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ORIGINAL ARTICLE01-10-2024
Nursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
Abstract
ORIGINAL ARTICLENursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
DOI 10.1590/0034-7167-2023-0459
Views0See moreABSTRACT
Objectives:
to identify how first-year nursing students use cyberspace and propose an orientation guide with criteria guiding the use of cyberspace.
Methods:
qualitative and descriptive research, carried out with 24 nursing students from a federal public institution in Rio de Janeiro. Data collection was carried out through semi-structured interviews. Data analysis occurred using IRAMUTEQ®. The research was approved by the institution’s Research Ethics Committee.
Results:
students use cyberspace to communicate, study, find “cool things”, share photos and memories. Furthermore, they are concerned about hate speech, intolerance and fake news. The good and bad sides and the types of technologies most used were also portrayed.
Final considerations:
the moral and ethical values of physical coexistence, together with awareness of individual responsibility, are the pillars for using cyberspace. The guide comes as an awareness tool.
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ORIGINAL ARTICLE01-10-2024
Maternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
Abstract
ORIGINAL ARTICLEMaternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
DOI 10.1590/0034-7167-2022-0576
Views0See moreABSTRACT
Objective:
to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection.
Method:
qualitative research with an ethnographic approach, developed in two women’s prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category.
Results:
three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization.
Final Considerations:
the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.
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ORIGINAL ARTICLE01-10-2024
Self-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
Abstract
ORIGINAL ARTICLESelf-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
DOI 10.1590/0034-7167-2024-0289
Views0See moreABSTRACT
Objective:
to analyze occurrence of self-harm, sociodemographic profile of victims and referrals in the first 24 months of the COVID-19 pandemic in São Paulo.
Method:
cross-sectional study carried out by the Notifiable Diseases Information System with data on self-harm in São Paulo. The period outlined was March 2020 to February 2022. R (4.0.2) software and chi-square test were used.
Results:
there were 15,946 incidents. Victims were young, white, single, heterosexual women. There was high incidence of people with previous mental disorders more than once and without clear motivation. The method used was poisoning/intoxication. There was a considerable number of referrals to the health network, although not totalitarian.
Conclusion:
the years of greater insecurity in relation to the pandemic have given rise to self-harm cases with peculiar characteristics. Agile health policies must be applied in atypical conditions, such as pandemics, especially for adolescents/young people with previous mental disorders.
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REVIEW01-10-2024
Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
Abstract
REVIEWHealth of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
DOI 10.1590/0034-7167-2024-0106
Views0See moreABSTRACT
Objective:
to map the literature on quilombola children’s health and its relationship with the Sustainable Development Goals.
Method:
a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework.
Results:
eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed.
Final considerations:
the study provided an extremely important mapping of the theme of quilombola children’s health and themes related to the Sustainable Development Goals.
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REVIEW01-10-2024
Prevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
Abstract
REVIEWPrevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
DOI 10.1590/0034-7167-2024-0052
Views0See moreABSTRACT
Objectives:
To identify in the scientific literature the prevalence, diagnostic methods, and exposure variables of latent infection by Mycobacterium tuberculosis in healthcare workers.
Methods:
An integrative review of the scientific literature based on the following review question: What are the available scientific evidence in the literature that address the prevalence of latent infection by Mycobacterium tuberculosis in healthcare workers and its association with possible risk factors among these workers?
Results:
Being a physician or nurse, being older, and being male were generally associated with higher prevalences. The study also showed that interferon-gamma release assays were more commonly used as a diagnostic method compared to skin tests.
Conclusions:
More studies are needed regarding the epidemiology of latent infection by Mycobacterium tuberculosis in the context of healthcare workers, aiming for higher impact actions that contribute to the reduction of tuberculosis worldwide.
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RESEARCH01-01-2017
Adherence to standard precautions in a teaching hospital
Revista Brasileira de Enfermagem. 2017;70(1):96-103
Abstract
RESEARCHAdherence to standard precautions in a teaching hospital
Revista Brasileira de Enfermagem. 2017;70(1):96-103
DOI 10.1590/0034-7167-2016-0138
Views0ABSTRACT
Objective:
analyze related factors and the level of adherence to standard precautions of nursing professionals from the clinical medical division of a teaching hospital.
Method:
a quantitative, cross-sectional, analytical study was conducted with 54 nursing professionals using the Psychometric Scale of Adherence to Standard Precautions, translated and validated to Brazilian Portuguese.
Results:
the global score of adherence was intermediate (4.41); no statistically significant correlation was observed between adherence and professional category (p=0.404) and length of professional practice (p= 0.612). A correlation was observed between ‘Washes hands after removing disposable gloves’ (p=0.026) and professionals with nursing practice above 10 years.
Conclusion:
adherence to standard precautions by the nursing team was intermediate, with no statistically significant difference in relation to the professional category and length of professional practice.
Keywords:Exposure to Biological AgentsNursing, TeamOccupational RisksPersonal Protective EquipmentUniversal PrecautionsSee more -
RESEARCH01-01-2017
Analysis of adverse events following immunization caused by immunization errors
Revista Brasileira de Enfermagem. 2017;70(1):87-95
Abstract
RESEARCHAnalysis of adverse events following immunization caused by immunization errors
Revista Brasileira de Enfermagem. 2017;70(1):87-95
DOI 10.1590/0034-7167-2016-0034
Views0See moreABSTRACT
Objective:
to analyze adverse events following immunization (AEFI) caused by immunization error in the state of Paraná, Brazil, from 2003 to 2013.
Method:
this is a descriptive, documental, retrospective, and quantitative research using secondary data from the Adverse Event Following Immunization Information System and the Immunization Program Evaluation System. We included cases confirmed and/or associated with different types of vaccines. For the analysis, we collected frequencies and incidence rates, and used simple linear regression models with Student’s t-test.
Results:
it was observed an AEFI increase due to immunization errors, especially hot subcutaneous abscesses. BCG vaccine had the highest incidence of adverse events and children under one year old were the most affected individuals.
Conclusion:
the current scenario is worrisome because these are preventable AEFI – injuring patients due to bad vaccination practices – that may undermine the population’s confidence, reducing immunization coverage, and the progress in the control of vaccine-preventable diseases.
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RESEARCH01-01-2017
Nursing practice environment and work satisfaction in critical units
Revista Brasileira de Enfermagem. 2017;70(1):79-86
Abstract
RESEARCHNursing practice environment and work satisfaction in critical units
Revista Brasileira de Enfermagem. 2017;70(1):79-86
DOI 10.1590/0034-7167-2016-0211
Views0See moreABSTRACT
Objective:
to analyze the association between the environment of nursing practices and work satisfaction in Intensive Care Units (ICU).
Method:
a cross-sectional study was performed in eight adult ICUs of a public university hospital between 2012 and 2015. The Nursing Work Index-Revised (NWI-R), in their short forms, and the Index of Work Satisfaction (IWS) were applied to investigate the environment of nursing practices and work satisfaction, respectively.
Results:
a total of 100 (34.84%) nurses and 187 (65.15%) nursing assistants/technicians participated in this study. The environment was favorable for autonomy and relationships and it showed vulnerability for control of practices and organizational support. The IWS score indicated low work satisfaction. “Environment of practices”, “length of work in the ICU” and “willingness to work” were associated with work satisfaction.
Conclusion:
to invest in the environment of practices, in factors that promote willingness to work and length of experience in the ICU increases nursing work satisfaction.
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RESEARCH01-01-2017
Emergency interventions for air medical services trauma victims
Revista Brasileira de Enfermagem. 2017;70(1):54-60
Abstract
RESEARCHEmergency interventions for air medical services trauma victims
Revista Brasileira de Enfermagem. 2017;70(1):54-60
DOI 10.1590/0034-7167-2016-0311
Views0See moreABSTRACT
Objective:
to analyze emergency interventions for air medical services trauma victims, considering the time at the scene of trauma and the severity of the victims.
Method:
This was a descriptive, correlational and quantitative study, conducted from October of 2014 to December of 2015. Six nurses participated, completing an instrument containing emergency interventions performed in the care of victims after the occurrence of trauma. The sample consisted of 97 treatments.
Results:
Among the 97 for whom care was provided, peripheral venipuncture was performed in 97.94% of the cases; immobilization, including a backboard, was used in 89.70% of cases. The most commonly used medications were dipyrone in 44.33%, and ondansetron in 76.29%. The time on the scene showed significance with the severity of the victims. The Glasgow Coma scores were inversely related to time on the scene.
Conclusion:
Further studies are necessary, focused on care protocols for trauma victims
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RESEARCH01-01-2017
Evaluation of the hospital accreditation program: face and content validation
Revista Brasileira de Enfermagem. 2017;70(1):47-53
Abstract
RESEARCHEvaluation of the hospital accreditation program: face and content validation
Revista Brasileira de Enfermagem. 2017;70(1):47-53
DOI 10.1590/0034-7167-2016-0184
Views0ABSTRACT
Objective:
to describe the results of face and content validation of the questionnaire entitled Quality Improvement Implementation Survey, and of two complementary scales as part of the adaptation process to the Brazilian language and culture.
Method:
included the following stages: (1) translation and synthesis of translations; (2) consideration by the expert committee; (3) back translation; (4) evaluation of verbal understanding by the target population.
Results:
the questionnaire was translated into Portuguese and its final version included 90 items. In the pre-test, the target population evaluated all items as easy to understand, with the global average of 4.58 (maximum value = 5).
Conclusion:
the questionnaire is currently translated into Portuguese and adapted to the Brazilian context. The adapted version maintained the semantic, idiomatic, conceptual and cultural equivalence, according to the assessment of the expert committee and the information provided by the target population, which confirmed the face and content validity.
Keywords:AccreditationAssurance of Health Care QualityHospital AdministrationOutcome Assessment (Health Care)Validation StudiesSee more -
RESEARCH01-01-2017
Adecuación de escalas para medir cargas de trabajo mediante metodología de calidad
Revista Brasileira de Enfermagem. 2017;70(1):39-46
Abstract
RESEARCHAdecuación de escalas para medir cargas de trabajo mediante metodología de calidad
Revista Brasileira de Enfermagem. 2017;70(1):39-46
DOI 10.1590/0034-7167-2016-0246
Views0RESUMEN
Objetivo:
Determinar cuál de las escalas evaluadas (NEMS y NAS), es más adecuada para Unidades de Cuidados Intensivos aplicando metodología de calidad.
Método:
Tras identificar como oportunidad de mejora la no adecuación de la escala NEMS para determinar cargas de trabajo de enfermería en UCI, se aplica metodología de los ciclos de mejora a dicha escala y a la NAS, como propuesta de mejora, evaluando los criterios: medición de cargas de trabajo al día y por turno, inclusión de todas las actividades enfermeras, y análisis por paciente y unidad.
Resultados:
Escala NEMS no muestra diferencias significativas en el cumplimiento (67%). Comparación NEMS-NAS, todos los criterios excepto el 1º, obtienen mejora significativa. NEMS sólo valora el criterio 1 (64,22%), y NAS todos con un cumplimiento para el 1º, 2º y 4º del 64,74%, y el 3º del 100%.
Conclusión:
La escala NAS es más adecuada para medir cargas de trabajo de enfermería en UCI.
Keywords:Carga de TrabajoControl de CalidadEnfermeríaGestión de la CalidadUnidades de Cuidados IntensivosSee more
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Patient safety with covid-19 in hospital units: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20220557
Abstract
Patient safety with covid-19 in hospital units: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20220557
DOI 10.1590/0034-7167-2022-0557
Views0See moreABSTRACT
Objective:
Map, in the scientific literature, the actions taken to promote the safety of patients with covid-19 in the hospital context.
Methods:
This is a scoping review according to the Joanna Briggs Institute, using the Checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. In April 2022, searches were performed on nine data sources. The results were summarized in a table and analyzed descriptively.
Results:
Fifteen studies were selected to compose the final sample. Most articles refer to cohort studies, followed by clinical trials. As for the areas of activity, there was a predominance of surgical centers, followed by adult and pediatric Intensive Care Units.
Conclusions:
With this review, it was possible to map measures such as contingency plans and reorganization of beds, rooms, and operating rooms, in addition to the isolation and distancing practiced by patients and professionals.
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ORIGINAL ARTICLE10-09-2023
Comportamentos saudáveis e risco de doenças cardiovasculares entre docentes de enfermagem durante a pandemia de COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220372
Abstract
ORIGINAL ARTICLEComportamentos saudáveis e risco de doenças cardiovasculares entre docentes de enfermagem durante a pandemia de COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220372
DOI 10.1590/0034-7167-2022-0372
Views0See moreRESUMEN
Objetivo:
Las enfermedades cardiovasculares son la primera causa de muerte en todo el mundo. La adopción de hábitos de vida que promuevan la salud mantendrá la salud cardiovascular del individuo y reducirá el riesgo de enfermedades cardiovasculares.
Métodos:
En este estudio descriptivo, se encuestó a 150 profesores de enfermería mediante un método de muestreo no probabilístico (intencional) para evaluar su adhesión a un estilo de vida promotor de la salud con el fin de conocer el riesgo de enfermedades cardiovasculares. Para ello, se utilizó la versión árabe del Health-Promoting Lifestyle Profile II (HPLP-II).
Resultados:
Setenta y dos profesores de enfermería completaron la encuesta. Los resultados indicaron que la muestra del estudio tenía un nivel moderado de promoción de la salud basado en el Health-Promoting Lifestyle Profile II.
Conclusión:
Los profesores de enfermería corren el riesgo de desarrollar enfermedades cardiovasculares en función de sus comportamientos de promoción de la salud, ya que obtuvieron una puntuación baja en responsabilidad de salud, actividad física y gestión del estrés. Se recomienda impulsar comportamientos saludables para prevenir enfermedades crónicas como las cardiovasculares.
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ORIGINAL ARTICLE10-09-2023
Healthy lifestyle behaviors and risk of cardiovascular diseases among nursing faculty during COVID-19 Pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220372
Abstract
ORIGINAL ARTICLEHealthy lifestyle behaviors and risk of cardiovascular diseases among nursing faculty during COVID-19 Pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220372
DOI 10.1590/0034-7167-2022-0372
Views0See moreABSTRACT
Objective:
Cardiovascular diseases are the first ranked cause of death worldwide. Adhering to health promoting lifestyle behaviors will maintain an individual’s cardiovascular health and decrease the risk of cardiovascular diseases.
Methods:
In this descriptive study, 150 nursing faculty were surveyed via a non-probability (purposive) sampling method to assess their adherence to health promoting lifestyle in order to know the risk of cardiovascular diseases. The Arabic version of Health-Promoting Lifestyle Profile II (HPLP-II) was used to achieve this goal.
Results:
Seventy-two nursing faculty completed the survey. The results indicated that the study sample had moderate level of health promotion based on Health-Promoting Lifestyle Profile II.
Conclusion:
Nursing faculty are at risk of developing cardiovascular diseases based on their health promoting lifestyle behaviors as they scored low level of “health responsibility”, “physical activity”, and “stress management “. Encouraging healthy behaviors is recommended to prevent chronic diseases such as cardiovascular diseases.
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ORIGINAL ARTICLE10-09-2023
Experience of the patient regarding their safety in the hospital environment
Revista Brasileira de Enfermagem. 2023;76(5):e20220512
Abstract
ORIGINAL ARTICLEExperience of the patient regarding their safety in the hospital environment
Revista Brasileira de Enfermagem. 2023;76(5):e20220512
DOI 10.1590/0034-7167-2022-0512
Views0See moreABSTRACT
Objectives:
to analyze the factors that can impact patients’ experience concerning safety-related measures in the hospital setting.
Methods:
this qualitative, descriptive, and exploratory study was conducted with patients and their family members at a hospital in southern Brazil. Semi-structured interviews were carried out using the Critical Incident Technique between January and February 2022. The collected data underwent content analysis with the assistance of IRaMuTeQ software.
Results:
five patients, four family members, and three patient-family units participated in the study. The following categories emerged: “Patientprofessional interaction as a component of safe care,” “Recognition of safety protocols in the patient’s experience,” and “Safe care and the challenges in hospital care.”
Conclusions:
patient-professional interaction, communication, awareness of safety protocols, and the availability of the nursing team are factors that influence patients’ experience regarding the safety of their care during hospitalization.
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ORIGINAL ARTICLE10-09-2023
Validity study of the Three-Dimensional Work Fatigue Inventory among higher education nursing faculty
Revista Brasileira de Enfermagem. 2023;76(4):e20230020
Abstract
ORIGINAL ARTICLEValidity study of the Three-Dimensional Work Fatigue Inventory among higher education nursing faculty
Revista Brasileira de Enfermagem. 2023;76(4):e20230020
DOI 10.1590/0034-7167-2023-0020
Views0See moreABSTRACT
Objective:
to adapt and validate the Three-Dimensional Work Fatigue Inventory (3D-WFI) for Brazil’s cultural reality and assess the psychometric properties.
Methods:
a methodological study developed in six stages: initial translation; synthesis of translations; back translation; review by expert committee; pretest; and review of the adaptation process by the researchers. For validity, the instrument was applied to a sample of 318 nursing professors from Brazilian federal and state public universities. Data were analyzed using exploratory and confirmatory factor analysis, composite reliability and instrument reliability (Cronbach’s alpha and McDonald’s omega).
Results:
the 3D-WFI instrument showed excellent internal consistency (α=0.95 and ω=0.97), three dimensions and explained variance of 62.77%.
Conclusions:
the Brazilian version of the instrument showed excellent psychometric properties for assessing fatigue among Brazilian workers.
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ORIGINAL ARTICLE10-09-2023
Construction and validity of an educational video to prevent immunization errors
Revista Brasileira de Enfermagem. 2023;76(4):e20230010
Abstract
ORIGINAL ARTICLEConstruction and validity of an educational video to prevent immunization errors
Revista Brasileira de Enfermagem. 2023;76(4):e20230010
DOI 10.1590/0034-7167-2023-0010
Views0See moreABSTRACT
Objective:
to construct and validate an orientation video, based on a low-fidelity clinical simulation scenario, to prevent immunization errors.
Methods:
a methodological study with video construction, validated in two stages by different audiences. Content was selected based on a realistic simulation scenario of the vaccine administration process to a patient-actor. Items with concordance greater than 0.8 and 0.6 were considered valid, verified using the Content Validity Index (CVI) and the Content Validity Ratio (CVR), respectively.
Results:
judges’ CVI had an average of 97.5%, and CVR, 0.9, and health professionals’ CVI, 95.4%, and CVR, 0.8. Successes in administering vaccines were addressed, such as careful reading of labels, double-checking the vaccine, distractions/interruptions and error reporting.
Conclusions:
the video was constructed and validated in terms of content, and can be used in training professionals working in vaccination.
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ORIGINAL ARTICLE10-09-2023
Variabilidade glicêmica e mortalidade em unidades de terapia intensiva oncológicas
Revista Brasileira de Enfermagem. 2023;76(4):e20220812
Abstract
ORIGINAL ARTICLEVariabilidade glicêmica e mortalidade em unidades de terapia intensiva oncológicas
Revista Brasileira de Enfermagem. 2023;76(4):e20220812
DOI 10.1590/0034-7167-2022-0812
Views0See moreRESUMEN
Objetivo:
investigar la asociación entre la variabilidad glucémica y la mortalidad en pacientes ingresados en unidades de cuidados intensivos oncológicos.
Métodos:
Se llevó a cabo un estudio de cohorte retrospectivo utilizando una muestra de conveniencia de 30 historias clínicas de pacientes de ambos sexos mayores de 18 años. La variabilidad glucémica se midió utilizando la desviación estándar y la amplitud general. El análisis estadístico se realizó utilizando la curva ROC (receiver operating characteristic) y el área bajo la curva (AUC). El nivel de significancia (α) se estableció en un 5% con un intervalo de confianza (IC) del 95%.
Resultados:
El estudio incluyó a 14 pacientes masculinos (46,67%) con una edad media de 60±15 años. Se recopilaron un total de 1503 muestras de glucemia. El análisis AUC para la desviación estándar no mostró ningún resultado estadísticamente significativo (p = 0,966; IC del 95% = [0,283, 0,726]). Por el contrario, la amplitud general tuvo una asociación estadísticamente significativa con la mortalidad (p = 0,049; IC del 95% = [0,514, 0,916]).
Conclusiones:
Este estudio encontró que la variabilidad glucémica medida por la amplitud general está significativamente asociada con la mortalidad del paciente en unidades de cuidados intensivos oncológicos. Estos hallazgos sugieren que el monitoreo de la variabilidad glucémica puede ser un factor importante en el manejo de pacientes críticamente enfermos en unidades de cuidados intensivos oncológicos.
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ORIGINAL ARTICLE10-09-2023
Glycemic variability and mortality in oncologic intensive care units
Revista Brasileira de Enfermagem. 2023;76(4):e20220812
Abstract
ORIGINAL ARTICLEGlycemic variability and mortality in oncologic intensive care units
Revista Brasileira de Enfermagem. 2023;76(4):e20220812
DOI 10.1590/0034-7167-2022-0812
Views0See moreABSTRACT
Objective:
This study aimed to investigate the association between glycemic variability and mortality in patients admitted to oncologic intensive care units.
Methods:
A retrospective cohort study was conducted using a convenience sample of 30 medical records of patients over 18 years of age of both sexes. Glycemic variability was measured using the standard deviation and general amplitude. Statistical analysis was performed using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). The significance level (α) was set at 5% with a confidence interval (CI) of 95%.
Results:
The study included 14 male patients (46.67%) with a mean age of 60±15 years. A total of 1503 blood glucose samples were collected. The AUC analysis for the standard deviation did not show a statistically significant result (p=.966; 95% CI=[0.283, 0.726]). In contrast, the general amplitude had a statistically significant association with mortality (p=.049; 95% CI=[0.514, 0.916]).
Conclusions:
This study found that glycemic variability measured by the general amplitude was significantly associated with patient mortality in oncologic intensive care units. These findings suggest that monitoring glycemic variability may be an important factor in the management of critically ill patients in oncologic intensive care units.
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