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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for assessing leprosy care in children and adolescents
Revista Brasileira de Enfermagem. 2024;77(2):e20230344
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
Views0See 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.
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ORIGINAL ARTICLE07-19-2024
Validation of the Brazilian Version of the Modified Scale for Delineating Advanced Practice Nursing Roles
Revista Brasileira de Enfermagem. 2024;77(2):e20230211
Abstract
ORIGINAL ARTICLEValidation of the Brazilian Version of the Modified Scale for Delineating Advanced Practice Nursing Roles
Revista Brasileira de Enfermagem. 2024;77(2):e20230211
DOI 10.1590/0034-7167-2023-0211
Views0See moreABSTRACT
Objectives:
to validate the Brazilian version of the Modified Scale for Delineating Advanced Practice Nursing Roles.
Methods:
this was a methodological study for the clinical validation of an instrument, conducted with 207 nurses working in primary care. Exploratory and confirmatory factor analysis, Cronbach’s alpha test, and z-test for proportion comparison were used.
Results:
the internal reliability of the scale was 0.944, with alpha greater than 0.80 in most domains, except for Education (0.786). In the exploratory factor analysis, considering the criterion of eigenvalue greater than one, eight factors were identified, explaining 79.38% of the variance. In the comparison of proportions, the adequate responses (≥ 2) in the domain of Comprehensive Direct Care, in both analyzed groups, were statistically equal. This domain had the highest score of adequate responses, followed by Education and Systems Support. Insufficient scoring was observed in the domains of Publication and Professional Leadership.
Conclusions:
the instrument demonstrated stability and reliability to be used in the evaluation of advanced nursing practice.
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REVIEW07-19-2024
Nursing care for hospitalized older adults – fall accidents versus safe mobility: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230180
Abstract
REVIEWNursing care for hospitalized older adults – fall accidents versus safe mobility: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230180
DOI 10.1590/0034-7167-2023-0180
Views0See moreABSTRACT
Objectives:
to map the constituent elements of the safe mobility concept present in hospital care for older adults.
Methods:
a scoping review of 35 articles searched in databases and gray literature – BDENF/VHL, Scopus, CINAHL/EBSCO, Embase, Web of Science, PEDro, MEDLINE/PubMed and CAPES Theses and Dissertations Catalog. No time or language cut-off was established.
Results:
none of the studies presented a clear safe mobility concept, however its constituent elements involve factors related to patient (behavioral factors, conditions, diseases, signs and symptoms, nutritional status, age, balance, strength, gait quality, sleep), the institution (environment, treatment devices, guidelines, medications and polypharmacy, material and human resources and clothing/shoes) and the nature of the interventions (related to the patient, institution and family).
Final Considerations:
the constituent elements of safe mobility express hospital units’ capacity to guarantee care and protection from fall accidents for hospitalized older adults.
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REVIEW07-19-2024
Drug-resistant tuberculosis: integrative review of nursing care in primary health care
Revista Brasileira de Enfermagem. 2024;77(2):e20230097
Abstract
REVIEWDrug-resistant tuberculosis: integrative review of nursing care in primary health care
Revista Brasileira de Enfermagem. 2024;77(2):e20230097
DOI 10.1590/0034-7167-2023-0097
Views0See moreABSTRACT
Objectives:
to identify, in the scientific literature, the care that should be provided to individuals with drug-resistant tuberculosis by nurses in primary health care.
Methods:
integrative review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses study selection flowchart. Data collection was conducted in November 2022, across ten databases.
Results:
six studies emphasized that nurses should perform directly observed treatment; two highlighted the importance of integrated care management between tuberculosis and human immunodeficiency virus; two demonstrated comprehensive nursing consultation using the nursing process; one emphasized person-centered care, with discharge planning and improved hospital communication with primary health care services.
Final Considerations:
the care that nurses should provide to individuals with drug-resistant tuberculosis in primary health care, for care resolution, is evidence-based.
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ORIGINAL ARTICLE07-19-2024
Translation and cross-cultural adaptation of the MISSCARE Survey-Ped into Brazilian Portuguese
Revista Brasileira de Enfermagem. 2024;77(2):e20230060
Abstract
ORIGINAL ARTICLETranslation and cross-cultural adaptation of the MISSCARE Survey-Ped into Brazilian Portuguese
Revista Brasileira de Enfermagem. 2024;77(2):e20230060
DOI 10.1590/0034-7167-2023-0060
Views0See moreABSTRACT
Objectives:
to translate and cross-culturally adapt the MISSCARE Survey-Ped for use in Brazil.
Methods:
a methodological study proposed by translation, synthesis of translations, back-translation, assessment by a committee of experts and pre-testing with the target population.
Results:
two direct translations of the instrument were carried out, followed by a consensual version between them. This synthetic version was back-translated and analyzed by a committee of five experts in pediatric nursing and patient safety, obtaining a Content Validity Index (CVI) of 0.95 and Cronbach’s alpha of 0.804. The final version was sent for pre-testing with 254 Brazilian pediatric nurses, with 44 (17.3%) analyzing the instrument for understanding (CVI 0.866; Content Validity Ratio (CVR) 0.773), relevance (CVI 0.931; CVR 0.864) and relevance (CVI 0.977; CVR 0.955).
Conclusions:
the MISSCARE Survey-Ped Brasil was considered suitable for application in pediatric nurses’ clinical practice in the country.
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EDITORIAL07-15-2024
Invisibilidade do trabalho da enfermagem: tecnologia como via de combate
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
Abstract
EDITORIALInvisibilidade do trabalho da enfermagem: tecnologia como via de combate
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
DOI 10.1590/0034-7167.202477suppl0301pt
Views0Na concepção comum, o trabalho é comumente associado a uma atividade remunerada em uma sociedade mercantil e de direito, refletindo a visão moderna que o limita ao tempo trocado por salário. Essa perspectiva, influenciada pelos princípios da Revolução Industrial, estabelece uma dicotomia entre o trabalho e o tempo fora dele, segmentando a vida em esferas […]See more -
EDITORIAL07-15-2024
Invisibility of nursing work: technology as a means of combat
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
Abstract
EDITORIALInvisibility of nursing work: technology as a means of combat
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
DOI 10.1590/0034-7167.202477suppl0301
Views0In the common conception, work is commonly associated with a paid activity in a commercial and legal society, reflecting the modern view that limits it to time exchanged for wage. This perspective, influenced by Industrial Revolution principles, establishes a dichotomy between work and time outside of work, segmenting life into professional and private spheres. However, […]See more
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REVIEW03-15-2024
Nursing care for parents who have experienced fetal demise: integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20220811
Abstract
REVIEWNursing care for parents who have experienced fetal demise: integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20220811
DOI 10.1590/0034-7167-2022-0811
Views0See moreABSTRACT
Objectives:
to identify scientific evidence regarding nursing care for parents who have experienced grief following fetal demise.
Methods:
an integrative review of original studies was conducted across six databases. The studies were classified according to the level of evidence.
Results:
the qualitative analysis of the nine studies comprising the sample involved thematic categories, exploring the impact of perinatal loss on families, inadequate communication by healthcare professionals, and the importance of a holistic approach in care. The role of the nurse is highlighted in making a positive contribution to the team, emphasizing participation in training and the provision of essential information.
Final Considerations:
grieving affects not only family dynamics but also the social environment, emphasizing the urgency of a more empathetic and comprehensive approach. Care should be holistic, going beyond technical nursing assistance, and addressing the biopsychosocial context of the parents.
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ORIGINAL ARTICLE03-15-2024
Is there scientific relevance to the plot of films and documentaries about eating disorders?
Revista Brasileira de Enfermagem. 2024;77(1):e20220547
Abstract
ORIGINAL ARTICLEIs there scientific relevance to the plot of films and documentaries about eating disorders?
Revista Brasileira de Enfermagem. 2024;77(1):e20220547
DOI 10.1590/0034-7167-2022-0547
Views0See moreABSTRACT
Objectives:
to analyze films and documentaries about eating disorders from the last twenty years, identifying the way they approach the topic as well as their relevance for didactic use in teaching the health field.
Methods:
a descriptive study, whose data collection was carried out on the main streaming and video platforms, resulting in the survey of 60 media. Of these, only 25 had audio/subtitles in Portuguese (inclusion criteria). scientific relevance was analyzed considering psychopathological and epidemiological aspects of these disorders. A questionnaire about the plot, characters and descriptive data analysis were used.
Results:
most media were dramas about female teenagers who tried to conform to beauty stereotypes, whose symptoms portrayed converged with current medical diagnostic manuals.
Conclusions:
in practical terms, a classificatory list of 11 media was prepared that could be used as a teaching resource for teaching this topic in the health field.
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ORIGINAL ARTICLE03-11-2024
Ethnically distinct populations and coping with violence against children in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230350
Abstract
ORIGINAL ARTICLEEthnically distinct populations and coping with violence against children in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230350
DOI 10.1590/0034-7167-2023-0350
Views0See moreABSTRACT
Objective:
To identify policies and programs adopted by a Brazilian municipality to address violence against children during the COVID-19 pandemic.
Method:
A qualitative documentary study. The study setting was the municipality of Ananindeua, Pará, Brazil. Data was collected from official websites between November 2021 and February 2022. Thematic content analysis was used with the support of webQDA software.
Results:
Three empirical categories emerged: a) Impacts of the COVID-19 pandemic on violence against children; b) Action strategies for tackling violence against children in the COVID-19 pandemic; c) Evaluation indicators and targets for action strategies for tackling violence against children.
Final considerations:
The documents revealed few direct mentions of children, especially traditional populations; they presented superficial and ineffective evaluations of the policies and programs adopted, using exclusively quantitative indicators.
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ORIGINAL ARTICLE03-11-2024
Experiences of women with physical disabilities in labor and delivery assistance
Revista Brasileira de Enfermagem. 2024;77:e20230290
Abstract
ORIGINAL ARTICLEExperiences of women with physical disabilities in labor and delivery assistance
Revista Brasileira de Enfermagem. 2024;77:e20230290
DOI 10.1590/0034-7167-2023-0290
Views0ABSTRACT
Objective:
To understand the meaning attributed by women with physical disabilities to the health care received and expected during labor and delivery.
Methods:
Qualitative study, based on Social Network Theory, conducted through an online workshop in April 2022, with the participation of six women with physical disabilities. Data, collected through the focus group technique, underwent thematic content analysis with the assistance of the IRaMuTeQ tool.
Results:
Three thematic categories emerged: Challenges experienced during pregnancy; The experience within the maternity ward; and, The importance of social networks. The assistance provided by healthcare professionals sometimes differed between what was expected and what was received by women with physical disabilities during labor and delivery.
Final Considerations:
Experiences were predominantly negative, resulting from inappropriate professional conduct due to ableist attitudes. Support from members of social networks is crucial for preventing stressors.
Keywords:Disabled PersonsHealth PersonnelLabor, ObstetricParturitionStress Disorders, Post-TraumaticSee more -
ORIGINAL ARTICLE03-11-2024
Use of an application on the measles vaccine for Warao indigenous refugees in Brazil
Revista Brasileira de Enfermagem. 2024;77:e20230253
Abstract
ORIGINAL ARTICLEUse of an application on the measles vaccine for Warao indigenous refugees in Brazil
Revista Brasileira de Enfermagem. 2024;77:e20230253
DOI 10.1590/0034-7167-2023-0253
Views0See moreABSTRACT
Objective:
To evaluate the need to develop an application with information about the measles vaccine for Warao indigenous people.
Methods:
This was a quantitative study conducted at the Espaço de Acolhimento Tapanã refugee shelter in the city of Belém, Pará, Brazil. The study sample was selected for convenience. Data were analyzed descriptively using Bioestat 5.0 software.
Results:
Twenty-one Warao indigenous individuals were interviewed. It was identified that 91% (n=20) had lost their vaccination card; 91% (n=20) stated they had lost their vaccination card more than three times, and 91% expressed interest in an application to store their vaccination information.
Conclusions:
The research provided important information for the development of a health application named WaraoMedI (Warao Measles Diversity Indigenous), as well as offered nursing professionals evidence about the challenges Warao indigenous refugees face in self-managing their vaccination information.
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REVIEW03-11-2024
Continuing nursing education actions in the face of homophobia: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230094
Abstract
REVIEWContinuing nursing education actions in the face of homophobia: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230094
DOI 10.1590/0034-7167-2023-0094
Views0ABSTRACT
Objectives:
to analyze continuing nursing education actions in the scientific literature in the face of homophobia.
Methods:
an integrative literature review with structured search in June 2022 in eight databases, using the descriptors Nursing Education, Homophobia, Sexual and Gender Minorities. Final sample consisted of six primary studies.
Results:
continuing nursing education actions are supported by strategies such as use of teaching materials, lectures, case studies and focus groups, addressing content such as gender identity issues and affective-sexual orientation, health disparities and their relationship with homophobia in healthcare settings.
Final considerations:
carried out in various healthcare settings, continuing education actions proved to be successful in raising nurses’ awareness in facing homophobia in health services, however, their expansion is necessary to create health spaces that meet the specific needs of these people.
Keywords:Continuing EducationHomophobiaNursingSexual and Gender MinoritiesTraining of Human Resources in HealthSee more -
EDITORIAL03-11-2024
O uso da ultrassonografia point-of-care na prática clínica do enfermeiro como alicerce para a segurança do paciente
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
Abstract
EDITORIALO uso da ultrassonografia point-of-care na prática clínica do enfermeiro como alicerce para a segurança do paciente
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
DOI 10.1590/0034-7167.202477suppl0201pt
Views0Recentemente, mais um caso de dano grave associado ao cuidado em saúde foi reportado pela mídia. Uma jovem grávida teve a mão e o punho amputados depois de dar à luz ao terceiro filho em um hospital do Rio de Janeiro(). Após o incidente ocasionado pelo acesso vascular, a mulher apresentou hemorragia e foi reinternada.Os […]See more -
EDITORIAL03-11-2024
The use of point-of-care ultrasound in nurses’ clinical practice as a foundation for patient safety
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
Abstract
EDITORIALThe use of point-of-care ultrasound in nurses’ clinical practice as a foundation for patient safety
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
DOI 10.1590/0034-7167.202477suppl0201
Views0Recently, another case of serious harm associated with healthcare was reported by the media. A young pregnant woman had her hand and wrist amputated after giving birth to her third child in a hospital in Rio de Janeiro(). After the incident caused by vascular access, the woman suffered hemorrhage and was readmitted.The harm caused to […]See more
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ORIGINAL ARTICLE11-10-2023
Prenatal assessment of high-risk pregnancies in primary and specialized outpatient care: a mixed study
Revista Brasileira de Enfermagem. 2023;76(5):e20220420
Abstract
ORIGINAL ARTICLEPrenatal assessment of high-risk pregnancies in primary and specialized outpatient care: a mixed study
Revista Brasileira de Enfermagem. 2023;76(5):e20220420
DOI 10.1590/0034-7167-2022-0420
Views0ABSTRACT
Objectives:
to assess high-risk prenatal care and identify strategies for improving care.
Methods:
a mixed study of a prospective cohort, with 319 mothers in a public maternity hospital, from October 2016 to August 2017, using a semi-structured instrument and interview. Analysis was performed using the chi-square test (p≤0.05). The qualitative approach was carried out through interviews with guiding questions to 13 managers, at their workplace, between January and March 2020, analyzed under social phenomenology.
Results:
higher rates of inadequacy were identified for all criteria. However, when care was shared, there was a higher rate for performing tests (p=0.023), consultations (p=0.002), risk stratification (p=0.013) and emergency information (≤0.000). Weaknesses in the record evidenced impairment in communication and continuity of care.
Final Considerations:
shared care is a strategy for improving care, however there is a need to strengthen effective referral and counter-referral to care continuity.
Keywords:Health Services AdministrationPregnancy, High-RiskPrenatal CarePrimary Health CareSecondary CareSee more -
ERRATUM11-10-2023
ERRATUM
Revista Brasileira de Enfermagem. 2023;76(4):e2023n4e03
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2023;76(4):e2023n4e03
DOI 10.1590/0034-7167.20237604e03
Views0In the article “Diabetic foot ulcer self-care assessment: a scoping review”, with DOI number: https://doi.org/10.1590/0034-7167-2022-0555, published in Revista Brasileira de Enfermagem, 2023;76(3): e20220555, in the title:Where it read:[…]See more -
ERRATUM10-30-2023
ERRATUM
Revista Brasileira de Enfermagem. 2023;76(3):e2023n3e01
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2023;76(3):e2023n3e01
DOI 10.1590/0034-7167.20237603e01
Views0In the article “Perceptions of adults with obesity about multiprofessional remote monitoring at the beginning of the COVID-19 pandemic”, with DOI number: , published in Revista Brasileira de Enfermagem, 2021;74(Suppl 1): e20200710, on page 8:Where it read:[…]See more -
EDITORIAL10-09-2023
A pós-pandemia de COVID-19: perspectivas da atuação profissional na enfermagem
Revista Brasileira de Enfermagem. 2023;76:e76Suppl101
Abstract
EDITORIALA pós-pandemia de COVID-19: perspectivas da atuação profissional na enfermagem
Revista Brasileira de Enfermagem. 2023;76:e76Suppl101
DOI 10.1590/0034-7167.202376Suppl101pt
Views0Durante a pandemia de COVID-19, os trabalhadores de enfermagem foram essenciais na prestação de cuidados à saúde, diante do elevado número de pessoas infectadas pelos vírus SARS-CoV-2 e adoecidos pela COVID-19 e pela Síndrome Respiratória Aguda Grave (SRAG). Neste contexto, os serviços de saúde ficaram sobrecarregados, e muitos de seus profissionais adoeceram e morreram.A enfermagem […]See more -
EDITORIAL10-09-2023
The post-COVID-19 pandemic: perspectives of professional practice in nursing
Revista Brasileira de Enfermagem. 2023;76:e76Suppl101
Abstract
EDITORIALThe post-COVID-19 pandemic: perspectives of professional practice in nursing
Revista Brasileira de Enfermagem. 2023;76:e76Suppl101
DOI 10.1590/0034-7167.202376Suppl101
Views0During the COVID-19 pandemic, nursing workers were essential in providing health care, given the high number of people infected with SARS-CoV-2 viruses and sick with COVID-19 and Severe Acute Respiratory Syndrome (SARS). In this context, health services were overloaded, and many of their professionals fell ill and died.Nursing proved to be essential during the critical […]See more -
ORIGINAL ARTICLE10-09-2023
Transition of care in post-hospitalization patients due to covid-19 in a hospital in northeastern Brazil
Revista Brasileira de Enfermagem. 2023;76:e20230030
Abstract
ORIGINAL ARTICLETransition of care in post-hospitalization patients due to covid-19 in a hospital in northeastern Brazil
Revista Brasileira de Enfermagem. 2023;76:e20230030
DOI 10.1590/0034-7167-2023-0030
Views0See moreABSTRACT
Objective:
To analyze the transition of care for post-hospitalization patients due to covid-19 in a hospital in northeastern Brazil.
Methods:
Quantitative, cross-sectional, descriptive, and analytical study carried out between 2020 and 2021. The sample had 78 patients. Data collection took place by telephone with the support of a sociodemographic questionnaire and the care transition assessment instrument (Care Transitions Measure).
Results:
The average length of stay was 24.04 days. The average score for care transition was 71.68 (±11.71). “Self-management training” and “Understanding of medications” had higher averages, 75.15 (±13.76) and 74.10 (±16.20).
Conclusions:
The average length of stay was 24.04 days. The average score for care transition was 71.68 (±11.71). “Self-management training” and “Understanding of medications” had higher averages, 75.15 (±13.76) and 74.10 (±16.20).
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ORIGINAL ARTICLE10-09-2023
Experiências de parto de mulheres durante a pandemia de COVID-19 na Indonésia
Revista Brasileira de Enfermagem. 2023;76:e20220640
Abstract
ORIGINAL ARTICLEExperiências de parto de mulheres durante a pandemia de COVID-19 na Indonésia
Revista Brasileira de Enfermagem. 2023;76:e20220640
DOI 10.1590/0034-7167-2022-0640
Views0See moreRESUMEN
Objetivo:
Explorar en profundidad las experiencias de las mujeres que dieron a luz durante la pandemia de COVID-19 en Indonesia.
Métodos:
Investigación cualitativa con enfoque fenomenológico descriptivo. Un total de 16 participantes que no sufrieron de COVID-19 dieron a luz durante la pandemia de COVID-19 en el entorno comunitario.
Resultados:
Hay cinco temas: 1: Los sentimientos de ansiedad y miedo de dar a luz en los hospitales son experimentados por las mujeres que dan a luz durante la pandemia de COVID-19, 2. Detección de COVID y protocolos de salud aplicados en los hospitales durante la pandemia de COVID-19, 3. Se necesita el apoyo de esposos, familias y trabajadores de la salud cuando se da a luz durante la pandemia de COVID-19, 4. La falta de horarios de visitas familiares es un obstáculo durante el parto, particularmente durante la pandemia de COVID-19, y 5: Vínculo entre madre y bebé mientras están en el hospital.
Conclusión:
la atención de enfermería de maternidad óptima y el apoyo de los centros de salud y las políticas públicas ayudarán a las madres a dar a luz durante la pandemia de COVID-19 en Indonesia.
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ORIGINAL ARTICLE10-09-2023
Women’s Childbirth Experiences During COVID-19 Pandemic in Indonesia
Revista Brasileira de Enfermagem. 2023;76:e20220640
Abstract
ORIGINAL ARTICLEWomen’s Childbirth Experiences During COVID-19 Pandemic in Indonesia
Revista Brasileira de Enfermagem. 2023;76:e20220640
DOI 10.1590/0034-7167-2022-0640
Views0See moreABSTRACT
Objective:
Explore in depth the experiences of women giving birth during the COVID-19 pandemic in Indonesia.
Methods:
Qualitative research with a descriptive phenomenological. A total of 16 participants did not suffer from COVID-19 and gave birth during the COVID-19 pandemic in the community setting area.
Results:
There are five themes: 1: Feelings of anxiety and fear of giving birth in hospitals are experienced by women giving birth during the COVID-19 pandemic, 2. Screening for COVID and health protocols applied in hospitals during the COVID-19 pandemic, 3. Support from husbands, families, and health workers is needed when giving birth during the COVID-19 pandemic, 4. Lack of family visits hours is an obstacle during childbirth, particularly during the COVID-19 pandemic, and 5: Bonding attachment between mother and baby while at the hospital.
Conclusion:
Optimal maternity nursing care and supporting health facilities and public policies will help mothers give birth during the COVID-19 pandemic in Indonesia.
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