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ORIGINAL ARTICLE12-04-2023
30-Year High Cardiovascular Risk Incidence and its Determinants: CUME Study
Revista Brasileira de Enfermagem. 2023;76(6):e20220544
Abstract
ORIGINAL ARTICLE30-Year High Cardiovascular Risk Incidence and its Determinants: CUME Study
Revista Brasileira de Enfermagem. 2023;76(6):e20220544
DOI 10.1590/0034-7167-2022-0544
Views0See moreABSTRACT
Objective:
Estimate the incidence of the 30-year high cardiovascular risk and its determinants among graduates of federal universities in Minas Gerais.
Methods:
This is a prospective cohort of 2,854 adults aged 20 to 59. The incidence of the outcome was calculated using the Framingham equation and its determinants were determined through multivariate Cox regression.
Results:
After an average of 2.62 years, the incidence of high cardiovascular risk was 8.09 and 20.1 cases per 1,000 person-years, for females and males respectively. Being male (HR: 2.34; 95% CI: 1.58 – 3.46), employment (HR: 2.13; 95% CI: 1.13 – 3.99), high consumption of processed foods (HR: 2.44; 95% CI: 1.21 – 4.90), and being physically active (HR: 0.63; 95% CI: 0.41 – 0.98) were associated with high cardiovascular risk.
Conclusions:
Among highly educated adults, being male, employment, and high consumption of processed foods are predictors of high cardiovascular risk, while being physically active acts as a protective factor.
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ORIGINAL ARTICLE12-04-2023
“Fala-M@no-COVID-19”: technological development of a health navigation program for men during the pandemic
Revista Brasileira de Enfermagem. 2023;76(6):e20220534
Abstract
ORIGINAL ARTICLE“Fala-M@no-COVID-19”: technological development of a health navigation program for men during the pandemic
Revista Brasileira de Enfermagem. 2023;76(6):e20220534
DOI 10.1590/0034-7167-2022-0534
Views0See moreABSTRACT
Objective:
to develop a care-educational technology similar to a health navigation program for men during the COVID-19 pandemic.
Methods:
a methodological and qualitative study of a care-educational technology of health navigation program, structured by Program Development Cycle, with 16 patient navigators and 10 professional navigators. It used reflective thematic content analysis and an adaptation model for data processing.
Results:
the ; navigation program was developed by: I) Observation of reality, problem mapping, needs assessment: content selection, creation of domains and questions; II) Theoretical-conceptual and methodological definition, creation of product under the elaboration of care plans, based on theory, process and taxonomies by a flowchart of operationalization of actions; and III) Self-assessment: qualitative research with professional navigators.
Final considerations:
the technology developed, with theoretical and methodological support, allowed to derive a viable navigation program compatible with reality based on the audience’s needs.
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The Medical Healing of Souls: a strategy for welcoming post-pandemic mental health
Revista Brasileira de Enfermagem. 2023;76(6):e20220331
Abstract
The Medical Healing of Souls: a strategy for welcoming post-pandemic mental health
Revista Brasileira de Enfermagem. 2023;76(6):e20220331
DOI 10.1590/0034-7167-2022-0331
Views0See moreABSTRACT
Objective:
to reflect on the applicability of the Medical Healing of Souls (MHS) by health professionals as a welcoming strategy in post-pandemic mental health.
Methods:
a theoretical and reflective study, based on Viktor Frankl’s philosophy, based on the book “The Doctor and the Soul, From Psychotherapy to Logotherapy” and scientific literature.
Results:
the study was structured in two discursive approaches: MHS in the field of health; The applicability of MHS in post-pandemic mental health care.
Final considerations:
MHS can be used in mental health care, in health emergencies, promoting a more humane performance of health professionals, facilitating the integration of inevitable suffering into a meaningful life.
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ORIGINAL ARTICLE12-04-2023
Translation, cross-cultural adaptation and validity study of the “Play Nicely Program: The Healthy Discipline Handbook” for use in Brazil
Revista Brasileira de Enfermagem. 2023;76(6):e20220281
Abstract
ORIGINAL ARTICLETranslation, cross-cultural adaptation and validity study of the “Play Nicely Program: The Healthy Discipline Handbook” for use in Brazil
Revista Brasileira de Enfermagem. 2023;76(6):e20220281
DOI 10.1590/0034-7167-2022-0281
Views0See moreABSTRACT
Objective:
to describe the translation, cross-cultural adaptation and validity process of the “Play Nicely Program: The Healthy Discipline Handbook” for use in Brazil.
Methods:
a methodological study that followed the translation, back-translation, expert committee assessment, and pre-test steps. The Content Validity Index (CVI) was calculated for both the judge population and the pre-test population. Four translators, seven expert judges in the field of child health and thirty participants in the pre-test, including parents, teachers and healthcare professionals, participated in the study.
Results:
in experts’ analysis (98.4%), a value of 100% of adequate assessments was obtained, and in the target population’s analysis (89.5%), there were 100% of adequate assessments. In both analyses, suggested adaptations were made.
Conclusios:
cross-cultural adaptation and content validity into Brazilian Portuguese of the “Play Nicely Program: The Healthy Discipline Handbook” were considered adequate for application in the target population.
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ORIGINAL ARTICLE12-04-2023
Emergency units and COVID-19: Burnout, and empathy reported by nursing professionals and perceived by patients
Revista Brasileira de Enfermagem. 2023;76(6):e20210869
Abstract
ORIGINAL ARTICLEEmergency units and COVID-19: Burnout, and empathy reported by nursing professionals and perceived by patients
Revista Brasileira de Enfermagem. 2023;76(6):e20210869
DOI 10.1590/0034-7167-2021-0869
Views0See moreABSTRACT
Objective:
To investigate Burnout Syndrome and empathy self-reported by the nursing staff and empathy perceived by the patient.
Method:
Cross-sectional study in a public emergency unit in São Paulo (from October/2020 to March/2021). The nursing staff answered the Maslach Burnout Inventory and the Consultation and Relational Empathy Measure-Nurses (Brazilian version), whereas adult patients answered the Consultation and Relational Empathy Measure (Brazilian version). Descriptive and inferential analysis, with a 5% significance level.
Results:
A total of 92 professionals and 271 patients participated. Most professionals reported impact of COVID-19 (80; 86.96%) and, among them, increased Burnout Syndrome (93; 75%), but with low emotional exhaustion (71; 74%), low depersonalization (59; 78%) and high level of professional accomplishment (72; 83%). Most reported impact and increased empathy, and the results reported by professionals and patients (mean and standard deviation) were: 39.89 (6.44) and 38.25 (9.45), respectively.
Conclusion:
The professionals reported a low level of Burnout Syndrome and a high level of empathy in pandemic.
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ERRATUM11-27-2023
ERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e05
DOI 10.1590/0034-7167.20237605e05
Views0In the article “Performance of Family Health Strategy Nurses in LGBT+ Healthcare”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(4): e20220514, authored:Where it read:[…]See more -
ORIGINAL ARTICLE11-27-2023
Mental suffering in family daily life: a temporal journey according to Merleau-Ponty
Revista Brasileira de Enfermagem. 2023;76(5):e20230258
Abstract
ORIGINAL ARTICLEMental suffering in family daily life: a temporal journey according to Merleau-Ponty
Revista Brasileira de Enfermagem. 2023;76(5):e20230258
DOI 10.1590/0034-7167-2023-0258
Views0See moreABSTRACT
Objectives:
to describe the family’s experience in relation to daily life with a family member experiencing mental suffering.
Methods:
a qualitative, descriptive, phenomenological study grounded in Merleau-Ponty’s ontology of experience was conducted in ten households in a city in the state of Bahia, Brazil, where 24 participants of the Intersubjectivity Wheels reside. The descriptions produced were subjected to the Ambiguity Analytics technique.
Results:
the descriptions were categorized into: absence as a creative power of the sense of “being” and “not being a family”; and exclusion and acceptance as expressions of mental suffering in the family context.
Final Considerations:
the experience of mental suffering in the family’s daily life is marked by ambiguous feelings, such as joy and sadness, disappointment and satisfaction, lack of love and love. However, experiencing these feelings can mobilize the desire to “become” a family, increase the sense of autonomy and independence, and drive the formation of new family configurations.
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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for assessing leprosy care in children and adolescents
Revista Brasileira de Enfermagem. 2024;77(2):e20230344
Abstract
ORIGINAL ARTICLEValidation of an instrument for assessing leprosy care in children and adolescents
Revista Brasileira de Enfermagem. 2024;77(2):e20230344
DOI 10.1590/0034-7167-2023-0344
Views0See moreABSTRACT
Objectives:
to validate the content of an instrument for assessing leprosy care in individuals under 15 years old in the context of Primary Health Care.
Methods:
methodological study of content validation, based on the evaluation of essential and derived attributes in primary care, in the professional version. For data analysis, the Content Validation Index (CVI ≥ 0.8) and Cronbach’s Alpha were calculated.
Results:
a higher percentage of judges among nurses (61.5%) was observed; with a doctorate (46.2%), and engaged in teaching and research (77%). The overall Content Validation Index of the instrument was 0.98. In the analysis of Cronbach’s Alpha of the instrument, the assigned value was 0.717.
Conclusions:
the instrument represents an advancement in the measurement of health evaluation policies and can significantly contribute to improving the quality of care provided to children and adolescents with leprosy.
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ORIGINAL ARTICLE07-19-2024
Validation of the Brazilian Version of the Modified Scale for Delineating Advanced Practice Nursing Roles
Revista Brasileira de Enfermagem. 2024;77(2):e20230211
Abstract
ORIGINAL ARTICLEValidation of the Brazilian Version of the Modified Scale for Delineating Advanced Practice Nursing Roles
Revista Brasileira de Enfermagem. 2024;77(2):e20230211
DOI 10.1590/0034-7167-2023-0211
Views0See moreABSTRACT
Objectives:
to validate the Brazilian version of the Modified Scale for Delineating Advanced Practice Nursing Roles.
Methods:
this was a methodological study for the clinical validation of an instrument, conducted with 207 nurses working in primary care. Exploratory and confirmatory factor analysis, Cronbach’s alpha test, and z-test for proportion comparison were used.
Results:
the internal reliability of the scale was 0.944, with alpha greater than 0.80 in most domains, except for Education (0.786). In the exploratory factor analysis, considering the criterion of eigenvalue greater than one, eight factors were identified, explaining 79.38% of the variance. In the comparison of proportions, the adequate responses (≥ 2) in the domain of Comprehensive Direct Care, in both analyzed groups, were statistically equal. This domain had the highest score of adequate responses, followed by Education and Systems Support. Insufficient scoring was observed in the domains of Publication and Professional Leadership.
Conclusions:
the instrument demonstrated stability and reliability to be used in the evaluation of advanced nursing practice.
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REVIEW07-19-2024
Nursing care for hospitalized older adults – fall accidents versus safe mobility: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230180
Abstract
REVIEWNursing care for hospitalized older adults – fall accidents versus safe mobility: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230180
DOI 10.1590/0034-7167-2023-0180
Views0See moreABSTRACT
Objectives:
to map the constituent elements of the safe mobility concept present in hospital care for older adults.
Methods:
a scoping review of 35 articles searched in databases and gray literature – BDENF/VHL, Scopus, CINAHL/EBSCO, Embase, Web of Science, PEDro, MEDLINE/PubMed and CAPES Theses and Dissertations Catalog. No time or language cut-off was established.
Results:
none of the studies presented a clear safe mobility concept, however its constituent elements involve factors related to patient (behavioral factors, conditions, diseases, signs and symptoms, nutritional status, age, balance, strength, gait quality, sleep), the institution (environment, treatment devices, guidelines, medications and polypharmacy, material and human resources and clothing/shoes) and the nature of the interventions (related to the patient, institution and family).
Final Considerations:
the constituent elements of safe mobility express hospital units’ capacity to guarantee care and protection from fall accidents for hospitalized older adults.
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REVIEW07-19-2024
Drug-resistant tuberculosis: integrative review of nursing care in primary health care
Revista Brasileira de Enfermagem. 2024;77(2):e20230097
Abstract
REVIEWDrug-resistant tuberculosis: integrative review of nursing care in primary health care
Revista Brasileira de Enfermagem. 2024;77(2):e20230097
DOI 10.1590/0034-7167-2023-0097
Views0See moreABSTRACT
Objectives:
to identify, in the scientific literature, the care that should be provided to individuals with drug-resistant tuberculosis by nurses in primary health care.
Methods:
integrative review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses study selection flowchart. Data collection was conducted in November 2022, across ten databases.
Results:
six studies emphasized that nurses should perform directly observed treatment; two highlighted the importance of integrated care management between tuberculosis and human immunodeficiency virus; two demonstrated comprehensive nursing consultation using the nursing process; one emphasized person-centered care, with discharge planning and improved hospital communication with primary health care services.
Final Considerations:
the care that nurses should provide to individuals with drug-resistant tuberculosis in primary health care, for care resolution, is evidence-based.
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ORIGINAL ARTICLE07-19-2024
Translation and cross-cultural adaptation of the MISSCARE Survey-Ped into Brazilian Portuguese
Revista Brasileira de Enfermagem. 2024;77(2):e20230060
Abstract
ORIGINAL ARTICLETranslation and cross-cultural adaptation of the MISSCARE Survey-Ped into Brazilian Portuguese
Revista Brasileira de Enfermagem. 2024;77(2):e20230060
DOI 10.1590/0034-7167-2023-0060
Views0See moreABSTRACT
Objectives:
to translate and cross-culturally adapt the MISSCARE Survey-Ped for use in Brazil.
Methods:
a methodological study proposed by translation, synthesis of translations, back-translation, assessment by a committee of experts and pre-testing with the target population.
Results:
two direct translations of the instrument were carried out, followed by a consensual version between them. This synthetic version was back-translated and analyzed by a committee of five experts in pediatric nursing and patient safety, obtaining a Content Validity Index (CVI) of 0.95 and Cronbach’s alpha of 0.804. The final version was sent for pre-testing with 254 Brazilian pediatric nurses, with 44 (17.3%) analyzing the instrument for understanding (CVI 0.866; Content Validity Ratio (CVR) 0.773), relevance (CVI 0.931; CVR 0.864) and relevance (CVI 0.977; CVR 0.955).
Conclusions:
the MISSCARE Survey-Ped Brasil was considered suitable for application in pediatric nurses’ clinical practice in the country.
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Invisibilidade do trabalho da enfermagem: tecnologia como via de combate
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
Abstract
Invisibilidade do trabalho da enfermagem: tecnologia como via de combate
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
DOI 10.1590/0034-7167.202477suppl0301pt
Views0Na concepção comum, o trabalho é comumente associado a uma atividade remunerada em uma sociedade mercantil e de direito, refletindo a visão moderna que o limita ao tempo trocado por salário. Essa perspectiva, influenciada pelos princípios da Revolução Industrial, estabelece uma dicotomia entre o trabalho e o tempo fora dele, segmentando a vida em esferas […]See more -
Invisibility of nursing work: technology as a means of combat
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
Abstract
Invisibility of nursing work: technology as a means of combat
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
DOI 10.1590/0034-7167.202477suppl0301
Views0In the common conception, work is commonly associated with a paid activity in a commercial and legal society, reflecting the modern view that limits it to time exchanged for wage. This perspective, influenced by Industrial Revolution principles, establishes a dichotomy between work and time outside of work, segmenting life into professional and private spheres. However, […]See more
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Ineffective airway clearance: accuracy of clinical indicators in asthmatic children
Revista Brasileira de Enfermagem. 2015;68(5):862-868
Abstract
Ineffective airway clearance: accuracy of clinical indicators in asthmatic children
Revista Brasileira de Enfermagem. 2015;68(5):862-868
DOI 10.1590/0034-7167.2015680514i
Views0See moreABSTRACT
Objective:
to analyze the accuracy measurements of clinical indicators of the nursing diagnosis Ineffective airway clearance.
Method:
cross-sectional study with 205 asthmatic children treated in the emergency unit of a hospital in the city of Fortaleza, Ceará. An interview script and pulmonary evaluation were used for data collection.
Results:
the diagnosis of Ineffective airway clearance was present in 89.3% of the sample. The most prevalent clinical indicators were dyspnea, change in respiratory rate, change in respiratory rhythm, orthopnea, adventitious respiratory sounds and ineffective cough. The clinical indicators with highest sensitivity were dyspnea, change in respiratory rate, change in respiratory rhythm, orthopnea and adventitious respiratory sounds. Ineffective cough and adventitious respiratory sounds were the indicators with best specifi city.
Conclusion:
the clinical indicator adventitious respiratory sounds was the best predictor of Ineffective airway clearance in asthmatic children treated in emergency units.
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Mortality from external causes in Pernambuco, 2001-2003 and 2011-2013
Revista Brasileira de Enfermagem. 2015;68(5):855-861
Abstract
Mortality from external causes in Pernambuco, 2001-2003 and 2011-2013
Revista Brasileira de Enfermagem. 2015;68(5):855-861
DOI 10.1590/0034-7167.2015680513i
Views0See moreABSTRACT
Objective:
to describe the mortality from external causes, by Health Regions in Pernambuco, during the periods of2001-2003 and 2011-2013.
Method:
descriptive study with data from the Mortality Information System. For data analysis we used percentage, percentage variation and proportion ratio.
Results:
mortality from external causes reduced in Pernambuco, however, mortality increased in some health regions of the countryside. Increased numbers of deaths from accidents and event of undetermined intent were registered. There was an increase of deaths classified as “other/unspecified” event of undetermined intent.
Conclusion:
there was a change in the spatial distribution of mortality from external causes moving to Pernambuco countryside regions. We found necessity for data classification regarding deaths from external causes and strengthening of the monitoring.
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Evaluation of scientific production, patents and human resources training in the Brazilian nursing
Revista Brasileira de Enfermagem. 2015;68(5):846-854
Abstract
Evaluation of scientific production, patents and human resources training in the Brazilian nursing
Revista Brasileira de Enfermagem. 2015;68(5):846-854
DOI 10.1590/0034-7167.2015680512i
Views0See moreABSTRACT
Objective:
to evaluate scientifi c production, patents and human resources training of nursing researchers with scholarships of research productivity (PQ) in National Counsel for Technological and Scientific Development (CNPq) in the 2000-2012 historic series; to verify the association between this production and characteristics of the researchers regarding gender, education and origin.
Methods:
this analytic cross-sectional study whose inclusion criterion was to be a nursing PQ/CNPq researcher during the period in question. We analyzed curriculum lattes of 208 researchers with scholarships between 2000 and 2012. For statistical analyses we used the SPSS® software.
Results:
the study points to female predominance, concentration in the Southeast region and existence of an association between scientific production, patents and human resources training and education, gender and origin of the researcher.
Conclusion:
the study presents a significant participation of nursing PQ/CNPq researchers in scientific production and in human resources training, and a modest involvement in the production of patents.
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Structure, process and outcomes of organ and tissue donation for transplantation
Revista Brasileira de Enfermagem. 2015;68(5):837-845
Abstract
Structure, process and outcomes of organ and tissue donation for transplantation
Revista Brasileira de Enfermagem. 2015;68(5):837-845
DOI 10.1590/0034-7167.2015680511i
Views0See moreABSTRACT
Objective:
to analyze the factors related to the structure, process and outcomes of organ and tissue donation for transplantation.
Method:
analytic, longitudinal and quantitative study, conducted in six hospitals in Natal/RN, between August 2010 and February 2011, with 65 potential donors (PD), by means of no participant observation structured script.
Results:
regarding the donation structure, there was deficiencies of physical resources (temperature control), materials (mobile radiology) human resources (nurse technicians) and lack of adequate records and care protocols. In the process of donation, the biggest problems were related to the evaluation stages, brain death diagnosis, maintenance and documentation, with greater proportion of care for the non-donor.
Conclusion:
the structure and process possibly determined the result of 72.3% no donation implementation of potential donors, indices compatible with the national data, but contradictory to those of Spain, which manages to transplant organs of 86.7% of its donors.
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The nurse in the area of collective health: conceptions and competencies
Revista Brasileira de Enfermagem. 2015;68(5):830-836
Abstract
The nurse in the area of collective health: conceptions and competencies
Revista Brasileira de Enfermagem. 2015;68(5):830-836
DOI 10.1590/0034-7167.2015680510i
Views0See moreABSTRACT
Objective:
to learn coordinators and professors’ conceptions from undergraduate Nursing courses of public universities in northern Brazil regarding collective health and to know the necessary competencies to work in the area.
Method:
data were collected through semi-structured interviews and subjected to thematic analysis.
Results:
the participants consider population health as an essential area for the training of nurses, where professionals have autonomy and confidence. It is an interdisciplinary, intersectoral and multidisciplinary field, with extensive scope, that studies the Unified Health System (SUS). The competencies to work in collective health identified were: to work at the SUS, to understand the health and disease process and its determinants and to develop actions towards integrality, to conduct health education, researches and systematization of the nursing care.
Conclusion:
the variety of conceptions about collective health among participants might reflect in training of nurses and their working area.
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Level of dependence among patients in a surgical unit
Revista Brasileira de Enfermagem. 2015;68(5):824-829
Abstract
Level of dependence among patients in a surgical unit
Revista Brasileira de Enfermagem. 2015;68(5):824-829
DOI 10.1590/0034-7167.2015680509i
Views0See moreABSTRACT
Objective:
to identify the complexity of the nursing care of inpatient surgical unit patients, using the Perroca patients classification scale.
Method:
a descriptive, cross-sectional study with 546 reviews of 187 patients between October and December of 2012. Data were analyzed using SPSS 18.0 and the Kappa test, to measure interrater agreement.
Results:
a predominance of patients in the categories of semi-intensive (46.5%) and intermediate care (44.0%) was found, with a prevalence of unassisted bath (58.4%) in the total sample, and bed bath (69.3%) in the semi-intensive care patients. The level of agreement between two pairs of raters was considered good.
Conclusion:
the systematic application of the instrument was useful as a complementary measure of the level of patient dependence, and may contribute to the improvement of the working process, refl ecting on management decision-making with regard to nursing workload
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Psychological violence in the nursing work
Revista Brasileira de Enfermagem. 2015;68(5):817-823
Abstract
Psychological violence in the nursing work
Revista Brasileira de Enfermagem. 2015;68(5):817-823
DOI 10.1590/0034-7167.2015680508i
Views0See moreABSTRACT
Objective:
to investigate and characterize psychological violence practices within teams in the relationship between patients, caregivers and other professionals with the nursing staff of the public hospital network of Caxias, in the State of Maranhão, Brazil.
Method:
descriptive, quantitative, cross-sectional study with data collected by form between November/2013-May/2014.
Results:
verbal aggression is the most common psychological violence subtype 95% (84), followed by bullying 27% (24). Emergency rooms 51% (45) are the most frequent place; patients 60% (53) are the main aggressors; nurses 76% (19) suffer more violence, being mostly female, young and inexperienced.
Conclusion:
the largest number of occurrences was of verbal aggression perpetrated by patients against nurses in the emergency room. Workers try to pretend that nothing happened or are inert in the face of violence. Employers do little about the case, referring to the need for strategies to control violence.
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Dietary intake and stress in patients with acute coronary syndrome
Revista Brasileira de Enfermagem. 2015;68(5):810-816
Abstract
Dietary intake and stress in patients with acute coronary syndrome
Revista Brasileira de Enfermagem. 2015;68(5):810-816
DOI 10.1590/0034-7167.2015680507i
Views0See moreABSTRACT
Objective:
to assess whether dietary intake of patients with acute coronary syndrome (ACS) meets national and international recommendations and whether there is a relationship with the levels of stress.
Method:
a cross-sectional study with 150 patients with ACS, who were interviewed with the Food Frequency Questionnaire and the Perceived Stress Scale-10.
Results:
daily intake above the recommendations: cholesterol (92%), fiber (42.7%) and protein (68%); intake below the recommendations: potassium (88%) and carbohydrates (68.7%); intake according to the recommendations: sodium (53.3%) and lipids (53.3%). Most patients with inadequate dietary intake (54%) were stressed or highly stressed. There was a signifi cant association between a lower stress level and a higher fi ber intake.
Conclusion:
in patients with ACS, dietary intake did not meet the guideline recommendations, and a lower fi ber intake occurs concomitantly with higher stress levels. Educational efforts can support patients in dietary intake adequacy and stress control.
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