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ORIGINAL ARTICLE11-28-2023
Efeitos da pandemia de COVID-19 no bem-estar psicológico dos enfermeiros de um serviço de urgência
Revista Brasileira de Enfermagem. 2023;76:e20220171
Abstract
ORIGINAL ARTICLEEfeitos da pandemia de COVID-19 no bem-estar psicológico dos enfermeiros de um serviço de urgência
Revista Brasileira de Enfermagem. 2023;76:e20220171
DOI 10.1590/0034-7167-2022-0171
Views0See moreRESUMEN
Objetivos:
evaluar nivel de ansiedad de enfermeros de un servicio de urgencia frente al nuevo coronavirus y describir la relación entre niveles de ansiedad y variables sociodemográficas.
Métodos:
estudio cuantitativo descriptivo-correlacional con una muestra de 60 enfermeros. Recorrido a la aplicación de una encuesta como instrumento de recolecta de datos basándose en la Escala de Evaluación de Ansiedad de Hamilton.
Resultados:
el escore mediano de ansiedad de los enfermeros es leve. Verificado que hay una relación estadísticamente significante entre la ansiedad y la variable “sexo” e “hijos”, con mujeres presentando niveles de ansiedad superiores a los hombres y los enfermeros sin hijos presentando niveles de ansiedad leve, moderada o severa.
Conclusiones:
la COVID-19 desencadena ansiedad en los enfermeros, por veces a niveles patológicos; y ser del sexo femenino y no tener hijos la aumenta. Es posible afirmar que el sexo fue el factor determinante para el nivel de ansiedad experimentado.
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ORIGINAL ARTICLE11-28-2023
Effects of the COVID-19 pandemic on nurses’ psychological well being in an emergency room
Revista Brasileira de Enfermagem. 2023;76:e20220171
Abstract
ORIGINAL ARTICLEEffects of the COVID-19 pandemic on nurses’ psychological well being in an emergency room
Revista Brasileira de Enfermagem. 2023;76:e20220171
DOI 10.1590/0034-7167-2022-0171
Views0See moreABSTRACT
Objectives:
to assess the level of anxiety of nurses in an emergency room in view of the new Coronavirus and describe the relationship between the degrees of anxiety and their sociodemographic variables.
Methods:
quantitative descriptive-correlational study with a sample of 60 nurses. A questionnaire was used as a data collection instrument based on the Hamilton Anxiety Assessment Scale.
Results:
the nurses’ average anxiety is mild. A statistically significant relationship was found between anxiety and the variables “sex” and “children”, with women having higher levels of anxiety than men, and nurses who do not have children showing mild, moderate, or severe anxiety.
Conclusions:
COVID-19 triggers anxiety in nurses, sometimes at pathological levels. Being female and not having children increase the anxiety experienced. Sex can be considered the determining factor for the level of anxiety experienced.
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ORIGINAL ARTICLE11-28-2023
Construction and validation of an algorithm for disinfection of ambulances transporting patients with contagious infectious diseases
Revista Brasileira de Enfermagem. 2023;76:e20220081
Abstract
ORIGINAL ARTICLEConstruction and validation of an algorithm for disinfection of ambulances transporting patients with contagious infectious diseases
Revista Brasileira de Enfermagem. 2023;76:e20220081
DOI 10.1590/0034-7167-2022-0081
Views0ABSTRACT
Objectives:
to develop and validate an algorithm to guide professionals in cleaning and disinfecting ambulances after transferring patients with contagious infectious diseases.
Methods:
the study was conducted between September and November 2021. The developed algorithm was validated by 104 judges, including nurses, physical therapists, and physicians who care for patients with contagious infectious diseases. It used the Delphi technique and content validity index.
Results:
in the first evaluation, the judges considered the algorithm “unsuitable” and “fully suitable”. The algorithm reviewed according to the judges’ suggestions was rated between “suitable” and “fully suitable” in the second evaluation. The overall content validity index was 0.960 and 0.998 in the first and second evaluations.
Conclusions:
the algorithm to guide the cleaning and disinfection of ambulances after transferring patients with contagious infectious diseases was developed and validated by specialists in the field, with consensus among the judges in the second evaluation.
Keywords:Contagious Infectious DiseasesHouse CallsOccupational ExposureOccupational HealthPersonal Protective EquipmentSee more -
EDITORIAL11-28-2023
O diagnóstico e o tratamento da tuberculose latente por enfermeiros no Brasil: estratégia necessária
Revista Brasileira de Enfermagem. 2023;76(1):e760101
Abstract
EDITORIALO diagnóstico e o tratamento da tuberculose latente por enfermeiros no Brasil: estratégia necessária
Revista Brasileira de Enfermagem. 2023;76(1):e760101
DOI 10.1590/0034-7167.2023760101pt
Views0A prevenção da tuberculose (TB), de impedir a progressão da infecção para a TB ativa, é a principal estratégia para reduzir a sua incidência e para o alcance das metas definidas pela Organização Mundial da Saúde, conforme a estratégia End TB().O Brasil, que ocupa a 19ª posição quanto ao número de casos, assumiu seu compromisso […]See more -
EDITORIAL11-28-2023
The diagnosis and treatment of latent tuberculosis by nurses in Brazil: a necessary strategy
Revista Brasileira de Enfermagem. 2023;76(1):e760101
Abstract
EDITORIALThe diagnosis and treatment of latent tuberculosis by nurses in Brazil: a necessary strategy
Revista Brasileira de Enfermagem. 2023;76(1):e760101
DOI 10.1590/0034-7167.2023760101
Views0Tuberculosis (TB) prevention, from preventing the progression of infection to active TB, is the main strategy to reduce its incidence and to reach the goals defined by the World Health Organization, according to the End TB strategy().Brazil, ranking 19th in terms of the number of cases, assumed its commitment to institute preventive treatment, especially among […]See more -
ORIGINAL ARTICLE11-28-2023
O pensamento crítico dos estudantes de graduação em enfermagem brasileiros precisa ser ampliado: estudo transversal
Revista Brasileira de Enfermagem. 2023;76(1):e20220315
Abstract
ORIGINAL ARTICLEO pensamento crítico dos estudantes de graduação em enfermagem brasileiros precisa ser ampliado: estudo transversal
Revista Brasileira de Enfermagem. 2023;76(1):e20220315
DOI 10.1590/0034-7167-2022-0315
Views0RESUMEN
Objetivos:
mapear el nivel de pensamiento crítico de los estudiantes brasileños de pregrado en enfermería e investigar la correlación entre los datos sociodemográficos seleccionados y los dominios del pensamiento crítico.
Métodos:
en este estudio transversal descriptivo, el pensamiento crítico de los participantes (N=89) fue evaluada mediante el Health Science Reasoning Test. La correlación entre los dominios de pensamiento crítico y los datos sociodemográficos se evaluó mediante el coeficiente de correlación de Pearson.
Resultados:
los resultados generales mostraron un nivel moderado de pensamiento crítico de los participantes (media=70,7; desviación estándar 5,7). Se identificó un desempeño deficiente en 5 de los 8 dominios del pensamiento crítico. Se encontró una correlación positiva significativa entre educación y pensamiento crítico (p<0,001).
Conclusiones:
los bajos niveles de los dominios del pensamiento crítico en los estudiantes pueden tener consecuencias negativas para sus resultados de aprendizaje. Se deben realizar más estudios para confirmar nuestros resultados, además de la investigación de métodos de enseñanza que fomenten y aseguren el desarrollo de habilidades de pensamiento crítico de los estudiantes durante su formación en enfermería.
Keywords:Educação em EnfermagemEstudantes de EnfermagemEstudos TransversaisPensamento CríticoServiços de SaúdeSee more -
ORIGINAL ARTICLE11-28-2023
Brazilian undergraduate nursing students’ critical thinking need to be increased: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(1):e20220315
Abstract
ORIGINAL ARTICLEBrazilian undergraduate nursing students’ critical thinking need to be increased: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(1):e20220315
DOI 10.1590/0034-7167-2022-0315
Views0See moreABSTRACT
Objectives:
to map Brazilian undergraduate nursing students’ critical thinking level and investigate the correlation between selected sociodemographic data and critical thinking domains.
Methods:
in this descriptive cross-sectional study, participants’ (N=89) critical thinking was assessed using the Health Science Reasoning Test. Correlation between critical thinking domains and sociodemographic data was assessed using the Pearson correlation coefficient.
Results:
the overall results showed a moderate level of participants’ critical thinking (mean = 70.7; standard deviation 5.7). A poor performance was identified in 5 of the 8 critical thinking domains. A significant positive correlation was found between education period and critical thinking (p<.001).
Conclusions:
poor level in students critical thinking domains may lead to negative consequences for their learning outcomes. Further studies should be carried out to confirm our results, in addition to investigation of teaching methods that encourage and ensure the development of students’ critical thinking skills during nursing education.
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ORIGINAL ARTICLE11-28-2023
Syphilis in pregnancy and congenital syphilis: women’s experiences from the perspective of symbolic interactionism
Revista Brasileira de Enfermagem. 2023;76(1):e20220210
Abstract
ORIGINAL ARTICLESyphilis in pregnancy and congenital syphilis: women’s experiences from the perspective of symbolic interactionism
Revista Brasileira de Enfermagem. 2023;76(1):e20220210
DOI 10.1590/0034-7167-2022-0210
Views1See moreABSTRACT
Objectives:
to understand the meanings attributed by women to the diagnosis and treatment of syphilis and congenital syphilis, and to outpatient follow-up of their children.
Methods:
this is a qualitative study conducted with 30 mothers of children with congenital syphilis using audio-recorded semi-structured interviews, which were submitted to inductive thematic analysis. Symbolic interactionism was the theoretical framework considered in this study.
Results:
two themes were identified, showing the maternal diagnosis involved shock, guilt, and fear of social exclusion, in addition to frustration due to failure to prevent vertical transmission. Moreover, the painful clinical procedures for the child’s treatment enhanced maternal guilt, and the symbolic process of re-signification of the disease/treatment took place with the child’s healing.
Final Considerations:
understanding the intersubjective aspects involved in this experience helps nurses rethink their care practice and contributes to their critical role in the context of syphilis.
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ORIGINAL ARTICLE01-10-2024
Nursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
Abstract
ORIGINAL ARTICLENursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
DOI 10.1590/0034-7167-2023-0459
Views0See moreABSTRACT
Objectives:
to identify how first-year nursing students use cyberspace and propose an orientation guide with criteria guiding the use of cyberspace.
Methods:
qualitative and descriptive research, carried out with 24 nursing students from a federal public institution in Rio de Janeiro. Data collection was carried out through semi-structured interviews. Data analysis occurred using IRAMUTEQ®. The research was approved by the institution’s Research Ethics Committee.
Results:
students use cyberspace to communicate, study, find “cool things”, share photos and memories. Furthermore, they are concerned about hate speech, intolerance and fake news. The good and bad sides and the types of technologies most used were also portrayed.
Final considerations:
the moral and ethical values of physical coexistence, together with awareness of individual responsibility, are the pillars for using cyberspace. The guide comes as an awareness tool.
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ORIGINAL ARTICLE01-10-2024
Maternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
Abstract
ORIGINAL ARTICLEMaternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
DOI 10.1590/0034-7167-2022-0576
Views0See moreABSTRACT
Objective:
to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection.
Method:
qualitative research with an ethnographic approach, developed in two women’s prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category.
Results:
three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization.
Final Considerations:
the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.
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ORIGINAL ARTICLE01-10-2024
Self-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
Abstract
ORIGINAL ARTICLESelf-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
DOI 10.1590/0034-7167-2024-0289
Views0See moreABSTRACT
Objective:
to analyze occurrence of self-harm, sociodemographic profile of victims and referrals in the first 24 months of the COVID-19 pandemic in São Paulo.
Method:
cross-sectional study carried out by the Notifiable Diseases Information System with data on self-harm in São Paulo. The period outlined was March 2020 to February 2022. R (4.0.2) software and chi-square test were used.
Results:
there were 15,946 incidents. Victims were young, white, single, heterosexual women. There was high incidence of people with previous mental disorders more than once and without clear motivation. The method used was poisoning/intoxication. There was a considerable number of referrals to the health network, although not totalitarian.
Conclusion:
the years of greater insecurity in relation to the pandemic have given rise to self-harm cases with peculiar characteristics. Agile health policies must be applied in atypical conditions, such as pandemics, especially for adolescents/young people with previous mental disorders.
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REVIEW01-10-2024
Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
Abstract
REVIEWHealth of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
DOI 10.1590/0034-7167-2024-0106
Views0See moreABSTRACT
Objective:
to map the literature on quilombola children’s health and its relationship with the Sustainable Development Goals.
Method:
a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework.
Results:
eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed.
Final considerations:
the study provided an extremely important mapping of the theme of quilombola children’s health and themes related to the Sustainable Development Goals.
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REVIEW01-10-2024
Prevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
Abstract
REVIEWPrevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
DOI 10.1590/0034-7167-2024-0052
Views0See moreABSTRACT
Objectives:
To identify in the scientific literature the prevalence, diagnostic methods, and exposure variables of latent infection by Mycobacterium tuberculosis in healthcare workers.
Methods:
An integrative review of the scientific literature based on the following review question: What are the available scientific evidence in the literature that address the prevalence of latent infection by Mycobacterium tuberculosis in healthcare workers and its association with possible risk factors among these workers?
Results:
Being a physician or nurse, being older, and being male were generally associated with higher prevalences. The study also showed that interferon-gamma release assays were more commonly used as a diagnostic method compared to skin tests.
Conclusions:
More studies are needed regarding the epidemiology of latent infection by Mycobacterium tuberculosis in the context of healthcare workers, aiming for higher impact actions that contribute to the reduction of tuberculosis worldwide.
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EDITORIAL08-19-2024
Sexual abuse, abortion and public health in Brazil: when moral judgment accentuates inequities
Revista Brasileira de Enfermagem. 2024;77:e77suppl0401
Abstract
EDITORIALSexual abuse, abortion and public health in Brazil: when moral judgment accentuates inequities
Revista Brasileira de Enfermagem. 2024;77:e77suppl0401
DOI 10.1590/0034-7167.202477suppl0401
Views0Here is an academic-political editorial that aims to call on the scientific field to reflect on the dangers of decisions regarding the right to abortion under moral rules, since there is no evidence that such a perspective translates into practices of care, protection of childhood and gender equity – elements that are so urgent and […]See more -
ORIGINAL ARTICLE08-19-2024
The use of individual tracking programs in public health: a bioethics dilemma
Revista Brasileira de Enfermagem. 2024;77:e20230041
Abstract
ORIGINAL ARTICLEThe use of individual tracking programs in public health: a bioethics dilemma
Revista Brasileira de Enfermagem. 2024;77:e20230041
DOI 10.1590/0034-7167-2023-0041
Views0See moreABSTRACT
Objective:
to understand the bioethical perspectives on mobile tracking device use.
Methods:
theoretical study based on action research, carried out with eight graduate students from a public university. A focus group was used, with a thematic content analysis methodology with a codebook structure, approved by the Research Ethics Committee.
Results:
from the analysis, there was a concern about using devices after the pandemic ended. Using or not the device, rights inherent to humans, legislation and effectiveness of methods deepen interpretations, moving participants from a personalistic conception of the topic to a vision focused on professional implications about the methods.
Final considerations:
the debate on the impact of using technological devices on health, especially those that imply restriction of rights that refer to individuals’ private life, involves a discussion of a professional nature, in addition to requirement for clear rules on the topic.
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ORIGINAL ARTICLE08-19-2024
Bioethical issues in the family health strategy: Considerations for nursing care management
Revista Brasileira de Enfermagem. 2024;77:e20220818
Abstract
ORIGINAL ARTICLEBioethical issues in the family health strategy: Considerations for nursing care management
Revista Brasileira de Enfermagem. 2024;77:e20220818
DOI 10.1590/0034-7167-2022-0818
Views0See moreABSTRACT
Objective:
To understand the bioethical issues involved in the care management of nurses working in the Family Health Strategy.
Method:
A qualitative study was conducted through five focus groups with 36 nurses selected in the sample. Thematic content analysis was performed based on the bioethical framework, and the synthesis was presented in a conceptual map.
Results:
Bioethical issues were identified in the nursing care practice, related to both specific bioethical themes and the peculiarities of the work. Additionally, challenges and facilitators that interfere with addressing these issues were identified.
Final considerations:
Understanding the bioethical issues involved in the care management of nurses was possible with the theoretical support of different bioethical perspectives. The identified issues relate to persistent and current themes in the field of bioethics. However, some aspects intrinsic to daily practice are still imperceptible to professionals, contributing to the difficulty of discussing bioethics in this care model.
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REVIEW07-29-2024
Telenursing in the postoperative period: a scoping review
Revista Brasileira de Enfermagem. 2024;77(3):e20240066
Abstract
REVIEWTelenursing in the postoperative period: a scoping review
Revista Brasileira de Enfermagem. 2024;77(3):e20240066
DOI 10.1590/0034-7167-2024-0066
Views0See moreABSTRACT
Objectives:
to map available evidence on telenursing use in the postoperative period and its impact on patient outcomes.
Methods:
a scoping review, conducted according to the JBI model and the PRISMA-ScR checklist. The search was carried out in the CINAHL, Embase, LILACS, PubMed, Web of Science, SciELO, Scopus and Cochrane Library databases.
Results:
twelve studies were included, published between 2011 and 2023, 66.6% of which were in developed countries. Of the positive outcomes, we highlight improved levels of disability, autonomy and quality of life, lower rates of post-operative complications, pain and reduced costs. Telephone monitoring was the most widely used modality, but there were few studies in the pediatric context and in Brazil.
Conclusions:
of the studies, 11 (91.6%) identified at least one positive outcome in telenursing use and none showed negative aspects in the postoperative period. The role of nurses in digital health needs further study.
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ORIGINAL ARTICLE07-29-2024
Men’s perception of paternal parenthood and the promotion of child development
Revista Brasileira de Enfermagem. 2024;77(3):e20230514
Abstract
ORIGINAL ARTICLEMen’s perception of paternal parenthood and the promotion of child development
Revista Brasileira de Enfermagem. 2024;77(3):e20230514
DOI 10.1590/0034-7167-2023-0514
Views0See moreABSTRACT
Objectives:
to comprehend men’s perception of paternal parenthood while caring for infants to promote child development.
Methods:
this qualitative study adopts an exploratory approach and was conducted with undergraduate and graduate students, faculty, and staff who are fathers of infants up to 6 months old from a higher education institution, excluding fathers from mononuclear families. Data collection occurred through semi-structured interviews and was analyzed using thematic categorical analysis.
Results:
fifteen men participated in the study. From the analysis, two empirical categories emerged: “Perception of being a father: challenges and novelties” and “Promotion of child development: actions carried out by fathers”. Fathers revealed feeling unprepared, the need for emotional support, and recognized activities aimed at their children’s development.
Final Considerations:
the relevance of the paternal figure for child development is highlighted, as well as the need for public policies to encourage paternal parenthood.
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ORIGINAL ARTICLE07-29-2024
Contribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
Abstract
ORIGINAL ARTICLEContribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
DOI 10.1590/0034-7167-2023-0492
Views0See moreABSTRACT
Objectives:
to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure.
Methods:
a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers’ contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman’s correlation.
Results:
the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction.
Conclusions:
informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.
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Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
Abstract
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
DOI 10.1590/0034-7167-2024-0486
Views0See moreABSTRACT
Objectives:
to reflect on theoretical framework use in nursing research.
Methods:
a theoretical-reflexive study, based on concepts and constructs pertinent to using nursing theories and other sciences, considering issues of epistemology or philosophy of science.
Results:
we presented what it is and why to do nursing research and what a theoretical framework is and why to use it, in addition to some considerations regarding theoretical framework use in nursing research, essential for constructing disciplinary knowledge, which enables the materialization of researchers’ work and the presentation of propositions resulting from investigations in and for nursing as a discipline and science.
Final Considerations:
based on a reflection based on epistemological conceptions, it is possible to affirm that a theoretical framework is the core of researchers’ thinking, delimiting a problem to be investigated and, based on it, outlining methodological strategies to be followed, supporting nursing action and thinking as discipline and science.
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REVIEW07-29-2024
Nursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
Abstract
REVIEWNursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
DOI 10.1590/0034-7167-2023-0471
Views0See moreABSTRACT
Objectives:
to identify in the literature the main nursing diagnoses according to the NANDA-I diagnostic classification for people hospitalized with heart failure.
Methods:
an integrative literature review, carried out in February 2019 and updated in July 2023, in the MEDLINE via PubMed, LILACS, SciELO and CINAHL databases. Given the use of acronym PEO, studies without a time cut in Portuguese, English and Spanish were included. Descriptive analysis was carried out to present the identified information.
Results:
analysis of 27 articles identified 24 nursing diagnoses, with emphasis on Decreased Cardiac Output, Excessive Fluid Volume, Decreased Activity Tolerance and Fatigue.
Final Considerations:
evidence can contribute to better diagnostic decisions centered on people with heart failure in search of more assertive health results and have the potential to support future studies on a possible syndromic pattern in this population.
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