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ORIGINAL ARTICLE05-27-2024
Assessment of educational technology in lactation physiology by health students
- Daiani Oliveira Cherubim
, - Polyana de Lima Ribeiro ,
- Tassiane Ferreira Langendorf ,
- Cristiane Cardoso de Paula ,
- Stela Maris de Mello Padoin
Abstract
ORIGINAL ARTICLEAssessment of educational technology in lactation physiology by health students
Revista Brasileira de Enfermagem. 2024;77(2):e20230252
DOI 10.1590/0034-7167-2023-0252
- Daiani Oliveira Cherubim ,
- Polyana de Lima Ribeiro ,
- Tassiane Ferreira Langendorf ,
- Cristiane Cardoso de Paula ,
- Stela Maris de Mello Padoin
Views0See moreABSTRACT
Objectives:
to assess the suitability, facilitators, and barriers of using a video clip for teaching lactation physiology to health students.
Methods:
a cross-sectional study was conducted with online data collection at a higher education institution, using the Assistive Technology Assessment Instrument and open-ended questions. The sample consisted of 88 students.
Results:
the video clip was deemed suitable in all attributes. Facilitators identified included attractiveness, musicality, and ease of access. Barriers noted were the music’s speed and the necessity for prior knowledge. The video clip achieved adequate scores for interactivity (1.71), purpose (1.77), relevance (1.64), and clarity (1.77). The overall average of the attributes was 1.72.
Conclusions:
the video clip can serve as an effective learning strategy to enhance hybrid education, potentially contributing to the promotion and support of breastfeeding. However, some barriers underscore the importance of prior knowledge for a complete understanding of the content.
- Daiani Oliveira Cherubim
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ORIGINAL ARTICLE05-27-2024
Technology for nursing care in a Maternal Intensive Care Unit: a methodological study
- Fabíola Nunes de Sá ,
- Jéssica Lourenço Carneiro ,
- Linicarla Fabiole de Souza Gomes ,
- Joselany Afio Caetano ,
- Ana Karina Bezerra Pinheiro , [ … ],
- Ana Kelve de Castro Damasceno
Abstract
ORIGINAL ARTICLETechnology for nursing care in a Maternal Intensive Care Unit: a methodological study
Revista Brasileira de Enfermagem. 2024;77(2):e20230202
DOI 10.1590/0034-7167-2023-0202
- Fabíola Nunes de Sá ,
- Jéssica Lourenço Carneiro ,
- Linicarla Fabiole de Souza Gomes ,
- Joselany Afio Caetano ,
- Ana Karina Bezerra Pinheiro ,
- Ana Kelve de Castro Damasceno
Views0See moreABSTRACT
Objectives:
to develop and validate a nursing care plan in a Maternal Intensive Care Unit.
Methods:
a methodological study, developed in stages: integrative review; Nursing History construction; care plan restructuring; appearance and content validity by judges.
Results:
the history was organized into sections: Identification; Basic Human Needs; Physical Examination; and Assessment of Basic Human Needs. A care plan was restructured with 34 diagnoses, organized according to basic human needs. A satisfactory level of appearance validity of the history and care plan was obtained (Concordance Index varying between 86.3 and 100 for both instruments), and content validity with average indexes of 90.8 and 92.8, respectively. Thirty-four diagnoses, their interventions and nursing actions were consolidated.
Conclusions:
the instruments were considered relevant and pertinent in terms of appearance and content, and their use in the institution under study as well as in other similar services may be recommended.
- Fabíola Nunes de Sá
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ORIGINAL ARTICLE05-27-2024
Nursing care protocol for critical users with tracheostomy under mechanical ventilation
- Fernando Conceição de Lima ,
- Wagner Felipe dos Santos Neves ,
- André Lucas de Lima Dias ,
- Clarissa Porfírio Mendes ,
- Alzinei Simor , [ … ],
- Mary Elizabeth de Santana
Abstract
ORIGINAL ARTICLENursing care protocol for critical users with tracheostomy under mechanical ventilation
Revista Brasileira de Enfermagem. 2024;77(2):e20230337
DOI 10.1590/0034-7167-2023-0337
- Fernando Conceição de Lima ,
- Wagner Felipe dos Santos Neves ,
- André Lucas de Lima Dias ,
- Clarissa Porfírio Mendes ,
- Alzinei Simor ,
- Ingrid Magali de Souza Pimentel ,
- Helena Megumi Sonobe ,
- Mary Elizabeth de Santana
Views0See moreABSTRACT
Objectives:
to develop and assess a nursing care protocol for critically ill users with tracheostomy under mechanical ventilation.
Methods:
a methodological study, developed through two phases, guided by the 5W2H management tool: I) target audience characterization and II) technology development.
Results:
thirty-four nursing professionals participated in this study, who presented educational demands in relation to care for critical users with tracheostomy, with an emphasis on standardizing care through a protocol and carrying out continuing education.
Final Considerations:
the creation and validity of new technologies aimed at this purpose enhanced the participation of nursing professionals and their empowerment in the health institution’s microsectoral actions and in macrosectoral actions, highlighting the need for public policies that guarantee the conduct of a line of care for users with tracheostomy.
- Fernando Conceição de Lima
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ORIGINAL ARTICLE05-27-2024
Fall Tailoring Interventions for Patient Safety Brazil Program: an evaluability study in a teaching hospital
Revista Brasileira de Enfermagem. 2024;77(2):e20230348
Abstract
ORIGINAL ARTICLEFall Tailoring Interventions for Patient Safety Brazil Program: an evaluability study in a teaching hospital
Revista Brasileira de Enfermagem. 2024;77(2):e20230348
DOI 10.1590/0034-7167-2023-0348
Views0See moreABSTRACT
Objectives:
to present the theoretical model, logic model, and the analysis and judgment matrix of the Fall TIPS Brazil Program.
Methods:
a qualitative, participatory research approach, in the form of an evaluability study, encompassing the phases (1) problem analysis; (2) program design, development, and adaptation to the Brazilian context; (3) program dissemination. Data were collected through document analysis and workshops.
Results:
through document analysis, workshops with stakeholders from the participating institution, and validation with key informants, it was possible to identify the program’s objectives, expected outcomes, and the target audience. This allowed the construction of theoretical and logic models and, through evaluative questions, the identification of indicators for the evaluation of the Fall TIPS Brazil Program.
Final Considerations:
this study has provided insights into the Fall TIPS program, the topic of hospital fall prevention, and the proposed models and indicators can be employed in the implementation and future evaluative processes of the program.
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05-13-2024
Qualitative methodology: considerations and singularities regarding the implementation of person-centered interventions
Revista Brasileira de Enfermagem. 2024;77(3):e770301
Abstract
Qualitative methodology: considerations and singularities regarding the implementation of person-centered interventions
Revista Brasileira de Enfermagem. 2024;77(3):e770301
DOI 10.1590/0034-7167.2024770301
Views0Qualitative health research allows for an in-depth understanding of how a person experiences different health transitions, their relationship with healthcare professionals and their passage through different clinical practice environments. At the same time, it has the potential to support professionals’ clinical decision-making and to empower citizens in their autonomy and responsibility for the health-disease process, […]See more -
05-13-2024
Metodologia qualitativa: considerações e singularidades sobre a implementação de intervenções centradas na pessoa
Revista Brasileira de Enfermagem. 2024;77(3):e770301
Abstract
Metodologia qualitativa: considerações e singularidades sobre a implementação de intervenções centradas na pessoa
Revista Brasileira de Enfermagem. 2024;77(3):e770301
DOI 10.1590/0034-7167.2024770301pt
Views0A investigação qualitativa em saúde permite a compreensão aprofundada de como a pessoa experiencia as diferentes transições de saúde, a relação com os profissionais de saúde e a passagem pelos diferentes ambientes de prática clínica. Concomitantemente, tem o potencial de suportar a tomada de decisão clínica dos profissionais e de empoderar o cidadão na sua […]See more -
ORIGINAL ARTICLE05-13-2024
Factors associated with Community Health Agents’ knowledge about tuberculosis
- Clery Mariano da Silva Alves ,
- Tauana de Souza Amaral ,
- Fabiana Ribeiro Rezende ,
- Hélio Galdino Júnior ,
- Rafael Alves Guimarães , [ … ],
- Anaclara Ferreira Veiga Tipple
Abstract
ORIGINAL ARTICLEFactors associated with Community Health Agents’ knowledge about tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20220520
DOI 10.1590/0034-7167-2022-0520
- Clery Mariano da Silva Alves ,
- Tauana de Souza Amaral ,
- Fabiana Ribeiro Rezende ,
- Hélio Galdino Júnior ,
- Rafael Alves Guimarães ,
- Dayane de Melo Costa ,
- Anaclara Ferreira Veiga Tipple
Views0See moreABSTRACT
Objective:
To analyze the factors associated with the knowledge of Community Health Agents (ACS) about tuberculosis.
Methods:
A cross-sectional study was conducted with 110 ACS. A questionnaire was used to assess knowledge about pulmonary tuberculosis (component 1) and the work functions of ACS in the National Tuberculosis Control Program (component 2). The level of knowledge, according to the scores converted into a scale of 0 to 100, was classified as: 0-50% (low), 51-75% (medium), and over 75% (high). Multiple regression was used in the analysis of associated factors.
Results:
The global score (average of the scores of components 1 and 2) median knowledge was 68.6%. Overall knowledge about tuberculosis was positively associated with the length of professional experience, having received training on tuberculosis, and access to the tuberculosis guide/handbook.
Conclusions:
Investments in training and capacity-building strategies for ACS will contribute to increasing these professionals’ knowledge, resulting in greater success in tuberculosis control.
- Clery Mariano da Silva Alves
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05-13-2024
Preditores de nanismo entre crianças de 0 a 24 meses no Sudeste Asiático: Uma revisão do escopo
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
Abstract
Preditores de nanismo entre crianças de 0 a 24 meses no Sudeste Asiático: Uma revisão do escopo
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
DOI 10.1590/0034-7167-2022-0625
Views0See moreRESUMEN
Objetivo:
Identificar indicadores de desnutrición crónica entre niños de 0 a 24 meses en el Sudeste Asiático.
Métodos:
Esta revisión de alcance se centró en artículos con diseño de estudio observacional publicados en inglés, entre los años 2012 y 2023 de cinco bases de datos internacionales. Las principales palabras clave utilizadas fueron: “stunting (Desnutrición crónica)” o “growth disorder (Desorden del crecimiento)”, y “newborn (Recién nacido)”, y “predict (Predecir)”, y “Southeast Asia (Sudeste Asiático)”.
Resultados:
De los 27 artículos seleccionados para el análisis final, se encontraron trece indicadores que influyen en la desnutrición crónica en siete países del Sudeste Asiático. Los trece indicadores incluyen el niño, la madre, el hogar, la alimentación inadequada complementaria, la lactancia materna inadecuada, la atención inadecuada, los alimentos de mala calidad, la seguridad de los alimentos y el agua, la infección, la economía política, la salud y la asistencia sanitaria, el agua, el saneamiento y el medio ambiente, y por último el factor sociocultural.
Conclusión:
Todos estos indicadores pueden provocar desnutrición crónica en niños del Sudeste Asiático. Para poder prevenirlo los prestadores de servicios de salud y otros sectores relacionados, necesitan realizar actividades de promoción y prevención de la salud de acuerdo con los indicadores encontrados en este artículo.
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ORIGINAL ARTICLE07-08-2020
Cognition and quality of life relationship among the elderly community: a cross-sectional study
- Barbara Maria Lopes da Silva Brandão ,
- Alice Maria Barbosa da Silva ,
- Rafaella Queiroga Souto ,
- Fabia Alexandra Pottes Alves ,
- Gleicy Karine Nascimento de Araújo , [ … ],
- Hulda Vale de Araújo
Abstract
ORIGINAL ARTICLECognition and quality of life relationship among the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73:e20190030
DOI 10.1590/0034-7167-2019-0030
- Barbara Maria Lopes da Silva Brandão ,
- Alice Maria Barbosa da Silva ,
- Rafaella Queiroga Souto ,
- Fabia Alexandra Pottes Alves ,
- Gleicy Karine Nascimento de Araújo ,
- Viviane Cristina Fonseca da Silva Jardim ,
- Hulda Vale de Araújo
Views0See moreABSTRACT
Objective:
to assess cognitive functions and their association with quality of life among elderly people enrolled in a Family Health Unit (FHU) of Primary Health Care in Recife-PE.
Methods:
a quantitative, descriptive, cross-sectional study in which elderly aged 60 years and over were studied.
Results:
76.7% of the elderly were women and the age group was less than or equal to 70 years. 68.6% had cognitive impairment, and in the quality of life assessment it was found that the social participation facet had the highest mean score among the elderly (14.25), while the lowest was observed in the sensory functioning facet (9.10). There was an association between cognitive decline and quality of life.
Conclusion:
most of the elderly had good quality of life rates, but low cognitive level. Using screening tools allows early detection of health problems, guiding the nursing staff in the construction of preventive measures.
- Barbara Maria Lopes da Silva Brandão
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REVIEW10-19-2020
Effectiveness of skin protectors and calendula officinalis for prevention and treatment of radiodermatitis: an integrative review
- Fabiana Verdan Simões ,
- Valdete Oliveira Santos ,
- Rodrigo Nogueira da Silva ,
- Rafael Celestino da Silva
Abstract
REVIEWEffectiveness of skin protectors and calendula officinalis for prevention and treatment of radiodermatitis: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190815
DOI 10.1590/0034-7167-2019-0815
- Fabiana Verdan Simões ,
- Valdete Oliveira Santos ,
- Rodrigo Nogueira da Silva ,
- Rafael Celestino da Silva
Views0See moreABSTRACT
Objective:
to analyze the effectiveness of skin protectors and Calendula officinalis for prevention and treatment of radiodermatitis.
Method:
an integrative review conducted at CINAHL, Cochrane Library, Embase, MEDLINE/PubMed, IBECS, LILACS, and Web of Science. The final sample consisted of five studies, four clinical studies and one preclinical. Critical appreciation and narrative synthesis of the findings were carried out.
Results:
the Cavilon™ skin protector was more effective than Sorbolene (cream with 10% glycerin) and less effective than Mometasone Furoate cream. Calendula officinalis was more effective than Trolamine and essential fatty acids and less effective than Ching Wan Hung® for prevention and treatment of radiodermatitis.
Conclusion:
data confirm the potential of Calendula officinalis for prevention and treatment of radiodermatitis and point to promising results regarding skin protector use; however, there is a need for further testing as to the effectiveness of such products.
- Fabiana Verdan Simões
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ORIGINAL ARTICLE04-03-2020
Nurse as an integrator in healthcare management of children with chronic condition
- Deborah Dinorah de Sá Mororó ,
- Rejane Maria Paiva de Menezes ,
- Ana Angélica Rêgo de Queiroz ,
- Carlos Jordão de Assis Silva ,
- Wanesca Caroline Pereira
Abstract
ORIGINAL ARTICLENurse as an integrator in healthcare management of children with chronic condition
Revista Brasileira de Enfermagem. 2020;73(3):e20180453
DOI 10.1590/0034-7167-2018-0453
- Deborah Dinorah de Sá Mororó ,
- Rejane Maria Paiva de Menezes ,
- Ana Angélica Rêgo de Queiroz ,
- Carlos Jordão de Assis Silva ,
- Wanesca Caroline Pereira
Views0See moreABSTRACT
Objectives:
to understand the practice of the nurse in healthcare management of children with chronic condition in the hospital setting.
Methods:
analytical study of qualitative approach with theoretical and methodological reference of institutional ethnography. Developed in the pediatric unit of a university hospital, in a municipality in Northeastern Brazil. Data collections techniques were: participant observation, documentary analysis and semi-structured interview. Participants of the study totaled twenty professionals, including nurses, social workers, psychologists, pharmacists, nutritionists, physiotherapists, and doctors. For data analysis, it was used the Bardin’s Content Analysis with interface of the Atlas.ti software.
Results:
categories of analysis were “Nurse as mediator of healthcare management”; “Nursing process as a mechanism of healthcare management”.
Final
considerations: the nurse proved to be essential for healthcare management of the child with chronic condition, acting as mediator of the relationship between the doctor, the members of the health team, the user and their family.
- Deborah Dinorah de Sá Mororó
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06-11-2021
Prevention of facial injuries caused by personal protective equipment during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20201219
Abstract
Prevention of facial injuries caused by personal protective equipment during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20201219
DOI 10.1590/0034-7167-2020-1219
Views0See moreABSTRACT
Objective:
Develop and validate a leaflet to guide health professionals in preventive measures related to injuries caused by the use of personal protective equipment during the COVID-19 pandemic.
Methods:
For the construction of the brochure, an integrative review was carried out in the main databases. The evaluation of the leaflet was made by 59 health professionals (nurses, physiotherapists, and doctors), using the Delphi technique.
Results:
In the first evaluation cycle, the items in the brochure were considered by the judges to be “inadequate” to “adequate”; the Content Validity Index was 0.80-1.0. After the adjustments suggested by the judges were implemented, the leaflet was sent back to the second evaluation cycle, in which all items were considered “adequate”, resulting in a Content Validity Index of 1.0.
Conclusion:
The developed brochure has content validity and can assist health professionals in preventing injuries caused by the use of personal protective equipment the developed brochure has content validity and can assist health professionals in preventing injuries caused by the use of personal protective equipment.
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ORIGINAL ARTICLE12-07-2020
Sarcopenia screening in elderly in primary health care: nurse knowledge and practices
- Rutielle Ferreira Silva ,
- Maria do Livramento Fortes Figueiredo ,
- Juan José Tirado Darder ,
- Ana Maria Ribeiro dos Santos ,
- Maria Antonieta Rubio Tyrrell
Abstract
ORIGINAL ARTICLESarcopenia screening in elderly in primary health care: nurse knowledge and practices
Revista Brasileira de Enfermagem. 2020;73:e20200421
DOI 10.1590/0034-7167-2020-0421
- Rutielle Ferreira Silva ,
- Maria do Livramento Fortes Figueiredo ,
- Juan José Tirado Darder ,
- Ana Maria Ribeiro dos Santos ,
- Maria Antonieta Rubio Tyrrell
Views0See moreABSTRACT
Objective:
Describe the knowledge and practices of the Primary Health Care nurse on sarcopenia screening in the elderly.
Methods:
Qualitative study conducted with 24 Primary Health Care nurses. The data was collected through semi-structured interviews, recorded and later transcribed. The speeches were grouped in thematic categories, later analyzed, supported by Paulo Freire’s reference.
Results:
The findings showed that the primary care nurses’ knowledge of sarcopenia screening in the elderly was incipient and fragile. This reality is reflected in a gap in practice, although some instruments already require the registration of characteristics indicative of sarcopenia, such as the evaluation of the calf circumference.
Final Considerations:
The need to train nurses to perform sarcopenia screening and to implement a promotional and preventive care plan, which will result in improving the quality of life of the elderly assisted in Primary Care, was highlighted.
- Rutielle Ferreira Silva
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REVIEW12-05-2019
Health promotion of frail elderly individuals and at risk of frailty
- Cynthia Roberta Dias Torres Silva ,
- Khelyane Mesquita de Carvalho ,
- Maria do Livramento Fortes Figueiredo ,
- Fernando Lopes Silva-Júnior ,
- Elaine Maria Leite Rangel Andrade , [ … ],
- Lydia Tolstenko Nogueira
Abstract
REVIEWHealth promotion of frail elderly individuals and at risk of frailty
Revista Brasileira de Enfermagem. 2019;72:319-327
DOI 10.1590/0034-7167-2018-0575
- Cynthia Roberta Dias Torres Silva ,
- Khelyane Mesquita de Carvalho ,
- Maria do Livramento Fortes Figueiredo ,
- Fernando Lopes Silva-Júnior ,
- Elaine Maria Leite Rangel Andrade ,
- Lydia Tolstenko Nogueira
Views0See moreABSTRACT
Objective:
To identify interventions for the health promotion of frail elderly individuals and those at risk of frailty.
Method:
Integrative review of the literature performed in the following databases: LILACS, CINAHL, MEDLINE, Web of Science, COCHRANE and Scopus, using the
Descriptors:
“frail elderly”, “aging”, “health services for the aged” and “health promotion” combined with Boolean operators “AND” and “OR”.
Results:
Randomized controlled clinical trials (RCTs) classified as level of evidence II represented 82.6% of studies. Interventions were analyzed according to the following categories: Interventions for the elderly at risk of frailty and Interventions for the frail elderly.
Conclusion:
The following interventions were identified: educational multiprofessional group meetings, physical training, home visit/home care program, nutrition assessment and supplementation, health maintenance programs and cognitive training; models/programs of management and monitoring, use of assistive technology devices and hospitalization program for geriatric rehabilitation.
- Cynthia Roberta Dias Torres Silva
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ORIGINAL ARTICLE09-16-2019
Analysis of compliance to antiretroviral treatment among patients with HIV/AIDS
- Hélia Carla de Souza ,
- Márcio Rabelo Mota ,
- Amanda Ribeiro Alves ,
- Filipe Dinato Lima ,
- Sandro Nobre Chaves , [ … ],
- Ana Paula Vaz da Silva Mota
Abstract
ORIGINAL ARTICLEAnalysis of compliance to antiretroviral treatment among patients with HIV/AIDS
Revista Brasileira de Enfermagem. 2019;72(5):1295-1303
DOI 10.1590/0034-7167-2018-0115
- Hélia Carla de Souza ,
- Márcio Rabelo Mota ,
- Amanda Ribeiro Alves ,
- Filipe Dinato Lima ,
- Sandro Nobre Chaves ,
- Renata Aparecida Elias Dantas ,
- Samuel Barbosa Mezavila Abdelmur ,
- Ana Paula Vaz da Silva Mota
Views1See moreABSTRACT
Objective:
To analyze the compliance to antiretroviral therapy among HIV/AIDS patients.
Method:
99 HIV-positive volunteers undergoing treatment responded to a semi-structured sociodemographic interview and to a questionnaire that assessed compliance to antiretroviral treatment.
Results:
In the sample analyzed, 52.5% of the volunteers presented good/adequate treatment compliance, while 33.3% presented low/insufficient compliance. There was no significant difference between men and women in the questionnaire score, nor between groups with different levels of education.
Conclusion:
The main items of the questionnaire that contributed to good/adequate compliance were: positive impact of treatment on health and quality of life, few side effects after initiation of therapy, and positive self-evaluation of participants regarding their compliance to antiretroviral therapy. The main barriers detected for compliance to antiretroviral therapy were the lack of knowledge about current medications and the lack of information on antiretroviral therapy drugs.
- Hélia Carla de Souza
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ORIGINAL ARTICLE07-08-2020
Self-efficacy in elderly with type 2 Diabetes Mellitus
- Mariana Campos de Sousa ,
- Bruna Stephanie Sousa Malaquias ,
- Suzel Regina Ribeiro Chavaglia ,
- Rosali Isabel Barduchi Ohl ,
- Fabiana Fernandes Silva de Paula , [ … ],
- Álvaro da Silva Santos
Abstract
ORIGINAL ARTICLESelf-efficacy in elderly with type 2 Diabetes Mellitus
Revista Brasileira de Enfermagem. 2020;73:e20180980
DOI 10.1590/0034-7167-2018-0980
- Mariana Campos de Sousa ,
- Bruna Stephanie Sousa Malaquias ,
- Suzel Regina Ribeiro Chavaglia ,
- Rosali Isabel Barduchi Ohl ,
- Fabiana Fernandes Silva de Paula ,
- Karina Santos da Silva ,
- Álvaro da Silva Santos
Views0See moreABSTRACT
Objective:
to analyze the self-efficacy of elderly with type 2 diabetes mellitus and the relationship with sociodemographic, clinical, knowledge, and attitude variables.
Method:
a cross-sectional quantitative study conducted with 256 elderly people enrolled in Family Health Strategies. Data were obtained through interviews. Descriptive statistical analysis and multiple linear regression model were performed (p <0.05).
Results:
female, 69.95-year mean age, white skin color, 4-7 years of schooling, living with a partner, retirees, low individual monthly income, 6 to 15 years of illness, Catholics, living with children (with or without spouse). The elderly’s low knowledge and negative attitude prevailed. Self-efficacy was associated with attitude and knowledge in the domains “General and Specific Diet”, “Physical Exercise” and “Blood Glucose”.
Conclusion:
self-efficacy investigations in type 2 Diabetes Mellitus management in the elderly are important and encourage treatment adherence.
- Mariana Campos de Sousa
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