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The experience of grandmothers of children with cancer
Revista Brasileira de Enfermagem. 2016;69(3):559-565
Abstract
The experience of grandmothers of children with cancer
Revista Brasileira de Enfermagem. 2016;69(3):559-565
DOI 10.1590/0034-7167.2016690320i
Views0See moreABSTRACT
Objective:
to understand, from grandmothers’ perspectives, the experience of having a grandchild with cancer.
Method:
qualitative study, guided by philosophical hermeneutics. Eight grandmothers of children who had finished an oncology treatment participated in this study. Data were collected through interviews, which were recorded, transcribed, and analyzed according to the principles of hermeneutics.
Results:
the grandmothers underwent an experience of multiplied, silent, transformative, and permanent suffering. They believe it is their role to be present, but they recognize their adult children’s independence and self-determination. Grandmothers highlighted that their experience has been very little accessed and considered by health care professionals.
Conclusion:
we recommend including grandparents in the context of care and in additional research.
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Knowledge of healthcare professionals on the evaluation and treatment of neonatal pain
Revista Brasileira de Enfermagem. 2016;69(3):552-558
Abstract
Knowledge of healthcare professionals on the evaluation and treatment of neonatal pain
Revista Brasileira de Enfermagem. 2016;69(3):552-558
DOI 10.1590/0034-7167.2016690319i
Views0See moreABSTRACT
Objective:
to identify knowledge of healthcare professionals on the management, evaluation and treatment of pain in a neonatal unit in a municipality of Rio de Janeiro.
Method:
descriptive, exploratory study with quantitative analysis. Data were analyzed using the software R. Core Team
Results:
of the 96 healthcare professionals who participated in the study, 42 nursing aides/technicians responded, along with 22 nurses, 20 physicians and 2 physical therapists. The results showed that 40.5% of the nursing aides/technicians, 50% of the physicians and 50% of the physical therapists confirmed that they coordinate/perform/assist in the care of babies’ pain while performing procedures (lumbar puncture, chest tube insertion and central line). There was a significant difference of agreement in relation to the nursing aides/technicians and physicians. Most (69.8%) of the healthcare professionals knew of some non-pharmacological measure effective for relief of acute pain.
Conclusion:
there is a need for an educational intervention program, with participation of those involved, in the process to change professional practice.
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Moments for hand hygiene in Material and Sterilization Center
Revista Brasileira de Enfermagem. 2016;69(3):546-551
Abstract
Moments for hand hygiene in Material and Sterilization Center
Revista Brasileira de Enfermagem. 2016;69(3):546-551
DOI 10.1590/0034-7167.2016690318i
Views0See moreABSTRACT
Objective:
to characterize the moments when there is a need for hand hygiene (HH) by employees who work in Material and Sterilization Center (MSC).
Method:
we conducted a descriptive cross-sectional study in the MSC of a large hospital, from July to November 2012, in Goiânia, state of Goiás, Brazil. Data obtained through observation of workers, following a previously evaluated and tested checklist.
Results:
to the dirty area, standardized moments of HH were enough. In the clean area, “Extra moments with indication” for HH, resulting from the work process, such as: after disinfecting benches, after verification and inventory of consigned products, before assembling boxes/trays, before loading and unloading the autoclave, before handling and distributing health care products, among others, were necessary.
Conclusion:
the moments of HH in the dirty area coincide with indications of the clinical practice; and, in the clean area, characteristic moments of the work process were captured.
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The experience of family care in transitional support houses
Revista Brasileira de Enfermagem. 2016;69(3):538-545
Abstract
The experience of family care in transitional support houses
Revista Brasileira de Enfermagem. 2016;69(3):538-545
DOI 10.1590/0034-7167.2016690317i
Views0See moreABSTRACT
Objective:
to present the theoretical model that represents the experience of care in transitional homes of support to families of children in a period of post-transplantation of hematopoietic stem cells.
Method:
grounded theory, performed with 18 participants from three different samples. For analysis, we used the QSR Nvivo10 software.
Results:
we elaborated four categories: living in the transitional support home; experiencing care of children in post-transplantation of hematopoietic stem cells; taking care of the family caregiver; and returning to a new life at home, which interrelate according to the theoretical code of the interactive family.
Conclusion:
this research contributes to understanding the experience of care in transitional support homes of families with children in post-transplantation of hematopoietic stem cells and subsidizes nursing and health actions provided to this population; it also contributes to the development of a hospital discharge guidance and care directed to this clientele.
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Health care for children and adolescents with HIV: a comparison of services
Revista Brasileira de Enfermagem. 2016;69(3):522-531
Abstract
Health care for children and adolescents with HIV: a comparison of services
Revista Brasileira de Enfermagem. 2016;69(3):522-531
DOI 10.1590/0034-7167.2016690315i
Views0See moreABSTRACT
Objective:
compare the quality of different types of health care for children and adolescents with HIV, in the experience of family members and caregivers.
Method:
a cross-sectional study was conducted with 71 family members and caregivers, using the children’s version of the Primary Care Assessment Tool (PCATool-Brazil). The Mann-Whitney or Student’s t-test and Pearson’s chi-square or Fisher’s exact test were used for the analysis.
Results:
primary care services and, predominantly, specialized HIV services, were identified as the regular health care sources. There were no significant differences in quality, since their scores were close to the ideal level.
Conclusion:
the attributes of these services need to be improved, which would entail reformulating their structural and performance aspects. In addition, it is imperative to recognize primary health care as an integral place for promoting the health of children and adolescents with HIV.
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Nursing care in Specialized HIV/Aids Outpatient Services
Revista Brasileira de Enfermagem. 2016;69(3):515-521
Abstract
Nursing care in Specialized HIV/Aids Outpatient Services
Revista Brasileira de Enfermagem. 2016;69(3):515-521
DOI 10.1590/0034-7167.2016690314i
Views0See moreABSTRACT
Objective:
to analyze the discourses about the care provided by nurses operating in Specialized HIV/Aids Outpatient Services in four public institutions of the city of Fortaleza, Ceará, Brazil.
Method:
descriptive and exploratory study with a qualitative approach, which used as a method the discourse analysis.
Results:
when titling the “care as negative”, such title came from the analogy proposed by Freud (1912) with the photographic negative, represented by what that care can configure from the unconscious movement, since nurses did not perceive themselves in the care actions developed by supporting the work of other occupational categories, contributing to maintain the ideology of biomedicine.
Conclusion:
it is necessary to justify and theorize a nursing clinical practice from epistemological issues of the profession, in such a way that nurses can understand their relevance within the care provided.
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Notification of health problems among nursing workers in university hospitals
Revista Brasileira de Enfermagem. 2016;69(3):507-514
Abstract
Notification of health problems among nursing workers in university hospitals
Revista Brasileira de Enfermagem. 2016;69(3):507-514
DOI 10.1590/0034-7167.2016690313i
Views0See moreABSTRACT
Objective:
to identify the health problems of nursing workers and describe their consequences.
Method:
an epidemiological, descriptive study with a quantitative approach. The survey was conducted through the Health Monitoring System for Nursing Workers (SIMOSTE) in three university hospitals in São Paulo within a 12-month period.
Results:
a total of 970 records related to health problems were identified; most of these were related to sick leave, occupational accidents with leave, absences, and occupational accidents without leave, with a predominance of musculoskeletal and respiratory system diseases, infectious and parasitic diseases, and nervous system diseases, among others. A total of 4,161 days of work were lost because of the mentioned health problems.
Conclusion:
the results evidence the need to propose preventive strategies to mitigate and reduce health problems in nursing workers.
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Determining impacts and factors in ventilator-associated pneumonia bundle
Revista Brasileira de Enfermagem. 2016;69(6):1108-1114
Abstract
Determining impacts and factors in ventilator-associated pneumonia bundle
Revista Brasileira de Enfermagem. 2016;69(6):1108-1114
DOI 10.1590/0034-7167-2016-0253
Views0See moreABSTRACT
Objective:
Assessing the determining impacts and factors in ventilator-associated pneumonia (VAP) bundle.
Method:
descriptive retrospective longitudinal study, with quantitative approach, held at a public teaching hospital. Collection held between May 2014 and April 2015. Patients of the ICU with VAP participated in the research. For organizing data, the Microsoft Excel 2010 program was used. A critical analysis between the data collected and infection rates was performed. The survey was approved under no. 566,136.
Results:
an increase in the incidence of VAP after implementing the bundle was observed; the prevalent pathogens were gram-negative bacteria. Deaths were equal to or greater than 50%. Changes of professionals and lack of supplies were determining factors.
Conclusion:
in this context, the need for permanent qualification of the team is emphasized, with the purpose of promoting the adherence to the protocol and preventing VAP.
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Multidisciplinary team of intensive therapy: humanization and fragmentation of the work process
Revista Brasileira de Enfermagem. 2016;69(6):1099-1107
Abstract
Multidisciplinary team of intensive therapy: humanization and fragmentation of the work process
Revista Brasileira de Enfermagem. 2016;69(6):1099-1107
DOI 10.1590/0034-7167-2016-0221
Views0See moreABSTRACT
Objective:
to understand the meaning of humanized care in intensive care units considering the experience of the multidisciplinary team.
Method:
descriptive and exploratory qualitative research. For this purpose, we conducted semi-structured interviews with 24 professionals of the heath-care team, and, after transcription, we organized the qualitative data according to content analysis.
Results:
from two main categories, we were able to understand that humanized care is characterized in the actions of health-care: effective communication, team work, empathy, singularity, and integrality; and mischaracterized in the management processes, specifically in the fragmentation of the work process and health-care, in the precarious work conditions, and in differing conceptual aspects of the political proposal of humanization.
Conclusion:
care activities in intensive therapy are guided by the humanization of care and corroborate the hospital management as a challenge to be overcome to boost advances in the operationalization of this Brazilian policy.
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Humanized Care: insertion of obstetric nurses in a teaching hospital
Revista Brasileira de Enfermagem. 2016;69(6):1091-1098
Abstract
Humanized Care: insertion of obstetric nurses in a teaching hospital
Revista Brasileira de Enfermagem. 2016;69(6):1091-1098
DOI 10.1590/0034-7167-2016-0295
Views0ABSTRACT
Objective:
to evaluate the care provided at an Antepartum, Intrapartum, Postpartum (AIP) unit at a teaching hospital following the inclusion of obstetric nurses.
Method:
transversal study, performed at a AIP unit at a teaching hospital in the capital of the Brazilian state of Mato Grosso. The sample comprised data regarding the 701 childbirths that took place between 2014 and 2016. The data were organized using Excel and analyzed using version 7 of Epi Info software.
Results:
the results suggest that including obstetric nurses contributed towards qualifying the care provided during labor and childbirth, followed by a reduction in the number of interventions, such as episiotomy caesareans sections, and resulting in encouragement to employ practices that do not interfere in the physiology of the parturition process, which in turn generate good perinatal results.
Conclusion:
inserting these nurses collaborated towards humanizing obstetric and neonatal care.
Keywords:Hospitals, TeachingHumanization of CareHumanized ChildbirthNatural ChildbirthObstetric NursesSee more -
Normative grounds of health care practice in Brazilian nursing
Revista Brasileira de Enfermagem. 2016;69(6):1082-1090
Abstract
Normative grounds of health care practice in Brazilian nursing
Revista Brasileira de Enfermagem. 2016;69(6):1082-1090
DOI 10.1590/0034-7167-2016-0228
Views0See moreABSTRACT
Objective:
to understand the normative grounds of health care practice in Brazilian nursing.
Method:
qualitative study with the use of document research, carried out based on resolutions of the Federal Nursing Council. From a total of 263 resolutions, in the period from 1975 to 2015, 38 which were in accordance with the objective of the study were selected.
Results:
three analytical categories were systematized: Normative grounds of health care practice by the nursing team, under coordination/supervision of the nurse; Normative grounds of the care performed privately by the nurse; and Management and administrative aspects which affect and permeate the practice of health care in nursing.
Conclusion:
the set of normative grounds of health care practice by the nursing team leads to the reflection on the possible overlapping of attributions between professional levels and requires expansion to the other fields of nursing which are coherent with the health care network model.
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Multi-professional intervention in adults with arterial hypertension: a randomized clinical trial
Revista Brasileira de Enfermagem. 2016;69(6):1067-1073
Abstract
Multi-professional intervention in adults with arterial hypertension: a randomized clinical trial
Revista Brasileira de Enfermagem. 2016;69(6):1067-1073
DOI 10.1590/0034-7167-2016-0320
Views0See moreABSTRACT
Objective:
assess the influence of an intervention, comprised of counseling related to health and aerobic physical training for lowering pressure values, in anthropometric indicators and in the adjustment of biochemical parameters in individuals with hypertension.
Method:
intervention study of the randomized clinical trial variety, with 42 individuals. The intervention-group followed the protocol of health counseling, nutrition and physical activity.
Results:
two intervention groups were considered: intervention-group (a) and intervention-group (b). Intervention-group (a) showed significant decrease in measurements of systolic and diastolic arterial pressure, of high-density lipoprotein parameters, hip circumference values and waist-hip ratio. Intervention-group (b) presented significant decrease in systolic arterial pressure values.
Conclusion:
it was found that the health intervention in conjunction with physical activities were effective in decreasing and/or controlling values for pressure, biochemical and anthropometric indicators.
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Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people
Revista Brasileira de Enfermagem. 2016;69(6):1059-1066
Abstract
Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people
Revista Brasileira de Enfermagem. 2016;69(6):1059-1066
DOI 10.1590/0034-7167-2016-0359
Views0See moreABSTRACT
Objective:
to describe the use of the Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people, aimed at analyzing these professionals’ perception on humane care towards the institutionalized elderly.
Method:
a convergent care research was conducted with 18 caregivers of a long-term care institution for elderly people in the state of Paraíba, Brazil. Data were collected from June to November 2013, consisting of two months of interaction with the care service and ten meetings conducted in workshops for caregivers. Data were based on the theoretical framework of the Clinical Caritas Processes. Data analysis was based on content analysis and produced ten thematic categories based on the Caritas factors of caring.
Conclusion:
it was found that the use of the ten Caritas factors of caring were useful for humanistic formations when introducing the group to the conceptions of caring that value the self of the people providing the care and of the ones-being cared for.
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Technological innovation for peripheral venipuncture: ultrasound training
Revista Brasileira de Enfermagem. 2016;69(6):1052-1058
Abstract
Technological innovation for peripheral venipuncture: ultrasound training
Revista Brasileira de Enfermagem. 2016;69(6):1052-1058
DOI 10.1590/0034-7167-2016-0125
Views0See moreABSTRACT
Objective:
to evaluate the training of nurses in the use of ultrasound in peripheral venipuncture.
Method:
descriptive research of quantitative approach performed with nurses as part of an analytical cross-sectional study in two patient care centers: an intensive care unit and an adult emergency center.
Results:
the results showed contributions of training for professional skill and visibility of nurses, requiring, however, more time for complete assimilation of this technological innovation as a safer clinical practice.
Conclusion:
as the use of this technology represents an innovation aimed to facilitate difficult venipuncture and to provide subsidies to the most appropriate clinical decision-making, it is urgent to qualify nurses for its use.
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ORIGINAL ARTICLE11-22-2024
Temporal trends in neonatal mortality in Pernambuco
Revista Brasileira de Enfermagem. 2024;77(4):e20230451
Abstract
ORIGINAL ARTICLETemporal trends in neonatal mortality in Pernambuco
Revista Brasileira de Enfermagem. 2024;77(4):e20230451
DOI 10.1590/0034-7167-2023-0451
Views0See moreABSTRACT
Objective:
To verify the temporal trend of neonatal mortality in the health regions of Pernambuco between 2000 and 2020.
Method:
A time-series ecological study was conducted, analyzing the total neonatal mortality rate and its early and late components. For regression analysis, Joinpoint Regression was applied, trends were classified, and annual and average percentage changes were calculated for the period, with a significance level of 95%.
Results:
The average neonatal mortality rate in Pernambuco was 11.5 during the studied period. A decreasing trend in neonatal mortality rate was observed, especially in the early component. The region where the state capital is located showed the fastest decrease across all components.
Conclusion:
The temporal trend of neonatal mortality was decreasing; however, the rate of reduction was not uniform across the health regions of the state, and the implementation of the Mãe Coruja Pernambucana Program did not impact the trend in neonatal mortality.
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ORIGINAL ARTICLE11-22-2024
Evaluation of a video to promote HIV testing in sexual minorities
Revista Brasileira de Enfermagem. 2024;77(4):e20230320
Abstract
ORIGINAL ARTICLEEvaluation of a video to promote HIV testing in sexual minorities
Revista Brasileira de Enfermagem. 2024;77(4):e20230320
DOI 10.1590/0034-7167-2023-0320
Views0ABSTRACT
Objective:
To design and evaluate an educational video aimed at promoting HIV testing in gay men from the theoretical perspective of the Nola J. Pender Health Promotion Model.
Methods:
The design comprised five steps: 1.- Literature search; 2.- Formulation of the educational objective; 3.- Drafting of the script and location of the information in the theoretical components; 4.- Production; and 5.- Evaluation by experts and the target population.
Results:
The video “Living Without Fear” was produced, which presents the dilemma faced by gay men before taking a HIV test. The content validity index was 0.85, which indicated that the information was adequate and acceptable for promoting the rapid HIV test.
Final Considerations:
The results contribute to the scientific evidence aimed at promoting healthy behavior. In addition, the video was shown to be an acceptable educational tool.
Keywords:Audiovisual ResourcesHIV TestingInstructional Film and VideoSexual and Gender MinoritiesValidation StudySee more -
ORIGINAL ARTICLE11-22-2024
Development and validity of a mobile application prototype for hospital shift handover
Revista Brasileira de Enfermagem. 2024;77(4):e20230173
Abstract
ORIGINAL ARTICLEDevelopment and validity of a mobile application prototype for hospital shift handover
Revista Brasileira de Enfermagem. 2024;77(4):e20230173
DOI 10.1590/0034-7167-2023-0173
Views0ABSTRACT
Objective:
To develop and validate a mobile application prototype for nursing shift handover in a hospital inpatient unit.
Methods:
A methodological study of technological production, carried out from April 2020 to January 2022, for mobile application construction and validity through the Design Thinking methodology. The study involved the stages of prototype development and validity by experts.
Results:
The application for mobile nursing shift handover obtained a usability score of 79 points and a content validity coefficient of 0.7.
Conclusions:
The instrument obtained an excellent assessment according to usability and agreement among experts. However, future studies are needed to implement this technology in order to assess effectiveness, time optimization and failures during communication.
Keywords:Health Information ExchangeHealth TechnologyHospitalizationMobile ApplicationsSoftware ValidationSee more -
ORIGINAL ARTICLE10-25-2024
Analysis of the vaccination situation against Mpox in people living with HIV/AIDS: an ecological study
Revista Brasileira de Enfermagem. 2024;77(5):e20230234
Abstract
ORIGINAL ARTICLEAnalysis of the vaccination situation against Mpox in people living with HIV/AIDS: an ecological study
Revista Brasileira de Enfermagem. 2024;77(5):e20230234
DOI 10.1590/0034-7167-2023-0234
Views0See moreABSTRACT
Objectives:
to analyze the vaccination situation against Mpox in people living with HIV/AIDS in Brazil.
Methods:
an ecological study on the vaccination status against Mpox in people living with HIV/AIDS (PLWHA) in Brazil. The data were collected in April 2023 through information from the Ministry of Health, using the “Microsoft app Power BI,” which is publicly accessible.
Results:
the data analysis revealed that in Brazil, 2,978 doses of the MVA-BN Jynneos Mpox vaccine were administered in PLWHA, resulting in a vaccination coverage of 18.3%, with the southern and southeastern regions showing the lowest and highest vaccination coverage, respectively. Gender-based evaluation showed a higher proportion of vaccinated males.
Conclusions:
we identified low vaccination coverage in all regions of Brazil, highlighting the need for intensified vaccination activities, especially for PLWHA.
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ORIGINAL ARTICLE10-11-2024
Indigenous women’s experiences about the pregnancy-puerperal cycle
Revista Brasileira de Enfermagem. 2024;77:e20230410
Abstract
ORIGINAL ARTICLEIndigenous women’s experiences about the pregnancy-puerperal cycle
Revista Brasileira de Enfermagem. 2024;77:e20230410
DOI 10.1590/0034-7167-2023-0410
Views0See moreABSTRACT
Objectives:
to understand the experiences of indigenous women regarding the pregnancy-puerperal cycle.
Methods:
qualitative, exploratory and descriptive research, carried out between May and August 2023 with 27 pregnant women from Indigenous Villages in Mato Grosso, Brazil, through open individual interviews. The data was analyzed using Reflexive thematic analysis.
Results:
data analysis resulted in the following themes: Cultivation of labor and birth in its natural and sacred path; Unique practices and beliefs associated with breastfeeding; Evolved or reductive thinking? The participants suggest inviolable practices and beliefs, which must be welcomed, respected and enhanced by indigenous health teams.
Final Considerations:
the experiences of indigenous women regarding the pregnancy-puerperal cycle are unique and motivated by inviolable cultural and religious beliefs, which transcend scientific knowledge, certainties and the linearity of contemporary approaches, normally established as order.
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REVIEW10-07-2024
Risk factors associated with the occurrence of the adverse event phlebitis in hospitalized adult patients
Revista Brasileira de Enfermagem. 2024;77(5):e20240162
Abstract
REVIEWRisk factors associated with the occurrence of the adverse event phlebitis in hospitalized adult patients
Revista Brasileira de Enfermagem. 2024;77(5):e20240162
DOI 10.1590/0034-7167-2024-0162
Views0See moreABSTRACT
Objectives:
to synthesize knowledge regarding risk factors associated with occurrence of adverse event phlebitis in hospitalized adult patients.
Methods:
an integrative literature review, carried out in the CINAHL, PubMed, Virtual Health Library, Embase, Web of Science and Scopus databases. The stages were carried out independently by two reviewers, and the data were analyzed descriptively.
Results:
from the analysis of 31 quantitative primary studies, the following risk factors were summarized: length of stay; use of antibiotics; peripheral intravenous catheter dwell time; receive less nursing care; catheter inserted multiple times; patients with infection and comorbidities; presence of pain at catheter insertion site; Teflon® catheter use; reduced patient mobility; quality of patient’s vein; skin elasticity; unsuccessful insertion.
Conclusions:
it is necessary to standardize the format for measuring occurrence of this adverse event and develop new studies with a higher level of evidence.
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ORIGINAL ARTICLE10-07-2024
Indicators of emotional distress and mindfulness in undergraduate students: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(5):e20230499
Abstract
ORIGINAL ARTICLEIndicators of emotional distress and mindfulness in undergraduate students: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(5):e20230499
DOI 10.1590/0034-7167-2023-0499
Views0See moreABSTRACT
Objectives:
to assess the association between indicators of emotional distress and dispositional mindfulness in health students at a Brazilian federal public university.
Methods:
a cross-sectional study, developed with university students in the health area of a public institution from May to June 2022. In the analysis, multiple linear regression was used using SPSS software.
Results:
the sample was mostly female, ≤ 22 years old, non-white, studying the first semesters, with a higher prevalence for the medicine course. Students presented moderate dispositional mindfulness scores. It was observed that the variables of stress, depression and current suicide risk were associated with the capacity for mindfulness.
Conclusions:
knowing the indicators of emotional distress that are related to the potential of mindfulness can contribute as a situational diagnosis to better design strategies that promote the improvement of emotional indicators of health students.
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ORIGINAL ARTICLE10-07-2024
Development and validation of a mobile application prototype for postoperative cardiac surgery
Revista Brasileira de Enfermagem. 2024;77(5):e20230491
Abstract
ORIGINAL ARTICLEDevelopment and validation of a mobile application prototype for postoperative cardiac surgery
Revista Brasileira de Enfermagem. 2024;77(5):e20230491
DOI 10.1590/0034-7167-2023-0491
Views0See moreABSTRACT
Objectives:
to develop and validate the content, appearance, and semantics of a prototype application for monitoring patients in the postoperative period of cardiac surgery.
Methods:
this is a technological development study based on Contextualized Instructional Design. The content and appearance evaluation was conducted by a committee of specialists, and semantic validation was carried out by patients from a cardiac surgery outpatient clinic.
Results:
the application prototype consisted of 43 screens, validated by 17 health specialists, with content validity ratio and appearance validity index results of 0.86 and 0.99, respectively. For semantic validation, 10 patients participated in data collection, with a total content validity index of 0.978.
Conclusions:
the prototype of the “VivaCor PósOp” application demonstrated evidence of content, appearance, and semantic validity, with the potential to stimulate self-care in patients in the postoperative period of cardiac surgery.
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