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ORIGINAL ARTICLE12-16-2024
Nursing team’s perceptions about care for pregnant women in a psychiatric unit
Revista Brasileira de Enfermagem. 2024;77(6):e20230186
Abstract
ORIGINAL ARTICLENursing team’s perceptions about care for pregnant women in a psychiatric unit
Revista Brasileira de Enfermagem. 2024;77(6):e20230186
DOI 10.1590/0034-7167-2023-0186
Views0See moreABSTRACT
Objectives:
to understand the nursing team’s perception in relation to the care provided to pregnant women with mental disorders admitted to a psychiatric hospital unit.
Methods:
Convergent Care Research carried out between August and December 2021, through semi-structured interviews with 25 nursing professionals from a Psychiatric Unit from a reference Hospital in Southern Brazil.
Results:
the organized and analyzed data resulted in two thematic categories: Technical, generic and impersonal care; and From impersonality to the singularity of nursing care. Ensuring unique care for pregnant women with mental disorders means giving them a meaning of existence and providing care from a multidimensional and continuous perspective.
Final Considerations:
nursing care for pregnant women in psychiatric hospitalization requires continuous professional qualification, interactive technologies and support for the nursing process, in addition to promoting singular and multidimensional care.
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ORIGINAL ARTICLE12-16-2024
Bladder ultrasound: evidence of content validity of a checklist for training nurses
Revista Brasileira de Enfermagem. 2024;77(6):e20230183
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
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.
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ORIGINAL ARTICLE12-16-2024
Childbirth care by health professionals: conflicting practices in obstetrics
Revista Brasileira de Enfermagem. 2024;77(6):e20230129
Abstract
ORIGINAL ARTICLEChildbirth care by health professionals: conflicting practices in obstetrics
Revista Brasileira de Enfermagem. 2024;77(6):e20230129
DOI 10.1590/0034-7167-2023-0129
Views0See moreABSTRACT
Objectives:
to understand the perceptions of women and health professionals regarding childbirth care at a teaching hospital in the western state of Paraná, Brazil.
Methods:
this qualitative study employed Grounded Theory, conducted in an obstetric care service with 38 participants (women and health professionals) through semi-structured interviews.
Results:
limitations in physical infrastructure and management of care, along with the women’s limited knowledge about the childbirth process and the decision-making and guidance of professionals, show conflicting obstetric practices-a discrepancy between good practices and obstetric violence. Training in obstetric nursing and active participation in care, alongside the presence of a companion, were identified as intervening conditions and strategies in the process.
Final Considerations:
childbirth care is characterized by dichotomous practices. While some professionals base their practices on scientific evidence, others rely on teachings and experiences from the time of their training.
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ORIGINAL ARTICLE12-16-2024
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
Abstract
ORIGINAL ARTICLEA 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
Views0See 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.
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ORIGINAL ARTICLE12-16-2024
The relationship between gender, educational background, and learning environment with nursing student’s anxiety
Revista Brasileira de Enfermagem. 2024;77(6):e20220615
Abstract
ORIGINAL ARTICLEThe relationship between gender, educational background, and learning environment with nursing student’s anxiety
Revista Brasileira de Enfermagem. 2024;77(6):e20220615
DOI 10.1590/0034-7167-2022-0615
Views0See moreABSTRACT
Objectives:
to identify variables associated with nursing students’ anxiety-related clinical practice.
Methods:
this study used a correlational quantitative descriptive design with the STROBE equator instrument. The population is 233 nursing students with a sample of 135. Data were collected from March to April 2022 using validated instruments.
Results:
the Chi-square test and the sig likelihood ratio on the gender, educational background, and learning environment is more than 0.05 so there is no significant relationship between the variables and student anxiety.
Conclusions:
students need to be prepared again before entering the practice field. Qualitative research is needed too.
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ORIGINAL ARTICLE12-13-2024
Educational booklet on labor and delivery: validity study
Revista Brasileira de Enfermagem. 2024;77(5):e20240138
Abstract
ORIGINAL ARTICLEEducational booklet on labor and delivery: validity study
Revista Brasileira de Enfermagem. 2024;77(5):e20240138
DOI 10.1590/0034-7167-2024-0138
Views0See moreABSTRACT
Objectives:
to develop and validate an educational booklet on labor and delivery for pregnant women.
Methods:
this methodological study involved constructing and validating a booklet based on Echer’s framework. We used the Content Validity Index and Cronbach’s alpha for content and face validation, selecting judges according to Fering’s criteria. We then conducted a clinical validation with the target population.
Results:
the booklet, developed based on evidence from an integrative review and validated by judges and the target audience, achieved global Content Validity Index of 0.919 and 0.913, respectively. After clinical validation with 22 pregnant women, it included 28 topics and 48 pages, with illustrations by a graphic designer.
Conclusions:
expert judges and the target audience considered this educational technology valid, deeming it a relevant tool for promoting the health of pregnant women.
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ORIGINAL ARTICLE12-13-2024
Knowledge and attitudes of nursing students regarding the sexuality of older adults: a quasi-experimental study
Revista Brasileira de Enfermagem. 2024;77(5):e20240011
Abstract
ORIGINAL ARTICLEKnowledge and attitudes of nursing students regarding the sexuality of older adults: a quasi-experimental study
Revista Brasileira de Enfermagem. 2024;77(5):e20240011
DOI 10.1590/0034-7167-2024-0011
Views0See moreABSTRACT
Objectives:
to compare the knowledge and attitudes of nursing students regarding sexual behavior and sexually transmitted infections (STIs) in older adults before and after an educational intervention.
Methods:
this quasi-experimental study involved a convenience sample of 45 nursing students from a public university, conducted in three stages: pre-intervention, intervention, and post-intervention. A questionnaire was used to assess sociodemographic characteristics, academic training, and knowledge and attitudes on the topic. The intervention was an educational web conference. Paired t-test and Wilcoxon test were used for data analysis.
Results:
there was a statistically significant difference in the knowledge and attitude scores of nursing students before and after the educational intervention (p < 0.001). A significant increase was observed in the knowledge score (from 9.3 to 12.2) and attitude score (from 108 to 117.2) in the post-intervention phase.
Conclusions:
the knowledge of nursing students regarding the sexuality of older adults increased after the educational intervention, and their attitudes on the subject became more positive.
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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
Views0See 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 ARTICLE01-10-2024
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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RESEARCH01-01-2018
Translation and adaptation of a questionnaire on the needs of postpartum adolescents
Revista Brasileira de Enfermagem. 2018;71(3):992-997
Abstract
RESEARCHTranslation and adaptation of a questionnaire on the needs of postpartum adolescents
Revista Brasileira de Enfermagem. 2018;71(3):992-997
DOI 10.1590/0034-7167-2017-0021
Views0See moreABSTRACT
Objective:
Describe the processes of translation to the Portuguese language and cultural adaptation of the Postpartum Learning Needs (PLN) to the Portuguese context.
Method:
Methodological study of an instrument that was constructed and validated in Jordan. Here are presented the procedures referring to linguistic, semantic and cultural validation, involving the stages of translation from English to European Portuguese, synthesis of translations, back-translation to the original language, expert committee, and pre-testing.
Results:
In the translation process, some vocabulary variations were solved through consensus among translators. The expert committee found that the version translated to Portuguese presented semantic, idiomatic, cultural and conceptual equivalence, while needing some adjustments. Pre-testing was applied to 45 adolescent mothers, of whom 86.6% considered the items comprehensible.
Conclusion:
Semantic, idiomatic, cultural and conceptual equivalences were conceptually satisfactory among questionnaire versions, which is relevant for the Portuguese culture and easily understandable. It is crucial to assess the psychometric properties of the questionnaire so its adapted version can be made available.
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RESEARCH01-01-2018
Cross-cultural adaptation of the instrument Readiness for Hospital Discharge Scale – Adult Form
Revista Brasileira de Enfermagem. 2018;71(3):983-991
Abstract
RESEARCHCross-cultural adaptation of the instrument Readiness for Hospital Discharge Scale – Adult Form
Revista Brasileira de Enfermagem. 2018;71(3):983-991
DOI 10.1590/0034-7167-2017-0241
Views0ABSTRACT
Objective:
to perform the cross-cultural adaptation of the Readiness for Hospital Discharge Scale – (RHDS) Adult Form for use in Brazil.
Method:
a methodological study was conducted in 2015, in Brazil’s federal capital, following the eight stages scientifically established.
Results:
analysis proved the maintenance of semantic, idiomatic, cultural, and conceptual equivalences and kept both the face and content validity of the original version. The judging committee and the pre-test participants declared they understood the RHDS items and answer scale.
Conclusion:
the instrument is culturally adapted for Brazil and can be used as one of the stages for planning hospital discharge.
Keywords:Continuity of Patient CareNursing Methodology ResearchPatient DischargePatient-Centered CareTransitional CareSee more -
RESEARCH01-01-2018
Validation of instrument to assess software of patients’ risk classification
Revista Brasileira de Enfermagem. 2018;71(3):975-982
Abstract
RESEARCHValidation of instrument to assess software of patients’ risk classification
Revista Brasileira de Enfermagem. 2018;71(3):975-982
DOI 10.1590/0034-7167-2017-0053
Views0ABSTRACT
Objective:
Validate the content of an instrument that assesses the quality of a software applied to the risk classification of patients.
Method:
Methodological study, conducted in three stages: adaptation of the instrument, content validation through Delphi technique and pre-test. The results were analyzed through Content Validity Index, Overall Content Validity Index and Inter-rater Reliability.
Results:
The final version of the instrument comprises 8 characteristics and 28 sub-characteristics, being 37 general questions to computer experts and nurse and 7 specific questions to computer experts, including 1 question and excluding 3 questions of the original instrument. We obtained Overall Content Validity of 92% and Inter-rater Reliability of 100% in the second Delphi round.
Final considerations:
The instrument has content validity, allowing to assess the technical quality and functional performance of the software applied to the risk classification of patients.
Keywords:ClassificationEmergency Medical ServicesHealthcare QualityValidation of Computer ProgramsValidation StudiesSee more -
RESEARCH01-01-2018
Stress of nursing students in clinical simulation: a randomized clinical trial
Revista Brasileira de Enfermagem. 2018;71(3):967-974
Abstract
RESEARCHStress of nursing students in clinical simulation: a randomized clinical trial
Revista Brasileira de Enfermagem. 2018;71(3):967-974
DOI 10.1590/0034-7167-2017-0187
Views0ABSTRACT
Objective:
To evaluate and compare the perception of stressors by nursing students before and after a high-fidelity clinical simulation or conventional laboratory practice class.
Method:
This is a randomized clinical trial conducted with 52 nursing students. Both groups had theoretical classes about cardiothoracic physical examination, followed by practice class in skill laboratory. In addition, the experimental group took part in a high-fidelity simulation scenario. Stressors were evaluated before and after class, with the application of KEZKAK questionnaire.
Results:
The experimental group was significantly more worried about six factors related to lack of competence and to interpersonal relationships (p < 0.05), while the control group was significantly more worried about being in contact with suffering (p = 0.0315).
Conclusion:
The simulation affects students’ perception of stressors and promotes their self-evaluation and critical thinking regarding the responsibility that comes with their learning.
Keywords:Evidence-based NursingNursing StudentsPsychological StressRandomized Controlled Clinical TrialSimulationSee more -
RESEARCH01-01-2018
Family caregiver of older adults and Cultural Care in Nursing care
Revista Brasileira de Enfermagem. 2018;71(3):959-966
Abstract
RESEARCHFamily caregiver of older adults and Cultural Care in Nursing care
Revista Brasileira de Enfermagem. 2018;71(3):959-966
DOI 10.1590/0034-7167-2017-0105
Views0See moreABSTRACT
Objective:
To analyze the experiences of family caregivers of dependent older adults, who show performance overload and emotional distress, using the Theory of Culture Care.
Method:
Qualitative study with nine caregivers of home care dependent older adults, based on Grounded Theory.
Results:
The findings allowed the identification of potentialities and frailties in the context of family home care and subsidizing the construction of a theoretical scheme resulting from the analysis of possibilities of the nursing care practice according to the culture, through the three modes of action: maintenance, adjustment and repatterning of cultural care.
Final considerations:
Respecting the cultural values and family beliefs, the nurse can help to institute mutually established changes, promoting a better quality in the nursing care relationship and a relief to the strain of the role of the caregiver.
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RESEARCH01-01-2018
Nursing team communication in a medical ward
Revista Brasileira de Enfermagem. 2018;71(3):951-958
Abstract
RESEARCHNursing team communication in a medical ward
Revista Brasileira de Enfermagem. 2018;71(3):951-958
DOI 10.1590/0034-7167-2017-0208
Views1See moreABSTRACT
Objective:
To describe the essential elements that make the nursing team communication process effective, and to analyze such elements in the light of two main theorists, Berlo and King.
Method:
This is a qualitative study of assistant convergent research approach. The data production technique was the semi-structured interview, with 25 nursing professionals from a public hospital. Data were analyzed with thematic content techniques.
Results:
The main element of consolidation of the communication process and interpersonal relationship, with consequent interaction, is the dialogue, which is guided by emotions, feelings, and team integration.
Conclusion:
The communication process and the interpersonal relationship reach their objectives and the reciprocal understanding expected when there is effective dialogue, validated by the source and receiver of the processes, with consequent interaction.
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RESEARCH01-01-2018
Assessment of health/functioning of older adults who consume psychoactive substances
Revista Brasileira de Enfermagem. 2018;71(3):942-950
Abstract
RESEARCHAssessment of health/functioning of older adults who consume psychoactive substances
Revista Brasileira de Enfermagem. 2018;71(3):942-950
DOI 10.1590/0034-7167-2016-0637
Views0ABSTRACT
Objective:
To assess the health/functioning of the older adult who consumes psychoactive substances through the International Classification of Functioning, Disability and Health, considering the theory of complexity.
Method:
Qualitative case study, with 11 older adults, held between December 2015 and February 2016 in the state of Rio Grande do Sul, using interviews, documents and non-systematic observation. It was approved by the ethics committee. The analysis followed the propositions of the case study, using the complexity of Morin as theoretical basis.
Results:
We identified older adults who consider themselves healthy and show alterations – the alterations can be exacerbated by the use of psychoactive substances – of health/functioning expected according to the natural course of aging such as: systemic arterial hypertension; depressive symptoms; dizziness; tinnitus; harmed sleep/rest; and inadequate food and water consumption.
Final consideration:
The assessment of health/functioning of older adults who use psychoactive substances, guided by complex thinking, exceeds the accuracy limits to risk the understanding of the phenomena in its complexity.
Keywords:Drug UsersGeriatric NursingInternational Classification of Functioning, Disability and HealthNursing CareOlder AdultSee more -
RESEARCH01-01-2018
Impaired comfort in children and adolescents with cancer
Revista Brasileira de Enfermagem. 2018;71(3):934-941
Abstract
RESEARCHImpaired comfort in children and adolescents with cancer
Revista Brasileira de Enfermagem. 2018;71(3):934-941
DOI 10.1590/0034-7167-2017-0050
Views0See moreABSTRACT
Objective:
To determine the strength of the association between the clinical indicators of Impaired Comfort and the evaluation sector in the hospital, age group and sex of patients with cancer.
Method:
Cross-sectional study, conducted in a children’s hospital, with 192 children and adolescents. For the collection, we used an instrument developed for the study.
Results:
The majority of the sample was male, with mean age of 11 years. The indicators most evidenced among the hospitalized patients were Crying, Report of lack of satisfaction with the situation, Report of feeling cold, and Report of feeling uncomfortable. Crying and Fear were more prevalent in children compared with adolescents, and boys were the ones that verbalized the most the Report of lack of satisfaction with the situation.
Conclusion:
This study enabled determining the strength of the association of the indicators of Impaired Comfort expressed by children and adolescents with cancer.
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