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ORIGINAL ARTICLE09-20-2024
Content validity of guidance on self-care in the post-operative period for breast cancer
- Cristina Poliana Rolim Saraiva dos Santos
, - Natália Frota Goyanna ,
- Erilaine de Freitas Corpes ,
- Romel Jonathan Velasco Yanez ,
- José Jeová Mourão Netto , [ … ],
- Ana Fátima Carvalho Fernandes
Abstract
ORIGINAL ARTICLEContent validity of guidance on self-care in the post-operative period for breast cancer
Revista Brasileira de Enfermagem. 2024;77(4):e20240188
DOI 10.1590/0034-7167-2024-0188
- Cristina Poliana Rolim Saraiva dos Santos ,
- Natália Frota Goyanna ,
- Erilaine de Freitas Corpes ,
- Romel Jonathan Velasco Yanez ,
- José Jeová Mourão Netto ,
- Régia Christina Moura Barbosa ,
- Ana Fátima Carvalho Fernandes
Views0See moreABSTRACT
Objectives:
to validate the content of a guidance guide on self-care in the postoperative period of breast surgery for breast cancer.
Methods:
a methodological study with content validity, carried out with 15 expert nurses and physiotherapists, between May and July 2022. Recruitment took place from the Lattes Platform, using snowball sampling. The level of relevance and representativeness for each item was verified using the Content Validity Index (CVI). It was considered valid when CVI was equal to or greater than 78% (0.78).
Results:
from the initial total of 37 items, two were excluded, as they had insufficient practical relevance and theoretical relevance, and another five items which, although presenting a CVI lower than the established cut-off, were suggested to be rewritten and grouped with other similar items.
Conclusions:
thirty items were considered valid and demonstrated important and significant characteristics, constituting suitable material for application in clinical practice.
- Cristina Poliana Rolim Saraiva dos Santos
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ORIGINAL ARTICLE09-20-2024
Sociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic
- Andressa Silva Torres dos Santos ,
- Ana Cristina de Oliveira e Silva ,
- Fernanda Maria Vieira Pereira-Ávila ,
- Hemílio Fernandes Campos Coêlho ,
- Laelson Rochelle Milanês Sousa , [ … ],
- Elucir Gir
Abstract
ORIGINAL ARTICLESociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77(4):e20230301
DOI 10.1590/0034-7167-2023-0301
- Andressa Silva Torres dos Santos ,
- Ana Cristina de Oliveira e Silva ,
- Fernanda Maria Vieira Pereira-Ávila ,
- Hemílio Fernandes Campos Coêlho ,
- Laelson Rochelle Milanês Sousa ,
- Renata Karina Reis ,
- Elucir Gir
Views0See moreABSTRACT
Objectives:
to assess the socio-cognitive factors determining adherence to standard precautions by nursing professionals in care practice during the COVID-19 pandemic in Brazil.
Methods:
an analytical cross-sectional study, carried out with 9,039 nursing professionals in Brazil, using an electronic form containing participant sociodemographic, training and work variables, and the Brazilian version of the Standard Precautions Questionnaire. Descriptive and inferential statistics were used using the statistical software R.
Results:
participants recognize standard precautions as effective measures to reduce infections and report intention to perform them. Training regarding standard precautions was evidenced as a facilitator of adherence (4.72; SD: 0.73), and problems related to materials (3.78; SD: 1.45) were a hindrance.
Conclusions:
among the determining factors, facilitating organization presented the highest score, followed by intention to perform. Facilitating and hindering factor identification makes it possible to develop intervention strategies to strengthen patient safety and reduce occupational risks among professionals.
- Andressa Silva Torres dos Santos
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ORIGINAL ARTICLE09-20-2024
Predictor variables effect on the development of Burnout Syndrome in higher education professor
- Italo Everton Bezerra Barbosa ,
- Aristéia Nunes Sampaio ,
- Cristiane Pereira de Souza ,
- Breno de Souza Mota ,
- Carla Roberta Monteiro Miura , [ … ],
- Angélica Gonçalves Silva Belasco
Abstract
ORIGINAL ARTICLEPredictor variables effect on the development of Burnout Syndrome in higher education professor
Revista Brasileira de Enfermagem. 2024;77(4):e20240132
DOI 10.1590/0034-7167-2024-0132
- Italo Everton Bezerra Barbosa ,
- Aristéia Nunes Sampaio ,
- Cristiane Pereira de Souza ,
- Breno de Souza Mota ,
- Carla Roberta Monteiro Miura ,
- Cassiane Dezoti da Fonseca ,
- Angélica Gonçalves Silva Belasco
Views0See moreABSTRACT
Objectives:
to correlate the development of Burnout Syndrome in higher education professors with the following variables: sociodemographic, economic, work, sleep pattern, level of anxiety and quality of life.
Methods:
observational, analytical, cross-sectional study with a quantitative approach. Data collection took place from August to November 2022, with 140 professors from a private higher education institution in the Western Brazilian Amazon.
Results:
professors who carried out activities outside institutional hours and who had sleep duration < 5 hours, presented lower scores in the personal fulfillment dimension of burnout, with (p=0.002) and (p=0.001), respectively. The higher the scores for the physical (p=0.001), psychological (p=0.000) and social relationships (p=0.002) domains of quality of life, the lower the personal fulfillment scores for the syndrome.
Conclusions:
through linear regression, it was evidenced that several variables explain the development of burnout. Institutional and governmental actions can minimize the negative influence of these variables.
- Italo Everton Bezerra Barbosa
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ORIGINAL ARTICLE09-20-2024
Transgender people’s knowledge about the adverse effects of cross-hormonization: challenges for nursing
- Andréa Felizardo Ahmad ,
- Adriana Lemos ,
- Cláudia Regina Ribeiro ,
- Luciane Marques de Araujo ,
- Vanessa de Almeida Ferreira Corrêa , [ … ],
- Beatriz Rodrigues Silva Selles Dantas
Abstract
ORIGINAL ARTICLETransgender people’s knowledge about the adverse effects of cross-hormonization: challenges for nursing
Revista Brasileira de Enfermagem. 2024;77(4):e20230346
DOI 10.1590/0034-7167-2023-0346
- Andréa Felizardo Ahmad ,
- Adriana Lemos ,
- Cláudia Regina Ribeiro ,
- Luciane Marques de Araujo ,
- Vanessa de Almeida Ferreira Corrêa ,
- Janaína Pinto Janini ,
- Rosâne Mello ,
- Beatriz Rodrigues Silva Selles Dantas
Views0See moreABSTRACT
Objectives:
to identify trans women’s and men’s knowledge about the adverse effects of cross-hormonization and understand the repercussions of hormonization practices on trans women’s and men’s health.
Methods:
exploratory, descriptive, qualitative research, developed with 41 participants, from July 2019 to February 2020, in a trans health outpatient clinic. Thematic-categorical content analysis was used.
Results:
from the analysis, the categories emerged: Knowledge about the adverse effects of cross-hormonization; and Cross-hormonization practices and their meaning.
Final Considerations:
nursing practices, based on the identification of knowledge about adverse effects and the understanding of cross-hormonization practices in trans women’s and men’s health, can result in more inclusive care.
- Andréa Felizardo Ahmad
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ORIGINAL ARTICLE09-20-2024
Construction and validation of a checklist for the management of totally implanted catheters in children
- Giselle Vieira de Souza ,
- Isabella Pavarine de Souza ,
- Maria Paula Custodio Silva ,
- Silmara Elaine Malaguti Toffano ,
- Divanice Contim
Abstract
ORIGINAL ARTICLEConstruction and validation of a checklist for the management of totally implanted catheters in children
Revista Brasileira de Enfermagem. 2024;77(4):e20230447
DOI 10.1590/0034-7167-2023-0447
- Giselle Vieira de Souza ,
- Isabella Pavarine de Souza ,
- Maria Paula Custodio Silva ,
- Silmara Elaine Malaguti Toffano ,
- Divanice Contim
Views0See moreABSTRACT
Objectives:
to construct and validate the content of a checklist for the management of totally implanted catheters in hospitalized children and adolescents.
Methods:
methodological research conducted from October 2021 to December 2022 in two stages: development of the instrument with care guidelines and content validation of the checklist. The instrument, containing 23 items presented in Likert format, was evaluated online by specialists in two rounds. The Content Validity Index was applied, considering indices above 0.8 as valid.
Results:
the final checklist included four domains and 22 checklist items, validated with a Content Validity Index of 0.98. The overall evaluation of the instrument presented a global score of 9.9.
Conclusions:
the validation and application of instruments that standardize procedures, in addition to supporting professionals, promote autonomy and quality of care for children and adolescents using this device.
- Giselle Vieira de Souza
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ORIGINAL ARTICLE09-20-2024
Cross-cultural adaptation and validation of the Healthy Work Environment Assessment Tool in Brazilian culture
- Renata Cristina Gasparino ,
- Sharlla Milênia Nogueira da Silva ,
- Letícia Bianchini de Barros Minatogawa ,
- Olga Maria Pimenta Lopes Ribeiro ,
- Andrea Bernardes
Abstract
ORIGINAL ARTICLECross-cultural adaptation and validation of the Healthy Work Environment Assessment Tool in Brazilian culture
Revista Brasileira de Enfermagem. 2024;77(4):e20230505
DOI 10.1590/0034-7167-2023-0505
- Renata Cristina Gasparino ,
- Sharlla Milênia Nogueira da Silva ,
- Letícia Bianchini de Barros Minatogawa ,
- Olga Maria Pimenta Lopes Ribeiro ,
- Andrea Bernardes
Views0See moreABSTRACT
Objectives:
to adapt and validate the content of the Healthy Work Environment Assessment Tool for Brazilian culture, and evaluate the practical aspects of its application.
Methods:
methodological study that followed six stages: translation; synthesis; back translation; content validation by a group of experts, pre-testing and approval of the process by the author of the original instrument.
Results:
the first three stages were carried out by contracted companies. In the committee, two items and the title of a subscale were evaluated in a second round, when consensus was reached among experts. In the pre-test, more than 93% of professionals agreed that the tool was easy to understand. The average completion time was 8.53 minutes. The American Association of Critical-Care Nurses authorized publication of the results.
Conclusions:
the adaptation of the tool to Brazilian culture was completed following the adopted framework. In addition to the evidence of content validity, the tool appears promising for managerial use.
- Renata Cristina Gasparino
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REVIEW09-20-2024
Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study
- Rosane Barreto Cardoso ,
- Marcos Antônio Gomes Brandão ,
- Jéssica Cristina Sobrinho da Silva Cavalcante ,
- Rafael Oliveira Pitta Lopes ,
- Kênia Rocha Leite Zaccaro , [ … ],
- Cândida Caniçali Primo
Abstract
REVIEWBrazilian nursing specific situation, middle and micro-range theories: a bibliometric study
Revista Brasileira de Enfermagem. 2024;77(4):e20230520
DOI 10.1590/0034-7167-2023-0520
- Rosane Barreto Cardoso ,
- Marcos Antônio Gomes Brandão ,
- Jéssica Cristina Sobrinho da Silva Cavalcante ,
- Rafael Oliveira Pitta Lopes ,
- Kênia Rocha Leite Zaccaro ,
- Cândida Caniçali Primo
Views0See moreABSTRACT
Objectives:
to map the nursing theories developed in stricto sensu graduate programs in nursing in Brazil.
Methods:
a bibliometric study, carried out on the Coordination for the Improvement of Higher Education Personnel Theses and Dissertations Portal in October 2023. The controlled descriptors “Nursing Theory” and “Nursing Models” and the uncontrolled descriptors “Theories” and “Middle-Range Theory” were used. Selected studies were cataloged for analysis, which was conducted by the study authors, who have a doctoral degree and expertise in research on nursing theories.
Results:
thirty-nine nursing theories were mapped, with a predominance of middle-range theories (79.5%), focusing on nursing diagnostic concepts and use of the theoretical-methodology strategy of theoretical-causal validity.
Conclusions:
the study identified nursing theories developed in Brazil, recognizing trends, development strategies, theorized objects of disciplinary interest and investments necessary for practical application in Brazilian contexts.
- Rosane Barreto Cardoso
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09-09-2024
Potential of Artificial Intelligence in Evidence-Based Practice in Nursing
Revista Brasileira de Enfermagem. 2024;77(5):e770501
Abstract
Potential of Artificial Intelligence in Evidence-Based Practice in Nursing
Revista Brasileira de Enfermagem. 2024;77(5):e770501
DOI 10.1590/0034-7167.2024770501
Views0Evidence-based practice (EBP) has established itself as a fundamental pillar in nursing, driving effective clinical decision-making based on high-quality scientific research. The primary goal of EBP is to ensure that patients receive the most appropriate and safe care, based on the best available evidence. In this context, knowledge synthesis methods are essential tools for EBP, […]See more
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ORIGINAL ARTICLE12-05-2019
ICNP ® nursing diagnoses, outcomes and interventions for community elderly
- Jorge Wilker Bezerra Clares ,
- Maria Miriam Lima da Nóbrega ,
- Maria Vilaní Cavalcante Guedes ,
- Lúcia de Fátima da Silva ,
- Maria Célia de Freitas
Abstract
ORIGINAL ARTICLEICNP ® nursing diagnoses, outcomes and interventions for community elderly
Revista Brasileira de Enfermagem. 2019;72:191-198
DOI 10.1590/0034-7167-2018-0540
- Jorge Wilker Bezerra Clares ,
- Maria Miriam Lima da Nóbrega ,
- Maria Vilaní Cavalcante Guedes ,
- Lúcia de Fátima da Silva ,
- Maria Célia de Freitas
Views0See moreABSTRACT
Objective:
To construct a nomenclature of nursing diagnoses, outcomes and interventions for elderly people under follow-up in the Family Health Strategy by using the International Classification for Nursing Practice and the theoretical reference of Virginia Henderson.
Method:
Methodological study developed according to guidelines of the International Council of Nurses.
Results:
A total of 127 concepts of nursing diagnoses/outcomes were constructed and distributed according to nursing care components in the subcategories of Biological/Physiological, Psychological, Social and Spiritual/Moral components. For these diagnoses, were proposed 551 nursing interventions.
Conclusion:
The concepts constructed may favor integral care for the elderly in the Family Health Strategy and the structuring of a terminological subset for this clientele.
- Jorge Wilker Bezerra Clares
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ORIGINAL ARTICLE12-13-2019
Health behaviors in sexual experiences of women in prison
- Karlayne Reynaux Vieira de Oliveira ,
- Amuzza Aylla Pereira dos Santos ,
- Jovânia Marques de Oliveira e Silva ,
- Maria Elisângela Torres de Lima Sanches ,
- Jessica de Melo Albuquerque , [ … ],
- Marianny Medeiros de Moraes
Abstract
ORIGINAL ARTICLEHealth behaviors in sexual experiences of women in prison
Revista Brasileira de Enfermagem. 2019;72:88-95
DOI 10.1590/0034-7167-2018-0092
- Karlayne Reynaux Vieira de Oliveira ,
- Amuzza Aylla Pereira dos Santos ,
- Jovânia Marques de Oliveira e Silva ,
- Maria Elisângela Torres de Lima Sanches ,
- Jessica de Melo Albuquerque ,
- Marianny Medeiros de Moraes
Views0See moreABSTRACT
Objective:
to describe the health behaviors related to the sexual experiences of women in the female prison system from January to March, 2017.
Method:
descriptive study with a qualitative approach. A semi-structured questionnaire containing mixed questions and patient records was used. The data analysis was performed through the Bardin’s content analysis and adopted as reference the Theory of Basic Human Needs.
Results:
18 women, young, single, brown, with a complete fundamental level participated in the study. After this characterization, two categories were evidenced: Health behaviors in sexual experiences and Health care in the face of sexual experiences. 33.3% reported on health behaviors such as Sexually Transmitted Infections (STIs), 27.7% associated with male condom use, 16.6% on prevention of unwanted pregnancies, 11.1% on health care and hygiene.
Final considerations:
it was evidenced that the health behaviors reported by women in sexual experiences are associated with actions to prevent STIs, use of condoms, unwanted pregnancies, and health and hygiene care. However, it is possible to infer that they understand and possess superficial knowledge about health behaviors and that there is no adoption of regular practice in their sexual experiences.
- Karlayne Reynaux Vieira de Oliveira
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ORIGINAL ARTICLE08-05-2020
Maternal nutritional status in diabetes mellitus and neonatal characteristics at birth
Revista Brasileira de Enfermagem. 2020;73:e20181000
Abstract
ORIGINAL ARTICLEMaternal nutritional status in diabetes mellitus and neonatal characteristics at birth
Revista Brasileira de Enfermagem. 2020;73:e20181000
DOI 10.1590/0034-7167-2018-1000
Views0See moreABSTRACT
Objectives:
to analyze the nutritional status of women with diagnosis of Diabetes mellitus in pregnancy and the newborns’ characteristics in relation to health conditions at birth.
Methods:
transversal study with data from 394 electronic medical charts (197 newborn and 197 mothers), between 2017 and 2018. Descriptive and analytical statistics.
Results:
there was prevalence of women with Gestational Diabetes (78.2%), followed by Type II Diabetes (13.7%) and Type I Diabetes (8.1%), and of term births (85.3%) and cesarean deliveries (54.8%). Type I Diabetes was associated to earlier gestational age at birth (p>0.001) and obesity during pregnancy was associated to higher birth weight of newborns (p=0.024). Clinical complications occurred in 37.6% of newborns. Among complications, Type I Diabetes was associated with respiratory disorder (p=0.005), and prematurity was associated with mother’s overweight/obesity (p=0.010).
Conclusions:
we strongly advise about the need of metabolic and nutritional control during gestations that course with Diabetes mellitus, due occurrence of negative consequences to the newborn´s health at birth.
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ORIGINAL ARTICLE08-14-2020
Social attributes of the male that incite the violence by intimate partner
- Andrey Ferreira da Silva ,
- Nadirlene Pereira Gomes ,
- Álvaro Pereira ,
- Júlia Renata Fernandes de Magalhães ,
- Fernanda Matheus Estrela , [ … ],
- Jordana Brock Carneiro
Abstract
ORIGINAL ARTICLESocial attributes of the male that incite the violence by intimate partner
Revista Brasileira de Enfermagem. 2020;73(6):e20190470
DOI 10.1590/0034-7167-2019-0470
- Andrey Ferreira da Silva ,
- Nadirlene Pereira Gomes ,
- Álvaro Pereira ,
- Júlia Renata Fernandes de Magalhães ,
- Fernanda Matheus Estrela ,
- Anderson Reis de Sousa ,
- Jordana Brock Carneiro
Views0INTRODUCTIONMasculinity can be understood as a set of symbols that structures the ideal identity model for being a man, represented by attributes, functions, values and culturally determined and expected behaviors for people of the male gender. Such attributes have been part of the social construction of male identity since childhood, outlining expected and socially legitimate […]See more - Andrey Ferreira da Silva
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ORIGINAL ARTICLE12-13-2019
The meaning of the care of hospitalized children: experiences of nursing professionals
Revista Brasileira de Enfermagem. 2019;72:251-258
Abstract
ORIGINAL ARTICLEThe meaning of the care of hospitalized children: experiences of nursing professionals
Revista Brasileira de Enfermagem. 2019;72:251-258
DOI 10.1590/0034-7167-2018-0597
Views0See moreABSTRACT
Objective:
to understand the meaning of the care of hospitalized children for the nursing professionals of a pediatric unit.
Method:
phenomenological study, based on the existential phenomenology of Martin Heidegger. Ten nursing professionals were interviewed with the guiding question: “What is the care of hospitalized children for you? Tell me, in detail, your experience with taking care of hospitalized children.”
Results:
the meaning of the care of hospitalized children materializes between the profession and the various ways of preoccupation. By engaging in/worrying about the ways of being of everyday life, the professionals tend to improperness when trying to mediate and level all possibilities of being. However, when they extrapolate reassurance and do not get caught up in themselves, they achieve empathy, respect, and indulgence.
Final Considerations:
it is necessary to reassess the teaching and practice of care, so that authentic care is offered to children and their families in the context of hospitalization.
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REVIEW11-06-2020
Suicide in the elderly: approach to social determinants of health in the Dahlgren and Whitehead model
- Mariana Lustosa de Carvalho ,
- Ana Paula Cardoso Costa ,
- Claudete Ferreira de Souza Monteiro ,
- Maria do Livramento Fortes Figueiredo ,
- Fernanda Valéria Silva Dantas Avelino , [ … ],
- Silvana Santiago da Rocha
Abstract
REVIEWSuicide in the elderly: approach to social determinants of health in the Dahlgren and Whitehead model
Revista Brasileira de Enfermagem. 2020;73:e20200332
DOI 10.1590/0034-7167-2020-0332
- Mariana Lustosa de Carvalho ,
- Ana Paula Cardoso Costa ,
- Claudete Ferreira de Souza Monteiro ,
- Maria do Livramento Fortes Figueiredo ,
- Fernanda Valéria Silva Dantas Avelino ,
- Silvana Santiago da Rocha
Views0See moreABSTRACT
Objective:
Identify in literature the social determinants of health related to suicide in the elderly, according to the model proposed by Dahlgren and Whitehead.
Method:
Integrative review of articles indexed in the databases BDENF, CINAHL, LILACS, and MEDLINE, with the following main descriptors: aged, suicide, social determinants of health, and risk factors. Primary studies were included which addressed social determinants of health and suicide in the elderly.
Results:
From the 19 articles analyzed, three categories emerged: proximal social determinants of health (male gender, mental disorders, physical illnesses, white race, 70-74 years old); intermediate social determinants of health (substance abuse, use of alcohol or psychotropic drugs, marital status, marital, social, and family problems, violence, previous suicide attempt, history of admission to psychiatric service); and distal social determinants of health (schooling, economic issues, sanitation, stressful events).
Conclusion:
Proximal determinants have more effects on suicide. Intermediate determinants are composed mainly of changeable factors. Distal determinants showed lesser associations.
- Mariana Lustosa de Carvalho
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ORIGINAL ARTICLE04-22-2020
Geospatial analysis of births with congenital disorders, Paraná, 2008-2015: ecological study
- Márcia Helena de Souza Freire ,
- Ana Paula de Morais Maia Barros ,
- Luciano de Andrade ,
- Oscar Kenji Nihei ,
- Kátia Biagio Fontes
Abstract
ORIGINAL ARTICLEGeospatial analysis of births with congenital disorders, Paraná, 2008-2015: ecological study
Revista Brasileira de Enfermagem. 2020;73(3):e20180741
DOI 10.1590/0034-7167-2018-0741
- Márcia Helena de Souza Freire ,
- Ana Paula de Morais Maia Barros ,
- Luciano de Andrade ,
- Oscar Kenji Nihei ,
- Kátia Biagio Fontes
Views0See moreABSTRACT
Objective:
analyze the pattern of spatial distribution of the prevalence rate of births with congenital disorders and its relationship with social, economic, health care and environmental indicators in Paraná, Brazil, from 2008 to 2015.
Method:
ecological study with variables extracted from secondary banks, related to the births of children of mothers residing in Paraná, in two quadrennial (2008-2011 and 2012-2015). The analysis of the rates was performed with univariate spatial (Moran) and multivariate approach (Ordinary Least Squares and Geographically Weighted Regression).
Results:
the occurrence of congenital disorders presented a significant association (p<0.05) with: registration in primary care of pregnant women over 20 years of age; urbanization degree; consumption of pesticides; and balance of female formal employment.
Conclusion/Final considerations:
social, health care and environmental variables showed a non-stationary spatial pattern in the analyzed period and influenced positively and negatively the rates.
- Márcia Helena de Souza Freire
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ORIGINAL ARTICLE03-09-2020
Embracement of the person with mental illness at an emergency hospital service: a qualitative research
Revista Brasileira de Enfermagem. 2020;73(2):e20180671
Abstract
ORIGINAL ARTICLEEmbracement of the person with mental illness at an emergency hospital service: a qualitative research
Revista Brasileira de Enfermagem. 2020;73(2):e20180671
DOI 10.1590/0034-7167-2018-0671
Views0See moreABSTRACT
Objectives:
to understand actions of nurses who care for people person with mental illness at a Referenced Emergency Unit in a university hospital.
Methods:
a qualitative research based on Alfred Schütz’s social phenomenology. Data collection was performed between December 2015 and January 2016 through phenomenological interviews with 13 nurses from an Emergency Unit.
Results:
nurses embrace according to their previous experiences. They easily identify biological complaints and, when they recognize psychiatric signs and symptoms, refer them to the psychiatrist. They raise doubts about what to do, so they expect to be qualified for such action, believing that a protocol could help as well as they need more time.
Final considerations:
the understanding of the lived type of nurse who embraces people with mental distress made possible in this study need recognition for research and interventions that focus on biological, psychic and social dimension articulation at embracement.
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