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RESEARCH06-01-2015
Workers of CEASA: factors associated with fatigue and work ability
Revista Brasileira de Enfermagem. 2015;68(3):460-466
Abstract
RESEARCHWorkers of CEASA: factors associated with fatigue and work ability
Revista Brasileira de Enfermagem. 2015;68(3):460-466
DOI 10.1590/0034-7167.2015680312i
Views0See moreABSTRACT
Objective:
to investigate the socio-demographic characteristics, lifestyle and health conditions related to fatigue and the work ability.
Method:
a cross-sectional study was conducted in 2011 and the sample was composed by 90 workers from the supply center of Campinas. Three questionnaires were used: Fatigue; Work ability index; and socio-demographic characteristics.
Results:
in the univariate regression analysis, the variables associated with work ability were: education, use of medicine, stress, pain in the last six months and pain in the last week. In univariate regression analysis the variables associated with fatigue were: education, stress, sleepiness, pain in the last six months, pain in the last week and health problems.
Conclusion:
these results indicate the need for health promotion program implementation among these workers.
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RESEARCH06-01-2015
Nursing Terminology defines domestic violence against children and adolescents
Revista Brasileira de Enfermagem. 2015;68(3):452-459
Abstract
RESEARCHNursing Terminology defines domestic violence against children and adolescents
Revista Brasileira de Enfermagem. 2015;68(3):452-459
DOI 10.1590/0034-7167.2015680311i
Views0See moreABSTRACT
Objective:
Identifi cation of terminology relating to nursing practices aimed at children and adolescents at risk of domestic violence.
Methods:
bibliographic descriptive research which selected 40 articles from the Virtual Health Library on domestic violence against children and adolescents, its manifestations, causes, and consequences, in association with nursing procedures for its confrontation and prevention, and which also identifi ed terminology via computer tools.
Results:
17,365 terms that, after standardization and uniformity procedures, resulted in a listing of 915 terms.
Conclusion:
The terminology selected focused on the individual biopsychic nexus and the historic manifestation of this phenomenon was partially identifi ed in terms that appear less frequently in these articles, thereby explaining the contradiction between the formal identifi cation logic of such terminology and the dialectic logic that recognizes the historic reasons for, and dynamicity of, such phenomena.
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RESEARCH06-01-2015
Instrumento para avaliação de estilo de vida sedentário em pacientes com hipertensão
Revista Brasileira de Enfermagem. 2015;68(3):445-451
Abstract
RESEARCHInstrumento para avaliação de estilo de vida sedentário em pacientes com hipertensão
Revista Brasileira de Enfermagem. 2015;68(3):445-451
DOI 10.1590/0034-7167.2015680310i
Views0See moreRESUMEN
Objetivo:
este artículo describe la precisión diagnóstica del International Physical Activity Questionnaire en la identifi cación del diagnóstico enfermero Estilo de vida sedentario.
Método:
un estudio de precisión diagnóstica se desarrolló con 240 individuos con hipertensión arterial establecida. El análisis de precisión diagnóstica se basó en medidas de sensibilidad, especifi cidad, valores predictivos, razones de verosimilitud, efi ciencia, odds ratio diagnóstica, índice de Youden y área bajo la curva característica receptor-operador.
Resultados:
diferencias estadísticas entre los sexos se observaron para las actividades intensidad moderada y la actividad física total. La edad se correlacionó negativamente con la actividad de intensidad moderada y la actividad física total.
Conclusión:
el análisis del área bajo la curva característica receptor-operador para las actividades de intensidad moderada, de caminar, y la actividad física total mostró que el International Physical Activity Questionnaire presenta moderada capacidad para clasificar correctamente los sujetos con y sin el estilo de vida sedentario.
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RESEARCH06-01-2015
Instrument for evaluation of sedentary lifestyle in patients with high blood pressure
Revista Brasileira de Enfermagem. 2015;68(3):445-451
Abstract
RESEARCHInstrument for evaluation of sedentary lifestyle in patients with high blood pressure
Revista Brasileira de Enfermagem. 2015;68(3):445-451
DOI 10.1590/0034-7167.2015680310i
Views0See moreABSTRACT
Objective:
this article describes the diagnostic accuracy of the International Physical Activity Questionnaire to identify the nursing diagnosis of sedentary lifestyle.
Method:
a diagnostic accuracy study was developed with 240 individuals with established high blood pressure. The analysis of diagnostic accuracy was based on measures of sensitivity, specifi city, predictive values, likelihood ratios, effi ciency, diagnostic odds ratio, Youden index, and area under the receiver-operating characteristic curve.
Results:
statistical differences between genders were observed for activities of moderate intensity and for total physical activity. Age was negatively correlated with activities of moderate intensity and total physical activity.
Conclusion:
the analysis of area under the receiver-operating characteristic curve for moderate intensity activities, walking, and total physical activity showed that the International Physical Activity Questionnaire present moderate capacity to correctly classify individuals with and without sedentary lifestyle.
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RESEARCH06-01-2015
Potentialities and weaknesses in the care network of people with HIV/AIDS
Revista Brasileira de Enfermagem. 2015;68(3):438-444
Abstract
RESEARCHPotentialities and weaknesses in the care network of people with HIV/AIDS
Revista Brasileira de Enfermagem. 2015;68(3):438-444
DOI 10.1590/0034-7167.2015680309i
Views0See moreABSTRACT
Objective:
to understand the strengths and weaknesses in the care network of people with HIV/AIDS in a referral center in the state of Santa Catarina-SC.
Method:
participants were eight subjects and their care network, totaling 18 participants. Data were collected through interviews and examined by content analysis, theoretically supported by symbolic interaction.
Results:
the analysis resulted in the following categories: The network offering care to people with acquired immunodefi ciency syndrome, and Facing Barriers in care, which refl ect the strengths and weaknesses in the care network. The fi rst depicts the provision of emotional and humanized care, and the second a restricted network formed by health professionals and a family member.
Conclusion:
the professional care network is important, despite the increased number of assistances in a physical structure and amount of professionals who no longer meet the growing demand.
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RESEARCH06-01-2015
AIDS epidemic in the triple frontier: subsidies for professional practice
Revista Brasileira de Enfermagem. 2015;68(3):429-437
Abstract
RESEARCHAIDS epidemic in the triple frontier: subsidies for professional practice
Revista Brasileira de Enfermagem. 2015;68(3):429-437
DOI 10.1590/0034-7167.2015680308i
Views0See moreABSTRACT
Objective:
to analyze the AIDS epidemic trend from 1988 to 2012, in a tri-border area.
Method:
Ecological time-series study with data from the Department of informatics from the Brazilian Unifi ed Health System (SUS).
Results:
A total of 1427 cases of AIDS were registered, and 82.1% were aged 20-49 years and 56% in males. The relationship man/woman went from 9/1 to 1/1 and increased the number of cases among individuals with more years of education, also, people aged more than 50 years old the age group from 20 to 34 years old. The most common exposure category was heterosexual, significantly higher among women; on the other hand, drug injection use was associated with male gender.
Conclusion:
seeking to embrace the changes in the epidemiological scenario of AIDS, nursing professionals should implement intervention strategies for people identified as the most vulnerable to HIV infection.
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RESEARCH06-01-2015
The Informal Caregiver Burden Assessment Questionnaire: validation for Brazil
Revista Brasileira de Enfermagem. 2015;68(3):421-428
Abstract
RESEARCHThe Informal Caregiver Burden Assessment Questionnaire: validation for Brazil
Revista Brasileira de Enfermagem. 2015;68(3):421-428
DOI 10.1590/0034-7167.2015680307i
Views0See moreABSTRACT
Objectives:
to analyze the dimensionality, convergent construct validity and internal consistency of the Informal Caregiver Burden Assessment Questionnaire (QASCI) after its semantic adaptation to Brazil.
Method:
this methodological study was developed with 132 informal caregivers of elders who are dependent of help for basic or instrumental activities of daily living, in a capital city in Northeast Brazil. Quality of life measures related to health, anxiety and depression were used in the analysis of the convergent construct validity of the QASCI.
Results:
the results of the instrument construct validation evidenced statistically signifi cant correlations with the three measures. The confi rmatory factor analysis evidenced good adjustment of the theoretical model of seven factors (domains) of the version used in the group studied. Cronbach’s alpha for the scale total was 0.92.
Conclusion:
the Brazilian version of the QASCI was considered to be valid and reliable for assessing the burden of informal elder caregivers.
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RESEARCH06-01-2015
Study of billing audits in a teaching hospital
Revista Brasileira de Enfermagem. 2015;68(3):414-420
Abstract
RESEARCHStudy of billing audits in a teaching hospital
Revista Brasileira de Enfermagem. 2015;68(3):414-420
DOI 10.1590/0034-7167.2015680306i
Views0See moreABSTRACT
Objectives:
to determine which component items of hospital bills, examined by nurse auditors, were adjusted the most during pre-analysis; to identify the impact upon revenue caused by the adjustments to bills analyzed by physician and nurse auditors; and to identify disallowances related to items checked by the audit team.
Method:
quantitative, exploratory, descriptive, singlecase study.
Results:
after analysis of 2,613 bills, it was found that the item most included by nurses was gas (90.5%) and the most excluded was inpatient drugs (41.2%). Hemodynamics materials, gases and equipment had the greatest impact on upward adjustments. Downward adjustments were the result of improper entries on bills and did not generate revenue losses. Of total disallowances, 52.24% were related to the pre-analysis of nurses and 47.76% to that of physicians.
Conclusion:
this study of the pre-analysis process provides input that enhances knowledge about hospital bill audits.
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EDITORIAL01-01-2017
Fundamentos e práticas do cuidar em Enfermagem Gerontológica
Revista Brasileira de Enfermagem. 2017;70(4):671-672
Abstract
EDITORIALFundamentos e práticas do cuidar em Enfermagem Gerontológica
Revista Brasileira de Enfermagem. 2017;70(4):671-672
DOI 10.1590/0034-7167.2017700401
Views0As intensas transformações sociais, econômicas, políticas, culturais, ambientais, epidemiológicas e demográficas, em conjunto com as aceleradas inovações tecnológicas, têm afetado significativamente a vida em sociedade, exigindo que as pessoas reflitam sobre as próprias concepções da natureza humana. Esse contexto de transformações tem estimulado os indivíduos a valorizar os avanços tecnológicos e a construção de relações […]See more -
EDITORIAL01-01-2017
Fundamentals and practice of care in Gerontological Nursing
Revista Brasileira de Enfermagem. 2017;70(4):671-672
Abstract
EDITORIALFundamentals and practice of care in Gerontological Nursing
Revista Brasileira de Enfermagem. 2017;70(4):671-672
DOI 10.1590/0034-7167.2017700401
Views0Intense social, economic, political, cultural, environmental, epidemiological, and demographical transformations, coupled with accelerated technological innovation, have significantly affected life in society, requiring people to reflect about the conceptions of human nature itself. This context of transformation has incentivized individuals to value technological advances and the construction of more autonomous, global, and unstable human relationships, outlining […]See more -
The importance of empathy in health and nursing care
Revista Brasileira de Enfermagem. 2017;70(3):669-670
Abstract
The importance of empathy in health and nursing care
Revista Brasileira de Enfermagem. 2017;70(3):669-670
DOI 10.1590/0034-7167-2016-0032
Views0“In her book “Cultivating Empathy”(), Kathleen Stephany, psychologist and professor at the College of Health Sciences at Douglas College, writes about empathy, which she considers to be the basis of effective communication and one of the most important skills to be developed by human beings. Empathy is the ability to put oneself in the place […]See more -
REFLECTION01-01-2017
Clinical reasoning in nursing: teaching strategies and assessment tools
Revista Brasileira de Enfermagem. 2017;70(3):662-668
Abstract
REFLECTIONClinical reasoning in nursing: teaching strategies and assessment tools
Revista Brasileira de Enfermagem. 2017;70(3):662-668
DOI 10.1590/0034-7167-2016-0509
Views0See moreABSTRACT
Objective:
To present the concept and development of teaching strategies and the assessment tools regarding clinical reasoning for accurate practice.
Method:
This is a theoretical reflection based on scientific studies.
Results:
Comprehension of the essential concepts of the thought process and its articulation with the different teaching strategies and the assessment tools which has allowed presenting ways to improve the process of diagnostic or therapeutic clinical reasoning.
Conclusion:
The use of new strategies and assessment tools should be encouraged in order to contribute to the development of skills that lead to safe and effective decision making.
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REFLECTION01-01-2017
Continuing education in health from the perspective of Augustine of Hippo
Revista Brasileira de Enfermagem. 2017;70(3):656-661
Abstract
REFLECTIONContinuing education in health from the perspective of Augustine of Hippo
Revista Brasileira de Enfermagem. 2017;70(3):656-661
DOI 10.1590/0034-7167-2016-0484
Views0See moreABSTRACT
Objective:
To reflect about continuing education from the perspective of Augustine of Hippo and his theories based on the construction of knowledge and the learning process.
Method:
This is a theoretical reflection study whose aim is to propose dimensions of analysis, emphasizing the history and challenges of continuing education. Such dimensions analyze the production of knowledge in Augustinian pedagogy, its historical aspects and its close relationship with lifelong education in health professions.
Results:
The results show the difficulty of continuing education to reach adequate importance in health services, and that of academia in appropriating the thoughts of renowned philosophers such as Augustine. This is a result of ignorance about the convergence of these principles and their relevance.
Final considerations:
Continuing education and Augustinian pedagogy walk hand in hand in terms of care, meeting the needs that originate from practice and that are reflected in it, challenging isolated knowledge and putting different areas of knowledge to work together.
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REVIEW01-01-2017
Influence of hormonal contraceptives and the occurrence of stroke: integrative review
Revista Brasileira de Enfermagem. 2017;70(3):647-655
Abstract
REVIEWInfluence of hormonal contraceptives and the occurrence of stroke: integrative review
Revista Brasileira de Enfermagem. 2017;70(3):647-655
DOI 10.1590/0034-7167-2016-0056
Views0See moreABSTRACT
Objective:
To identify scientific evidence regarding the influence of hormonal contraceptive use and the occurrence of stroke.
Method:
Integrative review of the literature, through database search using the descriptors “contraceptive agents“, “contraceptive devices“, “contraceptives, Oral” and “Stroke”. Original studies in Portuguese, Spanish and English, published in full and available online were included. Studies that did not answer our guiding questions and duplicated studies were excluded.
Results:
Women using combined oral contraceptives have higher risk of stroke, even with a lower hormonal dosage and different types of progestogen, regardless of the duration of use. The use of contraceptives associated with smoking, hypertension, migraine, hypercholesterolemia, obesity and sedentary lifestyle increases the chance of stroke. Contraceptive patch and vaginal ring are associated to increased risk.
Conclusion:
Use of combined hormonal contraceptives, except for the injectable and the transdermal ones, increases the chance of occurrence of the event. Progestogen-only contraceptives were considered safe.
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RESEARCH01-01-2017
Health Conditions and Memory Performance: a study with older adult women
Revista Brasileira de Enfermagem. 2017;70(3):640-646
Abstract
RESEARCHHealth Conditions and Memory Performance: a study with older adult women
Revista Brasileira de Enfermagem. 2017;70(3):640-646
DOI 10.1590/0034-7167-2016-0529
Views0See moreABSTRACT
Objective:
to verify the correlation between health condition and memory performance of older adult women in the community.
Method:
Analytical cross-sectional study developed with 28 older adult women living in Cuiabá-MT. They answered the Mini-Mental State Examination (MMSE), and a shortened Geriatric Depression Scale (GDS-15) to screen for dementia and depression symptoms. Memory skills were assessed through Rey Auditory Verbal Learning Test (RAVLT).
Results:
The mean age was 66.36 years and 75% of the participants had educational level higher than 7 years. The MMSE mean score was 28.45. The correlations found were: educational level and immediate memory (r = 0.49; p = 0.008); delayed recall and immediate memory (r = 0.71; p < 0.001); memory recognition and immediate memory (r = 0.43; p = 0.021) and recognition memory with delayed recall (r = 0.47; p = 0.012).
Conclusion:
High scores in the MMSE and a satisfactory health perception among the participants were evident. There was no correlation between memory performance and health perception.
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RESEARCH01-01-2017
Comprehension of the education handout and health literacy of pacemaker users
Revista Brasileira de Enfermagem. 2017;70(3):633-639
Abstract
RESEARCHComprehension of the education handout and health literacy of pacemaker users
Revista Brasileira de Enfermagem. 2017;70(3):633-639
DOI 10.1590/0034-7167-2016-0336
Views0See moreABSTRACT
Objective:
To verify the comprehension of the education handout and the level of Functional Health Literacy of individuals with cardiac pacemaker (PM) and whether there is correlation between the comprehension and Functional Health Literacy (FHL).
Method:
Cross-sectional study with 63 individuals with PM who answered to comprehension tests of the handout, literacy assessment (SAHLPA-50) and cognition (MMSE). Measurements of dispersion, Pearson correlation and multiple linear regression were calculated.
Results:
Most women, study time ≤ 9 years, 66.21 (average age) presented no cognitive changes. An adequate literacy level was evidenced in 50.8% individuals with PM and satisfactory comprehension of the handout. No correlation was identified between FHL, handout comprehension, age, years of study and cognition.
Conclusion:
The handout comprehension assessed by individuals with appropriate FHL indicated that it can be a printed material suitable for use, aiming to improve care process and knowledge of individuals with PM.
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ERRATUM01-13-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
DOI 10.1590/0034-7167.20247706e08
Views0In the article “Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(4):e20230520, Chart 1:Where it read:[…]See more -
ERRATUM01-13-2024
ERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
Abstract
ERRATUMERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
DOI 10.1590/0034-7167.20247706e06pt
Views0No artigo “Crenças e atitudes de pais ou responsáveis legais sobre a vacinação infantil: revisão de escopo”, com número DOI: , publicado no periódico Revista Brasileira de Enfermagem, 2024;77(4):e20240126, página 5:Onde se lia:[…]See more -
ORIGINAL ARTICLE01-13-2024
Indicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
Abstract
ORIGINAL ARTICLEIndicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
DOI 10.1590/0034-7167-2024-0204
Views0See moreABSTRACT
Objectives:
to compare the sociodemographic and clinical severity indicators of hospitalized people with HIV in relation to clinical outcomes and urgent hospital admission.
Methods:
a retrospective cohort study was conducted with 102 medical records of HIV-infected individuals hospitalized in a hospital in southern Brazil. In addition to descriptive analysis, Fisher’s exact test, Pearson’s Chi-square, and logistic regression were used.
Results:
the data showed a significant direct effect on severity indicators in the following variables: male sex (p=0.013), skin color (p=0.023), level of education (p=0.000), urgent admissions (p=0.000), late diagnosis (p=0.001), diabetes mellitus (p=0.001), hypertension (p=0.004), kidney disease (p=0.002), high viral load (p=0.006), CD4+ count below 200 (p=0.005), fever (p=0.016), weight loss (p=0.013), co-infection with hepatitis C (p=0.004), and mortality (p=0.007).
Conclusions:
three sociodemographic and thirteen clinical markers were identified as being associated with the risk of clinical deterioration in hospitalized people with HIV.
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ORIGINAL ARTICLE01-13-2024
Nurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
Abstract
ORIGINAL ARTICLENurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
DOI 10.1590/0034-7167-2023-0481
Views1See moreABSTRACT
Objectives:
to understand the perspective of nurses on the use of telemonitoring in the management of people with type 2 diabetes mellitus and arterial hypertension in primary care.
Methods:
this qualitative research involved sixteen nurses from eight municipalities in Paraná. Data were collected between November 2022 and January 2023 through inperson or remote interviews, which were audio-recorded and subjected to content analysis.
Results:
according to the nurses, telemonitoring enhances users’ knowledge about these conditions, communication and connection with the team, and productivity. However, the lack of electronic resources and equipment, high staff turnover, low user adherence, and the limited availability of professional time present significant challenges.
Final Considerations:
the effective implementation and operation of telemonitoring in the management of people with diabetes and hypertension involve both potential benefits and barriers. It is essential to have the availability of human and technological resources, managerial support, and the commitment of professionals and users.
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ORIGINAL ARTICLE01-13-2024
Knowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
Abstract
ORIGINAL ARTICLEKnowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
DOI 10.1590/0034-7167-2023-0424
Views0ABSTRACT
Objectives:
to investigate the knowledge, attitudes, and practices of nurses regarding blood culture collection.
Methods:
a cross-sectional study was conducted in five Brazilian public hospitals with 112 nurses. Data were collected using an adapted questionnaire and analyzed through descriptive and inferential statistics.
Results:
nurses who did not consider themselves capable of collecting blood cultures had a 72% lower chance of performing the collection at the recommended site and an 83% lower chance of using the same needle for blood inoculation into the vials. Nurses working in the emergency department had a 75% lower chance of knowing the international benchmark for blood culture contamination rates, and those with less than 5 years in the position decreased their chance of accuracy in this matter by 79%.
Conclusions:
there are gaps in the knowledge, attitudes, and practices of nurses regarding blood culture collection. Standardization of the technique, periodic education, supervision and guidance of the collection team, and process auditing are recommended coping strategies.
Keywords:Blood CultureBlood Specimen CollectionHealth Knowledge, Attitudes, PracticeNursing CareQuality of Health CareSee more -
ORIGINAL ARTICLE01-13-2024
Evaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
Abstract
ORIGINAL ARTICLEEvaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
DOI 10.1590/0034-7167-2023-0190
Views0ABSTRACT
Objectives:
to verify the construct validation of an instrument for evaluating care for people living with HIV in Primary Health Care.
Methods:
methodological study carried out in 2021 with 260 health professionals in Recife, PE. Validation based on the internal structure was carried out at this stage using exploratory and confirmatory factor analysis, and validity based on item response theory.
Results:
the validation determined the retention of five factors and 63 items. The instrument’s internal consistency and quality of fit was 0.90, the Tukey-Lewis index was 0.915 and the comparative fit index was 0.918 in the confirmatory factor analysis. The indication for the absolute majority of items is adequate fit.
Conclusions:
the instrument has construct validity, making it possible to use it to evaluate the decentralization process and care for People Living with HIV in Primary Health Care.
Keywords:Acquired Immunodeficiency SyndromeComprehensive Health CareHIVPrimary Health CareProgram EvaluationSee more -
ORIGINAL ARTICLE01-10-2024
Inventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
Abstract
ORIGINAL ARTICLEInventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
DOI 10.1590/0034-7167-2023-0539
Views0See moreABSTRACT
Objective:
to construct and validate the content of an inventory of ethical problems experienced by nurses in mobile pre-hospital care.
Method:
a psychometric approach study, developed with the following stages: (1) instrument construction through a theoretical matrix based on deliberative bioethics, scoping review and online qualitative research; (2) content validity by judges; (3) pre-testing with Mobile Emergency Care Service nurses in various Brazilian states. For content validity analysis, the Content Validity Ratio was calculated (CVR>0.45 for judges and CVR>0.35 for the target population).
Results:
the instrument had 44 items, distributed across four dimensions.
Final considerations:
the constructed instrument presented sources of evidence of content validity, providing good psychometric measurements and constituting a useful tool for nurses’ practice in the pre-hospital setting.
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