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RESEARCH
Learning Incubator: an instrument to foster entrepreneurship in Nursing
Revista Brasileira de Enfermagem. 2015;68(6):1103-1108
01-01-2015
Abstract
RESEARCHLearning Incubator: an instrument to foster entrepreneurship in Nursing
Revista Brasileira de Enfermagem. 2015;68(6):1103-1108
01-01-2015DOI 10.1590/0034-7167.2015680615i
Views0See moreABSTRACT
Objective:
this study aimed to know the contributions of the Learning Incubator to the process of lifelong education in health.
Method:
this is a qualitative field research whose data was collected from August to December 2014 by the focus group technique. The research had 34 employees of a Teaching Hospital in the central region of the state of Rio Grande do Sul that participated previously in the incubation process.
Results:
from the data encoded by content analysis, three themes were selected: Learning Incubator – welcoming and integrating space; An instigating instrument that enhances possibilities; Continuous and lifelong education strategy.
Conclusion:
the Learning Incubator is an important instrument to foster entrepreneurship in nursing and other health areas due to its capacity of rethinking mechanized practices, to the possibility of instigating new ways of being and acting, and to the ability of creating and developing new ideas based on individual and institutional needs.
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RESEARCH
Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
01-01-2015
Abstract
RESEARCHNon-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
01-01-2015DOI 10.1590/0034-7167.2015680614i
Views0See moreABSTRACT
Objective:
to identify and review the literature on non-pharmacological strategies used for reducing anxiety in patients receiving cardiac catheterization.
Method:
this study was an integrative literature review. The research was conducted using the databases LILACS, SciELO, Medline (through BVS and PubMed) and Scopus. Studies were analyzed according to their objective, method, instruments used for evaluating patients’ anxiety, and the results obtained.
Results:
the most used strategy for reducing anxiety in patients receiving cardiac catheterization was music therapy. However, no study identifying the most appropriate time for this intervention (before, during and/or after the procedure) was found. Other strategies identified in this review were educational videos, massage, and palm therapy.
Conclusion:
the results found suggest that anxiety can be reduced using non-pharmacological strategies.
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RESEARCH
Estratégias não farmacológicas para diminuição da ansiedade no cateterismo cardíaco: revisão integrativa
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
01-01-2015
Abstract
RESEARCHEstratégias não farmacológicas para diminuição da ansiedade no cateterismo cardíaco: revisão integrativa
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
01-01-2015DOI 10.1590/0034-7167.2015680614i
Views0See moreRESUMEN
Objetivo:
identificar y revisar los estudios de literatura que abordan las estrategias no farmacológicas utilizadas para reducir la ansiedad en los pacientes que reciben un cateterismo cardíaco.
Método:
revisión integradora. La investigación se llevó a cabo utilizando las bases de datos LILACS, SciELO, Medline (BVS y PubMed) y Scopus. Los estudios se analizaron de acuerdo con sus objetivos, la metodo, los instrumentos utilizados para la evaluación de la ansiedad de los pacientes, y los resultados obtenidos.
Resultados:
la estrategia dirigida más para reducir la ansiedad en los pacientes que recibieron cateterización cardíaca fue la musicoterapia. No se encontró estudio, sin embargo, identificando el momento más adecuado para esta intervención (antes, durante y / o después de este procedimiento). Otras estrategias identificados en esta revisión eran videos educativos, masajes y terapia de palma.
Conclusión:
los resultados sugieren que la ansiedad se puede reducir el uso de estrategias no farmacológicas.
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RESEARCH
Convergence, divergence and diagnostic accuracy in the light of two nursing terminologies
Revista Brasileira de Enfermagem. 2015;68(6):1086-1092
01-01-2015
Abstract
RESEARCHConvergence, divergence and diagnostic accuracy in the light of two nursing terminologies
Revista Brasileira de Enfermagem. 2015;68(6):1086-1092
01-01-2015DOI 10.1590/0034-7167.2015680613i
Views0See moreABSTRACT
Objective:
compare divergences and convergences between the nursing diagnoses established for a case study, in the light of two nursing terminologies.
Method:
a descriptive research was undertaken. The participants were 24 nurses from public teaching hospitals (N=12) and hospital care institutions (N=12) in the Northeast of Brazil.
Results:
in group A (6 faculty members and 6 clinical professionals), 51 diagnoses were established according to NANDA-I: 54.9% of high accuracy, 23.5% zero, 15.7% low and 5.9% moderate accuracy. In group B (6 faculty members and 6 clinical professionals), 43 declarations were established using the ICNP®: 44.2% of zero accuracy, 39.5% high, 16.3% low. Four out of fi ve diagnostic titles of high accuracy in group A and the seven titles in group B converged; divergences were attributed to the number of combinations among the focus, judgment and location axes of the ICNP®.
Conclusion:
a range of titles was observed with different diagnostic inferences and low diagnostic accuracy in both groups.
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RESEARCH
Speeches of managers about the policy of the directly observed treatment for tuberculosis
Revista Brasileira de Enfermagem. 2015;68(6):1069-1077
01-01-2015
Abstract
RESEARCHSpeeches of managers about the policy of the directly observed treatment for tuberculosis
Revista Brasileira de Enfermagem. 2015;68(6):1069-1077
01-01-2015DOI 10.1590/0034-7167.2015680611i
Views0See moreABSTRACT
Objective:
to analyze the managers’ speeches about the policy transfer of the directly observed treatment (DOT) for tuberculosis control in the city of João Pessoa, Paraíba, Brazil.
Method:
this is a qualitative study developed in May and June, 2013 through semi-directed interviews with twenty health professionals in five health districts in João Pessoa/PB. The empirical material produced was analyzed according to the theoretical-analytical basis of the French Discourse Analysis by Pêcheux.
Results:
the study demonstrated weaknesses in the conduction and organization of actions in relation to the DOT. It revealed that the lack of knowledge of the managers about this policy has direct implications to the care of tuberculosis patients.
Conclusion:
the management should trace strategic plans to rethink the care practices and thus, reorganize the entire care network to users in order to effectively contribute to user adherence in the fight against tuberculosis.
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RESEARCH
Women’s temporality after cardiac surgery: contributions to nursing care
Revista Brasileira de Enfermagem. 2015;68(6):1056-1062
01-01-2015
Abstract
RESEARCHWomen’s temporality after cardiac surgery: contributions to nursing care
Revista Brasileira de Enfermagem. 2015;68(6):1056-1062
01-01-2015DOI 10.1590/0034-7167.2015680609i
Views0See moreABSTRACT
Objective:
to unveil women’s existential movement after cardiac surgery.
Method:
qualitative phenomenological study. The research setting was a hospital in Minas Gerais, in which ten women were interviewed between December 2011 and January 2012.
Results:
after hospital discharge, the women experienced physical, social and emotional impairments, and expressed the desire to go back to the time before their diagnosis, because they felt as though they still had heart disease. This vague and average understanding led to three units of meaning that, from a Heideggerian hermeneutic point of view, revealed the phenomenon of cardiac surgery as a present circumstance that limited the participants’ daily lives.
Conclusion:
nurses supporting women patients after cardiac surgery should promote health considering existential facets that are expressed during care. The bases for comprehensive care are revealed in singular and whole meetings of subjectivity.
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ORIGINAL ARTICLE
Guide for Systematization of Care and Nursing Process: educational technology for professional practice
Revista Brasileira de Enfermagem. 2023;76:e20210975
04-14-2023
Abstract
ORIGINAL ARTICLEGuide for Systematization of Care and Nursing Process: educational technology for professional practice
Revista Brasileira de Enfermagem. 2023;76:e20210975
04-14-2023DOI 10.1590/0034-7167-2021-0975
Views1ABSTRACT
Objective:
to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process.
Methods:
applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout.
Results:
the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges.
Final considerations:
the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.
Keywords:Educational TechnologyNursing ProcessNursing RecordsProfessional PracticeStandardized Nursing TerminologySee more -
ORIGINAL ARTICLE
Adaptation and validation of an adult patient classification instrument with emphasis on the family dimension
Revista Brasileira de Enfermagem. 2023;76(2):e20220530
03-27-2023
Abstract
ORIGINAL ARTICLEAdaptation and validation of an adult patient classification instrument with emphasis on the family dimension
Revista Brasileira de Enfermagem. 2023;76(2):e20220530
03-27-2023DOI 10.1590/0034-7167-2022-0530
Views1ABSTRACT
Objectives:
to adapt and validate an instrument for classifying adult patients that emphasizes the family support network in the demand for nursing care.
Methods:
methodological study, carried out in three phases: adaptation of an instrument considering the reality of adult patients; content validation with seven experts and assessment of measurement properties (construct validity and internal consistency) with 781 hospitalized patients.
Results:
in content validation, the indicators reached the values established for the Content Validity Index (0.85-1.00). In the confirmatory factor analysis, the 11 indicators were distributed in three domains and presented average variance extracted and factor loading greater than 0.5. Composite reliability was greater than 0.7.
Conclusions:
the present study adapted and made available, with evidence of validity and reliability, an instrument for classifying adult patients that considers the family support network in the demand for nursing care.
Keywords:Factor AnalysisFamilyHospital Organization and AdministrationPatient-Centered CareValidation StudiesSee more -
ORIGINAL ARTICLE
Self-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
10-01-2022
Abstract
ORIGINAL ARTICLESelf-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
10-01-2022DOI 10.1590/0034-7167-2020-1257
Views1INTRODUCTIONChronic non-communicable diseases are the main causes of death and health problems in the world, causing about 41 million deaths each year, which corresponds to approximately 71% of all deaths. Among these diseases, diabetes mellitus has stood out due to the increase in its incidence and prevalence().Estimates indicate that 463 million people live with diabetes […]See more -
Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
05-21-2021
Abstract
Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
05-21-2021DOI 10.1590/0034-7167-2020-0422
Views1See moreABSTRACT
Objective:
To identify and map the technological tools of information and communication to support the teaching learning process in Nursing teaching courses.
Methods:
This is a scoping review whose search was carried out in seven databases and in grey literature. After an initial analysis of the selection, 88 texts were read integrally, and 29 made up the final sample.
Results:
Virtual learning environment and object, simulation, hypermedia, and software or cellphone applications were the tools the nursing professors used the most. Studies highlight that the application of technology was important in the teaching-learning process, since it encouraged teaching based on safe care, motivating and developing abilities/competences, supported on significant, effective, flexible, and autonomous learning.
Conclusion:
The contribution of the technology for nursing formation stands out, but it should be highlighted that its employment must be critical, reflective, based on pedagogical theories and developed by trained professors.
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EXPERIENCE REPORT
Hypothermia post-cardiopulmonary resuscitation with low inputs: an experience report
Revista Brasileira de Enfermagem. 2019;72(4):1114-1118
08-19-2019
Abstract
EXPERIENCE REPORTHypothermia post-cardiopulmonary resuscitation with low inputs: an experience report
Revista Brasileira de Enfermagem. 2019;72(4):1114-1118
08-19-2019DOI 10.1590/0034-7167-2017-0771
Views1ABSTRACT
Objective:
to report the experience of conducting directed temperature control of a post-cardiopulmonary resuscitation patient, with reduced and basic inputs available at the institution.
Method:
an experience report of directed temperature control in patient (age 15 years), after four hours of cardiopulmonary resuscitation in an Intensive Care Unit of a hospital in São Paulo State countryside in 2016, according to the protocol suggested by the American Heart Association, in 2015. There were applications of cold compresses, plastic bags with crushed ice and rectal temperature control.
Results:
after eight hours, temperature had reached 93.2 ºF. Body cooling was maintained for 24 hours. However, bags with crushed ice were used in the first 6 hours.
Conclusion:
conduct of nurses to obtain the body cooling with reduced and basic inputs was effective during the stay at the Intensive Care Unit.
Keywords:Body Temperature RegulationCardiopulmonary ResuscitationHeart ArrestHypothermia InducedIntensive Care UnitsSee more -
ORIGINAL ARTICLE
Curricular reforms in the transformation of nursing teaching in a federal university
Revista Brasileira de Enfermagem. 2021;74(4):e20201242
07-30-2021
Abstract
ORIGINAL ARTICLECurricular reforms in the transformation of nursing teaching in a federal university
Revista Brasileira de Enfermagem. 2021;74(4):e20201242
07-30-2021DOI 10.1590/0034-7167-2020-1242
Views1See moreABSTRACT
Objectives:
to discuss the curricular reforms adopted for nursing teaching in Brazil, from 1969 to 2019.
Methods:
historical, qualitative approach using the thematic oral history and document research. 13 interviews were carried out with graduation nursing professors from a federal university in the South of Brazil. The document sources were the political-pedagogical projects of the course and their associated documents. Minayo’s thematic analysis was used.
Results:
nursing curricula delineates the profile of the professional that must be formed and are reviewed in order to be adapted to social and educational changes, showing the scientific and professional potential of the nurse. Curricular reforms consider the quality of nursing formation.
Final Considerations:
the structure of the curriculum and the reforms that took place emerged according to the historical, political, epidemiological and social context demanded from the profession, to attend to the demands of society and to the work market.
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ORIGINAL ARTICLE
Cultural adaptation and validation of an instrument about nursing critical thinking skills
Revista Brasileira de Enfermagem. 2021;74(2):e20200720
05-28-2021
Abstract
ORIGINAL ARTICLECultural adaptation and validation of an instrument about nursing critical thinking skills
Revista Brasileira de Enfermagem. 2021;74(2):e20200720
05-28-2021DOI 10.1590/0034-7167-2020-0720
Views1See moreABSTRACT
Objectives:
to validate the Nursing Critical Thinking in Clinical Practice Questionnaire regarding cultural aspects and metric properties.
Methods:
a methodological research carried out through cross-cultural adaptation, face and content validity, dimensional construct and known groups validity, test-retest reliability and internal consistency. 511 nurses from four hospitals participated in the study, of which 54 participated in retest.
Results:
the instrument validation for Brazilian Portuguese maintained equivalences, according to the original version. The dimensional validity demonstrated adjustment to the tetrafactorial structure of the original version (GFI=0.69). There were statistically significant differences in critical thinking skills between nurses with graduate degrees and who undertook training, reading articles, developing research and working in an institution with a longer time implementation of the Nursing Process. The instrument showed temporal stability (ICC 073-0.84; p<0.001) and adequate internal consistency (α=0.97).
Conclusions:
the instrument proved to be valid and reliable for the studied population.
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ORIGINAL ARTICLE
Prevalence and severity levels of post-radical prostatectomy incontinence: different assessment instruments
Revista Brasileira de Enfermagem. 2021;74(2):e20200692
05-28-2021
Abstract
ORIGINAL ARTICLEPrevalence and severity levels of post-radical prostatectomy incontinence: different assessment instruments
Revista Brasileira de Enfermagem. 2021;74(2):e20200692
05-28-2021DOI 10.1590/0034-7167-2020-0692
Views1See moreABSTRACT
Objectives:
to analyze urinary incontinence prevalence and severity in prostatectomized men assessed by three different instruments.
Methods:
a cross-sectional study was conducted with 152 men. The pad test, pad used, and International Consultation on Incontinence Questionnaire – Short Form (self-report) were considered. Data were analyzed using Spearman’s correlation, Kappa index, considering a significance level of 0.05.
Results:
urinary incontinence prevalence was 41.4%, 46.7% and 80.3% according to pad used, pad test and self-report. Positive correlations and moderate to poor agreement were found between the instruments. As for severity, most participants had mild incontinence. The largest number of cases of mild and severe incontinence was identified by self-report.
Conclusions:
the self-report showed higher values for prevalence of mild and severe severity levels. Through the identified differences, we propose that the objective assessment (pad used and pad test) be associated with individuals’ perception (self-report) to better estimate prevalence and severity.
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ORIGINAL ARTICLE
Development, validation and application of clinical simulation scenarios for assessment of stomatherapy specialists
Revista Brasileira de Enfermagem. 2021;74(1):e20200360
03-24-2021
Abstract
ORIGINAL ARTICLEDevelopment, validation and application of clinical simulation scenarios for assessment of stomatherapy specialists
Revista Brasileira de Enfermagem. 2021;74(1):e20200360
03-24-2021DOI 10.1590/0034-7167-2020-0360
Views0ABSTRACT
Objectives:
to build and validate three clinical simulation scenarios and report the application with candidates for the specialist’s degree in stomatherapy.
Methods:
methodological study, building three scenarios and evaluation checklists; content validation with judges, using content validity index and Modified Kappa Coefficient; pre-test and application.
Results:
scenarios built based on nursing care for: 1. insufficiency and venous ulcer; 2. demarcation of intestinal stomia; and 3. Clean intermittent catheterization. In the content validation of the 24 items appreciated, 83%, 80%, and 92% were validated without change. In the pre-test, the objectives and checklists were adjusted. In the application, to standardize the evaluation, actors and evaluators were trained previously, and each candidate passed the three stations.
Conclusions:
scenarios built and with validated content, based on evidence and covering the three areas of stomatherapy. The pre-test allowed for adjustments in the scenarios, and the candidates achieved the expected objectives.
Keywords:Educational AssessmentNursing EducationPatient SimulationSimulation TrainingValidation StudiesSee more -
Nurse-midwives reconfiguring care in the scope of labor and births in COVID-19 times
Revista Brasileira de Enfermagem. 2021;74:e20200863
04-14-2021
Abstract
Nurse-midwives reconfiguring care in the scope of labor and births in COVID-19 times
Revista Brasileira de Enfermagem. 2021;74:e20200863
04-14-2021DOI 10.1590/0034-7167-2020-0863
Views0See moreABSTRACT
Objectives:
to analyze how the nurse-midwives of maternity wards that were fields of practice for an improvement course in obstetrics have reorganized care in the context of labor and birth amidst the COVID-19 pandemic.
Methods:
this is a descriptive, exploratory and qualitative study carried out with nine nurse-midwives who are preceptors and collaborators in maternity wards that were fields of practice for an improvement course, between February and April 2020, through a semi-structured interview through WhatsApp®. Content analysis was used to treat the information.
Results:
the pandemic brought the need to reorganize work, with a focus on service training and maintenance of good practices in labor and birth, whose movement was intensely experienced, interfering in nurse-midwives’ mental health.
Conclusion:
nurse-midwives have faced the pandemic with concerns about maintaining safe care, focused on practices based on updated scientific evidence.
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Quality of life and falls in elderly people: a mixed methods study
Revista Brasileira de Enfermagem. 2021;74:e20200400
05-21-2021
Abstract
Quality of life and falls in elderly people: a mixed methods study
Revista Brasileira de Enfermagem. 2021;74:e20200400
05-21-2021DOI 10.1590/0034-7167-2020-0400
Views0ABSTRACT
Objective:
to assess elderly people’s quality of life, understanding the social representations of falls.
Methods:
a convergent mixed methods research carried out at homes, with a sample of 134 elderly people. A structured questionnaire was used, covering sociodemographic variables and factors that indicated frailty and risk of falling. For quality of life assessment, Medical Outcomes Study Short-Form 36 and Theory of Social Representations, Abric’s structural approach were used, with data treated by dictionary of equivalent terms, processed in Evoc 2000, converging analytically according to Neuman.
Results:
quality of life impairment was identified in terms of physical, emotional and functional capacity. The elements of the possible central nucleus were fall, fear, and bruised-broken-bone.
Final considerations:
quality of life impairment can contribute to increase the number of falls, which has been shown to be an event present in elderly people’s lives through evocations. Understanding elderly people’s individual demands allows planning actions.
Keywords:Accident PreventionAccidental FallsCommunity Health NursingHealth Services for the AgedQuality of LifeSee more -
ORIGINAL ARTICLE
Knowledge and health promotion practice of Family Health Strategy nurses
Revista Brasileira de Enfermagem. 2020;73(5):e20190362
07-06-2020
Abstract
ORIGINAL ARTICLEKnowledge and health promotion practice of Family Health Strategy nurses
Revista Brasileira de Enfermagem. 2020;73(5):e20190362
07-06-2020DOI 10.1590/0034-7167-2019-0362
Views0See moreABSTRACT
Objectives:
to analyze the knowledge and health promotion practice carried out by Family Health Strategy nurses.
Methods:
a descriptive study and qualitative approach. The study was conducted with 18 Family Health Strategy nurses from the city of São Carlos. Data were collected through semi-structured interviews and analyzed through thematic analysis. The study was approved by the Research Ethics Committee.
Results:
the data revealed that nurses had difficulties to conceptualize health promotion, and it is common to describe the definition of disease prevention. Nurses also reported developing group activities for health promotion; however, individual actions and consultations were still predominant.
Final Considerations:
it is necessary to develop sustainable strategies for collective health-promoting activities, in addition to strengthening multidisciplinary work and Continuing Education actions.
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EDITORIAL
The era of precision medicine and its impact on nursing: paradigm shifts?
Revista Brasileira de Enfermagem. 2021;74(5):e740501
07-28-2021
Abstract
EDITORIALThe era of precision medicine and its impact on nursing: paradigm shifts?
Revista Brasileira de Enfermagem. 2021;74(5):e740501
07-28-2021DOI 10.1590/0034-7167.2021740501
Views0INTRODUCTIONThe large investment and development of research in genomics and molecular biology in the last two decades, especially after the conclusion of the Human Genome Project (HGP), has generated many expectations regarding its impact on the transformation from the conventional medicine paradigm to the precision medicine paradigm(–). The term precision medicine (PM) was used for […]See more -
REFLECTION
Art in evidence-based nursing practice from the perspective of Florence Nightingale
Revista Brasileira de Enfermagem. 2022;75(4):e20210664
02-25-2022
Abstract
REFLECTIONArt in evidence-based nursing practice from the perspective of Florence Nightingale
Revista Brasileira de Enfermagem. 2022;75(4):e20210664
02-25-2022DOI 10.1590/0034-7167-2021-0664
Views0See moreABSTRACT
Objectives:
to discuss, in the light of Florence Nightingale, the historical position of art as a constituent device of evidence-based nursing practice.
Methods:
reflective study anchored in the writings of Nightingale and other researchers with whom it is possible to have a profound dialogue on the theme “art in nursing”.
Results:
art is related to two essential elements in the practice of nursing: knowledge and skill. Understanding science as knowledge and art as skill leads to the idea that both make it possible to combine technical competence, compassion, ethics, and individualization of care. Final Considerations: the art of nursing is the continuous exercise of detailed perception, so that the subjective aspect becomes the center to which the nurse’s gaze converges, that which will allow them to unveil the “truth” posed by the patient, resulting in the best intervention for him.
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ORIGINAL ARTICLE
Family interview for organ and tissue donation: good practice assumptions
Revista Brasileira de Enfermagem. 2021;74(2):e20190206
06-16-2021
Abstract
ORIGINAL ARTICLEFamily interview for organ and tissue donation: good practice assumptions
Revista Brasileira de Enfermagem. 2021;74(2):e20190206
06-16-2021DOI 10.1590/0034-7167-2019-0206
Views0See moreABSTRACT
Objectives:
to identify information that can support creating good practice assumptions to develop family interview for organ and tissue donation.
Methods:
this scoping study, conducted in two Brazilian hospitals in the southern, between April and December 2017, included integrative review and consultation with 15 families who experienced interview for organ donation. For data analysis, thematic content analysis was used.
Results:
three categories emerged: communication of death, which shows the need to know the history of hospitalization of patients; emotional support, the team must have mastery of the stages of mourning; information about donation, professionals need to know the stages of the donation process and respect families’ time.
Final Considerations:
good practice assumptions point to the need for team training, respect for family time and the use of simple language.
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