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EXPERIENCE REPORT11-27-2023
Implementation of a nursing strategy for self-transcendence in older adults: an experience report
- Jesús Guadalupe Martínez Ramírez
, - Erika Adriana Torres Hernández ,
- Raúl Fernando Guerrero-Castañeda
Abstract
EXPERIENCE REPORTImplementation of a nursing strategy for self-transcendence in older adults: an experience report
Revista Brasileira de Enfermagem. 2023;76(5):e20220745
DOI 10.1590/0034-7167-2022-0745
- Jesús Guadalupe Martínez Ramírez ,
- Erika Adriana Torres Hernández ,
- Raúl Fernando Guerrero-Castañeda
Views0See moreABSTRACT
Objectives:
to report the experience of implementing a nursing strategy to promote self-transcendence in older adults attended at a Primary Health Care center.
Methods:
an experience report on the implementation of a strategy addressing the Theory of Self-Transcendence by nursing to older adults in a primary health unit, in San Luis Potosí, Mexico, from October to November 2022.
Results:
fourteen older adults and three nurses participated. From the expression of feelings, speeches about self-transcendence, spirituality and physical activity promotion, the strategy was satisfactory. Emotional, cognitive and spiritual changes were observed in the different dimensions of the Theory of Self-Transcendence.
Final Considerations:
the nursing strategy on self-transcendence made it possible to identify significant moments that helped to identify the key points in which older adults were; it helped to intervene from a person-to-person care perspective.
- Jesús Guadalupe Martínez Ramírez
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ORIGINAL ARTICLE11-27-2023
Validation of the hospital resources assessment scale for the preservation of urinary continence in the elderly
- Roberta Pereira Góes ,
- Larissa Chaves Pedreira ,
- João Paulo de Almeida Tavares ,
- Simone da Silva Oliveira ,
- Elaine de Oliveira Souza , [ … ],
- Fernanda Cajuhy dos Santos
Abstract
ORIGINAL ARTICLEValidation of the hospital resources assessment scale for the preservation of urinary continence in the elderly
Revista Brasileira de Enfermagem. 2023;76(5):e20220805
DOI 10.1590/0034-7167-2022-0805
- Roberta Pereira Góes ,
- Larissa Chaves Pedreira ,
- João Paulo de Almeida Tavares ,
- Simone da Silva Oliveira ,
- Elaine de Oliveira Souza ,
- Fernanda Cajuhy dos Santos
Views0See moreABSTRACT
Objectives:
to validate the internal structure of the Hospital Resources Assessment Scale for the Preservation of Urinary Continence in the Elderly.
Methods:
validation study of the internal structure of a scale constructed based on the Donabedian conceptual model and an integrative review, with prior content validation. The scale was applied to the target population, and 124 nurses responded to the questionnaire. Exploratory Factor Analysis was performed using the FACTOR software, employing multiple techniques.
Results:
a factorial model with 11 items organized into two dimensions (support for human resources and material resources) was obtained. The “physical structure” dimension was removed from the initial model and adopted as a complementary checklist to the instrument, as it was not possible to obtain a factorable model with this dimension.
Conclusions:
we provide a valid scale that can measure indicators, identifying weaknesses and/or strengths related to hospital resources for the preservation of urinary continence in the elderly.
- Roberta Pereira Góes
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REVIEW11-27-2023
Educational interventions for cervical cancer prevention: a scoping review
- Josiane Montanho Mariño ,
- Lailah Maria Pinto Nunes ,
- Yasmin Cardoso Metwaly Mohamed Ali ,
- Leonardo do Carmo Tonhi ,
- Marina de Góes Salvetti
Abstract
REVIEWEducational interventions for cervical cancer prevention: a scoping review
Revista Brasileira de Enfermagem. 2023;76(5):e20230018
DOI 10.1590/0034-7167-2023-0018
- Josiane Montanho Mariño ,
- Lailah Maria Pinto Nunes ,
- Yasmin Cardoso Metwaly Mohamed Ali ,
- Leonardo do Carmo Tonhi ,
- Marina de Góes Salvetti
Views0See moreABSTRACT
Objectives:
to identify, map and describe characteristics of educational interventions for cervical cancer prevention in adult women.
Methods:
a scoping review conducted on eleven databases and the gray literature, including studies that described educational interventions aimed at preventing cervical cancer in adult women.
Results:
thirty-three articles with 151,457 participants were analyzed. The most used educational strategies were participatory discussions and educational leaflets. Most of the interventions took place in a single session, ranging from 40 to 60 minutes. The most used theoretical model in interventions to improve women’s compliance with Pap smear was the Health Belief Model.
Conclusions:
group discussions, lectures and educational brochures can increase knowledge and reduce barriers to cervical cancer prevention. Theory-based and culturally sensitive interventions can have a positive impact on women’s health.
- Josiane Montanho Mariño
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ORIGINAL ARTICLE11-27-2023
Mental suffering in family daily life: a temporal journey according to Merleau-Ponty
- Patricia Anjos Lima de Carvalho ,
- Vanessa Thamyris Carvalho dos Santos ,
- Marlene Gomes Terra ,
- Márcia Aparecida Ferreira de Oliveira ,
- Ricardo Henrique Soares , [ … ],
- Edite Lago da Silva Sena
Abstract
ORIGINAL ARTICLEMental suffering in family daily life: a temporal journey according to Merleau-Ponty
Revista Brasileira de Enfermagem. 2023;76(5):e20230258
DOI 10.1590/0034-7167-2023-0258
- Patricia Anjos Lima de Carvalho ,
- Vanessa Thamyris Carvalho dos Santos ,
- Marlene Gomes Terra ,
- Márcia Aparecida Ferreira de Oliveira ,
- Ricardo Henrique Soares ,
- Edite Lago da Silva Sena
Views1See moreABSTRACT
Objectives:
to describe the family’s experience in relation to daily life with a family member experiencing mental suffering.
Methods:
a qualitative, descriptive, phenomenological study grounded in Merleau-Ponty’s ontology of experience was conducted in ten households in a city in the state of Bahia, Brazil, where 24 participants of the Intersubjectivity Wheels reside. The descriptions produced were subjected to the Ambiguity Analytics technique.
Results:
the descriptions were categorized into: absence as a creative power of the sense of “being” and “not being a family”; and exclusion and acceptance as expressions of mental suffering in the family context.
Final Considerations:
the experience of mental suffering in the family’s daily life is marked by ambiguous feelings, such as joy and sadness, disappointment and satisfaction, lack of love and love. However, experiencing these feelings can mobilize the desire to “become” a family, increase the sense of autonomy and independence, and drive the formation of new family configurations.
- Patricia Anjos Lima de Carvalho
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ERRATUM11-27-2023
ERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e05
DOI 10.1590/0034-7167.20237605e05
Views0In the article “Performance of Family Health Strategy Nurses in LGBT+ Healthcare”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(4): e20220514, authored:Where it read:[…]See more -
ORIGINAL ARTICLE11-21-2023
Coping strategies for chronically ill children and adolescents facing the COVID-19 pandemic
- Lívia Lopes Custódio ,
- Débora Cristina Couto Oliveira Costa ,
- Cláudia Patrícia da Silva Ribeiro Menezes ,
- Sarah Vieira Figueiredo ,
- Julyana Almeida Maia , [ … ],
- Ilvana Lima Verde Gomes
Abstract
ORIGINAL ARTICLECoping strategies for chronically ill children and adolescents facing the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230045
DOI 10.1590/0034-7167-2023-0045
- Lívia Lopes Custódio ,
- Débora Cristina Couto Oliveira Costa ,
- Cláudia Patrícia da Silva Ribeiro Menezes ,
- Sarah Vieira Figueiredo ,
- Julyana Almeida Maia ,
- Maria Salete Bessa Jorge ,
- Edna Maria Campelo Chaves ,
- Ilvana Lima Verde Gomes
Views0See moreABSTRACT
Objective:
to understand the experiences and coping strategies of children and adolescents with chronic illnesses during the COVID-19 pandemic.
Methods:
a descriptive study, with a qualitative approach, carried out with six children and adolescents at the reception of an outpatient clinic of a pediatric hospital in the state of Ceará. Data collection took place from April to September 2021, using story-drawing, analyzed in light of Coutinho’s criteria.
Results:
two thematic categories emerged: Situations experienced by children and adolescents in times of COVID-19; Coping strategies for children and adolescents in their chronic illness process during the COVID-19 pandemic.
Final considerations:
understanding the experiences and coping strategies of children and adolescents with chronic illness demonstrated the expression of creative imagination, incorporated by subjective components, which brings to light an approximation with the reality perceived and interpreted in a context of the COVID-19 pandemic.
- Lívia Lopes Custódio
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ORIGINAL ARTICLE11-13-2023
Vulnerability to physical inactivity: evidence of content validity and response processes
- Déborah Santana Pereira ,
- Raquel Sampaio Florêncio ,
- Virna Ribeiro Feitosa Cestari ,
- Thereza Maria Magalhães Moreira
Abstract
ORIGINAL ARTICLEVulnerability to physical inactivity: evidence of content validity and response processes
Revista Brasileira de Enfermagem. 2023;76:e20220563
DOI 10.1590/0034-7167-2022-0563
- Déborah Santana Pereira ,
- Raquel Sampaio Florêncio ,
- Virna Ribeiro Feitosa Cestari ,
- Thereza Maria Magalhães Moreira
Views0See moreABSTRACT
Objective:
To analyze content validity evidence and response processes of a bank of items for measuring vulnerability to physical inactivity in adults.
Method:
Methodological study, with 13 specialists and 46 representatives of the target population. The Content Validity Index (CVI) and binomial test were calculated; data obtained through validity based on response processes were collected through interviews.
Results:
Of the 105 constructed items, 16 were excluded (CVI<0.78); 89 items showed agreement <80% in the psychometric criteria, being modified. Of the 101 items that remained (CVI>0.78), 34 were changed and 4 were deleted after evaluating the evidence of response processes. In the end, 97 items remained, with a global CVI of 0.92, organized into two dimensions: Subject (CVI=0.91) and Social (CVI=0.94).
Conclusion:
The items presented adequate parameters and evidence of validity; and can subsidize the construction of instruments that consider the subject’s and social vulnerability in understanding physical inactivity.
- Déborah Santana Pereira
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ORIGINAL ARTICLE11-13-2023
Access of people with pulmonary tuberculosis to government programs: Primary Care professionals’ perceptions
- Hildegard Soares Barrozo de Lima ,
- Vitória Regina Domingues Sodré ,
- Cleide Aparecida Alves Souza ,
- Mirian Domingos Cardoso ,
- Crhistinne Cavalheiro Maymone Gonçalves , [ … ],
- Ethel Leonor Noia Maciel
Abstract
ORIGINAL ARTICLEAccess of people with pulmonary tuberculosis to government programs: Primary Care professionals’ perceptions
Revista Brasileira de Enfermagem. 2023;76:e20220716
DOI 10.1590/0034-7167-2022-0716
- Hildegard Soares Barrozo de Lima ,
- Vitória Regina Domingues Sodré ,
- Cleide Aparecida Alves Souza ,
- Mirian Domingos Cardoso ,
- Crhistinne Cavalheiro Maymone Gonçalves ,
- Laura Maria Vidal Nogueira ,
- Ivaneide Leal Ataíde Rodrigues ,
- Erlon Gabriel Rego de Andrade ,
- Alexandre Aguiar Pereira ,
- Maria Catarina Salvador da Motta ,
- Maria Helena do Nascimento Souza ,
- Regina Célia Gollner Zeitoune ,
- Ethel Leonor Noia Maciel
Views0See moreABSTRACT
Objective:
to analyze Primary Health Care professionals’ perceptions about the access of people with pulmonary tuberculosis to government social support and income transfer programs.
Methods:
multicenter/qualitative study, carried out in Family Health Units in four Brazilian capitals: Belém/Pará, Campo Grande/Mato Grosso do Sul, Recife/Pernambuco and Rio de Janeiro/Rio de Janeiro. Fifty-eight professionals participated (social workers, dentists, nurses, pharmacists, physicians and nursing technicians), who provided assistance to people with pulmonary tuberculosis. Individual interviews were conducted, and the content analysis technique was used.
Results:
among the participants, 45/77.6% were women and 33/56.9% were between 25 and 40 years old. Two thematic categories were organized, demonstrating the perceptions about the possibilities of access to government programs by people with pulmonary tuberculosis in vulnerable situations and the obstacles inherent to this context.
Final considerations:
it is necessary to move forward in improving patient access to social programs.
- Hildegard Soares Barrozo de Lima
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ORIGINAL ARTICLE03-24-2021
Costs of healthcare-associated infections in an Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(1):e20200275
Abstract
ORIGINAL ARTICLECosts of healthcare-associated infections in an Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(1):e20200275
DOI 10.1590/0034-7167-2020-0275
Views1See moreABSTRACT
Objectives:
to evaluate hospitalization costs of patients with and without Healthcare-Associated Infections an Intensive Care Unit.
Methods:
a retrospective case-control study. Data collection was retrieved from the medical records of Intensive Care Unit of a medium-sized public hospital in Goiás-Brazil. For each case, two controls were selected. Data on socioeconomic, clinical, and hospital costs were collected. To verify associations between variables, Odds Ratio and linear regression were calculated.
Results:
a total of 21 patients diagnosed with Healthcare-Associated Infections and 42 controls were evaluated. The hospitalization cost for patients with infection was four times higher than for non-infection patients (p-value<0.001). There was an association between infection and higher mortality (p-value <0.001), longer hospital-stay (p-value =0.021), and higher hospital costs (p-value =0.007).
Conclusions:
hospitalization costs of diagnosed Healthcare-Associated Infections patients are high compared to those who do not have this diagnosis.
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ORIGINAL ARTICLE03-24-2021
Feelings, experiences and expectations of kidney transplant individuals and challenges for the nurse
- Maria de Nazaré de Souza Ribeiro ,
- Fátima Helena do Espírito Santo ,
- Bruna da Silva Simões ,
- Cleisiane Xavier Diniz ,
- Helen Cristine Albuquerque Bezerra , [ … ],
- Luiz dos Santos
Abstract
ORIGINAL ARTICLEFeelings, experiences and expectations of kidney transplant individuals and challenges for the nurse
Revista Brasileira de Enfermagem. 2021;74(1):e20200392
DOI 10.1590/0034-7167-2020-0392
- Maria de Nazaré de Souza Ribeiro ,
- Fátima Helena do Espírito Santo ,
- Bruna da Silva Simões ,
- Cleisiane Xavier Diniz ,
- Helen Cristine Albuquerque Bezerra ,
- Luiz dos Santos
Views1See moreABSTRACT
Objectives:
to identify feelings, experiences, and expectations of kidney transplant patients, generated from the diagnosis of chronic renal disease until the post-transplant period, highlighting the challenges for nurses to incorporate individualized care to cope throughout the disease process.
Methods:
qualitative, descriptive research, carried with seven kidney transplant patients, in the city of Manaus, State of Amazonas. The data analysis followed the methodological referential of Bardin’s content analysis.
Results:
the diagnosis of the disease was experienced negatively, and hemodialysis was described as an imprisonment and health decline. The transplant meant an improvement in quality of life. The main difficulties were lack of a specialized hospital and low immunity.
Conclusions:
the nurses’ approach of chronic renal patient and with the renal transplantation favored the discovery of solutions facing the demands of the disease and allowed greater capacity to implement individualized care, surrounding a relationship of trust and respect.
- Maria de Nazaré de Souza Ribeiro
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ORIGINAL ARTICLE06-11-2021
Work at the surgical center: risks of the pathogenic suffering of the nursing team
Revista Brasileira de Enfermagem. 2021;74(2):e20190803
Abstract
ORIGINAL ARTICLEWork at the surgical center: risks of the pathogenic suffering of the nursing team
Revista Brasileira de Enfermagem. 2021;74(2):e20190803
DOI 10.1590/0034-7167-2019-0803
Views0See moreABSTRACT
Objectives:
to assess the risks of pathogenic suffering related to the experience of nursing workers in the operating room of a university hospital.
Methods:
cross-sectional, quantitative study, carried out from 11/2017 to 01/2018 in a university hospital in the South of Brazil. The sample was composed by 159 nursing workers of the units of a surgical center, that answered to the Scale of Evaluation of Pathogenic Suffering at Work. Data was submitted to statistical analysis.
Results:
the workers present low risk of pathogenic suffering related to the experiences at work, being the results of its factors: Uselessness (1.47±0.761) – low risk; Indignity (2.372±1.035) – medium risk; and Disqualification (1.74±0.903) – low risk.
Conclusions:
the evaluation of Pathogenic Suffering at Work Scale was positive, predominating low risk for pathogenic suffering of surgical center workers related to professional experiences, because they feel useful, valued and are not indignant about their work, feelings that reflect on the quality of care provided.
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ORIGINAL ARTICLE05-21-2021
Music in the relief of stress and distress in cancer patients
- Mariana Scheidegger dos Santos ,
- Filipe de Moraes Thomaz ,
- Rafael Tavares Jomar ,
- Angela Maria Mendes Abreu ,
- Gunnar Glauco De Cunto Carelli Taets
Abstract
ORIGINAL ARTICLEMusic in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838
DOI 10.1590/0034-7167-2019-0838
- Mariana Scheidegger dos Santos ,
- Filipe de Moraes Thomaz ,
- Rafael Tavares Jomar ,
- Angela Maria Mendes Abreu ,
- Gunnar Glauco De Cunto Carelli Taets
Views0See moreABSTRACT
Objectives:
to evaluate the effects of music on the physiological stress and distress of cancer patients being treated in a hospital.
Methods:
quasi-experimental study carried out with cancer patients hospitalized in the nursing wards of a public hospital. There was a single 15-minute intervention using music. It was individual, and headphones were used for patients to listen to three songs chosen by each one. The levels of stress and distress were measured before and after the intervention, using music to analyze the cortisol in the saliva and the answers to the distress thermometer. The significance level of the statistical analysis was 5%, using the non-parametric Wilcoxon test.
Results:
the mean age of the 26 patients was 56 years old. Most were female, white, and had breast cancer. After intervention, there were statistically significant diminutions in both stress and distress — p < 0.001.
Conclusions:
the use of music diminishes the stress and the distress of cancer patients.
- Mariana Scheidegger dos Santos
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ORIGINAL ARTICLE05-21-2021
Orthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period
- Tatiane Henrique ,
- Fábio Luiz Banhara ,
- Natiele Favarão da Silva ,
- Francely Tineli Farinha ,
- Maila Meryellen Ferreira Garcia Manso , [ … ],
- Armando dos Santos Trettene
Abstract
ORIGINAL ARTICLEOrthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period
Revista Brasileira de Enfermagem. 2021;74(2):e20200089
DOI 10.1590/0034-7167-2020-0089
- Tatiane Henrique ,
- Fábio Luiz Banhara ,
- Natiele Favarão da Silva ,
- Francely Tineli Farinha ,
- Maila Meryellen Ferreira Garcia Manso ,
- Armando dos Santos Trettene
Views1See moreABSTRACT
Objectives:
to identify the main doubts regarding the immediate postoperative care of patients with orofacial clefts undergoing orthognathic surgery.
Methods:
cross-sectional, quantitative study, developed in a public and tertiary hospital, between November 2017 and May 2018. Data collection occurred through interviews during the preoperative nursing consultation. An instrument was used to describe doubts, which later were grouped according to the subject.
Results:
48 patients participated. The doubts referred to sun exposure (56%), food/mastication (48%), the relationship between intermaxillary block-breathing-vomiting (48%), oral hygiene (31%), physical activity restriction (27%), nasopharyngeal cannula, removal of surgical stitches, hospitalization time and speech/communication (23%), bleeding, cryotherapy, facial massage, aesthetic and functional results, healing, edema/ecchymosis, postoperative pain, and changes in facial sensitivity (21%).
Conclusions:
the doubts were related to food, the period of convalescence, care for the surgical wound, postoperative complications, and medications.
- Tatiane Henrique
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ORIGINAL ARTICLE05-28-2021
The work of a Brazilian nursing team of collective health in the special indigenous health district
Revista Brasileira de Enfermagem. 2021;74(2):e20200116
Abstract
ORIGINAL ARTICLEThe work of a Brazilian nursing team of collective health in the special indigenous health district
Revista Brasileira de Enfermagem. 2021;74(2):e20200116
DOI 10.1590/0034-7167-2020-0116
Views0See moreABSTRACT
Objective:
To identify the potential and the limits of the actions of the nursing team in the Primary Health Care for the Health of the Indigenous.
Methods:
This is a quantitative study guided by the Theory of Practical Intervention of Nursing and Collective Health. 230 nursing professionals participated, responding to an instrument about the frequency of the actions carried out in assistance, management, teaching, and research.
Results:
168 nursing technicians and 62 nurses participated. As strengths, 80% participated in the assistance most of the time. Stand out: 90.3% and 71% of nurses carried out nursing consultations and house visits, respectively. As a limitation, the involvement in education and research is small. Only 2% of the interviewees carried out scientific researches, reflecting the need to broaden and qualify care and improve the use of traditional practices, overcoming the biomedical model.
Final considerations:
Nursing assistance is essential in the modification and monitoring of the epidemiological profile of indigenous populations, and its results allow for the planning of quality actions.
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ORIGINAL ARTICLE05-28-2021
Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
- Camila Brito Borguezam ,
- Caroline Tolentino Sanches ,
- Silvia Paulino Ribeiro Albaneser ,
- Uiara Rodrigues de Oliveira Moraes ,
- Cintia Magalhães Carvalho Grion , [ … ],
- Gilselena Kerbauy
Abstract
ORIGINAL ARTICLEManaged clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
DOI 10.1590/0034-7167-2020-0282
- Camila Brito Borguezam ,
- Caroline Tolentino Sanches ,
- Silvia Paulino Ribeiro Albaneser ,
- Uiara Rodrigues de Oliveira Moraes ,
- Cintia Magalhães Carvalho Grion ,
- Gilselena Kerbauy
Views1See moreABSTRACT
Objectives:
to assess the impact of the implementation of a managed sepsis protocol on quality indicators of treatment for septic patients in an emergency department of a university hospital.
Methods:
an observational epidemiological study involving septic patients. The study was divided into two phases, pre-intervention and intervention, resulting from the implementation of the managed sepsis protocol. The study variables included sepsis treatment quality indicators. The results were statistically analyzed using the program Epi InfoTM.
Results:
the study sample included 631 patients, 95 from pre-intervention phase and 536 from intervention phases. Implementing the protocol increased patients’ chances of receiving the recommended treatment by 14 times. Implementing the protocol reduced the hospitalization period by 6 days (p <0.001) and decreased mortality (p <0.001).
Conclusions:
this study showed that implementing the managed protocol had an impact on the improvement of sepsis treatment quality indicators.
- Camila Brito Borguezam
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ORIGINAL ARTICLE06-16-2021
The meaning of nursing 200 years after Nightingale – perceptions of professional practice in the intensivist context
Revista Brasileira de Enfermagem. 2021;74(2):e20200364
Abstract
ORIGINAL ARTICLEThe meaning of nursing 200 years after Nightingale – perceptions of professional practice in the intensivist context
Revista Brasileira de Enfermagem. 2021;74(2):e20200364
DOI 10.1590/0034-7167-2020-0364
Views0See moreABSTRACT
Objectives:
to know the meaning of contemporary nursing from the experience of intensive care nurses.
Methods:
qualitative research based on the theoretical framework of Symbolic Interactionism and the methodological framework of Interpretive Interactionism. The setting was a general hospital in Bahia, being carried out with 12 nurses working in intensive care for at least one year, through semi-structured interviews and drawing-text-theme technique, whose data were organized according to Miles and Huberman and analyzed upon the referential.
Results:
the sense of being a nurse was evidenced; a being for care, resulting from the experience in intensive care, capable of promoting the development of professional self-image, by causing, in nurses, other skills – besides the scientific ones, such as empathy, creativity, spirituality and compassion.
Final Considerations:
the sense of being a nurse, currently, expresses developments inherited from the Nightingalean proposal, but transcends the technical-managerial emphasis of this to a humanistic care perspective converging with our contemporary professional identity: a being for care.
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