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Validation of nursing diagnoses, interventions and outcomes in a pediatric clinic
Revista Brasileira de Enfermagem. 2018;71(1):80-88
Abstract
Validation of nursing diagnoses, interventions and outcomes in a pediatric clinic
Revista Brasileira de Enfermagem. 2018;71(1):80-88
DOI 10.1590/0034-7167-2016-0647
Views0See moreABSTRACT
Objectives:
To elaborate operational definitions for the Nomenclature nursing diagnoses, interventionsand outcomes of the Pediatric Clinic at a University Hospital and carry out a validation of the content and clinical aspects of this Nomenclature.
Method:
Methodological research, developed in two stages: documentary study, for the validation of content of the operational definitions of nursing diagnoses; and secondly applied research, via clinical cases, performed with children from 0 to 5 years.
Results:
The 126 diagnoses were submitted to consensus validation and 55.6% were validated. Six clinical case studies were carried out, using the phases of the nursing process, based on the theory of Basic Human Needs, identifying 24.3% of the validated diagnoses and 54.5% of the nursing interventions listed in the Nomenclature.
Conclusion:
The study showed the effectiveness of using the Nomenclature in the Pediatric Clinic, in order to optimize the care andquality of health services.
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Cognitive changes in nurses working in intensive care units
Revista Brasileira de Enfermagem. 2018;71(1):73-79
Abstract
Cognitive changes in nurses working in intensive care units
Revista Brasileira de Enfermagem. 2018;71(1):73-79
DOI 10.1590/0034-7167-2016-0513
Views0See moreABSTRACT
Objective:
To measure the levels of stress, anxiety, and depression of nurses working in ICUs, relating them to levels of attention before and after 24 hours.
Method:
An observational, quantitative, analytical study with 18 nurses undergoing an inventory of stress, anxiety, and depression, as well as assessment of attention levels and psychomotor functioning.
Results:
Sixty-one percent showed positive for stress. Depression was observed in 33%; and anxiety in 99.9%. A strong correlation between stress and depression (ρ = 0.564 with p <0.05) and anxiety (ρ = 1 with p <0.05) was observed. There was a weak correlation between stress and task execution time in M2 (ρ = 0.055) for TMT A, a fact that did not occur in M0 (ρ = -0.249).
Conclusion:
The study shows that the workload of the nurses working in 24-hour shifts in the ICU is correlated with high levels of stress, decreases in the attention process, and psychomotor decline.
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Realities and perspectives of adolescent mothers in their first pregnancy
Revista Brasileira de Enfermagem. 2018;71(1):65-72
Abstract
Realities and perspectives of adolescent mothers in their first pregnancy
Revista Brasileira de Enfermagem. 2018;71(1):65-72
DOI 10.1590/0034-7167-2016-0444
Views0See moreABSTRACT
Objective:
to understand the trajectory of adolescents regarding the first pregnancy, contemplating realities and perspectives.
Method:
qualitative study, based on the Schütz theoretical framework, with 30 adolescents assisted in an outpatient clinic for adolescents in Fortaleza, Ceará, Brazil. From the narrative interviews carried out in the first semester of 2013, in the return for the first consultation of the puerperium, the communicative processes were identified, the central ideas and units of meanings expressed in the themes were abstracted: I was dating and became pregnant; realities and perspectives.
Results:
adolescents justified pregnancy through sexual drive and insufficient prevention; they narrated the fear faced, difficulties in motherhood and continuity of studies. The realities coexisted with the prospects of family members and partners helping to educate the child to achieve a different future from what they themselves experienced.
Final considerations:
adolescents experienced motherhood with ambivalent conflicts because they were young mothers, but they wanted to raise and educate their children, even those with minimal living conditions.
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Health advocacy by nurses in the Family Health Strategy: barriers and facilitators
Revista Brasileira de Enfermagem. 2018;71(1):57-64
Abstract
Health advocacy by nurses in the Family Health Strategy: barriers and facilitators
Revista Brasileira de Enfermagem. 2018;71(1):57-64
DOI 10.1590/0034-7167-2016-0119
Views0See moreABSTRACT
Objective:
Identify the barriers and facilitators of health advocacy to users delivered by nurses from the Family Health Strategy.
Method:
Qualitative study carried out with nurses from the Family Health Strategy of a city in the south of Brazil. Study participants were 15 nurses, who were interviewed. The content of the interviews was recorded, transcribed and analyzed in the light of the discursive text analysis.
Results:
Two categories emerged, one about the lack of organization at the workplace, bureaucracy and limitations to professional work in health environments, and another about the facilitating aspects to exercise advocacy both individually and collectively.
Conclusion:
When nurses, provided with technical, scientific and relational knowledge, are empowered to make decisions, they are not only supported by other professionals at work but also develop actions of health advocacy to users, thus qualifying the care delivered.
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Cultural adaptation of Quality Of Care Through The Patient’s Eyes -QUOTE-HIV
Revista Brasileira de Enfermagem. 2018;71(1):47-56
Abstract
Cultural adaptation of Quality Of Care Through The Patient’s Eyes -QUOTE-HIV
Revista Brasileira de Enfermagem. 2018;71(1):47-56
DOI 10.1590/0034-7167-2016-0113
Views0See moreABSTRACT
Objective:
to translate and adapt Quality of Care Through the Patient’s Eyes – HIV (QUOTE-HIV) for the Brazilian population living with HIV/AIDS.
Method:
a methodological study, which followed the stages of translation, synthesis, back-translation, evaluation by the committee of experts and pre-test for cultural adaptation of the instrument.
Results:
the process of translation and cultural adaptation was considered adequate. Evaluation by the expert committee resulted in semantic, structural and grammatical adequacy of the evaluated items. 30 subjects considered the instrument to be easy to understand and suggested minor adjustments in some items.
Conclusion:
the Brazilian version of QUOTE-HIV has been adapted and validated in relation to its content. However, this is a study that precedes the process of evaluating the psychometric properties of the instrument, the results of which will be presented in a later publication.
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Knowledge, beliefs, and attitudes of older women in HIV/AIDS prevention
Revista Brasileira de Enfermagem. 2018;71(1):40-46
Abstract
Knowledge, beliefs, and attitudes of older women in HIV/AIDS prevention
Revista Brasileira de Enfermagem. 2018;71(1):40-46
DOI 10.1590/0034-7167-2016-0521
Views0See moreABSTRACT
Objective:
To analyze the knowledge, religious beliefs and the adoption of preventive measures against HIV/AIDS of non-Catholic elderly women.
Method:
A qualitative study, carried out in religious institutions of a municipality in the state of Ceará, Northeast Brazil, with 78 elderly women. Of these, 64 were evangelicals, seven spiritualists and seven Jehovah’s Witnesses. A semi-structured interview script was used followed by thematic content analysis of participants’ responses.
Results:
After analyzing the empirical data, three categories were elaborated: the first presented the knowledge they had about AIDS; the second, highlighted the beliefs attributed to people with HIV/AIDS; and the third, presented the preventive measures to HIV/AIDS adopted by them.
Final considerations:
There were participants with knowledge gaps and failure to use preventive measures against HIV/AIDS. They suggested that religious institutions can be venues for lectures on HIV/AIDS prevention.
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Mothers’ perspective on violence against children: constructing meanings
Revista Brasileira de Enfermagem. 2018;71(1):34-39
Abstract
Mothers’ perspective on violence against children: constructing meanings
Revista Brasileira de Enfermagem. 2018;71(1):34-39
DOI 10.1590/0034-7167-2016-0568
Views0See moreABSTRACT
Objective:
To explore the construct elaborated by the mother on the meaning of violence against the child and to identify, according to the mother’s perspective, which measures are most used for the prevention of this phenomenon.
Method:
This is a qualitative research, with the participation of thirty mothers, in a health service in the city of Ananindeua, in the state of Pará, Brazil. The methodology consisted of the categorical content analysis, which identified three categories: Violence, Threats of violence and Protective measures.
Results:
The research showed that mothers attribute different meanings to violence, but the physical and sexual violence were markedly the most highlighted, and the dialogue was the most used protective measure.
Conclusion:
It is essential to strengthen public policies through effective interventions, seeking solutions to address this phenomenon in all segments of society.
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Adolescent health promotion based on community-centered arts education
Revista Brasileira de Enfermagem. 2018;71(1):26-33
Abstract
Adolescent health promotion based on community-centered arts education
Revista Brasileira de Enfermagem. 2018;71(1):26-33
DOI 10.1590/0034-7167-2016-0078
Views0ABSTRACT
Objective:
To evaluate the contribution of arts education to health promotion of adolescents in situations of urban social vulnerability.
Method:
Participatory evaluative research, with a qualitative approach, using as a reference the theoretical constructs of Paulo Freire’s Conscientization and the Empowerment Evaluation as a method of collecting with adolescents and teachers of an arts education program in the field of the Family Health Strategy.
Results:
Participants constructed a collective mission that represented the concept of adolescent health promotion. Arts education activities were prioritized and ranked with a mission focus, and over a three-month period, the program implemented health goals through art. In the reevaluation, the group presented a broad look at the implementation of activities and self-determination for change.
Final considerations:
Arts education is a potential space for nurses to act in the conscientization and empowerment of adolescent health in Primary Health Care.
Keywords:AdolescentCommunity-Based Participatory ResearchConscientizationHealth EducationHealth PromotionSee more
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A enfermagem como protagonista no enfrentamento da hesitação e recusa vacinal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
A enfermagem como protagonista no enfrentamento da hesitação e recusa vacinal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
DOI 10.1590/0034-7167.202477suppl101pt
Views0Desde a década de 1970, o Ministério da Saúde do Brasil instituiu o Programa Nacional de Imunização (PNI), que precedeu o Sistema Único de Saúde e que lhe foi incorporado e fortalecido, devido ao modelo descentralizado aos municípios, mas de comando único ao nível central. Seu objetivo era e ainda é coordenar as ações de […]See more -
Nursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
Nursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
DOI 10.1590/0034-7167.202477suppl101
Views1Since the 1970s, the Brazilian Ministry of Health established the Brazilian National Immunization Program (PNI – Programa Nacional de Imunização), which preceded the Brazilian Health System and which was incorporated and strengthened due to the decentralized model to municipalities, but under single command at central level. Its objective was and still is to coordinate vaccination […]See more -
Enfermeiro Navegador de Pacientes com Câncer: contribuições para a discussão no cenário nacional
Revista Brasileira de Enfermagem. 2024;77(2):e770201
Abstract
Enfermeiro Navegador de Pacientes com Câncer: contribuições para a discussão no cenário nacional
Revista Brasileira de Enfermagem. 2024;77(2):e770201
DOI 10.1590/0034-7167.2024770201pt
Views0A prática profissional da navegação de pacientes é algo incipiente no Brasil e, sendo assim, é indispensável uma ampla discussão com vários setores da sociedade, sendo essa a principal propositura deste editorial. Comecemos pela história.A navegação de pacientes foi definida em 1989 como uma intervenção de prestação de serviços baseada na comunidade, com o objetivo […]See more -
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
Abstract
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
DOI 10.1590/0034-7167.2024770201
Views0The professional practice of patient navigation is incipient in Brazil and, therefore, a broad discussion with various sectors of society is essential, which is the main purpose of this editorial. Shall we start with the story.Patient navigation was defined in 1989 as a community-based service delivery intervention aimed at appropriately promoting access to diagnosis and […]See more -
ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e02
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e02
DOI 10.1590/0034-7167.20247701e02
Views0In the article “Active teaching model to promote critical thinking”, with DOI number: , published in Revista Brasileira de Enfermagem, 2019;72(1):293-8, on page 297:Include before REFERENCES:[…]See more -
REVIEW02-26-2024
Practice of immersion in hot water to relieve pain in neonatology: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230260
Abstract
REVIEWPractice of immersion in hot water to relieve pain in neonatology: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230260
DOI 10.1590/0034-7167-2023-0260
Views0See moreABSTRACT
Objectives:
to identify immersion use in hot water to relieve pain in newborns.
Methods:
an integrative literature review, carried out in the PubMed, VHL, EMBASE, Scopus, CINAHL, Cochrane and SciELO databases, with investigations in English, Spanish, French or Portuguese, published between 2002 and 2022. The Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) were used to answer the following question: what are the uses of hot water immersion in relieving pain in newborns?
Results:
nine studies were included, mainly Brazilian, experimental, with a predominance of strong and moderate levels of evidence. Hydrotherapy and bath use (immersion and bandaging) was observed, promising interventions in reducing pain scores, assessed using scales, physiological and endocrine parameters.
Conclusions:
hot water proved to be a promising non-pharmacological intervention in relieving pain in infants in different contexts.
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ORIGINAL ARTICLE02-26-2024
Artificial intelligence to predict bed bath time in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(1):e20230201
Abstract
ORIGINAL ARTICLEArtificial intelligence to predict bed bath time in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(1):e20230201
DOI 10.1590/0034-7167-2023-0201
Views0See moreABSTRACT
Objectives:
to assess the predictive performance of different artificial intelligence algorithms to estimate bed bath execution time in critically ill patients.
Methods:
a methodological study, which used artificial intelligence algorithms to predict bed bath time in critically ill patients. The results of multiple regression models, multilayer perceptron neural networks and radial basis function, decision tree and random forest were analyzed.
Results:
among the models assessed, the neural network model with a radial basis function, containing 13 neurons in the hidden layer, presented the best predictive performance to estimate the bed bath execution time. In data validation, the squared correlation between the predicted values and the original values was 62.3%.
Conclusions:
the neural network model with radial basis function showed better predictive performance to estimate bed bath execution time in critically ill patients.
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REVIEW02-26-2024
Evidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230134
Abstract
REVIEWEvidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230134
DOI 10.1590/0034-7167-2023-0134
Views0ABSTRACT
Objectives:
to synthesize and analyze evidence on intrauterine device insertion by nurses in Primary Health Care.
Methods:
an integrative review, carried out in the BDENF, CINAHL, LILACS, SciELO, Scopus, PubMed and Web of Science databases in June 2022, delimiting the period from 1960 to 2022.
Results:
141 articles were identified in the initial search, and 10 studies made up the final sample. Four (40%) were developed in the United States and one (10%) in Brazil, with publications from 1979 to 2021. The findings were grouped into three categories: Nurse training to insert an intrauterine device; Nurses’ competency to insert an intrauterine device; and Women’s access to intrauterine devices.
Conclusions:
nurse theoretical and practical training is a prominent element, consolidated in the favorable outcomes of insertions performed by nurses and satisfaction among women, a practice that has expanded access to the contraceptive method in Primary Health Care.
Keywords:Advanced Practice NursingIntrauterine DevicesLong-Acting Reversible ContraceptionNursesPrimary Health CareSee more
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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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