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ORIGINAL ARTICLE05-29-2023
Risk of violence and frailty syndrome among older adults treated at a hospital service
- Jefferson da Silva Soares
, - Ana Carolina dos Santos ,
- Renata Clemente dos Santos-Rodrigues ,
- Gleicy Karine Nascimento de Araújo-Monteiro ,
- Barbara Maria Lopes da Silva Brandão , [ … ],
- Rafaella Queiroga Souto
Abstract
ORIGINAL ARTICLERisk of violence and frailty syndrome among older adults treated at a hospital service
Revista Brasileira de Enfermagem. 2023;76:e20220278
DOI 10.1590/0034-7167-2022-0278
- Jefferson da Silva Soares ,
- Ana Carolina dos Santos ,
- Renata Clemente dos Santos-Rodrigues ,
- Gleicy Karine Nascimento de Araújo-Monteiro ,
- Barbara Maria Lopes da Silva Brandão ,
- Rafaella Queiroga Souto
Views0See moreABSTRACT
Objectives:
to assess the association between risk of violence and frailty syndrome among hospitalized older adults.
Methods:
quantitative, analytical and cross-sectional research, carried out with older adults in two university hospitals. Data collection was performed using the Brazil Old Age Schedule, Hwalek-Sengstock Elder Abuse Screening Test and Edmonton Frail Scale instruments. It was analyzed using descriptive statistics and inferential statistics.
Results:
risk of violence was higher among women (68.9%), over 70 years old (64.7%), with more than 3 years of study (68.9%), without relationship (67.1%), who do not work (65.1%) and with income above 1 minimum wage (65.2%). There is a significant association between risk of violence and frailty (72.3%; p<0.001) and a positive correlation between the instrument scores (r=0.350; p-value<0.001).
Conclusions:
risk of violence was associated with being female and frailty. The study is expected to encourage further discussions related to the theme and nursing practice.
- Jefferson da Silva Soares
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05-29-2023
Absenteeism in child health services: a systematic review
- Bianca Machado Cruz Shibukawa ,
- Gabrieli Patrício Rissi ,
- Roberta Tognollo Borotta Uema ,
- Marcela Demitto Furtado ,
- Maria de Fátima Garcia Lopes Merino , [ … ],
- Ieda Harumi Higarashi
Abstract
Absenteeism in child health services: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20210805
DOI 10.1590/0034-7167-2021-0805
- Bianca Machado Cruz Shibukawa ,
- Gabrieli Patrício Rissi ,
- Roberta Tognollo Borotta Uema ,
- Marcela Demitto Furtado ,
- Maria de Fátima Garcia Lopes Merino ,
- Ieda Harumi Higarashi
Views0See moreABSTRACT
Objectives:
to analyze data from qualitative studies related to the phenomenon of health follow-up dropout of newborns, infants and preschoolers in child health services.
Methods:
systematic review, carried out in 19 information bases. Studies were included that portray the reasons for dropping out health follow-up of children up to five years old. The JBI methodology was used for systematic reviews of qualitative evidence.
Results:
we identified 20,199 studies. After applying the eligibility criteria, 81 were selected. Seven were excluded due to duplicity, resulting in 74 articles that were read in full. After this phase, three articles were selected for the final sample and later after reading their references, one more was included, totaling four articles for critical analysis.
Conclusions:
the synthesized findings highlight that health follow-up dropout is based on personal knowledge and beliefs, the family routine dynamics and access to services.
- Bianca Machado Cruz Shibukawa
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ORIGINAL ARTICLE05-29-2023
Violence in rural areas against disabled people from the perspective of their families
- Carmem Layana Jadischke Bandeira ,
- Jaqueline Arboit ,
- Fernanda Honnef ,
- Ethel Bastos da Silva ,
- Andressa de Andrade , [ … ],
- Marta Cocco da Costa
Abstract
ORIGINAL ARTICLEViolence in rural areas against disabled people from the perspective of their families
Revista Brasileira de Enfermagem. 2023;76:e20220404
DOI 10.1590/0034-7167-2022-0404
- Carmem Layana Jadischke Bandeira ,
- Jaqueline Arboit ,
- Fernanda Honnef ,
- Ethel Bastos da Silva ,
- Andressa de Andrade ,
- Marta Cocco da Costa
Views0See moreABSTRACT
Objectives:
to know the violence spoken and felt by disabled people, living in rural areas, from the perspective of their families.
Methods:
a descriptive-exploratory and qualitative study, carried out in four municipalities in Rio Grande do Sul, Brazil. Twelve family members who lived with disabled people in rural areas participated. Data were collected through semi-structured interviews and analyzed using thematic content analysis.
Results:
disabled people, living in rural areas, experienced physical, psychological and sexual violence, perpetrated by family members, colleagues, community members and health professionals. Adaptations were mentioned in family dynamics for the care of disabled people, social, financial and leisure impacts, and challenges in access and accessibility to education and health services.
Final Considerations:
violence against this population manifests itself in a reality with socioeconomic and family particularities, marked by exclusion, disrespect and denial of rights and access to fundamental goods and services.
- Carmem Layana Jadischke Bandeira
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ORIGINAL ARTICLE05-29-2023
Quality of life from women’s perspective in the exercise of sex work: a study of social representations
- Pablo Luiz Santos Couto ,
- Maria Luisa Pereira Neves ,
- Luiz Carlos Moraes França ,
- Antônio Marcos Tosoli Gomes ,
- Samantha Souza da Costa Pereira , [ … ],
- Sérgio Correia Marques
Abstract
ORIGINAL ARTICLEQuality of life from women’s perspective in the exercise of sex work: a study of social representations
Revista Brasileira de Enfermagem. 2023;76:e20220169
DOI 10.1590/0034-7167-2022-0169
- Pablo Luiz Santos Couto ,
- Maria Luisa Pereira Neves ,
- Luiz Carlos Moraes França ,
- Antônio Marcos Tosoli Gomes ,
- Samantha Souza da Costa Pereira ,
- Alba Benemérita Alves Vilela ,
- Dejeane de Oliveira Silva ,
- Sérgio Correia Marques
Views1See moreABSTRACT
Objectives:
to analyze the social representations elaborated by sex workers from Alto Sertão Produtivo Baiano about quality of life.
Methods:
a qualitative study, based on the Social Representation Theory, carried out in the region of Alto Sertão Produtivo Baiano, with 30 sex workers. Individual in-depth interview was carried out, with speeches organized in a corpus and treated in IRAMUTEQ, enabling lexical analysis for Descending Hierarchical Classification.
Results:
four thematic classes emerged, in which social representations of quality of life pervade: money earned to supply needs; association with healthy living and obtaining health (physical and mental); balance of emotions (although there are some negative sensations such as fear and anxiety); and faith in a deity.
Final Considerations:
the social representations elaborated by sex workers about quality of life are anchored in concepts, subjective and practical, punctuated by the World Health Organization.
- Pablo Luiz Santos Couto
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ORIGINAL ARTICLE05-12-2023
Humanized care in the Intensive Care Unit: discourse of Angolan nursing professionals
- Eurico Mateus Sili ,
- Eliane Regina Pereira do Nascimento ,
- Luciana Bihain Hagemann de Malfussi ,
- Patrícia Madalena Vieira Hermida ,
- Ana Izabel Jatobá de Souza , [ … ],
- Marisa da Silva Martins
Abstract
ORIGINAL ARTICLEHumanized care in the Intensive Care Unit: discourse of Angolan nursing professionals
Revista Brasileira de Enfermagem. 2023;76(2):e20220474
DOI 10.1590/0034-7167-2022-0474
- Eurico Mateus Sili ,
- Eliane Regina Pereira do Nascimento ,
- Luciana Bihain Hagemann de Malfussi ,
- Patrícia Madalena Vieira Hermida ,
- Ana Izabel Jatobá de Souza ,
- Daniele Delacanal Lazzari ,
- Marisa da Silva Martins
Views0See moreABSTRACT
Objectives:
to analyze the perception of nursing professionals in an intensive care unit in Angola about humanized care and identify resources necessary for its implementation.
Methods:
a qualitative, descriptive study conducted with 15 professionals in June-October/2020 in intensive care unit in Angola. The data were collected through semi-structured interviews; analysis based on the collective subject discourse technique.
Results:
five central ideas emerged: three related to the perception of humanized care (“From integral vision and empathy to a set of actions in all phases of care”, “Humanizing is extending care to family members and companions”, “Humanized care requires the establishment of a bond of trust and guarantee of individualized care”); and two on the resources necessary for this care (“Need for infrastructure – human and material resources”, “Professional training and humanized care are interconnected”).
Final Considerations:
humanized care involves objectivity and subjectivity; it includes family members. An adequate infrastructure can provide it.
- Eurico Mateus Sili
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ORIGINAL ARTICLE05-12-2023
Preceptorship contributions to the development of clinical and managerial skills in nursing residency
- Mayssa da Conceição Araújo ,
- Marina Peduzzi ,
- Nathália Romeu de Mazzi ,
- Camila Mendes da Silva Souza ,
- Valéria Marli Leonello
Abstract
ORIGINAL ARTICLEPreceptorship contributions to the development of clinical and managerial skills in nursing residency
Revista Brasileira de Enfermagem. 2023;76(2):e20220510
DOI 10.1590/0034-7167-2022-0510
- Mayssa da Conceição Araújo ,
- Marina Peduzzi ,
- Nathália Romeu de Mazzi ,
- Camila Mendes da Silva Souza ,
- Valéria Marli Leonello
Views0See moreABSTRACT
Objectives:
to analyze the experience of resident nurses with preceptorship contributions to the development of common clinical and managerial skills acquired in pedagogical projects.
Methods:
exploratory qualitative research developed in two stages: document analysis of pedagogical projects and semi-structured interviews with residents. Content analysis was carried out based on the framework of the nurse’s work process and skills.
Results:
the pedagogical projects of the three programs foresee the development of common skills, mostly clinical and only two managerial skills. The 22 residents reported the contributions of preceptorship in the development of competences centered on clinical practice, focusing on technical procedures disjointed from clinical reasoning and the managerial dimension of the nurse’s work.
Final Considerations:
it is necessary to train preceptors and involve all social actors linked to residency programs to expand preceptorship potential.
- Mayssa da Conceição Araújo
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ORIGINAL ARTICLE05-12-2023
The history of obstetric nurses’ professional training of in Minas Gerais (1957-1999): a genealogical analysis
Revista Brasileira de Enfermagem. 2023;76(2):e20220459
Abstract
ORIGINAL ARTICLEThe history of obstetric nurses’ professional training of in Minas Gerais (1957-1999): a genealogical analysis
Revista Brasileira de Enfermagem. 2023;76(2):e20220459
DOI 10.1590/0034-7167-2022-0459
Views0See moreABSTRACT
Objectives:
to analyze obstetric nurses’ professional training in Minas Gerais between 1957 and 1999, according to genealogical principles.
Methods:
a qualitative interpretative study based on historical research with genealogical analysis. Data were obtained through documentary research and oral history, with six participants, and submitted to discourse analysis.
Results:
they recompose the genealogical path of obstetric nurses’ professional training from Minas. The speeches reveal field of practice deprivation in professional training and the importance of the articulation between the Universidade Federal de Minas Gerais Nursing School and Hospital Sofia Feldman for teaching and work in obstetric nursing. It was identified that training, in the national scenario, evolved from a Escola de Enfermagem Carlos Chagas’ peripheral initiative to centrality and capillarity.
Final Considerations:
the unique historical trajectory of obstetric nurses’ professional training in Minas Gerais, marked by ruptures, institutional articulations, conflicting games and interest, was unveiled.
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ORIGINAL ARTICLE05-08-2023
Factors associated with demand for emergency medical services by people with hypertension and diabetes
- Patrícia Chatalov Ferreira ,
- Sonia Silva Marcon ,
- Elen Ferraz Teston ,
- Viviane Cazetta de Lima Vieira ,
- Rebeca Rosa de Souza , [ … ],
- Robson Marcelo Rossi
Abstract
ORIGINAL ARTICLEFactors associated with demand for emergency medical services by people with hypertension and diabetes
Revista Brasileira de Enfermagem. 2023;76(2):e20220147
DOI 10.1590/0034-7167-2022-0147
- Patrícia Chatalov Ferreira ,
- Sonia Silva Marcon ,
- Elen Ferraz Teston ,
- Viviane Cazetta de Lima Vieira ,
- Rebeca Rosa de Souza ,
- Mislaine Casagrande de Lima Lopes ,
- Verônica Francisqueti Marquete ,
- Robson Marcelo Rossi
Views0See moreABSTRACT
Objectives:
to analyze the association between recurrence of emergency service visits due to lack of blood pressure and/or glycemic control with sociodemographic variables and disease registration in Primary Care.
Methods:
quantitative study, which consulted medical records of people who attended these services two or more times for 26 months. Descriptive statistics and multiple logistic regression models were used in analysis.
Results:
most people did not have hypertension and/or diabetes record in their Primary Care records. The absence of this record was more frequent in males, aged between 18 and 59 years, with low education and lack of blood pressure. There was association between greater number of people seeking these services in the same year and not monitoring the chronic condition in specialized care.
Conclusions:
people who do not follow up hypertension and/or diabetes in Primary Care are more likely to need assistance due to blood pressure and/or glycemic management.
- Patrícia Chatalov Ferreira
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REVIEW06-01-2020
Access of the black population to health services: integrative review
- Nelma Nunes da Silva ,
- Veronica Batista Cambraia Favacho ,
- Gabriella de Andrade Boska ,
- Emerson da Costa Andrade ,
- Neuri Pires das Merces , [ … ],
- Márcia Aparecida Ferreira de Oliveira
Abstract
REVIEWAccess of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
DOI 10.1590/0034-7167-2018-0834
- Nelma Nunes da Silva ,
- Veronica Batista Cambraia Favacho ,
- Gabriella de Andrade Boska ,
- Emerson da Costa Andrade ,
- Neuri Pires das Merces ,
- Márcia Aparecida Ferreira de Oliveira
Views1See moreABSTRACT
Objectives:
demonstrate and discuss how the black population’s access to health services occurs
Methods:
integrative literature review with the following question: How does the black population’s access to health services occur? The search was carried out in the Scholar, LILACS and SciELO databases and used the descriptor “access to health services” and the term “population,” resulting in a sample with twelve articles.
Results:
studies show that the difficulty of access is a fundamental factor for the quality of life of people, directly compromising preventive services, especially for women’s health and, in addition, it has significant impact on the illness process of the black population within its particularities.
Final Considerations:
several limiting factors compromise the black population’s access to health services, including institutional and structural factors
- Nelma Nunes da Silva
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REVIEW11-06-2020
Transitional care to caregivers of dependent older people: an integrative literature review
- Bruna Alexandra da Silva Ferreira ,
- Thawanna Jeremias Barbosa Gomes ,
- Cristina Rosa Soares Lavareda Baixinho ,
- Óscar Manuel Ramos Ferreira
Abstract
REVIEWTransitional care to caregivers of dependent older people: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20200394
DOI 10.1590/0034-7167-2020-0394
- Bruna Alexandra da Silva Ferreira ,
- Thawanna Jeremias Barbosa Gomes ,
- Cristina Rosa Soares Lavareda Baixinho ,
- Óscar Manuel Ramos Ferreira
Views1See moreABSTRACT
Objective:
To identify the needs of caregivers of dependent older people related to self-care in the transition from hospital to home.
Methods:
Integrative literature review that followed a predefined protocol, carried out from March to May 2019 in the platforms EBSCO, B-On, Scopus, Web of Science, and Joanna Briggs Institute. Descriptors and eligibility criteria were defined for the bibliographic sample, which was ten articles. The search was limited to articles published between 2015 and 2019 to guarantee evidence topicality.
Results:
The needs of caregivers related to transitional care can be grouped into five categories: needs in the transition into the role of caregiver; needs related to self-care of caregivers themselves; health needs; economic needs; and social and collective needs.
Final considerations:
The work developed by nurses regarding transitional care of caregivers must have two focuses: managing care provided to dependent older people and managing the needs of caregivers and the care offered to them.
- Bruna Alexandra da Silva Ferreira
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REVIEW10-19-2020
Validation methods of nursing protocols: an integrative review
- Tainara Wink Vieira ,
- Victória Tiyoko Moraes Sakamoto ,
- Luiza Casais de Moraes ,
- Carine Raquel Blatt ,
- Rita Catalina Aquino Caregnato
Abstract
REVIEWValidation methods of nursing protocols: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200050
DOI 10.1590/0034-7167-2020-0050
- Tainara Wink Vieira ,
- Victória Tiyoko Moraes Sakamoto ,
- Luiza Casais de Moraes ,
- Carine Raquel Blatt ,
- Rita Catalina Aquino Caregnato
Views0See moreABSTRACT
Objective:
to identify scientific production about validation methods of nursing care protocols.
Method:
an integrative review with search at Scielo, Pubmed/MEDLINE, Virtual Health Library, Web of Science, Scopus, and EBSCOhost. The descriptors “validation studies”, “validation studies as topic”, “protocols”, “clinical protocols”, “practice guidelines as topic”, “nursing” and “nursing assessment” and the uncontrolled descriptor “validation” were used.
Results:
thirty-two articles were selected, most of them Brazilian. Content validation by experts was the most frequent method, with no consensus on the number of participants for the process. The collection instruments were mostly created by the authors. Data analysis was performed using descriptive statistics and Content Validity Index, with a variable consensus rate in the analyzed articles.
Conclusion:
protocols validated by experts are robust tools for use in clinical practice, with methodological rigor in development essential for its quality.
- Tainara Wink Vieira
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ORIGINAL ARTICLE05-24-2021
PEDCARE: validation of a mobile application on diabetic foot self-care
- Antonio Dean Barbosa Marques ,
- Thereza Maria Magalhães Moreira ,
- Rhanna Emanuela Fontenele Lima de Carvalho ,
- Edna Maria Camelo Chaves ,
- Shérida Karanini Paz de Oliveira , [ … ],
- Jarbas Aryel Nunes da Silveira
Abstract
ORIGINAL ARTICLEPEDCARE: validation of a mobile application on diabetic foot self-care
Revista Brasileira de Enfermagem. 2021;74:e20200856
DOI 10.1590/0034-7167-2020-0856
- Antonio Dean Barbosa Marques ,
- Thereza Maria Magalhães Moreira ,
- Rhanna Emanuela Fontenele Lima de Carvalho ,
- Edna Maria Camelo Chaves ,
- Shérida Karanini Paz de Oliveira ,
- Gilvan Ferreira Felipe ,
- Jarbas Aryel Nunes da Silveira
Views0See moreABSTRACT
Objective:
to describe the process of validating a multimedia application on a mobile platform to promote foot care for people with diabetes.
Method:
a technological production and methodological type study. Content and appearance were validated by 39 judges (29 nursing judges and ten information and communication technology judges and 15 people from the target audience).
Results:
nursing judges made it possible to validate the material with a total Content Validity Index of 0.95, a non-significant binomial test for most items and Cronbach’s alpha of 0.92, information and communication technology judges with Suitability Assessment of Materials of 99.2% and the target audience with an agreement index of 98%.
Conclusion:
the application proved to be valid and reliable for use in clinical practice as an educational technology to promote foot care for people with diabetes.
- Antonio Dean Barbosa Marques
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EXPERIENCE REPORT04-09-2020
Implementation of an Artificial Intelligence Algorithm for sepsis detection
- Luciana Schleder Gonçalves ,
- Maria Luiza de Medeiros Amaro ,
- Andressa de Lima Miranda Romero ,
- Fernanda Karoline Schamne ,
- Jacson Luiz Fressatto , [ … ],
- Carolina Wrobel Bezerra
Abstract
EXPERIENCE REPORTImplementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
DOI 10.1590/0034-7167-2018-0421
- Luciana Schleder Gonçalves ,
- Maria Luiza de Medeiros Amaro ,
- Andressa de Lima Miranda Romero ,
- Fernanda Karoline Schamne ,
- Jacson Luiz Fressatto ,
- Carolina Wrobel Bezerra
Views0See moreABSTRACT
Objectives:
to present the nurses’ experience with technological tools to support the early identification of sepsis.
Methods:
experience report before and after the implementation of artificial intelligence algorithms in the clinical practice of a philanthropic hospital, in the first half of 2018.
Results:
describe the motivation for the creation and use of the algorithm; the role of the nurse in the development and implementation of this technology and its effects on the nursing work process.
Final Considerations:
technological innovations need to contribute to the improvement of professional practices in health. Thus, nurses must recognize their role in all stages of this process, in order to guarantee safe, effective and patient-centered care. In the case presented, the participation of the nurses in the technology incorporation process enables a rapid decision-making in the early identification of sepsis.
- Luciana Schleder Gonçalves
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REVIEW03-24-2021
Development of clinical competence in nursing in simulation: the perspective of Bloom’s taxonomy
- Juliana da Silva Garcia Nascimento ,
- Tainá Vilhar Siqueira ,
- Jordana Luiza Gouvêa de Oliveira ,
- Mateus Goulart Alves ,
- Daniela da Silva Garcia Regino , [ … ],
- Maria Celia Barcellos Dalri
Abstract
REVIEWDevelopment of clinical competence in nursing in simulation: the perspective of Bloom’s taxonomy
Revista Brasileira de Enfermagem. 2021;74(1):e20200135
DOI 10.1590/0034-7167-2020-0135
- Juliana da Silva Garcia Nascimento ,
- Tainá Vilhar Siqueira ,
- Jordana Luiza Gouvêa de Oliveira ,
- Mateus Goulart Alves ,
- Daniela da Silva Garcia Regino ,
- Maria Celia Barcellos Dalri
Views0See moreABSTRACT
Objectives:
to investigate the scientific evidence on the use of Bloom’s taxonomy for developing competence in nursing professionals and students in clinical simulation.
Methods:
integrative review of the National Library of Medicine (NLM), National Institutes of Health (NIH), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Web of Science and SCOPUS databases, using the Rayyan application.
Results:
a total of 871 studies were identified; four composed the sample. The development of clinical competence occurred through the coordination of knowledge, skills, and attitudes. To develop the cognitive domain, the objectives of knowledge and comprehension of the Bloom’s taxonomy were mobilized. The psychomotor domain required development of the skills demanded by the proposed clinical care. The affective domain was developed through will and motivation to learn.
Conclusions:
it is possible to develop clinical competence in nursing by adopting Bloom’s taxonomy in each phase of clinical simulation.
- Juliana da Silva Garcia Nascimento
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03-27-2020
Coronavirus 2020
Revista Brasileira de Enfermagem. 2020;73(2):e2020n2
Abstract
Coronavirus 2020
Revista Brasileira de Enfermagem. 2020;73(2):e2020n2
DOI 10.1590/0034-7167-2020730201
Views0Emerging and reemerging infectious diseases are constant challenges for public health worldwide. Recent cases of pneumonia of unknown cause in Wuhan, China, have led to the discovery of a new type of Coronavirus (2019-nCoV), which are enveloped RNA viruses, commonly found in humans, other mammals and birds, capable of causing respiratory, enteric, hepatic, and neurological […]See more -
ORIGINAL ARTICLE12-13-2019
Accessibility of children with special health needs to the health care network
- Eliane Tatsch Neves ,
- Aline Cristiane Cavicchioli Okido ,
- Fernanda Luisa Buboltz ,
- Raíssa Passos dos Santos ,
- Regina Aparecida Garcia de Lima
Abstract
ORIGINAL ARTICLEAccessibility of children with special health needs to the health care network
Revista Brasileira de Enfermagem. 2019;72:65-71
DOI 10.1590/0034-7167-2017-0899
- Eliane Tatsch Neves ,
- Aline Cristiane Cavicchioli Okido ,
- Fernanda Luisa Buboltz ,
- Raíssa Passos dos Santos ,
- Regina Aparecida Garcia de Lima
Views0See moreABSTRACT
Objective:
To know how children with special health needs access the health care network.
Method:
This is a qualitative research of descriptive-exploratory type, developed using semi-structured interviews mediated by the Talking Map design. Participants were 19 family caregivers of these children in two Brazilian municipalities. Data were submitted to inductive thematic analysis.
Results:
Difficulties were mentioned from the diagnosis moment to the specialized follow-up, something represented by the itinerary of the c hild and his/her family in the search for the definition of the medical diagnosis and the access to a specialized professional; a gap between the children’s needs and the care offered was observed in primary health care.
Conclusion:
The access of children with special health needs is filled with obstacles such as slowness in the process of defining the child’s diagnosis and referral to a specialist. Primary health care services were replaced by care in emergency care units.
- Eliane Tatsch Neves
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