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REVIEW
Nursing theories in the care of stroke patients: a scoping review
Revista Brasileira de Enfermagem. 2023;76(5):e20220791
10-06-2023
Abstract
REVIEWNursing theories in the care of stroke patients: a scoping review
Revista Brasileira de Enfermagem. 2023;76(5):e20220791
10-06-2023DOI 10.1590/0034-7167-2022-0791
Views0See moreABSTRACT
Objectives:
to map and synthesize nursing theories and conceptual frameworks that have been applied in the practice of nursing care for stroke patients in hospital settings.
Methods:
a scoping review was conducted in October 2022 using the MEDLINE (accessed via PubMed), CINAHL, Scielo, and Web of Science databases, following The Joanna Briggs Institute guidelines.
Results:
nine studies incorporated six nursing theories and three conceptual frameworks, which were employed to enhance stroke patient care. The objective of these theories and conceptual frameworks was to facilitate the identification of the patient’s psychobiological, psychosocial, and psychospiritual needs, elucidate the nurse’s role and expand their perspective on rehabilitation, and acknowledge the survivor’s process of transition.
Final Considerations:
this mapping exercise identified major nursing theories, middle-range theories, and conceptual frameworks applied to the care of stroke patients.
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ORIGINAL ARTICLE
Learning strategies of undergraduate nursing students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(5):e20220764
10-06-2023
Abstract
ORIGINAL ARTICLELearning strategies of undergraduate nursing students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(5):e20220764
10-06-2023DOI 10.1590/0034-7167-2022-0764
Views0See moreABSTRACT
Objectives:
to analyze the learning strategies used by nursing students from a public university, in remote teaching, during the COVID-19 pandemic.
Methods:
a cross-sectional study developed with nursing students who attended remote teaching classes. The sample was obtained by convenience and data were collected online, with 112 participants. Student and Mann-Whitney tests were performed for data analysis.
Results:
the most frequently used learning strategies were self-regulatory and cognitive. There was moderate use of interpersonal help-seeking and emotional control strategies. Male students, with a private study environment and good internet connection, used emotional control strategies more frequently.
Conclusions:
self-regulatory and cognitive learning strategies, appropriate for higher education, were frequently used by nursing students, which is an important tool for adapting these students to the university context.
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Advanced Practice Nursing: “Training” Pillar in Supporting the Proposal in Brazil
Revista Brasileira de Enfermagem. 2023;76(5):e20230118
10-06-2023
Abstract
Advanced Practice Nursing: “Training” Pillar in Supporting the Proposal in Brazil
Revista Brasileira de Enfermagem. 2023;76(5):e20230118
10-06-2023DOI 10.1590/0034-7167-2023-0118
Views0ABSTRACT
Objectives:
to present the pillars that support what has been called Advanced Practice Nursing and discuss the necessary training for its implementation.
Methods:
elements contained in assessment documents for graduate programs proposals, reports of presentations by international professors in countries and selected scientific publications were gathered to compose the argument.
Results:
practice/competency (adds broad and in-depth knowledge about health processes and scientific evidence, clinical reasoning and clinical skills for therapeutic indications); 3) professional regulation (corresponding legislation and monitoring); and 4) funding (broad training and professional practice policy).
Final Considerations:
the agenda for implementing Advanced Practice Nursing in Brazil involves joining efforts to identify stakeholders for a work to legitimize their importance in the country’s health and education overview.
Keywords:Advanced Practice NursingEducationGraduateHealth Postgraduate ProgramsNursingNursing EducationPublic PolicySee more -
EDITORIAL
Translational Health Research: where are we going?
Revista Brasileira de Enfermagem. 2023;76(5):e760501
10-06-2023
Abstract
EDITORIALTranslational Health Research: where are we going?
Revista Brasileira de Enfermagem. 2023;76(5):e760501
10-06-2023DOI 10.1590/0034-7167.2023760501
Views0The contributions of scientific research are undeniable for the advancement of science and for society. Therefore, more and more reflections on the impacts and applicability of studies have permeated the center of discussions at a global level, especially considering the growing increase in knowledge production. In this scenario, research translation (RT) has a notable importance […]See more -
ORIGINAL ARTICLE
Nursing, history, and orthopedics in manuals (1875-1928)
Revista Brasileira de Enfermagem. 2023;76(5):e20220567
10-06-2023
Abstract
ORIGINAL ARTICLENursing, history, and orthopedics in manuals (1875-1928)
Revista Brasileira de Enfermagem. 2023;76(5):e20220567
10-06-2023DOI 10.1590/0034-7167-2022-0567
Views0See moreABSTRACT
Objectives:
to discuss the content of manuals, with emphasis on orthopedics, in support of the development of nursing care culture.
Methods:
cultural-historical method articulated with document analysis technique. The sources were nursing manuals – Portuguese, French, English, and Spanish – from 1875 to 1928.
Results:
this study pointed to 12 works – 6 authored by physicians, 2 by nurses, 3 institutional, and 1 by a Sister of Charity – that presented, in a transversal way, the professionalization process initiated in Europe. The manuals addressed first aid care and immobilization methods, from the simplest, such as improvised splints, to the application of plaster casts.
Conclusions:
the nurses’ work, even in a limited capacity, showed that they were able to observe warning signs so that doctors could act, with some exceptions.
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ORIGINAL ARTICLE
Evidências do cuidado centrado no paciente no contexto da prática profissional de saúde brasileira
Revista Brasileira de Enfermagem. 2023;76(5):e20220448
10-06-2023
Abstract
ORIGINAL ARTICLEEvidências do cuidado centrado no paciente no contexto da prática profissional de saúde brasileira
Revista Brasileira de Enfermagem. 2023;76(5):e20220448
10-06-2023DOI 10.1590/0034-7167-2022-0448
Views0RESUMEN
Objetivos:
analizar las actitudes centradas en el paciente en el cuidado y compartir prácticas de profesionales de enfermería, logopedia, odontología y medicina.
Métodos:
se utilizó una investigación transversal con 411 profesionales, y como medida de resultado se aplicó el instrumento Patient-Practitioner Orientation Scale.
Resultados:
los médicos presentaron puntuaciones medias más altas, lo que refleja una orientación centrada en el paciente, control compartido y enfoque en la persona, con diferencia estadística para todos los dominios (p<0,02). Los odontólogos fueron los profesionales que presentaron puntajes más bajos, especialmente en el dominio compartir, con diferencia estadística en relación a los enfermeros, logopedas y médicos (p<0,05).
Conclusiones:
finalmente, las actitudes de los profesionales de las áreas de salud estudiadas indicaron preferencia autorreferida por la centralidad en los pacientes. En este contexto, el cuidado centrado en el paciente puede ser un recurso importante en el cuidado de la salud cuando se apuesta por la superación del objeto hombre.
Keywords:Assistência Centrada no PacienteCuidado Centrado no PacientePessoal de SaúdePrática ProfissionalProfissional de SaúdeSee more -
ORIGINAL ARTICLE
Perception of graduates about the education of Nursing Technicians
Revista Brasileira de Enfermagem. 2023;76(5):e20220325
10-06-2023
Abstract
ORIGINAL ARTICLEPerception of graduates about the education of Nursing Technicians
Revista Brasileira de Enfermagem. 2023;76(5):e20220325
10-06-2023DOI 10.1590/0034-7167-2022-0325
Views0ABSTRACT
Objectives:
to interpret the perception of graduates from the nursing technician program on the learning process developed during their education.
Methods:
a qualitative study was conducted from March to September 2021, based on interviews with 20 graduates from a nursing technician program at a school in the Midwest of São Paulo, using thematic analysis and the NVivo tool.
Results:
the following themes were identified: traditional teaching methods, active learning strategies, valuing proactivity and experiences in professional practice.
Final Considerations:
according to the graduates, the teaching process is essentially based on traditional methods, although there are initiatives to implement active strategies and recognition of the importance of advancing student proactivity and practical experience.
Keywords:AssociateEducationEducation, NursingHealth Human Resource TrainingLearningProfessional TrainingSee more -
EDITORIAL
Pesquisa Translacional em Saúde: para onde vamos?
Revista Brasileira de Enfermagem. 2023;76(5):e760501
10-06-2023
Abstract
EDITORIALPesquisa Translacional em Saúde: para onde vamos?
Revista Brasileira de Enfermagem. 2023;76(5):e760501
10-06-2023DOI 10.1590/0034-7167.2023760501pt
Views0Os contributos das pesquisas científicas são incontestáveis para o avanço da ciência e para a sociedade. Por isso, cada vez mais reflexões acerca dos impactos e da aplicabilidade dos estudos têm permeado o centro das discussões em nível global, sobretudo diante do aumento crescente da produção de conhecimentos. Nesse cenário, a translação da pesquisa (TP) […]See more
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ORIGINAL ARTICLE
Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
05-28-2021
Abstract
ORIGINAL ARTICLEManaged clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
05-28-2021DOI 10.1590/0034-7167-2020-0282
Views1See moreABSTRACT
Objectives:
to assess the impact of the implementation of a managed sepsis protocol on quality indicators of treatment for septic patients in an emergency department of a university hospital.
Methods:
an observational epidemiological study involving septic patients. The study was divided into two phases, pre-intervention and intervention, resulting from the implementation of the managed sepsis protocol. The study variables included sepsis treatment quality indicators. The results were statistically analyzed using the program Epi InfoTM.
Results:
the study sample included 631 patients, 95 from pre-intervention phase and 536 from intervention phases. Implementing the protocol increased patients’ chances of receiving the recommended treatment by 14 times. Implementing the protocol reduced the hospitalization period by 6 days (p <0.001) and decreased mortality (p <0.001).
Conclusions:
this study showed that implementing the managed protocol had an impact on the improvement of sepsis treatment quality indicators.
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ORIGINAL ARTICLE
Development of an appearance validity instrument for educational technology in health
Revista Brasileira de Enfermagem. 2020;73:e20190559
12-21-2020
Abstract
ORIGINAL ARTICLEDevelopment of an appearance validity instrument for educational technology in health
Revista Brasileira de Enfermagem. 2020;73:e20190559
12-21-2020DOI 10.1590/0034-7167-2019-0559
Views1ABSTRACT
Objectives:
to develop and evaluate the convergence of the instrument for the appearance validity of educational technologies in health.
Methods:
methodological study conducted in two steps. In step 1, the instrument items were developed, with subsequent content validity by nine specialists in the development of educational technologies in health. In step 2, the convergent validity between another instrument and the appearance instrument was performed. Correlation results above r> 0.3 and p <0.05 were considered as plausible convergent validity.
Results:
the ten items of the initial version of the appearance instrument were submitted to content validity that resulted in a final version with 12 items (Content Validity Index = 0.93). The correlation indexes were strong with the objective and appearance domains; moderate with motivation, organization and total; and weak with writing style.
Conclusions:
the appearance instrument demonstrated content validity and convergent validity, in addition to a strong correlation with the other instrument.
Keywords:Educational TechnologyHealth EducationMethodological Research in NursingTechnological DevelopmentValidation StudiesSee more -
REVIEW
Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
09-21-2020
Abstract
REVIEWMiddle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
09-21-2020DOI 10.1590/0034-7167-2019-0334
Views1See moreABSTRACT
Objective:
To stablish a middle range theory for the understanding of the causal mechanisms and clinical consequentes of the nursing diagnosis Excess Fluid Volume (00026) among pregnant women.
Method:
The Middle Range Theory was constructed in five stages: defining of construction approach, establishing main concepts, elaborating propositions, developing a pictorial diagram, and establishing the causal relationships and evidence for practice of the Middle Range Theory.
Results:
We identified 14 clinical indicators and 6 causal factors of Excess Fluid Volume. A pictorial diagram was developed and relationships between Excess Fluid Volume elements were established with 6 propositions for them.
Conclusion:
The Middle Range Theory included both physiological and pathological conditions to explain Excess Fluid Volume. This Middle Range Theory might help in the better understanding of interactions between causal factors and clinical indicators of Excess Fluid Volume.
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ORIGINAL ARTICLE
Nurses’ work process in an emergency hospital service
Revista Brasileira de Enfermagem. 2020;73(5):e20180923
07-06-2020
Abstract
ORIGINAL ARTICLENurses’ work process in an emergency hospital service
Revista Brasileira de Enfermagem. 2020;73(5):e20180923
07-06-2020DOI 10.1590/0034-7167-2018-0923
Views1ABSTRACT
Objectives:
to analyze the nurses’ work process in an Emergency Hospital Service.
Methods:
a qualitative, exploratory and descriptive research conducted with 17 nurses from the emergency service of a high complexity hospital in southern Brazil. Data were collected through interviews, focus group and document analysis. Data analysis followed the thematic content analysis framework.
Results:
four categories emerged: Work environment characteristics; Assistance dimension; Management dimension; Care management.
Final Considerations:
the nurses’ work process in Emergency Hospital Service is characterized by the peculiarities of the setting, with centrality in care and care management aiming at quality care and safety to patients.
Keywords:Emergency NursingEmergency Service, HospitalHealth ManagementNurse's RoleProfessional PracticeSee more -
ORIGINAL ARTICLE
Quality of life at work in a central sterile processing department
Revista Brasileira de Enfermagem. 2020;73(2):e20180792
03-09-2020
Abstract
ORIGINAL ARTICLEQuality of life at work in a central sterile processing department
Revista Brasileira de Enfermagem. 2020;73(2):e20180792
03-09-2020DOI 10.1590/0034-7167-2018-0792
Views1See moreABSTRACT
Objectives:
to evaluate the quality of life of nursing professionals who work in a central sterile processing department.
Methods:
a descriptive, quantitative, exploratory study, conducted with 82 nursing professionals working in the Central Sterile Processing Department of a University Hospital, from September to November 2017. A semi-structured instrument and the questionnaire “Medical Outcomes Study Short-Form 36” were used. Results: most of the participants were female, married, aged 31-40 years; 47.6% with 6-10 years of profession, and 82.9% reported working in CSPD for 1-5 years. The most affected quality of life domains were Pain, Vitality, General Health Status and Social Aspects.
Conclusions:
This study showed a need for rethinking and re-creating the labor dynamics in CSPD to improve the quality of life of these nursing professionals.
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ORIGINAL ARTICLE
Care complexity in hospitalized elderly according to cognitive performance
Revista Brasileira de Enfermagem. 2019;72:134-139
12-05-2019
Abstract
ORIGINAL ARTICLECare complexity in hospitalized elderly according to cognitive performance
Revista Brasileira de Enfermagem. 2019;72:134-139
12-05-2019DOI 10.1590/0034-7167-2018-0357
Views1See moreABSTRACT
Objective:
to investigate possible differences in care complexity, functional performance and biopsychosocial and health system aspects among hospitalized elderly with or without cognitive decline.
Method:
quantitative, cross-sectional and analytical study in which was used the INTERMED method and cognitive and functional screening scales. We investigated 384 elderly patients admitted to a medical and surgical clinic of a University Hospital located in São Paulo/SP.
Results:
cognitive decline was present in 40.1% of the sample, most of them were longer-lived elderly individuals with less schooling and income, more dependent in activities of daily living and had greater vulnerability in different domains of INTERMED. After adjustments, the elderly with cognitive decline presented greater vulnerability in the psychological domain.
Conclusion:
the relationship between cognitive decline and psychological vulnerability highlights the need to adopt long-term care based on involvement of the family, health team and different services, thereby maximizing the quality of care.
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ORIGINAL ARTICLE
Spatial analysis on tuberculosis and the network of primary health care
Revista Brasileira de Enfermagem. 2019;72(5):1197-1202
09-16-2019
Abstract
ORIGINAL ARTICLESpatial analysis on tuberculosis and the network of primary health care
Revista Brasileira de Enfermagem. 2019;72(5):1197-1202
09-16-2019DOI 10.1590/0034-7167-2017-0897
Views1See moreABSTRACT
Objective:
to analyze the spatial distribution of new cases of tuberculosis compared to the location of the Primary Healthcare Units that performed the compulsory notification.
Method:
ecological study conducted in Belém, Pará, with 5,294 new cases of tuberculosis notified to Sistema de Informação de Agravos de Notificação for the period from 2010 to 2014. The cases were georeferenced using the software applications ArcGis 10.2 and TerraView 4.2.2. The techniques of Kernel density and global Moran geostatistics were used.
Results:
the incidence of tuberculosis cases did not vary significantly between the years studied, however there was a variation in incidence between neighborhoods. Health units that exhibited higher number of notifications can suffer great influence of migration from nearby neighborhoods.
Conclusion:
the spatial dynamics of tuberculosis associated with health services allows to know the areas with increased risk of tuberculosis and the density of notifications of health units.
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EXPERIENCE REPORT
Implementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
04-09-2020
Abstract
EXPERIENCE REPORTImplementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
04-09-2020DOI 10.1590/0034-7167-2018-0421
Views0See moreABSTRACT
Objectives:
to present the nurses’ experience with technological tools to support the early identification of sepsis.
Methods:
experience report before and after the implementation of artificial intelligence algorithms in the clinical practice of a philanthropic hospital, in the first half of 2018.
Results:
describe the motivation for the creation and use of the algorithm; the role of the nurse in the development and implementation of this technology and its effects on the nursing work process.
Final Considerations:
technological innovations need to contribute to the improvement of professional practices in health. Thus, nurses must recognize their role in all stages of this process, in order to guarantee safe, effective and patient-centered care. In the case presented, the participation of the nurses in the technology incorporation process enables a rapid decision-making in the early identification of sepsis.
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ORIGINAL ARTICLE
Caring for the carer: quality of life and burden of female caregivers
Revista Brasileira de Enfermagem. 2019;72(3):728-736
06-27-2019
Abstract
ORIGINAL ARTICLECaring for the carer: quality of life and burden of female caregivers
Revista Brasileira de Enfermagem. 2019;72(3):728-736
06-27-2019DOI 10.1590/0034-7167-2018-0334
Views0See moreABSTRACT
Objective:
To assess the quality of life and the burden of female caregivers.
Method:
Descriptive, cross-sectional, quantitative study carried out with 224 informal caregivers from March to July 2016. Three instruments were used: a characterization form for the caregiver, the WHOQOL-Bref questionnaire and the Zarit Burden Interview. The following tests were used: Cronbach’s Alpha, Kolmogorov-Smirnov, Kruskal-Wallis, Spearman and Mann-Whitney.
Results:
The mean age of caregivers was 51.8 years with a standard deviation of 13.7. They were predominantly married, had a low income and low level of education, were first-degree relatives, had been providing care for one to five years and presented some pathology. The associations of quality of life that presented statistical significance were: income, marital status, number of people living with the caregiver and time of care.
Conclusion:
The burden was negatively correlated with QOL, that is, the greater the burden, the more impaired will be the life of these caregivers.
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REVIEW
Development of clinical competence in nursing in simulation: the perspective of Bloom’s taxonomy
Revista Brasileira de Enfermagem. 2021;74(1):e20200135
03-24-2021
Abstract
REVIEWDevelopment of clinical competence in nursing in simulation: the perspective of Bloom’s taxonomy
Revista Brasileira de Enfermagem. 2021;74(1):e20200135
03-24-2021DOI 10.1590/0034-7167-2020-0135
Views0See moreABSTRACT
Objectives:
to investigate the scientific evidence on the use of Bloom’s taxonomy for developing competence in nursing professionals and students in clinical simulation.
Methods:
integrative review of the National Library of Medicine (NLM), National Institutes of Health (NIH), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Web of Science and SCOPUS databases, using the Rayyan application.
Results:
a total of 871 studies were identified; four composed the sample. The development of clinical competence occurred through the coordination of knowledge, skills, and attitudes. To develop the cognitive domain, the objectives of knowledge and comprehension of the Bloom’s taxonomy were mobilized. The psychomotor domain required development of the skills demanded by the proposed clinical care. The affective domain was developed through will and motivation to learn.
Conclusions:
it is possible to develop clinical competence in nursing by adopting Bloom’s taxonomy in each phase of clinical simulation.
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ORIGINAL ARTICLE
Package of menthol measures for thirst relief: a randomized clinical study
Revista Brasileira de Enfermagem. 2019;72(3):600-608
06-27-2019
Abstract
ORIGINAL ARTICLEPackage of menthol measures for thirst relief: a randomized clinical study
Revista Brasileira de Enfermagem. 2019;72(3):600-608
06-27-2019DOI 10.1590/0034-7167-2018-0057
Views0See moreABSTRACT
Objective:
To evaluate the effectiveness of the menthol package (lip hydration and ice popsicles) compared to a package of non-menthol measures (lip hydration and ice popsicles) as a way to relieve thirst in patients in the Anesthetic Recovery Room.
Method:
Randomized and parallel trial study, with 120 patients randomized patients in an experimental group – menthol measurements (n=59) and control group – measures without menthol (n = 61).
Results:
There was a significant (p<0.05) decrease in intensity, hydration, dryness and taste in the oral cavity between the three moments of assessment/intervention in the two groups. The difference was significant in the experimental group for thirst intensity at the second assessment/intervention point (p<0.05) after a single administration of the menthol package.
Conclusion:
There was a reduction in thirst intensity in both groups. Patients who received menthol packages showed a significant decrease in intensity after a single evaluation/intervention time. NCT: 02869139.
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EDITORIAL
Coronavirus 2020
Revista Brasileira de Enfermagem. 2020;73(2):e2020n2
03-27-2020
Abstract
EDITORIALCoronavirus 2020
Revista Brasileira de Enfermagem. 2020;73(2):e2020n2
03-27-2020DOI 10.1590/0034-7167-2020730201
Views0Emerging and reemerging infectious diseases are constant challenges for public health worldwide. Recent cases of pneumonia of unknown cause in Wuhan, China, have led to the discovery of a new type of Coronavirus (2019-nCoV), which are enveloped RNA viruses, commonly found in humans, other mammals and birds, capable of causing respiratory, enteric, hepatic, and neurological […]See more -
ORIGINAL ARTICLE
Pressure injury related to the use of personal protective equipment in COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200670
12-04-2020
Abstract
ORIGINAL ARTICLEPressure injury related to the use of personal protective equipment in COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200670
12-04-2020DOI 10.1590/0034-7167-2020-0670
Views0See moreABSTRACT
Objective:
To describe the prevalence and factors associated with pressure injuries related to the use of personal protective equipment during the COVID-19 pandemic.
Methods:
Cross-sectional study conducted using an instrument made available in social networks with 1,106 health professionals. The data were analyzed using descriptive statistics and compared, considering pvalue < 0.05.
Results:
There was a prevalence of 69.4% for pressure injuries related to the use of personal protective equipment, with an average of 2.4 injuries per professional. The significant factors were: under 35 years of age, working and wearing personal protective equipment for more than six hours a day, in hospital units, and without the use of inputs for protection.
Conclusion:
Pressure injuries related to the use of medical devices showed a high prevalence in this population. The recognition of the damage in these professionals makes it possible to advance in prevention strategies.
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ORIGINAL ARTICLE
Accessibility of children with special health needs to the health care network
Revista Brasileira de Enfermagem. 2019;72:65-71
12-13-2019
Abstract
ORIGINAL ARTICLEAccessibility of children with special health needs to the health care network
Revista Brasileira de Enfermagem. 2019;72:65-71
12-13-2019DOI 10.1590/0034-7167-2017-0899
Views0See moreABSTRACT
Objective:
To know how children with special health needs access the health care network.
Method:
This is a qualitative research of descriptive-exploratory type, developed using semi-structured interviews mediated by the Talking Map design. Participants were 19 family caregivers of these children in two Brazilian municipalities. Data were submitted to inductive thematic analysis.
Results:
Difficulties were mentioned from the diagnosis moment to the specialized follow-up, something represented by the itinerary of the c hild and his/her family in the search for the definition of the medical diagnosis and the access to a specialized professional; a gap between the children’s needs and the care offered was observed in primary health care.
Conclusion:
The access of children with special health needs is filled with obstacles such as slowness in the process of defining the child’s diagnosis and referral to a specialist. Primary health care services were replaced by care in emergency care units.
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