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ORIGINAL ARTICLE12-16-2024
Construction and validation of an educational game on biosafety in the central sterile supply department
- Tatiana Nemoto Piccoli Moraes
, - Fernanda Moura D’Almeida Miranda ,
- Rafaela Danta de Sousa ,
- Luciana Schleder Gonçalves ,
- Maria de Fatima Mantovani , [ … ],
- Jenira Priscila dos Anjos
Abstract
ORIGINAL ARTICLEConstruction and validation of an educational game on biosafety in the central sterile supply department
Revista Brasileira de Enfermagem. 2024;77(6):e20230478
DOI 10.1590/0034-7167-2023-0478
- Tatiana Nemoto Piccoli Moraes ,
- Fernanda Moura D’Almeida Miranda ,
- Rafaela Danta de Sousa ,
- Luciana Schleder Gonçalves ,
- Maria de Fatima Mantovani ,
- Jenira Priscila dos Anjos
Views0See moreABSTRACT
Objectives:
to construct and validate an educational game on biosafety in the Central Sterile Supply Department of a hospital in Curitiba, PR.
Methods:
the study was conducted using a quantitative approach, employing applied and technological research with an exploratory design. The process was divided into six stages, from the definition of the theme to the validation and application of the game. The study was carried out from May to August 2022, involving 17 nursing professionals from a Central Sterile Supply Department during day and night shifts, as well as 9 judges.
Results:
the study resulted in the construction of a board game named by the authors as “My Health First.”
Conclusions:
the research achieved its objective of constructing and validating an educational game. By reflecting on professional practice and correlating the occupational risks present, the professionals were able to list safe actions, identify problems, and seek solutions.
- Tatiana Nemoto Piccoli Moraes
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ORIGINAL ARTICLE12-16-2024
Health literacy development of Primary Health Care patients: qualitative research
Revista Brasileira de Enfermagem. 2024;77(6):e20240154
Abstract
ORIGINAL ARTICLEHealth literacy development of Primary Health Care patients: qualitative research
Revista Brasileira de Enfermagem. 2024;77(6):e20240154
DOI 10.1590/0034-7167-2024-0154
Views0See moreABSTRACT
Objectives:
to identify the process of health literacy development among primary care patients, relating it to their self-care practices.
Methods:
qualitative, prospective research with 22 patients from two Family Health Strategy units. Data were obtained through individual semi-structured interviews, examined through descriptive statistics and thematic content analysis.
Results:
the results discuss how participants learn about health and how this resonates in their behaviors, culminating in two thematic categories: “Health knowledge construction”; and “Dialogue between health knowledge construction and patient care actions”.
Final Considerations:
health knowledge is developed mainly through interpersonal relationships, mediated by health professionals through bonding and communication. Community educational actions and training of health professionals in communication can promote health literacy and self-care among patients.
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ORIGINAL ARTICLE12-16-2024
Analysis of omission of antimicrobial doses in Intensive Care Units
- Isabelle Ribeiro Machado ,
- Danielle de Mendonça Henrique ,
- Flávia Giron Camerini ,
- Vanessa Galdino de Paula ,
- Cintia Silva Fassarella , [ … ],
- Lucas Rodrigo Garcia de Mello
Abstract
ORIGINAL ARTICLEAnalysis of omission of antimicrobial doses in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(6):e20240102
DOI 10.1590/0034-7167-2024-0102
- Isabelle Ribeiro Machado ,
- Danielle de Mendonça Henrique ,
- Flávia Giron Camerini ,
- Vanessa Galdino de Paula ,
- Cintia Silva Fassarella ,
- Lucas Rodrigo Garcia de Mello
Views0See moreABSTRACT
Objectives:
to analyze the rate of antimicrobial dose omission in intensive care units.
Methods:
cross-sectional study carried out between March 1 and September 30, 2023, in intensive care units of a University Hospital in Rio de Janeiro.
Results:
the sample consisted of 452 prescriptions and 1467 antimicrobial doses. The dose omission rate was 4.29%. Each antimicrobial prescribed increased the chance of omission by 51%. The strategy of double-checking prescriptions helped prevent 30% of antimicrobial dose omissions (p=0.0001).
Conclusions:
monitoring the omission of antimicrobial doses can guide nursing actions to improve quality and patient safety, contributing to the prevention of medication errors, antimicrobial stewardship and the fight against antimicrobial resistance.
- Isabelle Ribeiro Machado
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REVIEW12-16-2024
Recommendations for guidelines for promoting mental health in the workplace: an umbrella review
- Evelin Daiane Gabriel Pinhatti ,
- Amanda Salles Margatho do Nascimento ,
- Regina Celia Bueno Rezende Machado ,
- Rosangela Aparecida Pimenta ,
- André Estevam Jaques , [ … ],
- Maria do Carmo Fernandez Lourenço Haddad
Abstract
REVIEWRecommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
DOI 10.1590/0034-7167-2024-0086
- Evelin Daiane Gabriel Pinhatti ,
- Amanda Salles Margatho do Nascimento ,
- Regina Celia Bueno Rezende Machado ,
- Rosangela Aparecida Pimenta ,
- André Estevam Jaques ,
- Maria do Carmo Fernandez Lourenço Haddad
Views1See moreABSTRACT
Objectives:
to summarize the recommendations of guidelines for promoting mental health in the workplace.
Methods:
an umbrella review, according to Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses methodological assumptions. Data collection was carried out in January 2021 and updated in July 2023 in the American Psychological Association, Cochrane Library, EMBASE, National Library of Medicine, and Scopus databases. Systematic reviews that assessed guidelines with recommendations for mental health care for workers were included. PROSPERO registration CRD42023461845.
Results:
four systematic reviews published between 2015 and 2018 were identified. The abstracts highlighted actions that facilitate and inhibit the recommendations as well as three categories of intervention: primary prevention – worker protection; secondary prevention – promoting workers’ mental health; and tertiary prevention – supporting, monitoring and rehabilitating workers upon returning to work.
Conclusions:
the interventions are based on prevention, promotion and early recognition, support and rehabilitation of mental health problems.
- Evelin Daiane Gabriel Pinhatti
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ORIGINAL ARTICLE12-16-2024
Psychometric analysis of ProQOL-BR in nursing: building hospital safety and protection
- Frederico Marques Andrade ,
- Lanuza Borges Oliveira ,
- Igor Monteiro Lima Martins ,
- Maria Eduarda Borges Rodrigues ,
- Carla Silvana de Oliveira e Silva
Abstract
ORIGINAL ARTICLEPsychometric analysis of ProQOL-BR in nursing: building hospital safety and protection
Revista Brasileira de Enfermagem. 2024;77(6):e20240085
DOI 10.1590/0034-7167-2024-0085
- Frederico Marques Andrade ,
- Lanuza Borges Oliveira ,
- Igor Monteiro Lima Martins ,
- Maria Eduarda Borges Rodrigues ,
- Carla Silvana de Oliveira e Silva
Views0See moreABSTRACT
Objectives:
to analyze the psychometric properties of the ProQOL-BR instrument in hospital nursing professionals.
Methods:
a methodological study to validate the ProQOL-BR. Confirmatory factor analysis, assessment of local and global adjustment quality, Pearson hypothesis testing and Cronbach’s alpha internal consistency analysis were used.
Results:
a total of 490 professionals participated. The model presents adequate quality due to factor weights (λ≥ 0.40), acceptable overall fit quality and adequate chi-square ratio and degrees of freedom (χ2/g.1=2.51) for the parameters of CFI (0.923), GFI (0.902), TLI (0.914) and RMSEA (0.042). In terms of validity, it was shown to be adequate with CC=0.89. The internal consistency obtained by standardized Cronbach’s alpha was 0.761. Criterion validity was shown to be favorable with significant correlations (0.001).
Conclusions:
the instrument was validated regarding content, criteria and reliability. Three questions were removed from the original instrument, ProQOL-BR, leaving the final instrument with 25 questions.
- Frederico Marques Andrade
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12-16-2024
GerenciaDOR™: development of digital technology by nurses for the assessment of patients with chronic pain
Revista Brasileira de Enfermagem. 2024;77(6):e20240050
Abstract
GerenciaDOR™: development of digital technology by nurses for the assessment of patients with chronic pain
Revista Brasileira de Enfermagem. 2024;77(6):e20240050
DOI 10.1590/0034-7167-2024-0050
Views0See moreABSTRACT
Objectives:
to develop a digital technological solution (prototype) for assessing patients with chronic pain.
Methods:
this is a methodological and technological development study based on the Human-Centered Design framework and the principles of Patient-Centered Care. The prototype guides patients through a body diagram and directs them to an evaluation using specific instruments that address the multidimensional aspects of chronic pain.
Results:
the GerenciaDOR* project enables navigation through the Web App screens, providing access to pain assessment features up to the presentation of results.
Final Considerations:
the study describes a systematic approach to pain assessment and expands nurses’ knowledge in pain management. Additionally, it can promote the development of other digital technologies for chronic pain assessment and contribute to a multidisciplinary, patient centered treatment.
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ORIGINAL ARTICLE12-16-2024
Respectful care for postpartum women with sickle cell disease: a netnographic study
- Zannety Conceição Silva do Nascimento Souza ,
- Luana Gabriella Pinheiro Barrêto ,
- Paulo Roberto Lima Falcão do Vale ,
- Elysangela Dittz Duarte ,
- Cristiane dos Santos Silva , [ … ],
- Evanilda Souza de Santana Carvalho
Abstract
ORIGINAL ARTICLERespectful care for postpartum women with sickle cell disease: a netnographic study
Revista Brasileira de Enfermagem. 2024;77(6):e20230545
DOI 10.1590/0034-7167-2023-0545
- Zannety Conceição Silva do Nascimento Souza ,
- Luana Gabriella Pinheiro Barrêto ,
- Paulo Roberto Lima Falcão do Vale ,
- Elysangela Dittz Duarte ,
- Cristiane dos Santos Silva ,
- Evanilda Souza de Santana Carvalho
Views1See moreABSTRACT
Objectives:
to analyze principles of respectful maternity care in narratives of postpartum women with sickle cell disease, relating them to Sustainable Development Goals.
Methods:
netnographic study, with two videos published in 2020. Deductive iconographic and thematic analysis by Respectful Maternity Care Charter, organized in MAXQDA.
Results:
principles identified were the right to: freedom from harm and ill-treatment; information, informed consent, refusal of medical procedures, and respect for their choices and preferences including companion; be considered a person from birth, with dignified and respectful treatment; health at the highest possible level; newborns being with their parents or guardians. The Sustainable Development Goals for women by 2030 were not positively contemplated in postpartum women’s experience.
Final Considerations:
it is appropriate that health workers qualify themselves to provide respectful maternity care, with qualified listening, understanding, and resolution of unique demands of postpartum women with sickle cell disease, seeking equality in care for women.
- Zannety Conceição Silva do Nascimento Souza
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REVIEW12-16-2024
Strategies for expanding vaccination coverage in children in Brazil: systematic literature review
- Janaina Fonseca Almeida Souza ,
- Thales Philipe Rodrigues da Silva ,
- Camila Kümmel Duarte ,
- Anna Luiza de Fatima Pinho Lins Gryschek ,
- Elysângela Dittz Duarte , [ … ],
- Fernanda Penido Matozinhos
Abstract
REVIEWStrategies for expanding vaccination coverage in children in Brazil: systematic literature review
Revista Brasileira de Enfermagem. 2024;77(6):e20230343
DOI 10.1590/0034-7167-2023-0343
- Janaina Fonseca Almeida Souza ,
- Thales Philipe Rodrigues da Silva ,
- Camila Kümmel Duarte ,
- Anna Luiza de Fatima Pinho Lins Gryschek ,
- Elysângela Dittz Duarte ,
- Fernanda Penido Matozinhos
Views1See moreABSTRACT
Objectives:
to identify the strategies found in the literature for increasing vaccination coverage among children in Brazil. It is justified mainly by the current scenario of falling vaccination coverage.
Methods:
systematic literature review. The search was carried out in the Pubmed (MEDLINE), Embase and Scopus databases, following the PRISMA guidelines.
Results:
initially, 4,824 results were returned. In the end, 6 studies were included for narrative synthesis using the SWiM methodology. Of these, 50% dealt with studies related to the Bolsa Família Program (PBF). The others explored strategies for approaching parents directly, Rapid Vaccination Monitoring (MRV) and the Community Health Agents Program (PACS). The PBF did not guarantee compliance with the conditionality of keeping vaccinations up to date. The MRV and PACS are effective strategies, especially because they allow active search for absentees.
Conclusions:
we conclude that more publications are needed on strategies to increase vaccination coverage among children in Brazil.
- Janaina Fonseca Almeida Souza
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06-01-2015
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
Abstract
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
DOI 10.1590/0034-7167.2015680315i
Views1See moreABSTRACT
Objective:
to analyze health promotion programs in the supplementary health care.
Methods:
This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis.
Results:
Home care has been described as the main action in the fi eld of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the benefi ciaries.
Conclusions:
Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.
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ORIGINAL ARTICLE12-13-2019
Factors associated with low Apgar in newborns in birth center
- Nágela Cristine Pinheiro Santos ,
- Sibylle Emilie Vogt ,
- Elysângela Dittz Duarte ,
- Adriano Marçal Pimenta ,
- Lélia Maria Madeira , [ … ],
- Mery Natali Silva Abreu
Abstract
ORIGINAL ARTICLEFactors associated with low Apgar in newborns in birth center
Revista Brasileira de Enfermagem. 2019;72:297-304
DOI 10.1590/0034-7167-2018-0924
- Nágela Cristine Pinheiro Santos ,
- Sibylle Emilie Vogt ,
- Elysângela Dittz Duarte ,
- Adriano Marçal Pimenta ,
- Lélia Maria Madeira ,
- Mery Natali Silva Abreu
Views1See moreABSTRACT
Objective:
to analyze factors associated with Apgar of 5 minutes less than 7 of newborns of women selected for care at the Center for Normal Birth (ANC).
Method:
a descriptive cross-sectional study with data from 9,135 newborns collected between July 2001 and December 2012. The analysis used absolute and relative frequency frequencies and bivariate analysis using Pearson’s chi-square test or the exact Fisher.
Results:
fifty-three newborns (0.6%) had Apgar less than 7 in the 5th minute. The multivariate analysis found a positive association between low Apgar and gestational age less than 37 weeks, gestational pathologies and intercurrences in labor. The presence of the companion was a protective factor.
Conclusion:
the Normal Birth Center is a viable option for newborns of low risk women as long as the protocol for screening low-risk women is followed.
- Nágela Cristine Pinheiro Santos
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ORIGINAL ARTICLE09-29-2022
Palliative care production for health professionals in the context of home care
Revista Brasileira de Enfermagem. 2022;75(1):e20210030
Abstract
ORIGINAL ARTICLEPalliative care production for health professionals in the context of home care
Revista Brasileira de Enfermagem. 2022;75(1):e20210030
DOI 10.1590/0034-7167-2021-0030
Views1See moreABSTRACT
Objectives:
to analyze palliative care production developed by health professionals to home care patients.
Methods:
this is an exploratory study, with a qualitative approach, using the transpersonal care theoretical framework. Thirteen interviews were conducted with health professionals and 18 observations were conducted on different cases. Content analysis was performed using MAXQDA©.
Results:
actions performed: maintenance and follow-up measures to people eligible for palliative care, in acts of dialogue and “listening” to caregivers and users, conducting guidelines for the care and self-care process, performing technical procedures, delivery of materials, referrals and medical prescriptions to users.
Final Considerations:
it is perceived the need for advances in the implementation of government policies in Brazil that insert palliative care into the Health Care Network through educational, managerial and care actions that ensure human dignity, thus allowing the development of these and other palliative care interventions.
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12-08-2023
Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies
- Priscilla de Oliveira Luz ,
- Adriana Almeida de Souza ,
- Gabriella de Andrade Boska ,
- Marilia Mastrocolla de Almeida Cardoso ,
- Bruna de Paula Candido , [ … ],
- Márcia Aparecida Ferreira de Oliveira
Abstract
Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies
Revista Brasileira de Enfermagem. 2023;76:e20220550
DOI 10.1590/0034-7167-2022-0550
- Priscilla de Oliveira Luz ,
- Adriana Almeida de Souza ,
- Gabriella de Andrade Boska ,
- Marilia Mastrocolla de Almeida Cardoso ,
- Bruna de Paula Candido ,
- Márcia Aparecida Ferreira de Oliveira
Views1See moreABSTRACT
Objective:
to synthesize evidence from qualitative studies on nursing experiences regarding child and adolescent mental health care in specialized services.
Method:
a systematic review with meta-synthesis of qualitative studies according to JBI guidelines. CINAHL, EMBASE, MEDLINE, LILACS, PSYCinfo, Scopus and Web of Science databases were used. The findings were classified according to the level of reliability and credibility and categorized by similarity between contents.
Results:
229 articles were identified, and five were included in the final sample and organized into the categories: Emotional impact; and Understanding nursing role. The level of evidence found was moderate.
Final considerations:
nursing experiences are permeated by emotional exhaustion, feelings of frustration and difficulty in understanding their professional role. The need for training spaces that qualify this care is highlighted.
- Priscilla de Oliveira Luz
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ORIGINAL ARTICLE04-22-2024
Adherence to Covid-19 vaccination during the pandemic: the influence of fake news
- Luana Cristina Roberto Borges ,
- Sonia Silva Marcon ,
- Gabrielly Segatto Brito ,
- Miriam Terabe ,
- Nathalia Ivulic Pleutim , [ … ],
- Elen Ferraz Teston
Abstract
ORIGINAL ARTICLEAdherence to Covid-19 vaccination during the pandemic: the influence of fake news
Revista Brasileira de Enfermagem. 2024;77(1):e20230284
DOI 10.1590/0034-7167-2023-0284
- Luana Cristina Roberto Borges ,
- Sonia Silva Marcon ,
- Gabrielly Segatto Brito ,
- Miriam Terabe ,
- Nathalia Ivulic Pleutim ,
- Ana Heloisa Mendes ,
- Elen Ferraz Teston
Views1See moreABSTRACT
Objectives:
to understand how fake news has influenced adherence to Covid-19 immunization, from the perspective of health professionals.
Methods:
a qualitative, descriptive-exploratory study was conducted in Campo Grande – MS. Twenty nursing professionals working in vaccine rooms or managing immunobiologicals participated through semi-structured interviews. The interviews were audio-recorded, fully transcribed, and subjected to thematic content analysis.
Results:
two categories emerged in which the professionals highlighted an increase in vaccine hesitancy among the population, influenced by fake news and denialist actions, which negatively interfered with the population’s trust in vaccines and in the professionals administering them.
Final Considerations:
concerns about vaccine safety and denialist actions by authorities and media outlets can contribute to the phenomenon of non-vaccination. The valorization of science, the promotion of educational actions, and raising public awareness about immunization were presented as strategies to increase vaccine coverage
- Luana Cristina Roberto Borges
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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for assessing leprosy care in children and adolescents
- Gutembergue Santos de Sousa ,
- Isael Marcos Silva Mendonça ,
- Lia Hanna Martins Morita ,
- Denise da Costa Boamorte Cortela ,
- Pãmela Rodrigues de Souza Silva , [ … ],
- Silvana Margarida Benevides Ferreira
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
- Gutembergue Santos de Sousa ,
- Isael Marcos Silva Mendonça ,
- Lia Hanna Martins Morita ,
- Denise da Costa Boamorte Cortela ,
- Pãmela Rodrigues de Souza Silva ,
- Silvana Margarida Benevides Ferreira
Views1See 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.
- Gutembergue Santos de Sousa
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ORIGINAL ARTICLE09-06-2024
Middle-Range theory of the nursing diagnosis of sedentary lifestyle in young adults
- Renata Marinho Fernandes ,
- Ana Carolina Costa Carino ,
- Anna Thays Dias Almeida ,
- Maria Isabel da Conceição Dias Fernandes ,
- Sâmella Karine de Macêdo Leopoldino , [ … ],
- Ana Luisa Brandão de Carvalho Lira
Abstract
ORIGINAL ARTICLEMiddle-Range theory of the nursing diagnosis of sedentary lifestyle in young adults
Revista Brasileira de Enfermagem. 2024;77(4):e20230516
DOI 10.1590/0034-7167-2023-0516
- Renata Marinho Fernandes ,
- Ana Carolina Costa Carino ,
- Anna Thays Dias Almeida ,
- Maria Isabel da Conceição Dias Fernandes ,
- Sâmella Karine de Macêdo Leopoldino ,
- Camila Sayonara Tavares Gomes ,
- Ana Raquel Cortês Nelson ,
- Ana Luisa Brandão de Carvalho Lira
Views1See moreABSTRACT
Objective:
To construct a middle-range theory for the nursing diagnosis of Sedentary Lifestyle in young adults.
Methods:
A methodological study for the validation of a nursing diagnosis based on a Middle-Range Theory, carried out in six stages: definition of the approach; definition of theoretical-conceptual models; definition of main concepts; development of a pictorial scheme; construction of propositions; establishment of causal relationships and evidence for practice. The theory construction was operationalized through an integrative review and supported by Roy’s adaptation model.
Results:
Three essential attributes were identified; 10 antecedents; 7 clinical consequences; a pictogram, 9 propositions, and 11 causal relationships and evidence for practice.
Conclusion:
The middle-range theory for the nursing diagnosis of Sedentary Lifestyle in young adults was constructed, expanding the understanding of this phenomenon, to be applied in clinical practice by nurses.
- Renata Marinho Fernandes
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REVIEW11-22-2024
Transition to family parenting in the face of the first child: a scoping review
- Maria Isabel Ventura Araújo ,
- Alberto Carlos Marques Duarte ,
- Maria Henriqueta de Jesus Silva Figueiredo ,
- Carmen Maria da Silva Maciel Andrade
Abstract
REVIEWTransition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
DOI 10.1590/0034-7167-2023-0487
- Maria Isabel Ventura Araújo ,
- Alberto Carlos Marques Duarte ,
- Maria Henriqueta de Jesus Silva Figueiredo ,
- Carmen Maria da Silva Maciel Andrade
Views1See moreABSTRACT
Objectives:
to identify and summarize the elements that characterize the family transition process in relation to the first child.
Methods:
a scoping review was carried out based on JBI methodology, in six databases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results:
ten articles were included with factors characterizing the transition, such as hindering/facilitating conditions that influence the process, important support structures in adaptation and strategies/responses used in the transition process.
Final Considerations:
elements characterizing the transition process in relation to the first child were identified. However, no theoretical explanation for this was identified. Further research should be carried out to obtain a deeper understanding of this process.
- Maria Isabel Ventura Araújo
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