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ORIGINAL ARTICLE06-28-2024
Quality of life at work for health professionals during the COVID-19 pandemic
- Monalisa Maria Leandro da Silva Oliveira
, - Gabriela Ferreira de Oliveira Butrico ,
- Vanessa da Silva Carvalho Vila ,
- Katarinne Lima Moraes ,
- Marina Aleixo Diniz Rezende , [ … ],
- Sergiane Bisinoto Alves
Abstract
ORIGINAL ARTICLEQuality of life at work for health professionals during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230461
DOI 10.1590/0034-7167-2023-0461
- Monalisa Maria Leandro da Silva Oliveira ,
- Gabriela Ferreira de Oliveira Butrico ,
- Vanessa da Silva Carvalho Vila ,
- Katarinne Lima Moraes ,
- Marina Aleixo Diniz Rezende ,
- Laidilce Teles Zatta Santos ,
- Larissa Silva Magalhães ,
- Sergiane Bisinoto Alves
Views0See moreABSTRACT
Objective:
to evaluate the quality of life at work of health professionals in direct and indirect care of COVID-19 cases.
Methods:
this was a cross-sectional study with 156 health professionals from a referral hospital. The relationship between sociodemographic and work-related variables and perceived stress and domains of the Quality of Life at Work Scale was investigated using inferential statistics and regression.
Results:
Satisfaction with Compassion was moderate (mean: 38.2), with low perception of stress, Burnout and Secondary Traumatic Stress (means: 18.8, 21.6 and 19.1). There were associations between: education, salary, multiple jobs and direct care with Compassion Satisfaction; low income, being a nurse and working overtime with Burnout; and working more than 12 hours, underlying disease and hospitalization for COVID-19 with Secondary Traumatic Stress.
Conclusion:
quality of life at work was satisfactory, despite the presence of Burnout and Secondary Traumatic Stress.
- Monalisa Maria Leandro da Silva Oliveira
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ORIGINAL ARTICLE06-28-2024
Nursing leadership strategies in addressing COVID-19 in light of John Kotter’s framework
- Patrícia Alves Galhardo Varanda ,
- Gilberto Tadeu Reis da Silva ,
- Simone Coelho Amestoy ,
- Vânia Marli Schubert Backes ,
- Gabriela Marcellino de Melo Lanzoni , [ … ],
- Augusto Ferreira Umpiérrez
Abstract
ORIGINAL ARTICLENursing leadership strategies in addressing COVID-19 in light of John Kotter’s framework
Revista Brasileira de Enfermagem. 2024;77:e20230289
DOI 10.1590/0034-7167-2023-0289
- Patrícia Alves Galhardo Varanda ,
- Gilberto Tadeu Reis da Silva ,
- Simone Coelho Amestoy ,
- Vânia Marli Schubert Backes ,
- Gabriela Marcellino de Melo Lanzoni ,
- Augusto Ferreira Umpiérrez
Views0See moreABSTRACT
Objective:
To analyze the leadership strategies of nurses in university hospitals in response to care management changes during the COVID-19 pandemic, informed by John Kotter’s insights.
Methods:
This multicentric study utilized qualitative and analytical methods. It was conducted through semi-structured interviews with 139 lead nurses from 10 university hospitals in Brazil. Data analysis included Bardin’s content analysis and the webQDA software.
Results:
The primary category identified was “Nursing Leadership Strategies in the Battle Against COVID-19,” encompassing five subcategories. This category underscored the importance of strategic vision in nursing leadership for combating COVID-19 within hospital settings, as well as the necessity of working collaboratively with their teams and other healthcare professionals.
Final Considerations:
The results highlight the strategies used by lead nurses in confronting COVID-19, which can be associated with John Kotter’s theoretical framework and his model of change.
- Patrícia Alves Galhardo Varanda
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ORIGINAL ARTICLE06-28-2024
Quality of Care Transition for COVID-19 Patients in a University Hospital in Southern Brazil
- Ana Cecilia Boeng ,
- Caroline Cechinel-Peiter ,
- Maria Fernanda Baeta Neves Alonso da Costa ,
- Laísa Fisher Wachholz ,
- José Luís Guedes dos Santos , [ … ],
- Gabriela Marcellino de Melo Lanzoni
Abstract
ORIGINAL ARTICLEQuality of Care Transition for COVID-19 Patients in a University Hospital in Southern Brazil
Revista Brasileira de Enfermagem. 2024;77:e20230402
DOI 10.1590/0034-7167-2023-0402
- Ana Cecilia Boeng ,
- Caroline Cechinel-Peiter ,
- Maria Fernanda Baeta Neves Alonso da Costa ,
- Laísa Fisher Wachholz ,
- José Luís Guedes dos Santos ,
- Gabriela Marcellino de Melo Lanzoni
Views0See moreABSTRACT
Objective:
To assess the quality of care transition from hospital to home for COVID-19 patients.
Method:
A cross-sectional study conducted at a University Hospital in Southern Brazil, involving 78 patients discharged after COVID-19 hospitalization. Data collection was performed via telephone using the Brazilian version of the Care Transitions Measure (CTM-15). Data were analyzed using descriptive and analytical statistics.
Results:
The mean quality of care transition was 70.8 on a scale ranging from zero to 100, indicating moderate quality of care transition. The highest score was attributed to factor 1, “Preparation for self-management,” and the lowest to factor 4, “Care Plan.”
Conclusions:
It is important to enhance communication and support provided to patients during the transition process, especially regarding understanding prescribed medications and the development of clear care plans.
- Ana Cecilia Boeng
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REVIEW06-28-2024
Clinical outcomes in newborns of pregnant women with COVID-19: integrative review
- Iara Bezerra da Silva Ximenes ,
- Cassiano Richel Ferreira Leal ,
- Odinéia Maria Amorim Batista ,
- Maria Eliete Batista Moura ,
- Maria Zélia de Araújo Madeira , [ … ],
- Denise de Andrade
Abstract
REVIEWClinical outcomes in newborns of pregnant women with COVID-19: integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230400
DOI 10.1590/0034-7167-2023-0400
- Iara Bezerra da Silva Ximenes ,
- Cassiano Richel Ferreira Leal ,
- Odinéia Maria Amorim Batista ,
- Maria Eliete Batista Moura ,
- Maria Zélia de Araújo Madeira ,
- Andreia Rodrigues Moura da Costa Valle ,
- Pedro Emílio Gomes Prates ,
- Álvaro Francisco Lopes de Sousa ,
- Denise de Andrade
Views0See moreABSTRACT
Objectives:
to analyze clinical outcomes in newborns of pregnant women with COVID-19.
Methods:
integrative review conducted in PubMed, Web of Knowledge, SCOPUS, CINHAL; 2,111 studies were obtained, and 8 articles comprised the final sample.
Results:
clinical outcomes in neonates of pregnant women positive for COVID-19 were classified according to the following categories: a) contamination by COVID-19, reported in 62.5% of the studies; b) hospital discharge due to improvement, mentioned in 37.5% of the articles; c) death, representing rare cases in 25% of the sample. The most prevalent gestational complication was prematurity, mentioned in 75% of the studies. This complication has been observed due to cases of premature rupture of membranes and placental abruption.
Conclusions:
despite the knowledge of asymptomatic and mildly symptomatic behavior in neonates, it is important to continue the search for new clinical data, as this public has uncertain reactions to SARS-CoV-2 infection.
- Iara Bezerra da Silva Ximenes
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ORIGINAL ARTICLE06-17-2024
Website for families of non-breastfed children: development and validation of content and interface
Revista Brasileira de Enfermagem. 2024;77(3):e20230490
Abstract
ORIGINAL ARTICLEWebsite for families of non-breastfed children: development and validation of content and interface
Revista Brasileira de Enfermagem. 2024;77(3):e20230490
DOI 10.1590/0034-7167-2023-0490
Views0See moreABSTRACT
Objectives:
to develop and validate the content and interface of a guidance website to support families in promoting Food and Nutrition Security for children under six months who are not breastfed.
Methods:
methodological study, Knowledge Translation, in two stages of creation: 1) content and validation on the criterion of accuracy in a panel of experts; 2) interface and validation on the criteria of content, language, illustrations, layout, motivation, culture and applicability.
Results:
the “Milky Way” website is freely available: . The content was structured in a decision tree made up of types of milk: milk formula, whole cow’s milk and powdered milk; and utensils: bottle, cup and measuring spoon. There were 46 illustrations to elucidate the content, facilitate understanding and engage the target population. The Content Validity Index was 0.91.
Conclusions:
the website is a validated technology with evidence-based written and pictorial content translated for use with families.
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ORIGINAL ARTICLE06-17-2024
Quality of life associated with nursing professionals’ individual resources and work
- Isabela Saura Sartoreto Mallagoli ,
- Evandro Piccinelli da Silva ,
- Maria Aline do Nascimento Oliveira ,
- Italo Everton Bezerra Barbosa ,
- Aristeia Nunes Sampaio , [ … ],
- Angélica Gonçalves Silva Belasco
Abstract
ORIGINAL ARTICLEQuality of life associated with nursing professionals’ individual resources and work
Revista Brasileira de Enfermagem. 2024;77(3):e20230476
DOI 10.1590/0034-7167-2023-0476
- Isabela Saura Sartoreto Mallagoli ,
- Evandro Piccinelli da Silva ,
- Maria Aline do Nascimento Oliveira ,
- Italo Everton Bezerra Barbosa ,
- Aristeia Nunes Sampaio ,
- Aline Bicalho Matias ,
- Dulce Aparecida Barbosa ,
- Angélica Gonçalves Silva Belasco
Views0See moreABSTRACT
Objectives:
to assess the physical and mental components of nursing professionals’ quality of life and associate them with individual, health and work characteristics.
Methods:
cross-sectional research, with nursing professionals from a university hospital in São Paulo. Own questionnaire and validated instruments were applied.
Results:
the overall quality of life was compromised. The physical component was lower in relation to low family income and among those who perceived greater control/pressure at work, and better for those who practiced physical activity and had support of leader and organization. The mental component was lower in professionals who reported dissatisfaction with work, worse self-rated physical health and were older. Scores for both components reduced due to work-related illnesses, worse work ability and increased daytime sleepiness.
Conclusions:
quality of life was statistically associated with controllable institutional factors and individual resources that, except age, can be promoted.
- Isabela Saura Sartoreto Mallagoli
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ORIGINAL ARTICLE06-17-2024
Giving meaning to internalized violence throughout life by older adults living in rural areas
- Aline Balandis Costa ,
- Maria Aparecida Salci ,
- Francielle Renata Danielli Martins Marques ,
- Vanessa Denardi Antoniassi Baldissera ,
- Lígia Carreira
Abstract
ORIGINAL ARTICLEGiving meaning to internalized violence throughout life by older adults living in rural areas
Revista Brasileira de Enfermagem. 2024;77(3):e20230163
DOI 10.1590/0034-7167-2023-0163
- Aline Balandis Costa ,
- Maria Aparecida Salci ,
- Francielle Renata Danielli Martins Marques ,
- Vanessa Denardi Antoniassi Baldissera ,
- Lígia Carreira
Views0See moreABSTRACT
Objectives:
to understand the meanings of violence internalized throughout life by older adults living in rural areas.
Methods:
a qualitative study, anchored in the Symbolic Interactionism theoretical framework and the Grounded Theory methodological framework in the constructivist aspect. Data collection occurred through individual interviews. Data were coded using the Atlas.ti software.
Results:
it was possible to identify that the context of rural areas strengthens patriarchy culture as well as contributing to violence silence and naturalization. It was also found that violence is a product of social inequality and gender inequality.
Final Considerations:
older adults living in rural areas internalized the violence suffered in a unique way, and this scenario’s specific aspects can increase intra-family abuse, as there is a patriarchal culture that promotes social and gender inequality.
- Aline Balandis Costa
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ORIGINAL ARTICLE06-17-2024
Social protection in areas vulnerable to tuberculosis: a mixed methods study in São Luís, Maranhão
- Francisca Bruna Arruda Aragão ,
- Mellina Yamamura Calori ,
- Thais Zamboni Berra ,
- Antônio Carlos Vieira Ramos ,
- Ethel Leonor Noia Maciel , [ … ],
- Regina Célia Fiorati
Abstract
ORIGINAL ARTICLESocial protection in areas vulnerable to tuberculosis: a mixed methods study in São Luís, Maranhão
Revista Brasileira de Enfermagem. 2024;77(3):e20230428
DOI 10.1590/0034-7167-2023-0428
- Francisca Bruna Arruda Aragão ,
- Mellina Yamamura Calori ,
- Thais Zamboni Berra ,
- Antônio Carlos Vieira Ramos ,
- Ethel Leonor Noia Maciel ,
- José Henrique da Silva Cunha ,
- Larissa Barros de Souza ,
- Marcelino Santos Neto ,
- Ricardo Alexandre Arcêncio ,
- Regina Célia Fiorati
Views0See moreABSTRACT
Objectives:
to analyze the risk areas for tuberculosis and the influences of social protection on the development of treatment for the disease in the municipality of São Luís, Maranhão.
Methods:
this is explanatory sequential mixed method research. In the quantitative phase, the data were obtained from the Notifiable Diseases Information System from 2010 to 2019, with georeferencing being carried out to identify areas vulnerable to tuberculosis. In the qualitative phase, semi-structured interviews were carried out with individuals who received social benefits.
Results:
7,381 cases were geocoded, and, from the purely spatial scanning analysis, it was possible to identify 13 spatial clusters of risk. As for the interviews, there was a positive relationship between patient improvement and receiving benefits.
Conclusions:
geographic space and social determinants are relevant for reorienting monitoring actions for the conditions that generate the health-disease process.
- Francisca Bruna Arruda Aragão
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ORIGINAL ARTICLE03-07-2022
Critically ill COVID-19 patients: a sociodemographic and clinical profile and associations between variables and workload
- Marina Raffin Buffon ,
- Isis Marques Severo ,
- Ruy de Almeida Barcellos ,
- Karina de Oliveira Azzolin ,
- Amália de Fátima Lucena
Abstract
ORIGINAL ARTICLECritically ill COVID-19 patients: a sociodemographic and clinical profile and associations between variables and workload
Revista Brasileira de Enfermagem. 2022;75:e20210119
DOI 10.1590/0034-7167-2021-0119
- Marina Raffin Buffon ,
- Isis Marques Severo ,
- Ruy de Almeida Barcellos ,
- Karina de Oliveira Azzolin ,
- Amália de Fátima Lucena
Views0See moreABSTRACT
Objective:
To identify the sociodemographic and clinical profile of COVID-19 patients; measure workload and make associations between clinical variables.
Methods:
Cross-sectional study with 150 adult COVID-19 patients in an intensive care unit (from March to June 2020). Data from the electronic medical record in the first 24 hours of hospitalization: gender, age, education, origin, comorbidities, invasive mechanical ventilation, prone maneuver, renal replacement therapy, pressure injury, Braden, Nursing Activities Score, diagnoses, and nursing care. Descriptive statistical analysis, associations between clinical variables and age group.
Results:
Male (55.3%); mean age, 59 years; hypertensive (57.3%); obese (50.6%); diabetic (34%); invasive mechanical ventilation (66.7%); pronated (20.6%); hemodialysis (15.3%); Nursing Activities Score average, 86%. Twenty-eight nursing diagnoses and 73 cares were found.
Conclusion:
Patients required highly complex support. There was a significant association between pressure injury and workload with the prone maneuver. Nursing diagnoses and care reflect the needs of critical patients.
- Marina Raffin Buffon
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ORIGINAL ARTICLE06-01-2020
Factors associated with occupational stress among nursing professionals in health services of medium complexity
Revista Brasileira de Enfermagem. 2020;73:e20180913
Abstract
ORIGINAL ARTICLEFactors associated with occupational stress among nursing professionals in health services of medium complexity
Revista Brasileira de Enfermagem. 2020;73:e20180913
DOI 10.1590/0034-7167-2018-0913
Views0See moreABSTRACT
Objective:
To analyze the factors associated with occupational stress among nursing workers in health services of medium complexity.
Methods:
Epidemiological, cross-sectional, exploratory study. A randomly selected sample of 126 nursing professionals from medium complexity services in three cities in the state of Bahia (Santo Antônio de Jesus, Feira de Santana and Itabuna) was investigated. Data were collected in 2011 and 2012. The demand-control model proposed by Karasek was used to assess occupational stress. Simultaneous analysis of occupational stressors was performed using Poisson regression with robust variance.
Results:
The prevalence of occupational stress among nursing professionals was 77%. Occupational stress was associated with the professional category of nursing technician (p=0.01).
Conclusion:
The data indicates a concerning situation of exposure to occupational stressors, which requires coping strategies in order to protect the health of the worker.
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REVIEW07-06-2020
Patient safety challenges in primary health care: a scoping review
Revista Brasileira de Enfermagem. 2020;73(5):e20190209
Abstract
REVIEWPatient safety challenges in primary health care: a scoping review
Revista Brasileira de Enfermagem. 2020;73(5):e20190209
DOI 10.1590/0034-7167-2019-0209
Views1See moreABSTRACT
Objectives:
to identify the patient safety challenges described by health professionals in Primary Health Care.
Methods:
a scoping review was conducted on the LILACS, MEDLINE, IBECS, BDENF, and CINAHL databases, and on the Cochrane, SciELO, Pubmed, and Web of Science libraries in January 2019. Original articles on patient safety in the context of Primary Health Care by health professionals were included.
Results:
the review included 26 studies published between 2002 and 2019. Four categories resulted from the analysis: challenges of health professionals, administration challenges of health services, challenges with the patient and family, and the potential enhancing resources for patient safety.
Conclusions:
patient safety challenges for Primary Care professionals are multiple and complex. This study provides insight into resources to improve patient safety for health care professionals, patients, administrators, policy makers, educators, and researchers.
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ORIGINAL ARTICLE11-26-2022
Factors associated with suicide ideation of healthcare university students
- Girliani Silva de Sousa ,
- Barbara Moreira Duarte Ramos ,
- Luis Antônio Batista Tonaco ,
- Amanda Márcia dos Santos Reinaldo ,
- Maria Odete Pereira , [ … ],
- Nadja Cristiane Lappann Botti
Abstract
ORIGINAL ARTICLEFactors associated with suicide ideation of healthcare university students
Revista Brasileira de Enfermagem. 2022;75:e20200982
DOI 10.1590/0034-7167-2020-0982
- Girliani Silva de Sousa ,
- Barbara Moreira Duarte Ramos ,
- Luis Antônio Batista Tonaco ,
- Amanda Márcia dos Santos Reinaldo ,
- Maria Odete Pereira ,
- Nadja Cristiane Lappann Botti
Views0See moreABSTRACT
Objectives:
to analyze the factors associated with suicidal ideation in students from healthcare graduation courses.
Methods:
quantitative, cross-sectional study, with 251 students from the courses of radiology, speech-language therapy, medicine, nutrition, health service management, and nursing, from a federal higher education institution in the Southeast of Brazil. Data were collected from August to October 2019, using an electronic questionnaire.
Results:
the prevalence of suicidal ideation among participants was 26.33%. In the final logistic regression model, only depressive symptoms were associated with suicidal ideation. Having symptoms of depression increased the chances of suicidal ideation 2.6 times.
Conclusion:
the high prevalence of suicidal ideation and its associated factors constitutes a situational diagnosis that demands the elaboration of public and institutional policies, focused on the promotion and attention to the mental health of the students.
- Girliani Silva de Sousa
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REVIEW01-20-2021
Psychosocial factors in nursing work and occupational risks: a systematic review
Revista Brasileira de Enfermagem. 2021;74:e20200198
Abstract
REVIEWPsychosocial factors in nursing work and occupational risks: a systematic review
Revista Brasileira de Enfermagem. 2021;74:e20200198
DOI 10.1590/0034-7167-2020-0198
Views0See moreABSTRACT
Objective:
to identify, in international scientific production, the main psychosocial factors in nursing work, found through the Copenhagen Psychosocial Questionnaire (COPSOQ) application.
Methods:
a systematic review study of psychosocial factors at work among nursing professionals, who used COPSOQ in the assessment of work environments.
Results:
fifteen articles were identified, which highlighted as main psychosocial dimensions of nursing work demands, work organization, social relationships and leadership, work-home interface, workplace health and well-being and offensive behaviors.
Conclusion:
the high demands for cognitive, emotional work and work pace were identified in the nursing routine. Management support had a positive impact. Physical and psychological violence and shift work interfere in family life, aggravating the fatigue of these professionals. Interventions for reducing work stress presuppose the identification of psychosocial factors involved in nursing work.
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ORIGINAL ARTICLE08-10-2020
Eliot Freidson’s sociology of professions: an interpretation for Health and Nursing
Revista Brasileira de Enfermagem. 2020;73(6):e20180950
Abstract
ORIGINAL ARTICLEEliot Freidson’s sociology of professions: an interpretation for Health and Nursing
Revista Brasileira de Enfermagem. 2020;73(6):e20180950
DOI 10.1590/0034-7167-2018-0950
Views0See moreABSTRACT
Objectives:
to analyze theoretical conceptions of Eliot Freidson’s Sociology of Professions scoped on health and nursing professions.
Methods:
Eight nurses were interviewed, all involved in the development of the professional Council on the timeframe from 1975 to 1986. Documental resources were Laws, Ordinances, Resolutions, Reports, Meeting Minutes and Public Deeds. Information was organized as from literature and Eliot Freidson’s conceptions, and thematic content analysis was carried out.
Results:
the concepts authored by Eliot Freidson allowed for the development of a concept chart that portrays the nursing profession and that may be expanded for the other occupations in the health field, in consonance with professional organization in the country.
Final Considerations:
Eliot Freidson’s framework, in interpretation for nursing, consolidates the profession with relative autonomy, expertise by Nursing Care Systematization and credentialism by professional normalizations.
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07-16-2021
Sleep quality and its association with menopausal and climacteric symptoms
- Mariana Alvina dos Santos ,
- Aline Nascimento Vilerá ,
- Anneliese Domingues Wysocki ,
- Flávia Helena Pereira ,
- Deíse Moura de Oliveira , [ … ],
- Vinícius Batista Santos
Abstract
Sleep quality and its association with menopausal and climacteric symptoms
Revista Brasileira de Enfermagem. 2021;74:e20201150
DOI 10.1590/0034-7167-2020-1150
- Mariana Alvina dos Santos ,
- Aline Nascimento Vilerá ,
- Anneliese Domingues Wysocki ,
- Flávia Helena Pereira ,
- Deíse Moura de Oliveira ,
- Vinícius Batista Santos
Views0See moreABSTRACT
Objective:
to assess sleep quality in menopausal women and its association with symptoms related to this period.
Method:
this is a cross-sectional, analytical and correlational study. Sleep was assessed using the Pittsburgh Sleep Quality Index; and climacteric symptoms, according to the Menopause Rating Scale. To compare the total score and each Menopause Rating Scale domain with the PSQI classification, the Mann-Whitney U non-parametric test was used. P<0.05 was considered significant.
Results:
261 women (67.8%) were classified as bad sleepers. There was a positive and significant correlation between the sleep scale scores and the total menopause score and its domains. Women categorized as poor sleepers had worse scores on the menopause symptom scale.
Conclusion:
women with worse sleep quality revealed greater severity of symptoms related to menopause.
- Mariana Alvina dos Santos
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ORIGINAL ARTICLE12-05-2019
Aging, sexuality and nursing care: the elderly woman’s look
- Cinoélia Leal de Souza ,
- Vanda Santana Gomes ,
- Roberta Lopes da Silva ,
- Elaine Santos da Silva ,
- Jaqueline Pereira Alves , [ … ],
- Simone Aline Ferreira
Abstract
ORIGINAL ARTICLEAging, sexuality and nursing care: the elderly woman’s look
Revista Brasileira de Enfermagem. 2019;72:71-78
DOI 10.1590/0034-7167-2018-0015
- Cinoélia Leal de Souza ,
- Vanda Santana Gomes ,
- Roberta Lopes da Silva ,
- Elaine Santos da Silva ,
- Jaqueline Pereira Alves ,
- Núbia Rêgo Santos ,
- Victor Neves Reis ,
- Simone Aline Ferreira
Views0See moreABSTRACT
Objective:
to analyze the perception of elderly women about sexuality and practice of nursing care in this context.
Method:
a descriptive qualitative study. Fifty elderly women from Guanambi City – Bahia State were interviewed in 2016. Data collection technique was direct interview by using an unstructured script. Analysis of the semantic content described was carried out, and two empirical categories: the elderly woman’s view of nursing care in the promotion of sexual health and experience of sexuality in the elderly; and nursing care in the context of women’s aging.
Results:
it has been noted that the elderly women are afraid to talk about sexuality, especially with health professionals. By influences of society, they often exclude this issue of health care for elderly women.
Final considerations:
changes must be thought about assistance provided in relation to sexuality.
- Cinoélia Leal de Souza
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