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RESEARCH01-01-2018
Nursing diagnoses from ICNP® for people with metabolic syndrome
Revista Brasileira de Enfermagem. 2018;71:467-474
Abstract
RESEARCHNursing diagnoses from ICNP® for people with metabolic syndrome
Revista Brasileira de Enfermagem. 2018;71:467-474
DOI 10.1590/0034-7167-2017-0125
Views0See moreABSTRACT
Objective:
To construct nursing diagnosis statements based on the International Classification for Nursing Practice (ICNP®) for people with metabolic syndrome, settled on the theoretical framework of Basic Human Needs.
Method:
Descriptive study developed in four stages: 1) Identification and validation of terms relevant to care with health priority; 2) Cross-mapping of the terms identified with ICNP® terms; 3) Construction of the nursing diagnosis statements; and 4) Cross-mapping of constructed statements with the ones in ICNP®.
Results:
Regarding terms extracted, 370 were validated based on the consensus (100%) among specialists, subsidizing the elaboration of 52 nursing diagnosis statements from ICNP® version 2015, distributed among the Basic Human Needs proposed by theoretical framework.
Conclusion:
It was possible to construct nursing diagnoses for people with metabolic syndrome based on the terms extracted from the literature, with a predominance of the need for “Health education and learning”.
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01-01-2018
Street Clinic as good practice in Collective Health
Revista Brasileira de Enfermagem. 2018;71:465-466
Abstract
Street Clinic as good practice in Collective Health
Revista Brasileira de Enfermagem. 2018;71:465-466
DOI 10.1590/0034-7167-201871sup102
Views0“Freely translated as “How can I face this world? Life is ungrateful itself; but it brings hope even from the midst of the bitterness of despair”().Life on the streets has presented itself as a reality for an increasing number of people, especially in the big cities of Brazil and the world. This harsh social reality […]See more -
01-01-2018
Consultório na Rua como boa prática em Saúde Coletiva
Revista Brasileira de Enfermagem. 2018;71:465-466
Abstract
Consultório na Rua como boa prática em Saúde Coletiva
Revista Brasileira de Enfermagem. 2018;71:465-466
DOI 10.1590/0034-7167-201871sup102
Views0“Como é que posso com este mundo? A vida é ingrata no macio de si; mas transtraz a esperança mesmo do meio do fel do desespero”().A vida nas ruas tem se apresentado como uma realidade para um número cada vez maior de pessoas, sobretudo nas grandes cidades do Brasil e do mundo. Essa dura realidade […]See more -
01-01-2018
30 years of Nursing in Collective Health
Revista Brasileira de Enfermagem. 2018;71:463-464
Abstract
30 years of Nursing in Collective Health
Revista Brasileira de Enfermagem. 2018;71:463-464
DOI 10.1590/0034-7167-201871sup101
Views1It is celebrated 30 years of the official launch, in Brazil, of the Nursing in Collective Health, a field of theories and practices supported by the historical and dialectical materialism. Nothing is more instigating than bringing to readers the special edition of REBEn called “Contributions of Public Health to nursing practice”. In this editorial, it […]See more -
01-01-2018
30 anos de Enfermagem em Saúde Coletiva
Revista Brasileira de Enfermagem. 2018;71:463-464
Abstract
30 anos de Enfermagem em Saúde Coletiva
Revista Brasileira de Enfermagem. 2018;71:463-464
DOI 10.1590/0034-7167-201871sup101
Views1Comemora-se os 30 anos do lançamento oficial, no Brasil, da Enfermagem em Saúde Coletiva, um campo de teorias e práticas sustentadas pelo materialismo histórico e dialético. Nada mais instigante do que trazer aos leitores o número especial da REBEn intitulado “Contribuições e desafios das práticas de Enfermagem em Saúde Coletiva”. Neste editorial, indaga-se: teremos sido […]See more -
RESEARCH01-24-2017
Nurses in the labor market: professional insertion, competencies and skills
Revista Brasileira de Enfermagem. 2017;70(6):1220-1226
Abstract
RESEARCHNurses in the labor market: professional insertion, competencies and skills
Revista Brasileira de Enfermagem. 2017;70(6):1220-1226
DOI 10.1590/0034-7167-2016-0061
Views0See moreABSTRACT
Objective:
to characterize nurses graduated from the School of Nursing of the University of São Paulo, from 2006 to 2012; verify their entry, facilitating factors and difficulties of these graduates in the labor market and to consider their skills and competences in the world of work.
Method:
an exploratory, descriptive study with a qualitative approach.
Results:
out of 505 graduates, 172 (34.1%) participated in the research. Entry into the labor market was mainly via public hospital institutions, in the SE of Brazil, in the caregiving sectors. The greater part remained from one to two years in their first job. Most agreed that they were prepared to meet the health needs of the population. Furthermore, they had been encouraged to seek systematic and continuous improvement in a critical, reflexive and creative way, while combining technical-scientific knowledge and personal skills.
Conclusion:
the results show that the University of São Paulo has been preparing nurses for work in the labor market, in accordance with the provisions of the National Curricular Guidelines.
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ERRATUM01-01-2017
ERRATUM
Revista Brasileira de Enfermagem. 2017;70(6):1348-1348
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2017;70(6):1348-1348
DOI 10.1590/0034-7167.20177006e02
Views0Article “Nursing appointment and cardiometabolic control of diabetics: a randomized clinical trial”, with number of DOI: , published in the journal Revista Brasileira de Enfermagem, v70(3):468-7, on page 468:Where it read:[…]See more -
ERRATUM01-01-2017
ERRATUM
Revista Brasileira de Enfermagem. 2017;70(6):1347-1347
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2017;70(6):1347-1347
DOI 10.1590/0034-7167.20177006e01
Views0Article “Physical and psychological violence against the elderly: prevalence and associated factors”, with number of DOI: , published in the journal Revista Brasileira de Enfermagem, v68(6):727-33, on page 732, it is added:“FUNDING[…]See more
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RESEARCH01-01-2018
Self-care of men with priapism and sickle cell disease
Revista Brasileira de Enfermagem. 2018;71(5):2418-2424
Abstract
RESEARCHSelf-care of men with priapism and sickle cell disease
Revista Brasileira de Enfermagem. 2018;71(5):2418-2424
DOI 10.1590/0034-7167-2017-0464
Views0See moreABSTRACT
Objective:
To identify self-care demands of men with sickle cell disease and priapism and describe self-care measures in light of Orem’s Self-Care Theory.
Method:
This is a descriptive exploratory study with qualitative approach conducted with nine men with a history of sickle cell disease and priapism. Data were analyzed using Orem’s Self-Care Theory.
Results:
Some demands were identified: from universal self-care – difficulty in social interaction and solitude, changes in self-image, self-esteem and sexual activity; from development – the experience with priapism and little knowledge about the pathophysiology of the disease; regarding health deviations – pain crises.
Conclusion:
Orem’s theory allowed to identify self-care demands, which are essential for the nursing care provided for men with priapism. Nursing has an essential role in the measures for the different demands presented.
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ORIGINAL ARTICLE10-09-2023
Compliance with central venous catheter infection prevention practices after intervention with simulation
Revista Brasileira de Enfermagem. 2023;76(4):e20220574
Abstract
ORIGINAL ARTICLECompliance with central venous catheter infection prevention practices after intervention with simulation
Revista Brasileira de Enfermagem. 2023;76(4):e20220574
DOI 10.1590/0034-7167-2022-0574
Views0See moreABSTRACT
Objectives:
to assess the effect of an educational intervention based on clinical simulation on nursing professionals’ compliance with practices to prevent peripherally inserted central venous catheter-associated primary bloodstream infections in a Neonatal Intensive Care Unit.
Methods:
a quasi-experimental study, with preand post-intervention assessment with a single group. The population consisted of 41 nursing professionals, with 31 observations being made before and after the intervention. Analyzes were performed using descriptive statistics and the McNemar non-parametric test. A significance level of 5% was adopted.
Results:
after the intervention, there was an increase in compliance with prevention practices of surgical antisepsis and professional hand hygiene, skin antisepsis with chlorhexidine, waiting for the time of the effect of alcoholic chlorhexidine and compliance with the sterile technique.
Conclusions:
the educational intervention showed an effect on increasing compliance with catheter-associated infection prevention practices.
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EXPERIENCE REPORT10-09-2023
Focus group in the development of concepts for a Nursing model: experience report
Revista Brasileira de Enfermagem. 2023;76(4):e20220689
Abstract
EXPERIENCE REPORTFocus group in the development of concepts for a Nursing model: experience report
Revista Brasileira de Enfermagem. 2023;76(4):e20220689
DOI 10.1590/0034-7167-2022-0689
Views0See moreABSTRACT
Objective:
To communicate the experience of developing concepts for the construction of a care model through focus groups.
Methods:
An experience report on the development of concepts through remote focus groups with members of a research group from a public university in southern Brazil.
Results:
Focus groups were developed in which homogeneity and heterogeneity criteria were observed among participants. In addition to the concepts of the nursing metaparadigm, the concepts of care and family-centered care were developed, relevant to the nursing care model in question.
Final considerations:
Despite the challenges of conducting remote focus groups, they were suitable for the collective construction of concepts for a nursing care model, allowing the interaction of participants from different locations.
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ORIGINAL ARTICLE10-09-2023
Independent and combined effects of lifestyle behaviors on adolescent health-related quality of life
Revista Brasileira de Enfermagem. 2023;76(4):e20220780
Abstract
ORIGINAL ARTICLEIndependent and combined effects of lifestyle behaviors on adolescent health-related quality of life
Revista Brasileira de Enfermagem. 2023;76(4):e20220780
DOI 10.1590/0034-7167-2022-0780
Views0See moreABSTRACT
Objective:
To investigate the independent and combined effects of lifestyle behaviors, including physical activity, sedentary behavior, sleep duration and food intake, in the health-related quality of life (HRQoL) of Brazilian adolescents.
Methods:
Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect lifestyle behaviors data. Perception of the HRQoL was identified using the Kidscreen-27. The study used covariance analysis and linear regression models for statistical analysis.
Results:
Adolescents who reported ≤ 2 hours/day of screen-based sedentary behavior and sleep duration equivalent to 8-10 hours/night presented significantly higher HRQoL. Adolescents who reported joint adherence ≥ 3 healthy lifestyle behaviors demonstrated approximately two [OR=2.12] to three times [OR=3.04] more chance of presenting higher perceptions of HRQoL.
Conclusion:
Although healthy lifestyle behaviors had a positive independent effect on HRQoL, joint adherence to healthy behaviors enhances the cumulative effect.
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ORIGINAL ARTICLE12-04-2023
Working conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
Abstract
ORIGINAL ARTICLEWorking conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
DOI 10.1590/0034-7167-2022-0679
Views0See moreABSTRACT
Objective:
To investigate working conditions in nursing when facing the Covid-19 pandemic, in light of aspects of precarious work.
Methods:
Cross-sectional study, with 131 nursing workers who worked against Covid-19 in hospitals in Alagoas State, Northeast Brazil. Data were collected online, using a workers’ health assessment questionnaire. The Chi -Square or Fisher’s Exact test and logistic regression were used.
Results:
among nursing workers, 71% had precarious contracts, 33.6% reported extended working hours and 23.7% were union members. In the multivariable analysis, having little hospital experience was a predictor for poor employment (OR= 2.408; 95%CI= 1.051-5.518). The predictor variables for lengthening the working day were being a nurse (OR= 3.824; 95%CI= 1.274-11.483); overtime (OR= 3.668; 95%CI= 1.009-13.333) and inadequate number of workers (OR= 10.872; 95%CI= 3.409-34.675). Being a nursing technician was a predictor of being a union member (OR= 8.967; 95%CI=2.560-31.410).
Conclusions:
The pandemic has accentuated the precariousness of working conditions in nursing professionals, especially among nurses.
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ORIGINAL ARTICLE05-29-2023
Quality of life from women’s perspective in the exercise of sex work: a study of social representations
Revista Brasileira de Enfermagem. 2023;76:e20220169
Abstract
ORIGINAL ARTICLEQuality of life from women’s perspective in the exercise of sex work: a study of social representations
Revista Brasileira de Enfermagem. 2023;76:e20220169
DOI 10.1590/0034-7167-2022-0169
Views1See moreABSTRACT
Objectives:
to analyze the social representations elaborated by sex workers from Alto Sertão Produtivo Baiano about quality of life.
Methods:
a qualitative study, based on the Social Representation Theory, carried out in the region of Alto Sertão Produtivo Baiano, with 30 sex workers. Individual in-depth interview was carried out, with speeches organized in a corpus and treated in IRAMUTEQ, enabling lexical analysis for Descending Hierarchical Classification.
Results:
four thematic classes emerged, in which social representations of quality of life pervade: money earned to supply needs; association with healthy living and obtaining health (physical and mental); balance of emotions (although there are some negative sensations such as fear and anxiety); and faith in a deity.
Final Considerations:
the social representations elaborated by sex workers about quality of life are anchored in concepts, subjective and practical, punctuated by the World Health Organization.
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ORIGINAL ARTICLE12-08-2023
Care for older adults with disabilities in Long Term Care Facility
Revista Brasileira de Enfermagem. 2023;76:e20220767
Abstract
ORIGINAL ARTICLECare for older adults with disabilities in Long Term Care Facility
Revista Brasileira de Enfermagem. 2023;76:e20220767
DOI 10.1590/0034-7167-2022-0767
Views0See moreABSTRACT
Objective:
to analyze the constitution of care offered to older adults with disabilities, from Long Term Care Facility professionals’ perspective.
Methods:
this is a discourse analysis based on the post-structuralist framework. Participants in this study are professionals involved in the care for older adults, totaling 14 respondents, 13 women and one man.
Results:
from professionals’ perspective, there is a fine line between caring for older adults with disabilities and maintaining their autonomy. Care in which autonomy is restricted predisposes older adults to a process of dependency.
Final considerations:
caring for older adults with disabilities constitutes the challenge between caring and maintaining independence. Thus, older adult-centered care should be taken as a premise so that their individualities are respected.
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ORIGINAL ARTICLE12-08-2023
Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
Abstract
ORIGINAL ARTICLEPolypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
DOI 10.1590/0034-7167-2022-0785
Views0See moreABSTRACT
Objective:
to identify the prevalence and associations of polypharmacy and potentially inappropriate medication use among older adults with hypertension treated in primary care.
Methods:
a cross-sectional study carried out with older adults with hypertension treated at a Family Health Strategy unit. Data collection included analysis of medical records, interviews and multidimensional assessment of older adults. Socio-demographic information and clinical variables were collected. Statistical analysis was performed by multiple logistic regression.
Results:
polypharmacy prevalence was 38.09%, and potentially inappropriate medication (PIM), 28.57%. There was a significant association between polypharmacy and PIM use, altered sleep and ethnicity. PIM use was associated with polypharmacy, worse family functioning, and absence of a caregiver. Cognitive decline reduces the prevalence of these medications.
Conclusions:
polypharmacy and PIM use among older adults with hypertension represent a problem in this population, especially among the most vulnerable.
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ORIGINAL ARTICLE05-15-2020
Stress and quality of sleep in undergraduate nursing students
Revista Brasileira de Enfermagem. 2020;73:e20180227
Abstract
ORIGINAL ARTICLEStress and quality of sleep in undergraduate nursing students
Revista Brasileira de Enfermagem. 2020;73:e20180227
DOI 10.1590/0034-7167-2018-0227
Views0See moreABSTRACT
Objective:
to analyze the level of stress and sleep quality in nursing students according to terms of the nursing program.
Method:
descriptive and cross-sectional research developed in a higher education institution in Northeastern Brazil on 167 students. We used data collection, sociodemographic information, and a scale for assessing stress and sleep quality in nursing students.
Results:
we identified a statistically significant difference between domains of the stress scale and the terms of the undergraduate program, and between the quality of sleep and such terms such as as in the fourth and sixth semesters.
Conclusion:
different stress scores show that the semester which concerns students the most is the fifth. Quality of sleep was deemed good for the first, third, fifth, seventh, and eighth semesters; and poor for the fourth and sixth terms.
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ORIGINAL ARTICLE09-21-2020
Clinical judgment and diagnostic reasoning of nursing students in clinical simulation
Revista Brasileira de Enfermagem. 2020;73(6):e20180878
Abstract
ORIGINAL ARTICLEClinical judgment and diagnostic reasoning of nursing students in clinical simulation
Revista Brasileira de Enfermagem. 2020;73(6):e20180878
DOI 10.1590/0034-7167-2018-0878
Views0See moreABSTRACT
Objectives:
to determine the degree of association between clinical judgment and diagnostic reasoning of nursing students in clinical simulation.
Methods:
this is a correlational research design using a quantitative approach. The sample consisted of 41 nursing students who assisted a patient with vaso-occlusive crisis in a high-fidelity clinical simulation setting. The instruments used included the Lasater Clinical Judgment Rubric – Brazilian Version and the Diagnostic Thinking Inventory.
Results:
clinical judgment was associated with diagnostic reasoning (r=0.313; p=0.046), as well as the “noticing” aspect of clinical judgment with diagnostic reasoning (r=0.312; p=0.047).
Conclusions:
the results show that skills to interpret patient data are associated with diagnostic reasoning skills. Teaching clinical judgment skills is necessary to develop the diagnostic reasoning of nursing students.
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ORIGINAL ARTICLE12-05-2019
Quality of life of institutionalized aged with and without symptoms of depression
Revista Brasileira de Enfermagem. 2019;72:127-133
Abstract
ORIGINAL ARTICLEQuality of life of institutionalized aged with and without symptoms of depression
Revista Brasileira de Enfermagem. 2019;72:127-133
DOI 10.1590/0034-7167-2018-0316
Views0See moreABSTRACT
Objective:
compare the quality of life (QOL) of aged residents in homes for aged people with or without symptoms of depression, and identify social, physical activity; leisure; health and basic activities of daily living (ADL) variables that correlate with QOL scores.
Method:
cross-sectional study conducted with 101 institutionalized aged. Multiple linear regression was used for data analysis.
Results:
symptoms of depression changed negatively the QOL in the domains: autonomy; present, past and future activities; social participation; intimacy and total score. Dependent aged presented lower QOL for the performance of ADL in the domains: autonomy; social participation and total score; dancing without limitation of movement; liking the residential and not presenting symptoms of depression were the variables that positively influenced the QOL of the aged.
Conclusion:
social and psychological support, good living conditions and stimulating assistance can improve the QOL of institutionalized elderlies.
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ORIGINAL ARTICLE07-08-2020
Spirituality and religiousity in the experience of suffering, guilt, and death of the elderly with cancer
Revista Brasileira de Enfermagem. 2020;73:e20190034
Abstract
ORIGINAL ARTICLESpirituality and religiousity in the experience of suffering, guilt, and death of the elderly with cancer
Revista Brasileira de Enfermagem. 2020;73:e20190034
DOI 10.1590/0034-7167-2019-0034
Views0See moreABSTRACT
Objective:
to understand spirituality and religiosity in the experience of suffering, guilt, and death of the elderly with cancer.
Method:
qualitative research based on Viktor Frankl’s Existential Analysis. Twenty phenomenological interviews were conducted with people over 60 years old undergoing chemotherapy treatment at an oncology unit of a hospital in the city of Salvador, Bahia State, Brazil, between August and October 2018.
Results:
the following categories emerged: Experiences spirituality and religiosity in the face of the tragic triad and existential emptiness; Uses spirituality/religiosity as resilience strategies. After apprehension of ontic aspects, it was possible the ontological understanding of spirituality and religiosity in the face of suffering, guilt, and death experienced in the elderly with cancer’s daily life.
Final considerations:
spirituality and religiosity were understood as coping strategies used in the unstable experience of the elderly with cancer, providing comfort and resilience.
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ORIGINAL ARTICLE02-10-2020
Mental health profile of the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73(1):e20180191
Abstract
ORIGINAL ARTICLEMental health profile of the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73(1):e20180191
DOI 10.1590/0034-7167-2018-0191
Views0See moreABSTRACT
Objective:
to describe the mental health profile of the elderly registered in a Family Health Unit in the city of Recife, Pernambuco State.
Method:
it was a descriptive quantitative study, conducted with 159 elderly through the scales Geriatric Depression, Resilience, Social Support, Life Satisfaction, and Positive and Negative Affects, Mini-Mental State Examination, Stressful Events Inventory and Brazil Old Age Shedule.
Results:
females, young and literate elderly predominated. Most were satisfied with life, 52.2% without depressive symptoms, 68.6% without cognitive impairment, 67.9% high resilience and 95.8% high social support, but 62% of elderly with depressive symptoms showed cognitive deficit. Negative correlation was identified between depression and cognitive impairment, resilience, social support and life satisfaction.
Conclusion:
assessment of these indicators identifies triggers of psychological distress, assisting the nursing staff in the development of preventive and care actions.
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EXPERIENCE REPORT10-26-2020
Collaborative practices from health care teams to face the covid-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200470
Abstract
EXPERIENCE REPORTCollaborative practices from health care teams to face the covid-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200470
DOI 10.1590/0034-7167-2020-0470
Views0See moreABSTRACT
Objective:
To report the experience of collaborative practices facing the COVID-19 pandemic.
Methods:
This is a report about the experience of collaborative practices conducted by health care teams in emergency service in the Emergency Care Units facing of COVID-19 pandemic in the city of Fortaleza, State of Ceará, in the first semester of 2020.
Results:
Collaborative actions, cooperation and effective communication among nursing and medical team contribute to the management of mild and complex cases of COVID-19, as well as qualify them in suitable and necessary care and confrontation measures.
Final considerations:
The report shows the need for collaborative practices to minimize negative effects on the population in the face of the new coronavirus pandemic.
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ORIGINAL ARTICLE11-25-2020
Family experiences in discovering Autism Spectrum Disorder: implications for family nursing
Revista Brasileira de Enfermagem. 2020;73:e20190489
Abstract
ORIGINAL ARTICLEFamily experiences in discovering Autism Spectrum Disorder: implications for family nursing
Revista Brasileira de Enfermagem. 2020;73:e20190489
DOI 10.1590/0034-7167-2019-0489
Views0See moreabstract
Objectives:
to describe the family’s experience in the process of discovering the diagnosis and initiation of treatment of children with Autism Spectrum Disorder.
Methods:
this qualitative and descriptive study interviewed nine relatives of eight children on autism spectrum. They were inserted in health services, public education, and Association of Parents and Friends of The Exceptional of cities in the countryside of the Center-West. Data were collected through open interviews from July to September 2017. Data was submitted to thematic analysis.
Results:
at the beginning, the family was difficult to perceive the first atypical signs presented by the children. Families experience situations of vulnerability, since support networks are insufficient. The school played a significant role in recognizing unexpected behaviors.
Final Considerations:
support, offered by nurses, health professionals, school and social support devices, is important to family and children in this trajectory.
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ORIGINAL ARTICLE10-21-2019
Nurses defending the autonomy of the elderly at the end of life
Revista Brasileira de Enfermagem. 2019;72(6):1639-1645
Abstract
ORIGINAL ARTICLENurses defending the autonomy of the elderly at the end of life
Revista Brasileira de Enfermagem. 2019;72(6):1639-1645
DOI 10.1590/0034-7167-2018-0768
Views1See moreABSTRACT
Objective:
to understand how nurses deal with the elderly’s autonomy at the end of life.
Method:
qualitative, exploratory study, guided by the Grounded Theory. Ten nurses, eight doctors and 15 nursing technicians were interviewed between November 2016 and May 2017 at a university hospital in Rio de Janeiro/Brazil.
Results:
nurses deal with the elderly’s autonomy in compliance with the code of ethics and exercise leadership in actions and interactions to defend this right, evaluating, guiding and listening to the preferences of the elderly; interacting with the family; and sharing information with the health team.
Final considerations:
the elderly’s autonomy must be ensured in care planning, based on patient-centered communication and developed in the interaction among agents involved in care. The discussion on “Living Wills” Health Care Directives and principles of palliative care must be encouraged.
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