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Stimulus-response time to alarms of the intra-aortic balloon pump: safe care practices
Revista Brasileira de Enfermagem. 2017;70(6):1206-1211
Abstract
Stimulus-response time to alarms of the intra-aortic balloon pump: safe care practices
Revista Brasileira de Enfermagem. 2017;70(6):1206-1211
DOI 10.1590/0034-7167-2016-0432
Views0See moreABSTRACT
Objective:
To characterize the sound alarms of the Intra-Aortic Balloon Pump (IABP) during aortic counterpulsation therapy; to measure the stimulus-response time of the team to these; and to discuss the implications of increasing this time for patient safety from the alarm fatigue perspective.
Method:
This is an observational and descriptive study with quantitative and qualitative approach, case study type, carried out in a Cardiac Surgical Intensive Care Unit.
Results:
The most audible IABP alarm was the one of high priority increased-reduced diastolic blood pressure. The stimulus-response time was 33.9 seconds on average.
Conclusion:
Managing the alarms of these equipment is essential to minimize the occurrence of the alarm fatigue phenomenon and to offer a safer assistance to patients who rely on this technology.
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Possibilities of care for serodiscordant couples for HIV who got pregnant
Revista Brasileira de Enfermagem. 2017;70(6):1199-1205
Abstract
Possibilities of care for serodiscordant couples for HIV who got pregnant
Revista Brasileira de Enfermagem. 2017;70(6):1199-1205
DOI 10.1590/0034-7167-2016-0344
Views0See moreABSTRACT
Objective:
Understanding the meaning of pregnancy for heterosexual couples facing serodiscordant situation for HIV, aiming at construction of care possibilities based on subjectivity.
Method:
Phenomenological research, theoretical-philosophical-methodological framework by Martin Heidegger. Research was conducted in a University Hospital in the countryside of Southern Brazil, from September 2013 to May 2014 through a phenomenological interview, with participation of eleven couples.
Results:
For the couples, pregnancy is part of life when they wish to have a child, even when one or both of them already have children from previous relationships. In addition, it is part of life when they consider the risks and do not want to have children in such circumstances anymore, but it happened unexpectedly.
Conclusion:
Understanding reproductive needs and demands of these couples is an aid for qualification and improvement of care as a contribution to nursing care planning towards reproductive health of these couples.
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Interactive Theory of Breastfeeding: creation and application of a middle-range theory
Revista Brasileira de Enfermagem. 2017;70(6):1191-1198
Abstract
Interactive Theory of Breastfeeding: creation and application of a middle-range theory
Revista Brasileira de Enfermagem. 2017;70(6):1191-1198
DOI 10.1590/0034-7167-2016-0523
Views0See moreABSTRACT
Objective:
To describe a breastfeeding theory based on King’s Conceptual System.
Method:
Theoretical study that used analysis of concept, assertion synthesis, and derivation of theory for the creation of a new theory.
Results:
King’s system components were associated with elements of the breastfeeding process and a middle-range theory was created, which describes, explains, predicts, and prescribes breastfeeding by analyzing factors that precede and affect it, as well as their consequences on the breastfeeding process.
Conclusion:
The Breastfeeding Interactive Model is abstract enough to be applied in different social, cultural, political, and economic contexts, because it conceptualizes breastfeeding in systemic, dynamic, and procedural aspects. Based on a conceptual model of nursing, it contributes to the scientific construction of the subject; however it can also potentially be applied by other professionals involved in breastfeeding assistance.
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Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods
Revista Brasileira de Enfermagem. 2017;70(6):1176-1183
Abstract
Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods
Revista Brasileira de Enfermagem. 2017;70(6):1176-1183
DOI 10.1590/0034-7167-2016-0608
Views0ABSTRACT
Objective:
to assess the correlation among the ATP-bioluminescence assay, visual inspection and microbiological culture in monitoring the efficiency of cleaning and disinfection (C&D) of high-touch clinical surfaces (HTCS) in a walk-in emergency care unit.
Method:
a prospective and comparative study was carried out from March to June 2015, in which five HTCS were sampled before and after C&D by means of the three methods. The HTCS were considered dirty when dust, waste, humidity and stains were detected in visual inspection; when ≥2.5 colony forming units per cm2 were found in culture; when ≥5 relative light units per cm2 were found at the ATP-bioluminescence assay.
Results:
720 analyses were performed, 240 per method. The overall rates of clean surfaces per visual inspection, culture and ATP-bioluminescence assay were 8.3%, 20.8% and 44.2% before C&D, and 92.5%, 50% and 84.2% after C&D, respectively (p<0.001). There were only occasional statistically significant relationships between methods.
Conclusion:
the methods did not present a good correlation, neither quantitative nor qualitatively.
Keywords:Equipment ContaminationHealth Facility EnvironmentHousekeepingInfectious Disease TransmissionNursing AuditSee more -
Cultural adaptation of The End-Stage Renal Disease Adherence Questionnaire for hemodialysis patients
Revista Brasileira de Enfermagem. 2017;70(6):1169-1175
Abstract
Cultural adaptation of The End-Stage Renal Disease Adherence Questionnaire for hemodialysis patients
Revista Brasileira de Enfermagem. 2017;70(6):1169-1175
DOI 10.1590/0034-7167-2016-0519
Views0ABSTRACT
Objective:
To describe the stages in the cultural adaptation of “The End-Stage Renal Disease Adherence Questionnaire” for use in Brazil.
Method:
A descriptive, transversal study with a quantitative approach. The cultural adaptation followed the steps of translation, professional committee, back translation, panel of patients and pretest.
Results:
the translation stage created a version in Portuguese that was analyzed by specialists, who suggested alterations in the title, seven sentences in the questions and three sets of answers. In the panel of patients phase, two questions were altered. The back translation considered the original characteristics of the instrument were maintained, likewise there were no modifications in the pretest phase. The third version written in Portuguese was considered to be the final version of the questionnaire.
Conclusion:
this instrument should facilitate nursing care management in hemodialysis, enabling the monitoring of adherence among these patients and also contribute to improving the indicators of morbidity and mortality.
Keywords:Adherence to MedicationChronic Renal InsufficiencyHemodialysisNephrology NursingPatient CooperationSee more -
Revalidation of game for teaching blood pressure auscultatory measurement: a pilot study
Revista Brasileira de Enfermagem. 2017;70(6):1159-1168
Abstract
Revalidation of game for teaching blood pressure auscultatory measurement: a pilot study
Revista Brasileira de Enfermagem. 2017;70(6):1159-1168
DOI 10.1590/0034-7167-2016-0578
Views0ABSTRACT
Objective:
To adapt a pre-existing educational game, making it specific to the teaching of blood pressure auscultatory measurement, and to apply this game in a pilot study.
Method:
The original game cards were altered by the authors and submitted to content validation by six experts in the field. After redesigns, the game was applied to 30 subjects, who answered a questionnaire (pre-test and post-test) on auscultatory measurement. Data were analyzed descriptively and by the paired Student’s t-test and paired Wilcoxon test.
Results:
Throughout the content validation process, 17 of the 28 original cards were modified. Of these 17 cards, 13 obtained 80% agreement, and the rest were modified according to the judges’ suggestions. The obtained grades significantly increased between pre- and the post-test.
Conclusion:
It was concluded that the reformulated game presented satisfactory evidence of content validity. Its use as a teaching-learning method was effective for this sample.
Keywords:Determination of Blood PressureEducation in NursingEducational TechnologyExperimental GamesGames and ToysSee more -
Validation of Family Management Measure for the Brazilian culture
Revista Brasileira de Enfermagem. 2017;70(6):1151-1158
Abstract
Validation of Family Management Measure for the Brazilian culture
Revista Brasileira de Enfermagem. 2017;70(6):1151-1158
DOI 10.1590/0034-7167-2016-0326
Views0See moreABSTRACT
Etjective:
To validate the Family Management Measure (FaMM) for Brazilian culture.
Method:
Quantitative research excerpt, following the recommendations for validation studies. The data presented refer to the last stage of the process.
Results:
The internal consistency of the items was analyzed through Cronbach’s alpha of the six domains: Child’s Daily Life (0.78); Condition Management Effort (0.51); Condition Management Ability (0.55); Family Life Difficulty (0.86); View of Condition Impact (0.56); and Parental Mutuality (0.80). Exploratory factorial analysis of the instrument was carried out, obtaining an acceptable adjustment, according to validation standards.
Conclusion:
The FaMM presents evidence of validation and can be used in the Brazilian culture under the name of Instrumento de Medida de Manejo Familiar, which was adjusted in eight domains, providing varied aspects of family management and a good evaluation of the fundamental aspects of family life in the context of childhood chronic conditions.
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ORIGINAL ARTICLE01-10-2024
Childbirth dynamics in the riverside region of the Brazilian Amazon from the perspective of geospatialization
Revista Brasileira de Enfermagem. 2024;77:e20240038
Abstract
ORIGINAL ARTICLEChildbirth dynamics in the riverside region of the Brazilian Amazon from the perspective of geospatialization
Revista Brasileira de Enfermagem. 2024;77:e20240038
DOI 10.1590/0034-7167-2024-0038
Views0See moreABSTRACT
Objective:
to analyze the spatial-temporal pattern of childbirths and flow of postpartum women assisted at a regional reference maternity hospital.
Methods:
ecological study of 4,081 childbirths, between September 2018 and December 2021, at a public maternity hospital in the Baixo Tocantins region, Pará, Brazil. With data collected from five sources, a geographic database was constructed, and spatial analysis was used with Kernel density interpolator. Maps were generated using QGis/3.5 and TerraView/4.3, calculating chi-square (p<0.05).
Results:
the highest concentrations of normal and cesarean childbirths were observed in Barcarena (n=2,558/62.68%), Abaetetuba (n=750/18.38%), Moju (n=363/8.89%) and Igarapé-Miri (n=219/5.37%). Among the municipalities in the region, ten had obstetric beds, totaling 210 beds. In this scenario, postpartum women traveled up to 288 km to reach the maternity hospital.
Conclusions:
long distances between certain municipalities of residence and maternity hospital, and low supply of obstetric beds, were identified as risk factors for unfavorable obstetric outcomes.
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REVIEW01-10-2024
Nurses’ practical contributions to improving healthy and sustainable public spaces: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240023
Abstract
REVIEWNurses’ practical contributions to improving healthy and sustainable public spaces: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240023
DOI 10.1590/0034-7167-2024-0023
Views0ABSTRACT
Objective:
to identify knowledge production about nurses’ contributions to improving healthy and sustainable public spaces.
Methods:
an integrative review carried out in February 2023 in electronic databases. Studies that answered the research question and that were available in full, in Portuguese, English and Spanish, were included.
Results:
a total of five articles were selected. The findings highlighted the importance of educational projects in the training of local managers and community autonomy; citizen participation and health promotion as ways to implement Sustainable Development Goal 11; nurses as facilitators of collective care; new health practices and modes of producing subjectivity; and use of public transportation, bicycles and/or walking in these spaces.
Final considerations:
there is a clear need for greater incentives from local governments to develop effective sustainability strategies that are led by nurses and the community.
Keywords:AttitudesCommunity HealthHealth KnowledgeHealthy Lifestyle, NursesNursesPracticeSustainable DevelopmentSee more -
ORIGINAL ARTICLE01-10-2024
Pain management in hospitalized infants: recommendations for achieving the Sustainable Development Goals
Revista Brasileira de Enfermagem. 2024;77:e20230421
Abstract
ORIGINAL ARTICLEPain management in hospitalized infants: recommendations for achieving the Sustainable Development Goals
Revista Brasileira de Enfermagem. 2024;77:e20230421
DOI 10.1590/0034-7167-2023-0421
Views1See moreABSTRACT
Objective:
to assess pain management in infants in a Neonatal Intensive Care Unit (NICU) and discuss its articulation with the Sustainable Development Goals, with a focus on promoting neonatal well-being.
Method:
a documentary study, retrospective in nature and quantitative approach, conducted in a NICU of a public hospital in Paraná, Brazil, between January and July 2022, with 386 medical records of infants, hospitalized for more than 24 hours, between 2019 and 2021. Data were subjected to descriptive and inferential analysis, considering p-value<0.05 as a statistical difference. National ethical guidelines were respected.
Results:
all infants underwent at least one painful procedure, but only 13.7% had documented pain. Pharmacological interventions, such as fentanyl (25.9%), and non-pharmacological interventions, such as breastfeeding encouragement (86%) were used. Only 2.8% were reassessed.
Conclusion:
there was a devaluation of neonatal pain management that may perpetuate neonatal well-being and sustainable development.
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LETTER TO THE EDITOR01-10-2024
Adherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
Abstract
LETTER TO THE EDITORAdherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
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LETTER TO THE EDITOR01-10-2024
Adherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
Abstract
LETTER TO THE EDITORAdherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
DOI 10.1590/0034-7167.202477Suppl101c
Views0Dear Dr Dulce Aparecida BarbosaEditor in Chief of the Revista Brasileira de Enfermagem[…]See more -
ORIGINAL ARTICLE01-10-2024
Clinical and epidemiological characteristics and outcomes of patients affected by COVID-19 in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2024;77:e20230527
Abstract
ORIGINAL ARTICLEClinical and epidemiological characteristics and outcomes of patients affected by COVID-19 in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2024;77:e20230527
DOI 10.1590/0034-7167-2023-0527
Views0See moreABSTRACT
Objective:
To understand the clinical and epidemiological characteristics, outcomes, and nursing care of adult patients affected by COVID-19 in the Intensive Care Unit.
Methods:
This is a quantitative, retrospective, and descriptive study. The study participants were clinical and epidemiological statistical reports. Variables analyzed included age, gender, race, comorbidities, signs and symptoms, length of hospital stay, use of mechanical ventilation, medications, infections, monitoring, invasive devices, positioning, diet, comfort, and clinical outcomes.
Results:
The majority of individuals were men, of white race, with a mean age of 63 years, hypertensive, diabetic, and obese. The average length of hospital stay was 16 days. Most required invasive mechanical ventilation, vasopressor drugs, sedoanalgesia, and neuromuscular blockers.
Conclusion:
Nursing care is related to monitoring, ventilation, medication administration, installation of devices, prone positioning, diet administration, and providing comfort.
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ORIGINAL ARTICLE01-10-2024
Morbidity and factors associated with frailty in post-COVID-19 elderly patients attended at a reference center
Revista Brasileira de Enfermagem. 2024;77:e20230454
Abstract
ORIGINAL ARTICLEMorbidity and factors associated with frailty in post-COVID-19 elderly patients attended at a reference center
Revista Brasileira de Enfermagem. 2024;77:e20230454
DOI 10.1590/0034-7167-2023-0454
Views0See moreABSTRACT
Objective:
To assess the morbidity profile and identify factors associated with frailty syndrome in post-COVID-19 elderly patients treated at the only Reference Center for Elderly Health Care in northern Minas Gerais.
Methods:
This is a case series study, utilizing the Clinical-Functional Vulnerability Index-20 (CFVI-20) and Comprehensive Geriatric Assessment (CGA) to characterize and evaluate the health condition of the group. To define the variables associated with frailty, a multivariate analysis was conducted.
Results:
The study included 204 elderly individuals, with a predominance of females (63.7%). The variables associated with frailty were cognitive impairment (OR: 2.95; 95% CI: 1.12-7.80; p=0.029), the presence of five or more comorbidities (OR: 11.55; 95% CI: 2.22-60.01; p=0.004), and impairment in instrumental activities of daily living (OR: 41.97; 95% CI: 5.47-321.93; p<0.001).
Conclusions:
The results of this study highlight the need for a well-established and prepared coordination of integrated care to meet the demands of the post-COVID-19 elderly population.
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ORIGINAL ARTICLE01-10-2024
Nursing care management strategies to address the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230254
Abstract
ORIGINAL ARTICLENursing care management strategies to address the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230254
DOI 10.1590/0034-7167-20230254
Views0See moreABSTRACT
Objective:
To characterize nursing care management strategies for addressing the COVID-19 pandemic.
Method:
A descriptive, qualitative study conducted with 22 nurse professionals at a University Hospital in Southern Brazil. Data collection through interviews in June and August 2021, analyzed according to Bardin’s Content Analysis and the theoretical framework of complex thinking.
Results:
The identified strategies were organized into four categories: Reorganization of health services; People management and emergency admission; Multiprofessional articulation; and Bedside nursing care.
Final Considerations:
Professional performance revealed a complex interplay between leadership and care management practices, even in the face of working condition restrictions, and were understood as crucial in the pandemic scenario.
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Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
Abstract
Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
DOI 10.1590/0034-7167.2015680320i
Views0See moreABSTRACT
Objective:
To analyze the perceptions of adolescent public school students about drugs.
Method:
Qualitative approach of focus groups with 16 adolescent students. The data collected were analyzed by means of content analysis, leading to the following categories: meaning of drugs; living with drug use; opinions, beliefs and attitudes toward drug use; and preventing drug abuse in adolescence.
Results:
The adolescent students know about some drugs, and associate their use with delinquent and criminal behavior. The students identifi ed factors that lead to drug abuse, such as easy access, use by family and friends, idleness, dropping out of school and the characteristic vulnerability of adolescence.
Conclusion:
the results point to the need for educational activities in the context of where the adolescents live, including school, community and family environments, to support and to minimize their vulnerability.
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Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
Abstract
Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
DOI 10.1590/0034-7167.2015680319i
Views0See moreABSTRACT
Objective:
to learn the infl uence of cognitive therapy at home, conducted by the caregivers of older people with Alzheimer’s Disease.
Method:
a case study was developed with fi ve older people with Alzheimer’s Disease and their caregivers. The stages of research development were: orientation with the caregivers; selection of older people and caregivers; approach of the study subjects at home; weekly meetings and reapplication of tests to follow up the cognitive function of the participants.
Results:
in three months it was possible to identify improved cognition, verifi ed by the result of the Mini-Mental State Examination (MMSE). The scores of the other tests (KATZ, LAWTON, CLOCK TEST and VFT) remained the same.
Conclusion:
this strategy can be considered a light technology of nursing care for older people with dementia. When providing this care with the support of a nurse, caregivers re feel less anxious and understand the disease better.
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Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
Abstract
Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
DOI 10.1590/0034-7167.2015680318i
Views0See moreABSTRACT
Objective:
to study anxiety and spirituality and the relationship between them in university students.
Method:
the State-Trait-Anxiety Inventory (STAI) and Pinto and Pais-Ribeiro Spirituality Scales were used for data collection.
Results:
six hundred and sixty-nine students participated in the study, of whom 91.5% had moderate and high levels of trait anxiety and 92.9% of state anxiety; 93.8% had high spirituality scores. The multiple linear regression test showed a signifi cant relationship between anxiety and the presence of physical discomfort, unusual body movements, and the need for treatment. Furthermore, higher levels of anxiety were associated with the female gender, the lack of leisure activities, and low levels of optimism in the spirituality scale.
Conclusion:
it is important to develop strategies for coping with anxiety, which in turn can be oriented toward protective factors such as spirituality.
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Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
Abstract
Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
DOI 10.1590/0034-7167.2015680317i
Views0See moreABSTRACT
Objective:
to evaluate the effectiveness of a nursing guidance protocol to reduce the anxiety of patients with acute coronary syndrome undergoing bed bath, and the correlation of vital signs with state-anxiety.
Method:
randomized clinical trial study. The sample consisted of 120 patients. The intervention group received a nursing guidance protocol about bed bath and the control group received the unit’s routine information. The STAI-State scale was used to assess anxiety, and data were collected at three times: immediately after informing the patients about the bed bath; immediately after interventions; and immediately after the bath.
Results:
the intervention group presented signifi cantly lower state-anxiety compared to the control group (p<0.001) after the intervention.
Conclusion:
the nursing orientation was effective to reduce anxiety in patients with acute coronary syndrome undergoing bed bath.
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Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
Abstract
Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
DOI 10.1590/0034-7167.2015680316i
Views0See moreABSTRACT
Objective:
to classify body language used in nursing care, and propose “Body language in nursing care” as an analytical category for nursing communication.
Method:
quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions.
Results:
sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches.
Conclusion:
nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classifi ed body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.
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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
Views0See 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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Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
Abstract
Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
DOI 10.1590/0034-7167.2015680313i
Views0See moreABSTRACT
Objective:
to analyze the factors associated with the gateway of the health systems of Brazilian municipalities for the diagnosis of tuberculosis in older people.
Method:
survey study type, with a sample of 91 elders, in a population with 706 cases of tuberculosis. Data were collected by means of an instrument based on the Primary Care Assessment Tool (PCAT) adapted for tuberculosis care, emphasizing the gateway variable. Variables were categorized and compared between primary health care (PHC) and specialized care (SC) services. Bivariate analysis and the Chi-square association test were used.
Results:
a statistically signifi cant association (p = 0.0001) was found between the fi rst health service sought and the unit that diagnosed tuberculosis, showing better performance of specialized care services in the diagnosis.
Conclusion:
it is necessary to improve primary health care services to tackle delayed diagnosis of tuberculosis in older people.
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