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01-01-2017
Nursing process in mental health: an integrative literature review
Revista Brasileira de Enfermagem. 2017;70(1):220-230
Abstract
Nursing process in mental health: an integrative literature review
Revista Brasileira de Enfermagem. 2017;70(1):220-230
DOI 10.1590/0034-7167-2016-0031
Views0See moreABSTRACT
Objective:
to identify evidences from the literature on the application of nursing process in care developed by the nurse in mental health.
Method:
integrative literature review between 1990 and 2013, in the PubMed, Scopus, CINAHL and LILCACS bases. Descriptors: nursing processes, mental health, nursing care.
Results:
19 papers were identified. Limited and partial usage of the nursing process in care established by a therapeutic relationship that respects the patient’s individuality. We observe care proposals systematized for patients that present pathological aspects in the limits between the physical and psychical, which might be a response to the influence of the practice based on evidences.
Conclusion:
it was found an antagonistic movement between care based on the relationship and located in the standardization of diagnoses that respond to physical malaise. A lack of evidence was verified for the usage of the nursing process in mental health, and we point at the necessity for the creation of new possibilities for dialogue between relational and biological perspectives.
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01-01-2017
Nursing practice in home care: an integrative literature review
Revista Brasileira de Enfermagem. 2017;70(1):210-219
Abstract
Nursing practice in home care: an integrative literature review
Revista Brasileira de Enfermagem. 2017;70(1):210-219
DOI 10.1590/0034-7167-2016-0214
Views0See moreABSTRACT
Objective:
analyze scientific production on nursing practice in home care.
Method:
integrative review employing databases LILACS, BDENF, IBECS, and MEDLINE. Studies in Spanish, English, and Portuguese were included, regardless of publishing date.
Results:
after analyzing 48 articles, it was found that nursing practice in home care is complex, employing a multitude of actions by using three technologies: soft; soft-hard especially; and hard. Challenges related to the home-care training process are reported in the literature. Nurses use knowledge from their experience and scientific recommendations in conjunction with their reflections on the practice.
Conclusion:
home nursing practice is fundamental and widespread. Relational and educational actions stand out as necessary even in technical care, with a predominant need for home-care training.
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01-01-2017
Nonpharmacological interventions to improve quality of life in heart failure: an integrative review
Revista Brasileira de Enfermagem. 2017;70(1):198-209
Abstract
Nonpharmacological interventions to improve quality of life in heart failure: an integrative review
Revista Brasileira de Enfermagem. 2017;70(1):198-209
DOI 10.1590/0034-7167-2016-0112
Views0See moreABSTRACT
Objective:
to identify articles that assessed the effectiveness or efficacy of nonpharmacological interventions to improve quality of life of people with heart failure in the literature.
Method:
an integrative literature review was performed in Lilacs, MedLine and SciELO databases, including randomized or nonrandomized clinical trials and quasi-experimental studies published between 2003 and 2014, in Portuguese, English or Spanish.
Results:
twenty-three studies were included. The categories of nonpharmacological interventions that improved quality of life of people with heart failure were: Remote health monitoring, Instructions on health practices, Physical activity follow-up and Traditional Chinese Medicine practices.
Conclusion:
these results can guide the selection of interventions to be implemented by health professionals that treat people with heart failure. Future systematic reviews with meta-analyses are needed in order to identify the most effective interventions for improving these individuals’ quality of life.
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01-01-2017
Quality of working life: assessment of intervention studies
Revista Brasileira de Enfermagem. 2017;70(1):189-197
Abstract
Quality of working life: assessment of intervention studies
Revista Brasileira de Enfermagem. 2017;70(1):189-197
DOI 10.1590/0034-7167-2015-0069
Views0See moreABSTRACT
Objective:
to analyze the production of knowledge about interventions on quality of working life.
Method:
integrative review study. The following databases were used for study selection: SciELO, Medline and PubMed.
Results:
the sample included 25 national and international articles that described programs and methods to acquire healthy habits at the workplace and attenuate its mental demands.
Conclusion:
by observing the number of businesses throughout the world, a low number of programs addressing workers’ health and well-being can be found, and the establishment of efficient policies at institutions could improve this situation.
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01-01-2017
Letramento em saúde para pessoas com HIV/Aids: revisão integrativa
Revista Brasileira de Enfermagem. 2017;70(1):180-188
Abstract
Letramento em saúde para pessoas com HIV/Aids: revisão integrativa
Revista Brasileira de Enfermagem. 2017;70(1):180-188
DOI 10.1590/0034-7167-2015-0052
Views1See moreRESUMEN
Objetivo:
analizar el conocimiento producido por la investigación sobre la salud de alfabetización para adultos con VIH/SIDA.
Método:
una revisión integradora de la literatura, con seis bases de datos, se llevó a cabo entre enero y abril de 2014. Los descriptores SIDA y Educación de la Salud se utilizaron, en portugués, inglés y español. Se encontró un total de 130 artículos y se seleccionaron 14. Se identificaron tres categorías: tecnologías de la educación y alfabetización de la salud para el VIH/SIDA; evaluación de conocimientos sobre la salud de los pacientes con VIH/SIDA; y conocimientos sobre la salud y la adherencia a la terapia antirretroviral.
Resultados:
análisis de los conocimientos sobre la salud, el estatus socioeconómico y nivel educativo de las personas que viven con el VIH / SIDA era esencial para la implementación de estrategias educativas que el aumento de la adherencia a la orientación de la salud.
Conclusión:
Este estudio demostró la importancia de la alfabetización en salud para trabajar con personas que viven con el VIH / SIDA, especialmente teniendo en cuenta a las personas que no poseen el mínimo necesario para la supervivencia, lo que hace que sea aún más relevante y alienta la investigación sobre el tema.
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REVIEW01-01-2017
Health literacy for people living with HIV/Aids: an integrative review
Revista Brasileira de Enfermagem. 2017;70(1):180-188
Abstract
REVIEWHealth literacy for people living with HIV/Aids: an integrative review
Revista Brasileira de Enfermagem. 2017;70(1):180-188
DOI 10.1590/0034-7167-2015-0052
Views0See moreABSTRACT
Objective:
to analyze knowledge produced by research about health literacy for adult with HIV/Aids.
Method:
an integrative literature review, using six databases, was conducted between January and April of 2014. The descriptors aids and Health Literacy were used, in Portuguese, English and Spanish. A total of 130 articles were found and 14 were selected. Three categories were identified: educational technologies and health literacy for HIV/Aids; assessment of health literacy of patients with HIV/Aids; and health literacy and adherence to antiretroviral therapy.
Results:
analysis of health literacy, socioeconomic status and educational level of people living with HIV/ Aids was essential for implementation of educational strategies that increased adherence to health guidance.
Conclusion:
this study showed the importance of health literacy for working with people living with HIV/Aids, especially considering individuals who did not possess the minimum necessary for survival, which makes it relevant and encourages further research on the topic.
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01-01-2017
Factors that interfere with the response of nurses in the monitoring of clinical alarms
Revista Brasileira de Enfermagem. 2017;70(1):172-179
Abstract
Factors that interfere with the response of nurses in the monitoring of clinical alarms
Revista Brasileira de Enfermagem. 2017;70(1):172-179
DOI 10.1590/0034-7167-2015-0092
Views0See moreABSTRACT
Objective:
The objective of the present study was to identify and synthesize the best empirical evidence found on factors that influence the response of nurses regarding clinical alarms.
Method:
An integrative literature review was conducted with searches undertaken in ten electronic databases restricted to the period from 2005 to 2016.
Results:
Eight articles were included by cross-checking the descriptors selected.
Conclusion:
In the analysis of the studies, the following possible factors that might interfere with the response of nurses in the monitoring of clinical alarms were found: high number of false alarms, inaudibility of alarms due to the competition of sounds, difficulty in distinguishing the urgency of alarms, and increase in noise caused by the raise in the number of alarms.
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01-01-2017
Discourses on discharge care for children with special healthcare needs
Revista Brasileira de Enfermagem. 2017;70(1):163-171
Abstract
Discourses on discharge care for children with special healthcare needs
Revista Brasileira de Enfermagem. 2017;70(1):163-171
DOI 10.1590/0034-7167-2016-0248
Views0See moreABSTRACT
Objectives:
analyze the discourse of healthcare professionals and families on the continuous and complex care for children with special healthcare needs; understand hospital discharge as a process centered on children demands and family learning.
Method:
qualitative research conducted between 2013 and 2015 through semi-structured interviews, document analysis and the sensitive creative method; the participants were ten children with special healthcare needs, six professionals and eleven family members from a public pediatric teaching hospital in Rio de Janeiro. The data underwent critical discourse analysis.
Results:
at discharge, family caregivers should learn innovative care to guarantee the maintenance of their children’s lives at home, but preparation is limited.
Conclusion:
the clinicians and the families pointed out Nurse as the most qualified professional for this preparation, since caring for these children requires nursing care skills.
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ORIGINAL ARTICLE02-26-2024
Technological prospecting of patents related to monitoring accidents due to falls in hospitals
Revista Brasileira de Enfermagem. 2024;77(1):e20230084
Abstract
ORIGINAL ARTICLETechnological prospecting of patents related to monitoring accidents due to falls in hospitals
Revista Brasileira de Enfermagem. 2024;77(1):e20230084
DOI 10.1590/0034-7167-2023-0084
Views0See moreABSTRACT
Objectives:
to map the production of technologies aimed at monitoring falls in a hospital environment protected by registered patents.
Methods:
a technological prospecting of international patents, with a quantitative approach, with search carried out between February and March 2022 in the Derwent Innovations Index database with descriptors fall, hospital, monitoring.
Results:
212 patents were found, with the majority filed and published since 2010, by Tran B (9) and Cerner Innovation Inc (9), focused on health technology. Universities were responsible for 13% of deposits. There was a predominance of records from the United States (43.4%), China (21.7%) and Japan (12.3%), in addition to technological strategies classified as devices for the environment (80.7%) and for preventing falls (66.5%) as well as trend towards resources with multiple functionalities in the same technology.
Conclusions:
the plurality of functions in the same device reflects the search for optimizing resources and the concern with comprehensive care.
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ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20230045
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20230045
DOI 10.1590/0034-7167.20247701e04
Views0In the article “Coping strategies for chronically ill children and adolescents facing the COVID-19 pandemic”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 2):e20230045, in the author:Where it read:[…]See more -
ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
DOI 10.1590/0034-7167.20247701e03
Views0In the article “Nurses in the labor market: professional insertion, competencies and skills”, with DOI number: , published in Revista Brasileira de Enfermagem, 2017;70(6):1220-6, on page 1225:Include before REFERENCES:[…]See more -
ORIGINAL ARTICLE01-24-2019
Active teaching model to promote critical thinking
- Fábio da Costa Carbogim
, - Larissa Bertacchini de Oliveira ,
- Melina Mafra Toledo ,
- Flávia Batista Barbosa de Sá Diaz ,
- Greicy Kelly Gouveia Dias Bittencourt , [ … ],
- Vilanice Alves de Araújo Püschel
Abstract
ORIGINAL ARTICLEActive teaching model to promote critical thinking
Revista Brasileira de Enfermagem. 2019;72(1):293-298
DOI 10.1590/0034-7167-2018-0002
- Fábio da Costa Carbogim ,
- Larissa Bertacchini de Oliveira ,
- Melina Mafra Toledo ,
- Flávia Batista Barbosa de Sá Diaz ,
- Greicy Kelly Gouveia Dias Bittencourt ,
- Vilanice Alves de Araújo Püschel
Views0See moreABSTRACT
Objective:
To present the experience of elaboration and implementation of the Active Teaching Model to Promote Critical Thinking (MEAPC), associated to Problem-Based Learning (PBL), for undergraduate students in Nursing.
Method:
Case report on the experience of the educational intervention (MEAPC + PBL) with undergraduate students in Nursing, in a 20-hour course on Basic Life Support (BLS). The MEAPC was validated by judges to guide the analysis of clinical cases. Critical Thinking (CT) skills were assessed using the California Critical Thinking Skills Test.
Result:
The educational intervention took place in two phases: elaboration and implementation, allowing not only the production of knowledge about BLS, but also the development of CT and exchange of experiences for teaching-learning.
Conclusion:
The association of the MEAPC to the PBL in the course of BLS organized the learning, gave opportunity to acquire knowledge and to stimulate the skills of the CT.
- Fábio da Costa Carbogim
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RESEARCH01-24-2017
Nurses in the labor market: professional insertion, competencies and skills
Revista Brasileira de Enfermagem. 2017;70(6):1220-1226
Abstract
RESEARCHNurses in the labor market: professional insertion, competencies and skills
Revista Brasileira de Enfermagem. 2017;70(6):1220-1226
DOI 10.1590/0034-7167-2016-0061
Views0See moreABSTRACT
Objective:
to characterize nurses graduated from the School of Nursing of the University of São Paulo, from 2006 to 2012; verify their entry, facilitating factors and difficulties of these graduates in the labor market and to consider their skills and competences in the world of work.
Method:
an exploratory, descriptive study with a qualitative approach.
Results:
out of 505 graduates, 172 (34.1%) participated in the research. Entry into the labor market was mainly via public hospital institutions, in the SE of Brazil, in the caregiving sectors. The greater part remained from one to two years in their first job. Most agreed that they were prepared to meet the health needs of the population. Furthermore, they had been encouraged to seek systematic and continuous improvement in a critical, reflexive and creative way, while combining technical-scientific knowledge and personal skills.
Conclusion:
the results show that the University of São Paulo has been preparing nurses for work in the labor market, in accordance with the provisions of the National Curricular Guidelines.
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01-15-2024
ERRATA
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
Abstract
ERRATA
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
DOI 10.1590/0034-7167.20247701e01
Views0En el artículo “La ética del cuidado de enfermería para personas transgénero”, con número DOI: , publicado en la Revista Brasileira de Enfermagem, 2023;76( Suppl 3):e20220797, en autoría:Onde se lia:[…]See more -
ERRATUM01-15-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
DOI 10.1590/0034-7167.20247701e01
Views1In the article “The ethics of nursing care for transgender people”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 3):e20220797, in authorship:Where it read:[…]See more -
12-08-2024
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
Abstract
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
DOI 10.1590/0034-7167.2024770101pt
Views0Na próxima semana, acontecerão dois grandes eventos científicos em Madri e Granada (Espanha). Serão atividades internacionais, específicas e de forma muito especial, embora não exclusivas do campo ibero-americano, organizadas e desenvolvidas por duas sociedades científicas de enfermagem muito importantes, como a Associação de Enfermagem Comunitária (AEC) e a Associação Latino-Americana de Escolas e Faculdades de […]See more
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01-01-2016
Avaliação do risco de úlceras por pressão em pacientes hospitalizados com HIV/Aids
Revista Brasileira de Enfermagem. 2016;69(1):96-101
Abstract
Avaliação do risco de úlceras por pressão em pacientes hospitalizados com HIV/Aids
Revista Brasileira de Enfermagem. 2016;69(1):96-101
DOI 10.1590/0034-7167.2016690113i
Views0See moreRESUMEN
Objetivo:
evaluar el riesgo de desarrollar úlceras por presión en pacientes hospitalizados con VIH/SIDA.
Método:
estudio cuantitativo descriptivo con 35 pacientes. Caracterización epidemiológica y clínica de los pacientes en un instrumento mediante la Escala de Braden. Las variables se realizaron en forma descriptiva simple, por números absolutos.
Resultados:
la incidencia de la PU observada en 2 pacientes, y las comorbilidades fueron neumocistosis pneumocisti carinii y tuberculosis pulmonar. Se reveló que la subescala de fricción y fuerza de deslizamiento obtuvo una puntuación más baja, seguido por actividad y la nutrición, la movilidad y la humedad. La percepción sensorial obtuvo la puntuación más alta. Dos pacientes fueron clasificados como de “alto riesgo” a 6 de “alto riesgo”, 3 para “bajo riesgo” y el otro “ningún riesgo”.
Conclusión:
la calificación de riesgo, mediante el uso de escalas proporciona información objetiva para la toma de decisione de enfermería a un modo específico.
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01-01-2016
Assessment of the risk of pressure ulcer development among hospitalized HIV/Aids patients
Revista Brasileira de Enfermagem. 2016;69(1):96-101
Abstract
Assessment of the risk of pressure ulcer development among hospitalized HIV/Aids patients
Revista Brasileira de Enfermagem. 2016;69(1):96-101
DOI 10.1590/0034-7167.2016690113i
Views0See moreABSTRACT
Objective:
to assess the risk of pressure ulcer development among hospitalized HIV/Aids.
Metod:
study quantitative descriptive with 35 patients admitted to an infectious diseases hospital in Curitiba-PR-BR. Characterized clinical and epidemiological of patients using a data collection instrument and the Braden Scale. Data was compiled using Excel® and a simple descriptive analysis.
Results:
two patients were found to have pressure ulcers and the most common comorbidities associated with HIV/Aids were pneumocystis pneumonia, caused by pneumocisti cariini (16), and pulmonary tuberculosis (13). The lowest scores were obtained in the friction and shear subscale, followed by the activity, nutrition, mobility and moisture subscales. The highest score was obtained in the sensory perception subscale. Two patients were classified as ‘very high risk’, six as ‘high risk’, three as ‘low risk’, and the rest as ‘no risk’.
Conclusion:
risk assessment using scales provides objective information to assist with systemized and targeted nursing decision-making.
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01-01-2016
Children with special health needs and family: implications for Nursing
Revista Brasileira de Enfermagem. 2016;69(1):88-95
Abstract
Children with special health needs and family: implications for Nursing
Revista Brasileira de Enfermagem. 2016;69(1):88-95
DOI 10.1590/0034-7167.2016690112i
Views0See moreABSTRACT
Objective:
to understand the family experience of children and adolescents with myelomeningocele by the discovery of chronic illness and their daily life in the realization of needed care to these people.
Method:
qualitative study, developed from October 2013 to February 2014, with family, in a pediatric hospital in Fortaleza. Data were collected through interviews and checked by analysis thematic category.
Results:
it was found that the diagnosis after the birth of the child caused fear and anguish to the families in front of the unknown and the unexpected and that over the years they started to deal with many challenges conducting the daily care due to the disease sequelae.
Conclusion:
nursing plays an important role in the lives of families, children and adolescents, through emotional support, guidelines and care inserted in the health care network.
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01-01-2016
Evaluation of the care program implementation to people with high blood pressure
Revista Brasileira de Enfermagem. 2016;69(1):79-87
Abstract
Evaluation of the care program implementation to people with high blood pressure
Revista Brasileira de Enfermagem. 2016;69(1):79-87
DOI 10.1590/0034-7167.2016690111i
Views0See moreABSTRACT
Objective:
to evaluate the implementation of the care program for people with hypertension in Maringá-PR.
Method:
it is an evaluative research of cross-sectional design. Data were collected through structured interviews with 63 nurses between April and June 2013.
Results:
as missing or insufficient, there were: transportation for outside activities; work equipment; educational materials; training resources; inclusion of the family in the care plan; risk classification of individuals; determination of therapy from the risk classification and referral of the patient to medical and/or specialized tests.
Conclusion:
in addition to qualifying structure, there are: the need to identify people with hypertension as risk factors, perform risk stratification and systematic care planning, establishing an advanced clinical practice, such as support for self-care and management cases, accomplish with existing protocols and develop collective actions based on information systems.
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01-01-2016
Evaluation of quality of life of visually impaired
Revista Brasileira de Enfermagem. 2016;69(1):72-78
Abstract
Evaluation of quality of life of visually impaired
Revista Brasileira de Enfermagem. 2016;69(1):72-78
DOI 10.1590/0034-7167.2016690110i
Views0See moreABSTRACT
Objective:
to evaluate the quality of life of visually impaired using WHOQOL-100.
Method:
exploratory, descriptive, and quantitative study, performed between April and May 2013 with 20 visually impaired of the Blind Association of Ceará, through interviews.
Results:
the analysis showed that males predominated (80%), 41-55 years (40%), students (50%) and personal income than the minimum wage (70%). Participants were self-rated with good quality of life (68.75%). The facets with the highest rates were personal relationships (74.06%), sexual activity (66.88%) and spirituality/religion/personal beliefs (65%). With lower rates were financial (43.44%), physical environment: pollution/noise/traffic/climate (46.88%), physical security and protection (37.19%), transport (35.63%) and medication or treatment dependency (8.25%).
Conclusion:
these results reflect the importance of the nurse to perform health education actions promoting the empowerment, autonomy and guaranteed of access in society for this clientele.
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01-01-2016
Coping strategies for oncology nurses in high complexity
Revista Brasileira de Enfermagem. 2016;69(1):67-71
Abstract
Coping strategies for oncology nurses in high complexity
Revista Brasileira de Enfermagem. 2016;69(1):67-71
DOI 10.1590/0034-7167.2016690109i
Views0See moreABSTRACT
Objective:
to identify the coping strategies of oncology services of nurses in highly complex hospital care before the person with cancer.
Method:
it is a qualitative research, with 18 nurses in inpatient oncology units and/or outpatient chemotherapy in two cities in southern Brazil, sampled by a snowball and carrying out semi-structured interviews. Data were submitted to thematic analysis.
Results:
three categories emerged that show strategies such as denial and resignation in care, for support in the health team and the plurality and multiplicity of perspectives on the care, including the patient and his family and the search for personal and professional improvement.
Conclusion:
coping strategies are expressed in the cultural understanding of what it means to have cancer or not and management of health institutions for nurses to work with satisfaction. The service in education is a major factor in the development of ethical competence.
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01-01-2016
Implementation of fast tests for syphilis and HIV in prenatal care in Fortaleza – Ceará
Revista Brasileira de Enfermagem. 2016;69(1):62-66
Abstract
Implementation of fast tests for syphilis and HIV in prenatal care in Fortaleza – Ceará
Revista Brasileira de Enfermagem. 2016;69(1):62-66
DOI 10.1590/0034-7167.2016690108i
Views0See moreABSTRACT
Objective:
to describe the implementation of the Fast Test (FT) of syphilis and HIV in prenatal care in primary healthcare units in Fortaleza, Ceará.
Method:
a descriptive study with a quantitative approach. There were training supervisions carried out in 24 units between May and August 2014, and the inclusion criterion was to have at least one trained professional.
Results:
the physical space, the availability, validity and the performance of FT in prenatal were analyzed. The data were presented in simple frequency tables. It was identified adequate space in 79.2% of the units, availability of FT in 62.5%, performing the tests in 37.5%, and of these, 55.6% doing these procedures in routine prenatal care.
Conclusion:
the primary units have difficulties in implementing FT in syphilis and HIV in the prenatal routine. This activity is seen as an effective strategy to reduce vertical transmission of these infections.
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01-01-2016
Evaluating child care in the Family Health Strategy
Revista Brasileira de Enfermagem. 2016;69(1):54-61
Abstract
Evaluating child care in the Family Health Strategy
Revista Brasileira de Enfermagem. 2016;69(1):54-61
DOI 10.1590/0034-7167.2016690107i
Views0See moreABSTRACT
Objective:
to evaluate the healthcare provided to children under two years old by the Family Health Strategy.
Method:
evaluative, quantitative, cross-sectional study that used the Primary Care Assessment Tool – Child Version for measuring the access, longitudinality, coordination, integrality, family orientation and community orientation.
Results:
a total of 586 adults responsible for children under two years old and linked to 33 health units in eleven municipalities of the state of Minas Gerais, Brazil, were interviewed. The evaluation was positive for the attributes longitudinality and coordination, and negative for access, integrality, Family orientation and community orientation.
Conclusion:
there are discrepancies between health needs of children and what is offered by the service; organizational barriers to access; absence of counter-reference; predominance of curative and long-standing and individual preventive practices; verticalization in organization of actions; and lack of good communication between professionals and users.
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