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06-01-2015
Elderly families of South of Brazil in the Health Strategy
Revista Brasileira de Enfermagem. 2015;68(3):406-413
Abstract
Elderly families of South of Brazil in the Health Strategy
Revista Brasileira de Enfermagem. 2015;68(3):406-413
DOI 10.1590/0034-7167.2015680305i
Views0See moreABSTRACT
Objective:
to characterize families and health status of the elderly in the Family Health Strategy and to verify the association of family composition with sociodemographic characteristics and health of the elderly.
Method:
population-based study with 215 families and 266 elderly, linked to the Family Health Strategy from a city of Rio Grande do Sul state.
Results:
there was predominance of nuclear family composition, considered as the main source of informal support, families of female elderly (62.6%) and cardiovascular complication. The nuclear structure was signifi cantly associated with female gender (PR = 0.77; p = 0.025) and smoking (PR = 1.35; p = 0.009).
Conclusion:
the results reinforce the need to maintain a network of formal and informal support to the elderly and their families to preserve the independence or to postpone the decline in functional capacity.
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06-01-2015
From real to ideal – the health (un)care of long-lived elders
Revista Brasileira de Enfermagem. 2015;68(3):398-405
Abstract
From real to ideal – the health (un)care of long-lived elders
Revista Brasileira de Enfermagem. 2015;68(3):398-405
DOI 10.1590/0034-7167.2015680304i
Views0See moreABSTRACT
Objective:
to analyze similarities and dissimilarities in the meanings assigned to health care by long-lived elders and nursing professionals in a healthcare setting.
Method:
ethnographic qualitative research, based on the Spradley-McCurdy method and the interpretive anthropology of Geertz and Kleinman. The sample consisted of 20 key informants. Data were collected through participatory observation and ethnographic interviews from March to October 2013 and analyzed in domains, taxonomies and cultural themes.
Results:
Six domains and cultural taxonomies emerged and revealed reasons, attributes, and resources in providing care in relationship to long-lived elders and nursing professionals; fi nally, the following cultural theme emerged: the real to the ideal – the health (un)care of long-lived elders.
Conclusion:
The study showed the distance between the desired and actual health care provided to aged people in the scenario studied.
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06-01-2015
Rescuing the pleasure of playing of child with cancer in a hospital setting
Revista Brasileira de Enfermagem. 2015;68(3):391-397
Abstract
Rescuing the pleasure of playing of child with cancer in a hospital setting
Revista Brasileira de Enfermagem. 2015;68(3):391-397
DOI 10.1590/0034-7167.2015680303i
Views0See moreABSTRACT
Objective:
to dimension spaces and people that act on playing of children with cancer in outpatient treatment.
Method:
qualitative research developed with the creative sensitive method. A total of twenty two family members of seven children with cancer in outpatient treatment at a public hospital in Rio de Janeiro participated of this research. Data were generated in the family members’ homes, from September 2011 to May 2012.
Results:
after the diagnosis of childhood cancer, there was a change of scene and in the people who interact and play with children. Hospital has a central place for it, since children discover the pleasure of playing in this setting.
Conclusion:
the health care professional, especially nurses, who work on hospital care needs, should develop the ability of facilitate playing and therefore, enable care that promotes childhood development.
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06-01-2015
Child Health Surveillance: nurses perspective
Revista Brasileira de Enfermagem. 2015;68(3):384-390
Abstract
Child Health Surveillance: nurses perspective
Revista Brasileira de Enfermagem. 2015;68(3):384-390
DOI 10.1590/0034-7167.2015680302i
Views0See moreABSTRACT
Objective:
to analyze conceptions of nurses on child health surveillance in family health units.
Method:
a qualitative study with thematic analysis of the data, based on the paradigm of Health Surveillance. Interviews were conducted with 13 nurses in a countryside city in the state of Sao Paulo.
Results:
nurses conceived child health surveillance as an active monitoring, which should be comprehensive, identifying risks/vulnerabilities, through multidisciplinary and intersectoral actions that are dependent on maternal involvement. We found partial development of these assumptions in practice, due to diffi culties such as lack of maternal involvement in the proposed actions, lack of time for discussion and adoption of measures in the units and disarticulation between levels and sectors of the city.
Conclusion:
a greater political and technical investment is needed to ensure the adoption of this model in different sectors and levels of care of the city.
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06-01-2015
As diversas faces da Integridade em Pesquisa: por uma Enfermagem íntegra!
Revista Brasileira de Enfermagem. 2015;68(3):375-377
Abstract
As diversas faces da Integridade em Pesquisa: por uma Enfermagem íntegra!
Revista Brasileira de Enfermagem. 2015;68(3):375-377
DOI 10.1590/0034-7167.2015680301i
Views0Recentemente, tivemos oportunidade de participar da 4ª Conferência Mundial de Integridade em Pesquisa, no Rio de Janeiro. Para nós, pesquisadores, docentes, autores, pareceristas e editores científicos de periódicos de Enfermagem foi um evento divisor de águas: de ora em diante precisamos apertar o passo para alcançar as áreas que já têm as questões de Integridade […]See more -
06-01-2015
The many sides of Research Integrity: For Integrity in Nursing!
Revista Brasileira de Enfermagem. 2015;68(3):375-377
Abstract
The many sides of Research Integrity: For Integrity in Nursing!
Revista Brasileira de Enfermagem. 2015;68(3):375-377
DOI 10.1590/0034-7167.2015680301i
Views1We recently had the opportunity to participate in the 4th World Conference on Research Integrity in Rio de Janeiro. For us researchers, professors, authors, reviewers and scientific editors of nursing periodicals, the event was a watershed: From this point forward, we must step up our game and catch up with other areas that already discuss […]See more -
01-01-2015
Professional Master’s Degree: potential contribution to Advanced Practice Nursing
Revista Brasileira de Enfermagem. 2015;68(6):1186-1189
Abstract
Professional Master’s Degree: potential contribution to Advanced Practice Nursing
Revista Brasileira de Enfermagem. 2015;68(6):1186-1189
DOI 10.1590/0034-7167.2015680626i
Views0See moreABSTRACT
A reflection articleabout the contribution of Master’s Degree Programs in Advanced Practice Nursing and the Universal Health Coverage and the Universal Health Access, topicsthat have been discussed by the Pan American Health Organization, and which the Brazilian Nursingrequires not just appropriate, but further studyto reflect in order to define directions for our profession.
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01-01-2015
Concept of family insufficiency in the aged: critical literature analysis
Revista Brasileira de Enfermagem. 2015;68(6):1176-1185
Abstract
Concept of family insufficiency in the aged: critical literature analysis
Revista Brasileira de Enfermagem. 2015;68(6):1176-1185
DOI 10.1590/0034-7167.2015680625i
Views0See moreABSTRACT
Objective:
to identify the attributes of the “family insufficiency” concept of the aged in the literature.
Method:
critical literature analysis.
Results:
family insufficiency is characterized as a complex process of psychosocial interaction, founded mainly on low social support of the aged and impaired family ties. Its antecedents are found in contemporary transformations within the family system, intergenerational conflicts, impaired family relationships and social vulnerability of the family. The consequences of family insufficiency include social vulnerability of the aged, decline of psychological and functional health, lower quality of life and unsuccessful aging. An original theoretical proposal was elaborated for the concept of family insufficiency in the elderly, with the identification of its attributes, antecedents and consequences.
Conclusion:
the findings of this study constitute a theoretical advancement in the Family Insufficiency Syndrome in elderly people and provide data for future field research in developing the concept.
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ORIGINAL ARTICLE04-09-2020
Factors associated with the discontinuance of outpatient follow-up in neonatal units
Revista Brasileira de Enfermagem. 2020;73(3):e20180793
Abstract
ORIGINAL ARTICLEFactors associated with the discontinuance of outpatient follow-up in neonatal units
Revista Brasileira de Enfermagem. 2020;73(3):e20180793
DOI 10.1590/0034-7167-2018-0793
Views1See moreABSTRACT
Objectives:
to identify predisposing and enabling factors as well as the health needs associated with the discontinuance of outpatient follow-up of newborns who were hospitalized at neonatal intensive care unit.
Methods:
cross-sectional study, using the behavioral model of health services use. The study was composed of 358 mothers and newborns referred to the outpatient follow-up after discharge. Characterization, perception of social support, postnatal depression, and attendance to appointments data were collected, analyzed by the R software (3.3.1).
Results:
outpatient follow-up was discontinued by 31.28% of children in the first year after discharge. In multiple regression analysis, the chance of discontinuance was higher for newborns who used mechanical ventilation (OR = 1.68; 95%CI 1.04-2.72) and depended on technology (OR = 3.54; 95%CI 1.32-9.5).
Conclusions:
predisposing factors were associated with the discontinuance of follow-up; enabling factors and health needs did not present a significant association. Children with more complex health conditions require additional support to participate in follow-up programs, thus ensuring the continuity of care.
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ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
DOI 10.1590/0034-7167.20247701e03
Views2In the article “Nurses in the labor market: professional insertion, competencies and skills”, with DOI number: , published in Revista Brasileira de Enfermagem, 2017;70(6):1220-6, on page 1225:Include before REFERENCES:[…]See more -
REVIEW12-08-2024
Interventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
Revista Brasileira de Enfermagem. 2024;77(1):e20230192
Abstract
REVIEWInterventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
Revista Brasileira de Enfermagem. 2024;77(1):e20230192
DOI 10.1590/0034-7167-2023-0192
Views0See moreABSTRACT
Objective:
To assess the evidence regarding the effectiveness of interventions aimed at strengthening self-efficacy beliefs in college students.
Methods:
Integrative Review conducted on the Lilacs, PubMed, CinahL, Cochrane Collaboration Databases, Scopus, and PsycInfo databases. The methodological quality of the studies was assessed using tools proposed by the Joanna Briggs Institute, and the results were analyzed descriptively.
Results:
Out of the 10 selected studies, six demonstrated that interventions aimed at strengthening self-efficacy were effective (Levels of Evidence II and III), and four revealed contrary results (Levels of Evidence I and II). Programs aimed at enhancing self-efficacy should include content on positive mental health, psychoeducation strategies, cover a period of eight to twelve weeks, and consider the completion of homework assignments.
Conclusion:
The synthesis of evidence pointed to pathways for building an effective self-efficacy strengthening program to be implemented in universities.
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ORIGINAL ARTICLE05-13-2024
Generalized Resistance Deficits in inmates with hypertension: missing resources that limit health
Revista Brasileira de Enfermagem. 2024;77(2):e20230246
Abstract
ORIGINAL ARTICLEGeneralized Resistance Deficits in inmates with hypertension: missing resources that limit health
Revista Brasileira de Enfermagem. 2024;77(2):e20230246
DOI 10.1590/0034-7167-2023-0246
Views0See moreABSTRACT
Objective:
to understand the Generalized Resistance Deficits of people deprived of liberty with hypertension in a Brazilian prison unit.
Method:
qualitative research, anchored in Salutogenesis, carried out with 38 people with hypertension from a Brazilian prison unit, from February to July 2022, with a semi-structured interview with open-ended questions, whose analysis was thematic, explaining the limitations to health in prison.
Results:
13 Generalized Resistance Deficits were reported, mostly related to the prison environment and, to a lesser extent, to the social group and the individual, respectively. Living in prison for people with hypertension implies living with a high number of Generalized Resistance Deficits, accentuating the movement towards the disease pole.
Final considerations:
knowing Generalized Resistance Deficits allows directing health promotion to support the use of available Generalized Resistance Resources and contributes to the expansion of intersectoral policies.
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ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e05
DOI 10.1590/0034-7167.20247702e05
Views2In the article “Educational technologies used to promote self-care for people with diabetes mellitus: integrative review”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 4):e20230049, in the title:Where it read:[…]See more -
ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
DOI 10.1590/0034-7167.20247702e06
Views2In the article “Is there scientific relevance to the plot of films and documentaries about eating disorders?”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(1):e20220547, page 7:Where it read:[…]See more -
REVIEW07-29-2024
Profile of scientific production on nursing technology construction, validity and application: a bibliometric study
Revista Brasileira de Enfermagem. 2024;77(3):e20230452
Abstract
REVIEWProfile of scientific production on nursing technology construction, validity and application: a bibliometric study
Revista Brasileira de Enfermagem. 2024;77(3):e20230452
DOI 10.1590/0034-7167-2023-0452
Views1See moreABSTRACT
Objective:
to analyze the profile of scientific production on nursing technology construction, validity and application.
Methods:
this is a bibliometric study, carried out in six databases, based on the Methodi Ordinatio application, arranged in nine stages. To represent the findings, the VOSviewer® software was used.
Results:
346 studies were identified, obtained from BDENF, CINAHL, EMBASE, LILACS, PubMed/MEDLINE, Scopus and Web of Science. There was a predominance of the English language, and 20% of the authors hold more than 25% of studies. Only two journals account for 25% of studies in the period studied. Twenty-six studies were selected for the InOrdinatio classification. Nursing Process (23%) stood out among the studies. The most produced technology was software (27%), and 50% of works describe construction and validity.
Conclusions:
there is an emphasis on the creation of educational technologies, especially information technology. The data demonstrates opportunities for future research in the area.
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ORIGINAL ARTICLE01-10-2024
Inventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
Abstract
ORIGINAL ARTICLEInventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
DOI 10.1590/0034-7167-2023-0539
Views1See moreABSTRACT
Objective:
to construct and validate the content of an inventory of ethical problems experienced by nurses in mobile pre-hospital care.
Method:
a psychometric approach study, developed with the following stages: (1) instrument construction through a theoretical matrix based on deliberative bioethics, scoping review and online qualitative research; (2) content validity by judges; (3) pre-testing with Mobile Emergency Care Service nurses in various Brazilian states. For content validity analysis, the Content Validity Ratio was calculated (CVR>0.45 for judges and CVR>0.35 for the target population).
Results:
the instrument had 44 items, distributed across four dimensions.
Final considerations:
the constructed instrument presented sources of evidence of content validity, providing good psychometric measurements and constituting a useful tool for nurses’ practice in the pre-hospital setting.
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ORIGINAL ARTICLE07-31-2020
Sexuality and associated risk factors in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20180786
Abstract
ORIGINAL ARTICLESexuality and associated risk factors in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20180786
DOI 10.1590/0034-7167-2018-0786
Views0See moreABSTRACT
Objectives:
to assess the sexual function of pregnant women and the influence of sociodemographic, obstetric, and behavioral factors on sexual dysfunction.
Methods:
cross-sectional study conducted with 141 pregnant women attended by the Single Health System and 120 by one private service, totaling 261 participants. A questionnaire containing sociodemographic, obstetric, and behavioral variables was applied, as well as the Female Sexual Function Index instrument, which was used to assess sexual function. Associations between variables and sexual dysfunction were made using the chi-square test, considering a statistically significant result when p < 0.05.
Results:
among the participants, 32.1% had sexual dysfunction, and the variables “age”, “income” and “type of health service” had an influence on sexual dysfunction. The prevalence of pregnant women was between 21 and 30 years old (p < 0.001), with an income between 1 and 2 minimum wages (p = 0.048) and used the public health system network (p = 0.000).
Conclusions:
the factors associated with sexual dysfunction are “young pregnant women”, “low income” and “attended in the public health service”.
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ORIGINAL ARTICLE06-01-2020
Relationship between functional capacity, performance and symptoms in hospitalized patients with heart failure
Revista Brasileira de Enfermagem. 2020;73(4):e20190123
Abstract
ORIGINAL ARTICLERelationship between functional capacity, performance and symptoms in hospitalized patients with heart failure
Revista Brasileira de Enfermagem. 2020;73(4):e20190123
DOI 10.1590/0034-7167-2019-0123
Views0See moreABSTRACT
Objectives:
to evaluate the prevalence of symptoms in heart failure patients and to investigate the relationship between symptoms, functional capacity and performance.
Methods:
cross-sectional study, developed at a hospital specializing in cardiology. The sample (n=170) consisted of patients with heart failure, assessed by means of a sociodemographic form, New York Heart Association Functional Class, Edmonton Symptom Rating Scale and Karnofsky Physical Performance Scale. Analyzes were performed using Spearman’s Correlation and Pearson’s Chi-Square test.
Results:
dyspnea, fatigue and edema were the main symptoms that led to the search for health services. During hospitalization, the main symptoms were anxiety, sleep disturbance and sadness. Weak negative correlations were observed between functionality, functional class, and symptom overload.
Conclusions:
the prevalence of symptoms was high and changed throughout the hospitalization period. Patients with poorer functional capacity and poorer performance had greater symptom overload.
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ORIGINAL ARTICLE10-01-2022
Continuity of care for children with special healthcare needs during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75(2):e20210150
Abstract
ORIGINAL ARTICLEContinuity of care for children with special healthcare needs during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75(2):e20210150
DOI 10.1590/0034-7167-2021-0150
Views0See moreABSTRACT
Objective:
To describe the continuity of care for children with special healthcare needs during the COVID-19 pandemic through the perception of their caregivers in the Northeast of Brazil.
Methods:
Qualitative descriptive-exploratory research carried out between June and September 2020, in a municipality in the Northeast of Brazil. Eleven caregivers participated through semi-structured interviews conducted at home. The data were submitted to thematic content analysis.
Results:
The social isolation period and the suspension of health services affected the continuity of care, configuring the category “Implications of the COVID-19 pandemic for the continuity of care”. Caregivers expressed fear of children contracting the coronavirus, characterizing the category “Fears and uncertainties of the COVID-19 pandemic in view of the vulnerability of children with special healthcare needs”.
Final considerations:
Caregivers’ reports revealed problems in the continuity of care for the studied cohort. Therefore, health care practices must be rethought in times of pandemic.
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ORIGINAL ARTICLE06-16-2021
Social representations of the quality of life of the young people living with HIV
Revista Brasileira de Enfermagem. 2021;74(2):e20200149
Abstract
ORIGINAL ARTICLESocial representations of the quality of life of the young people living with HIV
Revista Brasileira de Enfermagem. 2021;74(2):e20200149
DOI 10.1590/0034-7167-2020-0149
Views0See moreABSTRACT
Objectives:
to analyze the social representations of the quality of life of the young people living with HIV.
Methods:
qualitative survey, based on the Social Representations Theory, with 24 young people living with HIV, monitored in specialized services in Rio de Janeiro, through semi-structured interviews, and the analysis supported by the software IRAMUTEQ.
Results:
multidimensionality of the quality of life was observed unfolding the implications of living with HIV/aids concerning the familiar and social support network, time of diagnosis, healthcare services, antiretroviral therapy, and prejudice expressions.
Final Considerations:
a conceptual synthesis of quality of life is observed when it is associated with healthy lifestyle habits, interpersonal relationships, and health services and professional practices.
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ORIGINAL ARTICLE12-08-2023
Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
Abstract
ORIGINAL ARTICLEPolypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
DOI 10.1590/0034-7167-2022-0785
Views0See moreABSTRACT
Objective:
to identify the prevalence and associations of polypharmacy and potentially inappropriate medication use among older adults with hypertension treated in primary care.
Methods:
a cross-sectional study carried out with older adults with hypertension treated at a Family Health Strategy unit. Data collection included analysis of medical records, interviews and multidimensional assessment of older adults. Socio-demographic information and clinical variables were collected. Statistical analysis was performed by multiple logistic regression.
Results:
polypharmacy prevalence was 38.09%, and potentially inappropriate medication (PIM), 28.57%. There was a significant association between polypharmacy and PIM use, altered sleep and ethnicity. PIM use was associated with polypharmacy, worse family functioning, and absence of a caregiver. Cognitive decline reduces the prevalence of these medications.
Conclusions:
polypharmacy and PIM use among older adults with hypertension represent a problem in this population, especially among the most vulnerable.
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ORIGINAL ARTICLE02-10-2020
Healthcare professionals’ perception of mental health in primary care
Revista Brasileira de Enfermagem. 2020;73(1):e20180201
Abstract
ORIGINAL ARTICLEHealthcare professionals’ perception of mental health in primary care
Revista Brasileira de Enfermagem. 2020;73(1):e20180201
DOI 10.1590/0034-7167-2018-02011
Views0See moreABSTRACT
Objective:
To characterize the mental health care provided in Primary Care from the perception of health professionals in the cities to the 5th Regional Health Center of the state of Paraná.
Method:
An exploratory qualitative research. Participants were 121 health professionals working in primary care in the 20 cities of 5th Regional Health Center of the state of Parana. Twenty-two focus groups were recorded, transcribed and analyzed by content analysis.
Results:
Five thematic categories emerged, of which two were analyzed in this study: actions that professionals consider to be mental health actions; mental health actions developed by Primary Care professionals.
Final Considerations:
Despite of the indications of inclusion of mental health actions in Primary Care, this relationship is still occasional and unplanned. Policies that foster this interaction from a psychosocial perspective are needed.
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ORIGINAL ARTICLE08-30-2021
Historical aspects in pain management in palliative care in an oncological reference unit
Revista Brasileira de Enfermagem. 2021;74(5):e20200761
Abstract
ORIGINAL ARTICLEHistorical aspects in pain management in palliative care in an oncological reference unit
Revista Brasileira de Enfermagem. 2021;74(5):e20200761
DOI 10.1590/0034-7167-2020-0761
Views0See moreABSTRACT
Objective:
Describe the actions implemented for pain management in palliative care oncology and analyze the contribution of Hospital do Câncer IV, as a reference unit at the National Cancer Institute.
Methods:
Study of the history of the present time, whose sources were written documents and interviews with five participants. The collection took place from February to June 2018. The analysis of the written sources took place through internal and external criticism of the documents, considering their chronology and theme.
Results:
Professionals contributed with actions for pain management in palliative oncology care: in discussions and final drafting of ordinances, as rapporteurs at national and international events, in the elaboration of humanization conducts and systematization of assistance in addressing pain.
Final considerations:
These actions favored assistance in palliative oncology care at various levels of health care for patients and families, with greater technical and scientific recognition for all.
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REVIEW12-21-2020
Contrast-Induced Nephropathy in patients submitted to percutaneous coronary intervention: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200190
Abstract
REVIEWContrast-Induced Nephropathy in patients submitted to percutaneous coronary intervention: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200190
DOI 10.1590/0034-7167-2020-0190
Views0See moreABSTRACT
Objective:
to demonstrate scientific evidence on incidence and factors associated with contrast-induced nephropathy in patients undergoing percutaneous coronary intervention.
Methods:
an integrative review carried out in the VHL, PubMed, VHL Regional Portal and SciELO databases, of articles published between 2014 and 2019.
Results:
the sample consisted of five original articles, two cohorts, two control cases and a clinical trial. The incidence of contrast-induced nephropathy ranged from 6% to 24%. It stands out among patients with advanced age, male gender, diabetes mellitus, systemic arterial hypertension, volume of contrast infused and osmolarity. Intravenous hydration, sodium bicarbonate, ascorbic acid and statin were important prophylactic agents.
Conclusion:
this study envisioned the main risk factors for contrast-induced nephropathy in patients undergoing percutaneous coronary intervention and elucidated preventive measures that guide multidisciplinary health care aiming at a quality and safe care.
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