Health Organization Surgical Safety Checklist in Brazilian hospitals.
Methods:
this is a cross-sectional study with 531 participants during a Congress of Perioperative Nursing, promoted by the Brazilian Association of Operating Room Nurses, Anesthetic Recovery and Material and Sterilization Center, in 2017.
Results:
among the nursing professionals included, 84.27% reported the checklist implementation in the workplace. Regarding daily application in the Sign-in stage, 79.65% of professionals confirmed patient identification with two indicators; in the Time-out stage, 51.36% of surgeries started regardless of confirmation of one of the items. In the Sign-out stage, 69.34% of professionals did not count or occasionally counted the surgical instruments and suture needles, and only 36.36% reviewed concerns about postoperative recovery.
Conclusion:
this study identified needs for improvements in applying the checklist in the Brazilian reality, to guarantee safer surgical procedures.
- Vanessa de Brito Poveda
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ORIGINAL ARTICLE06-18-2021
Standard drug consumption: a study with elderly people in Primary Health Care
- Josefa Muriele da Silva Marinho ,
- Karyne Beatriz Almeida de Medeiros ,
- Romário Nóbrega Santos Fonseca ,
- Thiego Santos de Araujo ,
- Wanessa Cristina Tomaz dos Santos Barros , [ … ],
- Luciane Paula Batista Araújo de Oliveira
Abstract
ORIGINAL ARTICLEStandard drug consumption: a study with elderly people in Primary Health Care
Revista Brasileira de Enfermagem. 2021;74(3):e20200729
DOI 10.1590/0034-7167-2020-0729
- Josefa Muriele da Silva Marinho ,
- Karyne Beatriz Almeida de Medeiros ,
- Romário Nóbrega Santos Fonseca ,
- Thiego Santos de Araujo ,
- Wanessa Cristina Tomaz dos Santos Barros ,
- Luciane Paula Batista Araújo de Oliveira
Views0See moreABSTRACT
Objective:
To identify the pattern of medication consumption among the elderly assisted in Primary Health Care.
Methods:
Descriptive, quantitative, cross-sectional study, with a sample of 315 elderly people, in a city in rural Rio Grande do Norte.
Results:
The average age was 72.41 years, with an average consumption of 3.15 medications per day, ranging from 1 to 16 medications daily. There was a prevalence of antihypertensives, antidiabetics, hypolipidemic and psychotropic drugs. 238 different drugs were mentioned, 15 of which were “potentially inappropriate drugs” for the elderly. Most of these patients follow treatment according to medical prescription, with low self-medication. Most elderly people buy their drugs, although many are available for free.
Conclusion:
The most consumed drugs are consistent with the most reported diseases (hypertension and diabetes). The daily use of inappropriate medications for the elderly is worrying, especially psychotropics, given the risks of dependence or health complications of these users.
- Josefa Muriele da Silva Marinho
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ORIGINAL ARTICLE04-15-2022
Analysis of the temporal trend of mortality from sickle cell anemia in Brazil
- Felipe Machado Mota ,
- Marcos Antonio Ferreira Júnior ,
- Andréia Insabralde de Queiroz Cardoso ,
- Carolina Mariana Pompeo ,
- Oleci Pereira Frota , [ … ],
- Albert Schiaveto de Souza
Abstract
ORIGINAL ARTICLEAnalysis of the temporal trend of mortality from sickle cell anemia in Brazil
Revista Brasileira de Enfermagem. 2022;75(4):e20210640
DOI 10.1590/0034-7167-2021-0640
- Felipe Machado Mota ,
- Marcos Antonio Ferreira Júnior ,
- Andréia Insabralde de Queiroz Cardoso ,
- Carolina Mariana Pompeo ,
- Oleci Pereira Frota ,
- Daniel Henrique Tsuha ,
- Albert Schiaveto de Souza
Views0See moreABSTRACT
Objectives:
To analyze the temporal trend of mortality from sickle cell anemia in Brazil, by region, in the period 1997-2017.
Methods:
epidemiological study, with an ecological design, with a temporal trend, carried out with data from the Mortality Information System. For descriptive analysis, absolute and relative frequencies were used. In the correlation analysis, the ANOVA test was used, followed by Tukey’s post-test. The temporal trend was obtained using the cubic polynomial regression test.
Results:
6,813 deaths from sickle cell anemia were registered. Brown individuals (50.87%) were more frequent, with a predominance of males (50.4%), aged between 25 and 34 years and a higher incidence of deaths in the Midwest (0.25/100 thousand inhabitants). The time curve showed an increasing trend of deaths in the country between 1997 and 2015 (R2 = 0.98).
Conclusions:
sickle cell anemia showed increasing mortality in the 21 years analyzed and alerts health professionals and managers.
- Felipe Machado Mota
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TECHNOLOGICAL INNOVATION06-04-2021
Integrated Care model: Transition from acute to chronic care
Revista Brasileira de Enfermagem. 2021;74:e20200910
Abstract
TECHNOLOGICAL INNOVATIONIntegrated Care model: Transition from acute to chronic care
Revista Brasileira de Enfermagem. 2021;74:e20200910
DOI 10.1590/0034-7167-2020-0910
Views0See moreABSTRACT
Objective:
Description and discussion dimensions of Integrated Care Model.
Methods:
A descriptive study is done that describe a technological innovation, intervention strategies for professional performance.
Results:
Integrated Care Model (ICM) has two main categories include individual and Group-and disease-specific Model. First, is used for risky patients or with comorbidities. In second category; Chronic Care Model (CCM) is common form of Integrated Care Model to improve resultants in the patients with chronic condition, to move from acute care to integrate, regular, long-lasting, preventative and community-based nursing.
Final considerations:
It is important to consider patient as an active member of the treatment team. It seems to be essential to monitor performance of care system. On the other hand, offer multidisciplinary care leads to present desirable care, tailored to the specific needs of patients regarding safety, patient-centered care and their culture.
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ORIGINAL ARTICLE09-06-2022
Evaluation of the health level of the elderly: patient care team considerations
- Maria Clara Duarte Monteiro ,
- Maria Manuela Ferreira Pereira da Silva Martins ,
- Soraia Dornelles Schoeller
Abstract
ORIGINAL ARTICLEEvaluation of the health level of the elderly: patient care team considerations
Revista Brasileira de Enfermagem. 2022;75(1):e20201277
DOI 10.1590/0034-7167-2020-1277
- Maria Clara Duarte Monteiro ,
- Maria Manuela Ferreira Pereira da Silva Martins ,
- Soraia Dornelles Schoeller
Views0See moreABSTRACT
Objective:
To understand the differences of physicians, nurses, and social workers in the evaluation of the health status of the elderly.
Methods:
A cross-sectional quantitative study, using descriptive statistics. Non-probabilistic sample, consisting of 291 participants from three professional categories: 71 (24.4%) physicians, 192 (66%) nurses, and 28 (9.6%) social workers. We used a questionnaire including the variables: sociodemographic characteristics and instruments used for evaluation.
Results:
Instruments with greater utility for the evaluation of the elderly: for physicians, Mini Mental State Examination; for nurses, Braden scale; and for social workers, genogram. In the physical examination, the data most collected by physicians and nurses are the vital signs; and by social workers, the condition for performing the Activities of Daily Living.
Conclusions:
The evaluation of the elderly is based on a diversity of instruments and is an area in which health and social professionals need to share information.
- Maria Clara Duarte Monteiro
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EXPERIENCE REPORT09-01-2021
Process modeling: technological innovation to control the risk for perioperative positioning injury
- Ana Luzia Rodrigues ,
- Fernanda Broering Gomes Torres ,
- Eduardo Alves Portela Santos ,
- Marcia Regina Cubas
Abstract
EXPERIENCE REPORTProcess modeling: technological innovation to control the risk for perioperative positioning injury
Revista Brasileira de Enfermagem. 2021;74:e20200145
DOI 10.1590/0034-7167-2020-0145
- Ana Luzia Rodrigues ,
- Fernanda Broering Gomes Torres ,
- Eduardo Alves Portela Santos ,
- Marcia Regina Cubas
Views0See moreABSTRACT
Objectives:
to report the construction of a process model to support the decision making of operating room nurses to control the risk for perioperative positioning injury.
Methods:
experience report on a process model that helps nurses with decision making regarding clients at risk for perioperative positioning injury. By following the steps, it was possible to identify intrinsic and extrinsic variables of the literature and of the workflows of teams involved in the positioning of the client for surgery. The Business Process Model and Notation, the Bizagi Modeler software and terms from the International Classification for Nursing Practice were used in the model.
Results:
the experience allowed the observation of the knowledge integration between different areas, which enabled the process modeling and its validation.
Conclusions:
process modeling is an innovative option for the development of support systems for clinical nursing decisions.
- Ana Luzia Rodrigues
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