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A Pesquisa em Enfermagem e os novos rumos a partir do SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
Abstract
A Pesquisa em Enfermagem e os novos rumos a partir do SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
DOI 10.1590/0034-7167.2015680401i
Views0Após quase meio século do início da pesquisa em Enfermagem no Brasil, ainda há necessidade de investimentos para considerá-la consolidada. Os seminários nacionais que discutem a investigação nesta área demonstram esta afirmação ao longo de 17 eventos, por seus resultados e participação da categoria de pesquisadores e prestadores de serviço. O 18º Seminário Nacional de […]See more -
Comprehensive health care: dilemmas and challenges in nursing
Revista Brasileira de Enfermagem. 2015;68(2):333-338
Abstract
Comprehensive health care: dilemmas and challenges in nursing
Revista Brasileira de Enfermagem. 2015;68(2):333-338
DOI 10.1590/0034-7167.2015680221i
Views0See moreABSTRACT
Objective:
this article discusses comprehensive care as a guiding tenet of the Brazilian Unifi ed Health System (SUS), outlining health care practices, especially nursing, and the relationships built by subjects in action by means of different knowledge.
Methods:
this is a theoretical refl ection that aims to propose dimensions of analysis (access to services, reception, links, lines of care, accountability, and responsiveness), with an emphasis on the dilemmas and challenges of nursing. The proposed dimensions analyze the production of care and its political and technical aspects.
Conclusion:
care should be the focus of all health care work, bearing in mind that intervention for technological action of each profession goes beyond the core of isolated knowledge, as is the case of nursing, which is connected to other professional practices, and can peruse other territories that operate through relational technologies, entering into the world of the needs of users and families.
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Gender and violence against women in nursing literature: a review
Revista Brasileira de Enfermagem. 2015;68(2):325-332
Abstract
Gender and violence against women in nursing literature: a review
Revista Brasileira de Enfermagem. 2015;68(2):325-332
DOI 10.1590/0034-7167.2015680220i
Views0See moreABSTRACT
Objective:
considering the potential of nursing to expand understanding on this theme, this study aims to learn what is being published on gender and violence against women in the main Brazilian nursing journals.
Method:
an integrative review of online publications between 2000 and 2012 was conducted. Of the 138 articles selected, 25 addressed gender and violence against women as social constructs.
Results:
there was a predominance of qualitative approaches (60%), empirical research (60%), academic (100%), authors who were nurses (96%), spousal violence (32%) and domestic violence (20%). Violence against women in the light of gender was associated in only 32% of the articles.
Conclusion:
there is a need for increased studies in partnership with the public health care service, and to expand discussions on the dynamics of power and resistance, which are the basis of the concept of gender.
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Nasal colonization in nursing professionals from units specialized in HIV/AIDS
Revista Brasileira de Enfermagem. 2015;68(2):320-324
Abstract
Nasal colonization in nursing professionals from units specialized in HIV/AIDS
Revista Brasileira de Enfermagem. 2015;68(2):320-324
DOI 10.1590/0034-7167.2015680119i
Views0See moreABSTRACT
Objective:
to investigate the presence of microorganisms in the nostrils of the nursing professionals of a Brazilian teaching hospital.
Method:
cross-sectional study in two inpatient units specialized in HIV/AIDS. Nasal secretion samples of nursing professionals were collected in one month. The samples were processed at the microbiology laboratory of the institution and analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 19.0. Ethical aspects were abided.
Results:
from the 73 members of the nursing staff, samples of nasal secretions were collected from 61 (80.2%). Six types of microorganisms were isolated in 22 (41.0%) positive cultures. It is noteworthy that Staphylococcus aureus accounted for 22.9%, four of them oxacillin-resistant (MRSA).
Conclusion:
Staphylococcus aureus microorganism accounted for the largest prevalence in individuals of this study.
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Evaluation of nursing students about learning with clinical simulation
Revista Brasileira de Enfermagem. 2015;68(2):311-319
Abstract
Evaluation of nursing students about learning with clinical simulation
Revista Brasileira de Enfermagem. 2015;68(2):311-319
DOI 10.1590/0034-7167.2015680218i
Views0See moreABSTRACT
Objective:
to describe the contributions of clinical simulation for learning cognitive and procedural attributes through debriefi ng, from the perspective of nursing students.
Method:
descriptive exploratory study. Twenty nursing undergraduate students from a university in the interior of the state of São Paulo participated in this study. Data collection was performed at the debriefi ng stage. Student’s perceptions about the simulation, positive aspects and what they could have done differently were registered. The students’ statements were grouped according to the central themes and the framework of Bardin’s content analysis (2011) and were analyzed using descriptive statistics.
Results:
enhancement of active, critical and refl ective learning (47.5%) was identifi ed due to the closeness to reality in nursing care (20.3%), manifestation of feelings experienced during the simulation (15.3%) and composition of the scenario (15.3%).
Conclusion:
the clinical simulation followed by debriefi ng promotes the understanding of the link between action and achievements in learning.
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Risk assessment of patient falls while taking medications ordered in a teaching hospital
Revista Brasileira de Enfermagem. 2015;68(2):305-310
Abstract
Risk assessment of patient falls while taking medications ordered in a teaching hospital
Revista Brasileira de Enfermagem. 2015;68(2):305-310
DOI 10.1590/0034-7167.2015680217i
Views0See moreABSTRACT
Objective:
to stratify prescribed medication in a fall risk scale, identifying subgroups of drugs and inpatient units with higher risk of falls.
Method:
retrospective study on prescription order forms given by medical clinic, surgical clinic, and general intensive care unit. Risk factors under consideration: 1) orthostatic hypotension; 2) arterial hypotension; 3) arterial hypertension; 4) bradycardia; 5) psychomotor agitation; 6) mental confusion; 7) dizziness; 8) drowsiness/sedation; 9) reduced eyesight; 10) seizures; 11) atonia/dystonia/muscle weakness; 12) hypoglycemia; 13) urgent urination and 14) urgent defecation/diarrhea. Risk levels adopted: 0: 0 factor; I: 1-2 factors; II: 3-5 factors; III: 6-9 factors; IV: 10-14 factors.
Results:
3893 drugs were analyzed and stratifi ed in levels: 0 22.7%; I 33.5%; II 28%; III 15.1%; IV 0.7%. Levels III and IV more often refer to drugs for stomach acid disorders, 22.6%, and psycholeptics, 100%.
Conclusion:
knowing the risk factors associated with medication may help prevent and reduce falls, especially when therapeutic regimens cannot be modifi ed.
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Knowledge and practice of the nurse about leprosy: actions of control and elimination
Revista Brasileira de Enfermagem. 2015;68(2):297-304
Abstract
Knowledge and practice of the nurse about leprosy: actions of control and elimination
Revista Brasileira de Enfermagem. 2015;68(2):297-304
DOI 10.1590/0034-7167.2015680216i
Views0See moreABSTRACT
Objective:
to assess the knowledge and practice of primary health care nurses about control and elimination actions of leprosy.
Method:
evaluation study with qualitative approach, using the Discourse of the Collective Subject, data were collected through semi-structured interviews conducted with 16 nurses.
Results:
the data collected revealed that health professionals have suffi cient knowledge about the National Policy on Control and Elimination of Leprosy (NPCEL) and that the main actions preconized were applied, however, notifi cation of suspected or confi rmed cases and social reintegration of the patient were not mentioned.
Conclusion:
keeping patients in treatment, overload of work, lack of interdisciplinarity and treatment performed at other locations outside of the community were diffi culties reported by professionals. Nurses know the actions addressed at assistance of leprosy patients, however, the study points to the need for a practice which is more aligned to what advocates NPCEL.
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Weaknesses of vaccine storage in Primary Healthcare Centers
Revista Brasileira de Enfermagem. 2015;68(2):291-296
Abstract
Weaknesses of vaccine storage in Primary Healthcare Centers
Revista Brasileira de Enfermagem. 2015;68(2):291-296
DOI 10.1590/0034-7167.2015680215i
Views0See moreABSTRACT
Objective:
assessment through qualitative approach of vaccine storage in Primary Healthcare Centers.
Method:
assessment study of qualitative approach in which 30 interviews were conducted with nurses, nursing technicians or assistants and technical reference in immunization, in 12 vaccine rooms that had 100% of the structural criteria evaluated. Recorded testimonials of the subjects were organized and analyzed using thematic Content Analysis.
Results:
the assessment pointed to absence of knowledge on the parts of nurses and nursing technicians and assistants with respect to the effects of low temperature on vaccines. Barriers were also encountered in relation to the supervision of nurses in the vaccine room activities and in relation to the knowledge needed by workers to care for preservation of vaccines.
Conclusion:
vaccine storage is inadequate and may compromise the quality of the immunobiologicals dispensed to the populace.
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Unna’s boot: experience of care of people with venous ulcers
Revista Brasileira de Enfermagem. 2017;70(2):349-356
Abstract
Unna’s boot: experience of care of people with venous ulcers
Revista Brasileira de Enfermagem. 2017;70(2):349-356
DOI 10.1590/0034-7167-2016-0219
Views0See moreABSTRACT
Objective:
to understand the experience of care of people with venous ulcers using an Unna’s boot.
Method:
a qualitative study, based on the social phenomenology by Alfred Schütz, was carried out with 12 adults interviewed in 2015. The statements were analyzed and organized in thematic categories.
Results:
the following categories emerged: “Unna’s boot annoyance versus wound improvement”, “Difficulties for accessing care with the Unna’s boot”, “Care for healing and preventing recurrence”, and “Receiving more attention from the healthcare professional”.
Conclusion:
the experience of care of people using an Unna’s boot revealed the annoyance caused by this device, which was overcome due to the wound improvement. However, access to care was compromised by the lack of structure at the service, frustrating the patients’ expectations regarding wound healing. The issues of these people’s intersubjective universe should be considered in the management of care of venous ulcers.
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Spanish version of the scale of attitudes toward alcohol, alcoholism and alcoholics: content validation
Revista Brasileira de Enfermagem. 2017;70(2):342-348
Abstract
Spanish version of the scale of attitudes toward alcohol, alcoholism and alcoholics: content validation
Revista Brasileira de Enfermagem. 2017;70(2):342-348
DOI 10.1590/0034-7167-2015-0149
Views0See moreABSTACT
Objective:
to describe the process of translation and cultural adaptation of the scale of attitudes towards alcohol, alcoholism and alcoholics into the Spanish language.
Methods:
this was a methodological study, which followed the international guidelines for translation and adaptation of measurement scales.
Results:
During the process of translation and cultural adaptation of scale of attitudes towards alcohol, alcoholism and alcoholics to the Spanish language, the items were adjusted based on semantic, idiomatic and conceptual equivalence of the expressions contained in the scale of attitudes towards alcohol, alcoholism and alcoholics. Content validation indicated satisfactory validity indexes, with Intraclass Correlation Coefficient (ICC) (0.97), Content Validity Index (CVI) (0.92), and the Prevalence Adjusted Bias Adjusted Kappa (PABAK) (0.80).
Conclusion:
the scale of attitudes towards alcohol, alcoholism and alcoholics, adapted and translated into the Spanish language, presented content validity with satisfactory indexes, which affirmed that the instrument was adapted for the Colombian context. The next step will be evaluation of its psychometric properties in order to guarantee reliability for its use in Hispanic populations.
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Nursing care protocol for patients with a ventricular assist device
Revista Brasileira de Enfermagem. 2017;70(2):335-341
Abstract
Nursing care protocol for patients with a ventricular assist device
Revista Brasileira de Enfermagem. 2017;70(2):335-341
DOI 10.1590/0034-7167-2016-0363
Views0See moreABSTRACT
Objective:
to develop and validate a nursing care protocol for patients with a ventricular assist device (VAD).
Method:
descriptive study, with a quantitative approach, for an instrument’s methodological validation. Three stages were conducted: development of the instrument; protocol content validation according to the Delphi technique, and agreement among experts and the scientific literature.
Results:
based on the content validation, a care protocol for patients with a VAD was created and assessed by Spanish experts. Of the 15 items evaluated by means of the content validity index (CVI), 10 presented solid evidence of validation, with Kappa ranging between 0.87 and 1.
Conclusion:
the method enabled the validation of interventions that will contribute to qualified and standardized care for patients with a VAD.
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Nasoenteral tube: factors associated with delay between indication and use in emergency services
Revista Brasileira de Enfermagem. 2017;70(2):326-334
Abstract
Nasoenteral tube: factors associated with delay between indication and use in emergency services
Revista Brasileira de Enfermagem. 2017;70(2):326-334
DOI 10.1590/0034-7167-2016-0222
Views0ABSTRACT
Objective:
to know the time between indication and use of a nasoenteral tube (NET) and factors associated with delays.
Method:
A prospective cohort study that followed adults in a Brazilian emergency department, since the indication of the use of a NET, evaluating clinical variables and the work process. The Generalized Estimated Equations model was adopted to identify factors associated with the delays in each stage of the process.
Results:
the time between indication and use of NET was 573 (IQR: 3601,093) minutes, in 150 insertions of NET. Insertions in patients who previously did not use it; delays in the medical, nutrition, and nursing care routine; use of mechanical ventilation; noradrenaline; and fasting were factors for longer time before the use of the tube.
Conclusion:
the time between indication and use of NET was high, exceeding 10 hours in half of the cases. Factors related to the clinical condition of the patient and to the care management would contribute to delays.
Keywords:Emergency Medical ServicesGastrointestinal IntubationNursing CarePatient SafetyTreatment TimeSee more -
Non-pharmacological measures in preterm newborns submitted to arterial puncture
Revista Brasileira de Enfermagem. 2017;70(2):317-325
Abstract
Non-pharmacological measures in preterm newborns submitted to arterial puncture
Revista Brasileira de Enfermagem. 2017;70(2):317-325
DOI 10.1590/0034-7167-2016-0003
Views0See moreABSTRACT
Objective:
to assess pain in preterm newborns and to compare the neonatal and therapeutic variables with the total scores of the Neonatal Facial Coding System of preterm newborns submitted to arterial puncture exposed to music and 25% oral glucose.
Method:
a comparative study with 48 recordings of preterm newborns – Group 1, music (26); Group 2, glucose 25% (22) – individually analyzed by three trained nurses, after Kappa of at least 80%.
Results:
the variables and the pain scores of the groups did not present statistical significance (p < 0.05) according to the Neonatal Facial Coding System. 80.8% of the preterm infants in Group 1 had a higher quantitative score ≥ 3 in the neonatal variables (gender, type of delivery), and therapeutic variables (type of oxygen therapy, place of hospitalization, type of puncture).
Conclusion:
There was no difference when comparing the music and glucose 25% groups and the variables studied.
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Moral sensitivity in Primary Health Care nurses
Revista Brasileira de Enfermagem. 2017;70(2):308-316
Abstract
Moral sensitivity in Primary Health Care nurses
Revista Brasileira de Enfermagem. 2017;70(2):308-316
DOI 10.1590/0034-7167-2016-0453
Views0See moreABSTRACT
Objective:
to characterize the profile and describe the moral sensitivity of primary health care nurses.
Method:
this is a quantitative, transversal, exploratory, descriptive study. The data were collected through the Moral Sensitivity Questionnaire translated and adapted to Brazil. 100 primary health care nurses participated, from Rio Grande do Sul, Brazil. The data collection took place during the months of March and July 2016, in an online form. The analysis of the data occurred through descriptive statistical analysis.
Results:
the nurses had an average moral sensitivity of 4.5 (out of 7). The dimensions with the greatest moral sensitivity were: interpersonal orientation, professional knowledge, moral conflict and moral meaning.
Conclusion:
the nurses of Rio Grande do Sul have a moderate moral sensitivity, which may contribute to a lower quality in Primary Health Care.
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Moral suffering among nurse educators of technical courses in nursing
Revista Brasileira de Enfermagem. 2017;70(2):301-307
Abstract
Moral suffering among nurse educators of technical courses in nursing
Revista Brasileira de Enfermagem. 2017;70(2):301-307
DOI 10.1590/0034-7167-2016-0185
Views0See moreABSTRACT
Objective:
to understand situations of moral suffering experienced at work by nurse educators of technical courses in nursing.
Method:
a qualitative study with discursive textual analysis by means of semi-structured interviews with ten nurse educators at two professional educational institutions in southern Brazil.
Results:
two categories were established: lack of commitment on the part of students to the future profession, expressed through disrespect and disregard for the work of nurse educators, with inappropriate behaviors and attitudes; and lack of commitment to the learning-teaching process, expressed by indifference to the professional profile and lack of interest in lessons and care practices associated with learning gaps.
Conclusion:
these situations have an impact on experiences of moral suffering by nurse educators, and show a need for rethinking their practice, relationships, and educational spaces, and implementing strategies to favor the confrontation of dilemmas and conflicts experienced in educational practice in technical courses in nursing.
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Knowledge of the nursing team on pressure ulcer prevention
Revista Brasileira de Enfermagem. 2017;70(2):294-300
Abstract
Knowledge of the nursing team on pressure ulcer prevention
Revista Brasileira de Enfermagem. 2017;70(2):294-300
DOI 10.1590/0034-7167-2016-0063
Views0See moreABSTRACT
Objective:
describe and analyze the nursing team’s knowledge about classification, evaluation and measures to prevent pressure ulcers (PU) in patients hospitalized in the ICU of a teaching hospital in the city of Manaus.
Method:
a descriptive and exploratory study was conducted after approval by a research ethics committee. Data were collected using a validated instrument. The study sample was made up of 40 nursing staff members, of whom 14 were nurses and 26 were nursing technicians/aides. Data were analyzed through descriptive statistics and Student’s t-test, with value of p<0.05.
Results:
the overall mean of hits was 63.4% for technicians/aides and 51.4% for nurses, with statistically significant differences between the groups only for the PU prevention category (p<0.001).
Conclusion:
a deficit of knowledge on PU prevention was found among nurses and nursing technicians/aides, demanding the training of these professionals.
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A enfermagem como protagonista no enfrentamento da hesitação e recusa vacinal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
A enfermagem como protagonista no enfrentamento da hesitação e recusa vacinal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
DOI 10.1590/0034-7167.202477suppl101pt
Views0Desde a década de 1970, o Ministério da Saúde do Brasil instituiu o Programa Nacional de Imunização (PNI), que precedeu o Sistema Único de Saúde e que lhe foi incorporado e fortalecido, devido ao modelo descentralizado aos municípios, mas de comando único ao nível central. Seu objetivo era e ainda é coordenar as ações de […]See more -
Nursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
Nursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
DOI 10.1590/0034-7167.202477suppl101
Views1Since the 1970s, the Brazilian Ministry of Health established the Brazilian National Immunization Program (PNI – Programa Nacional de Imunização), which preceded the Brazilian Health System and which was incorporated and strengthened due to the decentralized model to municipalities, but under single command at central level. Its objective was and still is to coordinate vaccination […]See more -
Enfermeiro Navegador de Pacientes com Câncer: contribuições para a discussão no cenário nacional
Revista Brasileira de Enfermagem. 2024;77(2):e770201
Abstract
Enfermeiro Navegador de Pacientes com Câncer: contribuições para a discussão no cenário nacional
Revista Brasileira de Enfermagem. 2024;77(2):e770201
DOI 10.1590/0034-7167.2024770201pt
Views0A prática profissional da navegação de pacientes é algo incipiente no Brasil e, sendo assim, é indispensável uma ampla discussão com vários setores da sociedade, sendo essa a principal propositura deste editorial. Comecemos pela história.A navegação de pacientes foi definida em 1989 como uma intervenção de prestação de serviços baseada na comunidade, com o objetivo […]See more -
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
Abstract
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
DOI 10.1590/0034-7167.2024770201
Views0The professional practice of patient navigation is incipient in Brazil and, therefore, a broad discussion with various sectors of society is essential, which is the main purpose of this editorial. Shall we start with the story.Patient navigation was defined in 1989 as a community-based service delivery intervention aimed at appropriately promoting access to diagnosis and […]See more -
ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e02
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e02
DOI 10.1590/0034-7167.20247701e02
Views0In the article “Active teaching model to promote critical thinking”, with DOI number: , published in Revista Brasileira de Enfermagem, 2019;72(1):293-8, on page 297:Include before REFERENCES:[…]See more -
REVIEW02-26-2024
Practice of immersion in hot water to relieve pain in neonatology: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230260
Abstract
REVIEWPractice of immersion in hot water to relieve pain in neonatology: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230260
DOI 10.1590/0034-7167-2023-0260
Views0See moreABSTRACT
Objectives:
to identify immersion use in hot water to relieve pain in newborns.
Methods:
an integrative literature review, carried out in the PubMed, VHL, EMBASE, Scopus, CINAHL, Cochrane and SciELO databases, with investigations in English, Spanish, French or Portuguese, published between 2002 and 2022. The Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) were used to answer the following question: what are the uses of hot water immersion in relieving pain in newborns?
Results:
nine studies were included, mainly Brazilian, experimental, with a predominance of strong and moderate levels of evidence. Hydrotherapy and bath use (immersion and bandaging) was observed, promising interventions in reducing pain scores, assessed using scales, physiological and endocrine parameters.
Conclusions:
hot water proved to be a promising non-pharmacological intervention in relieving pain in infants in different contexts.
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ORIGINAL ARTICLE02-26-2024
Artificial intelligence to predict bed bath time in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(1):e20230201
Abstract
ORIGINAL ARTICLEArtificial intelligence to predict bed bath time in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(1):e20230201
DOI 10.1590/0034-7167-2023-0201
Views0See moreABSTRACT
Objectives:
to assess the predictive performance of different artificial intelligence algorithms to estimate bed bath execution time in critically ill patients.
Methods:
a methodological study, which used artificial intelligence algorithms to predict bed bath time in critically ill patients. The results of multiple regression models, multilayer perceptron neural networks and radial basis function, decision tree and random forest were analyzed.
Results:
among the models assessed, the neural network model with a radial basis function, containing 13 neurons in the hidden layer, presented the best predictive performance to estimate the bed bath execution time. In data validation, the squared correlation between the predicted values and the original values was 62.3%.
Conclusions:
the neural network model with radial basis function showed better predictive performance to estimate bed bath execution time in critically ill patients.
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REVIEW02-26-2024
Evidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230134
Abstract
REVIEWEvidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230134
DOI 10.1590/0034-7167-2023-0134
Views0ABSTRACT
Objectives:
to synthesize and analyze evidence on intrauterine device insertion by nurses in Primary Health Care.
Methods:
an integrative review, carried out in the BDENF, CINAHL, LILACS, SciELO, Scopus, PubMed and Web of Science databases in June 2022, delimiting the period from 1960 to 2022.
Results:
141 articles were identified in the initial search, and 10 studies made up the final sample. Four (40%) were developed in the United States and one (10%) in Brazil, with publications from 1979 to 2021. The findings were grouped into three categories: Nurse training to insert an intrauterine device; Nurses’ competency to insert an intrauterine device; and Women’s access to intrauterine devices.
Conclusions:
nurse theoretical and practical training is a prominent element, consolidated in the favorable outcomes of insertions performed by nurses and satisfaction among women, a practice that has expanded access to the contraceptive method in Primary Health Care.
Keywords:Advanced Practice NursingIntrauterine DevicesLong-Acting Reversible ContraceptionNursesPrimary Health CareSee more
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