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ORIGINAL ARTICLE09-29-2022
Construction and validation of an instrument for classifying nipple and areola complex lesions resulting from breastfeeding
- Marina Possato Cervellini
, - Kelly Pereira Coca ,
- Mônica Antar Gamba ,
- Karla Oliveira Marcacine ,
- Ana Cristina Freitas de Vilhena Abrão
Abstract
ORIGINAL ARTICLEConstruction and validation of an instrument for classifying nipple and areola complex lesions resulting from breastfeeding
Revista Brasileira de Enfermagem. 2022;75(1):e20210051
DOI 10.1590/0034-7167-2021-0051
- Marina Possato Cervellini ,
- Kelly Pereira Coca ,
- Mônica Antar Gamba ,
- Karla Oliveira Marcacine ,
- Ana Cristina Freitas de Vilhena Abrão
Views0See moreABSTRACT
Objectives:
to construct and validate a classification of nipple and areola complex lesions resulting from breastfeeding, according to content and appearance.
Methods:
this is a methodological study, developed in four stages: operational definition, instrument construction, content and appearance validation. The Delphi technique and a Likert-type scale were used to validate content and appearance, through the participation of ten and sixteen judges, respectively. For analysis, Content Validity Index and Kappa Coefficient were applied.
Results:
Content Validity Index obtained an overall value of 0.93 and, for appearance, 0.94. Kappa values ranged between 0.46 and 1. The high rates of agreement among judges demonstrated the quality of the proposed content validity.
Conclusions:
the Nipple and Areola Complex Lesions Classification Instrument developed obtained acceptable values of its indexes, proving to be valid in terms of content and appearance.
- Marina Possato Cervellini
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ORIGINAL ARTICLE09-29-2022
Incidence of acute radiodermatitis in women with breast cancer undergoing hypofractionated radiotherapy
- Laura Beatriz Sousa de Jesus Martelletti ,
- Beatriz Regina Lima de Aguiar ,
- Larissa Aparecida Corrêa Vieira ,
- Amanda Gomes de Menêses ,
- Priscila de Sousa Maggi Bontempo , [ … ],
- Paula Elaine Diniz dos Reis
Abstract
ORIGINAL ARTICLEIncidence of acute radiodermatitis in women with breast cancer undergoing hypofractionated radiotherapy
Revista Brasileira de Enfermagem. 2022;75(1):e20210118
DOI 10.1590/0034-7167-2021-0118
- Laura Beatriz Sousa de Jesus Martelletti ,
- Beatriz Regina Lima de Aguiar ,
- Larissa Aparecida Corrêa Vieira ,
- Amanda Gomes de Menêses ,
- Priscila de Sousa Maggi Bontempo ,
- Elaine Barros Ferreira ,
- Paula Elaine Diniz dos Reis
Views0See moreABSTRACT
Objective:
To estimate the incidence and degree of acute radiodermatitis at the end and after the end of treatment in women with breast cancer undergoing hypofractionated radiotherapy.
Methods:
Observational, prospective, and longitudinal study, conducted between March 2019 and January 2020, in a radiotherapy outpatient clinic.
Results:
Thirty-two women participated in the study, among whom, in the last session of hypofractionated radiotherapy, 15 (46.9%) had radiodermatitis, erythema in 13 (40.6%), and wet peeling in 2 (6.3%). In the post-treatment evaluation, 27 (84.4%) had radiodermatitis, erythema in 17 (53.1%), dry peeling in 8 (25%), and wet peeling in 2 (6.3%).
Conclusion:
The general incidence of radiodermatitis after hypofractionated radiotherapy in women with breast cancer was 37.5%, erythema, 12.5%, and dry peeling, 25%. The development of care protocols for the management of radiodermatitis after treatment is of paramount importance.
- Laura Beatriz Sousa de Jesus Martelletti
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ORIGINAL ARTICLE09-29-2022
Palliative care production for health professionals in the context of home care
Revista Brasileira de Enfermagem. 2022;75(1):e20210030
Abstract
ORIGINAL ARTICLEPalliative care production for health professionals in the context of home care
Revista Brasileira de Enfermagem. 2022;75(1):e20210030
DOI 10.1590/0034-7167-2021-0030
Views1See moreABSTRACT
Objectives:
to analyze palliative care production developed by health professionals to home care patients.
Methods:
this is an exploratory study, with a qualitative approach, using the transpersonal care theoretical framework. Thirteen interviews were conducted with health professionals and 18 observations were conducted on different cases. Content analysis was performed using MAXQDA©.
Results:
actions performed: maintenance and follow-up measures to people eligible for palliative care, in acts of dialogue and “listening” to caregivers and users, conducting guidelines for the care and self-care process, performing technical procedures, delivery of materials, referrals and medical prescriptions to users.
Final Considerations:
it is perceived the need for advances in the implementation of government policies in Brazil that insert palliative care into the Health Care Network through educational, managerial and care actions that ensure human dignity, thus allowing the development of these and other palliative care interventions.
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REVIEW09-29-2022
Children with congenital heart disease in COVID-19 pandemic times: an integrative review
- Aline Cerqueira Santos Santana da Silva ,
- Fernanda Garcia Bezerra Góes ,
- Liliane Faria da Silva ,
- Laura Johanson da Silva ,
- Michelly Cristynne Souza Bonifácio , [ … ],
- Yasminn Canella Cabral Banjar Coelho
Abstract
REVIEWChildren with congenital heart disease in COVID-19 pandemic times: an integrative review
Revista Brasileira de Enfermagem. 2022;75(1):e20201033
DOI 10.1590/0034-7167-2020-1033
- Aline Cerqueira Santos Santana da Silva ,
- Fernanda Garcia Bezerra Góes ,
- Liliane Faria da Silva ,
- Laura Johanson da Silva ,
- Michelly Cristynne Souza Bonifácio ,
- Yasminn Canella Cabral Banjar Coelho
Views0See moreABSTRACT
Objective:
to identify the scientific production in health about children with congenital heart disease in COVID-19 pandemic times.
Method:
this is an integrative review, carried out in June 2020 in the information resources Latin American and Caribbean Literature in Health Sciences (LILACS), National Library of Medicine, National Institutes of Health (PubMed), Scientific Electronic Library Online Journal Portal (SciELO) and Brazilian Institute of Information Science and Technology (Oasis Ibict).
Results:
14 studies composed this review. Most studies pointed to tests, interventional procedures and surgery for children with heart disease in pandemic times; others discussed possible complications of COVID-19 among children with congenital heart disease.
Conclusion:
the incipient production of studies and the weak level of evidence denote an important knowledge gap so far, highlighting the need for studies with strong scientific evidence for the formulation of care guidelines aimed at children with heart disease.
- Aline Cerqueira Santos Santana da Silva
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REVIEW09-29-2022
Nursing students’ learning from involvement in research projects: an integrative literature review
- David de Sousa Loura ,
- Rafael Alves Bernardes ,
- Cristina Lavareda Baixinho ,
- Helga Rafael Henriques ,
- Isa Brito Félix , [ … ],
- Mara Pereira Guerreiro
Abstract
REVIEWNursing students’ learning from involvement in research projects: an integrative literature review
Revista Brasileira de Enfermagem. 2022;75(1):e20210053
DOI 10.1590/0034-7167-2021-0053
- David de Sousa Loura ,
- Rafael Alves Bernardes ,
- Cristina Lavareda Baixinho ,
- Helga Rafael Henriques ,
- Isa Brito Félix ,
- Mara Pereira Guerreiro
Views0See moreABSTRACT
Objective:
To identify the learning outcomes and skills obtained of undergraduate nursing students involved in research projects.
Methods:
This was an integrative literature review, based on a research protocol in the CINAHL Complete databases; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Cochrane Methodology Register; MedicLatina; MEDLINE, Scopus and JBI, including primary and secondary studies, published between 2015 and 2020.
Results:
A total of five heterogeneous articles were included, which were categorized using Kirkpatrick’s (adapted) model. Seventeen learning outcomes acquired through participation in research projects were identified, from the learning of new knowledge and skills to the development of new attitudes and behaviors.
Final considerations:
The involvement of nursing students in research projects is important to their professional development. Future investment in research on this topic can help cement the potential of this type of student involvement.
- David de Sousa Loura
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ORIGINAL ARTICLE09-29-2022
The presence of anemia in patients with leg ulcer: laboratory test
- Beatriz Guitton Renaud Baptista de Oliveira ,
- Joyce Beatriz de Abreu Castro ,
- Emilly Freire Novaes Silva Lisboa ,
- Hye Chung Kang ,
- Márcia de Assunção Ferreira
Abstract
ORIGINAL ARTICLEThe presence of anemia in patients with leg ulcer: laboratory test
Revista Brasileira de Enfermagem. 2022;75(1):e20210064
DOI 10.1590/0034-7167-2021-0064
- Beatriz Guitton Renaud Baptista de Oliveira ,
- Joyce Beatriz de Abreu Castro ,
- Emilly Freire Novaes Silva Lisboa ,
- Hye Chung Kang ,
- Márcia de Assunção Ferreira
Views0See moreABSTRACT
Objective:
To evaluate the presence of anemia in patients with chronic lower limb ulcers based on profile and hematometric indices.
Method:
This is a cross-sectional study carried out in a university hospital in Rio de Janeiro. The sample was composed of 64 participants with lower limb ulcers and evolution time greater than 12 weeks. Data was collected between May/2016 and December/2017 from hematological analyses, records from medical records, and wound assessment form.
Results:
36 (56.2%) were male; 38 (59.4%) between 60 and 80 years old; 56 (87.5%) with chronic diseases and 52 (81.2%) with venous ulcers. 6 years mean of active ulceration. Anemia was detected in 36 (56.2%), 27 (75%) of which were normochromic and normocytic; 14 (38.8%) had deficiency anemia recorded in their medical chart.
Conclusion:
The low hemoglobin concentration is recurrent among the participants characterizing an anemia condition, whose profile reveals congruence to the anemia of chronic disease.
- Beatriz Guitton Renaud Baptista de Oliveira
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ORIGINAL ARTICLE09-29-2022
Hand hygiene determinants of informal caregivers in hospitals under Pender’s perspective
- Maria Fabiana de Sena Neri ,
- Renan Alves Silva ,
- Jennara Cândido do Nascimento ,
- Érica do Nascimento Sousa ,
- Renata Rocha , [ … ],
- Joselany Áfio Caetano
Abstract
ORIGINAL ARTICLEHand hygiene determinants of informal caregivers in hospitals under Pender’s perspective
Revista Brasileira de Enfermagem. 2022;75(1):e20210012
DOI 10.1590/0034-7167-2021-0012
- Maria Fabiana de Sena Neri ,
- Renan Alves Silva ,
- Jennara Cândido do Nascimento ,
- Érica do Nascimento Sousa ,
- Renata Rocha ,
- Lívia Moreira Barros ,
- Cynthia Lima Sampaio ,
- Joselany Áfio Caetano
Views0See moreABSTRACT
Objectives:
to analyze hand hygiene determinants of informal caregivers in a hospital environment.
Methods:
qualitative study conducted with 55 caregivers at a university hospital in the Northeast of Brazil. A semi-structured instrument was used, adapted from Nola Pender’s Health Promotion Model, from which the deductive categories were derived.
Results:
the general behavior included hand hygiene before meals and after using the bathroom. Sensitivity to the requirements for hand hygiene was observed, but the barriers and self-efficacy consisted of the availability of soap or alcohol-based hand sanitizers, the lack of knowledge on the importance of and forgetfulness of the practice. The reinforcement on the importance of the practice and being in a contaminated environment were influencers, and commitment, warnings, and training were indispensable.
Conclusions:
benefits related to protection from infections were seen as positive determinants for hand hygiene adherence. For non-adherence, factors such as lack of sanitizing supplies, ignorance towards the importance of the activity, and forgetfulness stood out.
- Maria Fabiana de Sena Neri
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ORIGINAL ARTICLE09-29-2022
Effects of sexuality on frailty and quality of life in the elderly: a cross-sectional study
- Edison Vitório de Souza Júnior ,
- Cristiane dos Santos Silva ,
- Uanderson Silva Pirôpo ,
- Brenaráise Freitas Martins dos Santos ,
- Tarcísio Pereira Guedes , [ … ],
- Namie Okino Sawada
Abstract
ORIGINAL ARTICLEEffects of sexuality on frailty and quality of life in the elderly: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(1):e20210049
DOI 10.1590/0034-7167-2021-0049
- Edison Vitório de Souza Júnior ,
- Cristiane dos Santos Silva ,
- Uanderson Silva Pirôpo ,
- Brenaráise Freitas Martins dos Santos ,
- Tarcísio Pereira Guedes ,
- Lais Reis Siqueira ,
- Namie Okino Sawada
Views0See moreABSTRACT
Objectives:
to analyze the effects of sexuality on frailty and quality of life in the elderly.
Methods:
a sectional study conducted with 662 elderly people between July and October 2020. Four self-administered instruments were used to collect bio-sociodemographic variables, sexuality, frailty and quality of life. Correlation analysis and structural equation modeling were performed.
Results:
among the dimensions that assess sexuality, sexual intercourse had a weak, positive effect on quality of life (SC: 0.134, 95%CI: 0.153 – 0.254, p = 0.027), while affective relationships had a strong, positive effect (SC: 0.556, 95%CI: 0.442 – 0.670, p < 0.001). Frailty was only significantly related to a weak to moderate negative effect with sexual intercourse (SC: -0.216, 95%CI: -0.385 - -0.047, p = 0.012).
Conclusions:
two dimensions of sexuality, Sexual intercourse and Affective relationships, were found to have an effect on the quality of life and frailty of the elderly people investigated.
- Edison Vitório de Souza Júnior
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ORIGINAL ARTICLE03-07-2022
Critically ill COVID-19 patients: a sociodemographic and clinical profile and associations between variables and workload
- Marina Raffin Buffon ,
- Isis Marques Severo ,
- Ruy de Almeida Barcellos ,
- Karina de Oliveira Azzolin ,
- Amália de Fátima Lucena
Abstract
ORIGINAL ARTICLECritically ill COVID-19 patients: a sociodemographic and clinical profile and associations between variables and workload
Revista Brasileira de Enfermagem. 2022;75:e20210119
DOI 10.1590/0034-7167-2021-0119
- Marina Raffin Buffon ,
- Isis Marques Severo ,
- Ruy de Almeida Barcellos ,
- Karina de Oliveira Azzolin ,
- Amália de Fátima Lucena
Views0See moreABSTRACT
Objective:
To identify the sociodemographic and clinical profile of COVID-19 patients; measure workload and make associations between clinical variables.
Methods:
Cross-sectional study with 150 adult COVID-19 patients in an intensive care unit (from March to June 2020). Data from the electronic medical record in the first 24 hours of hospitalization: gender, age, education, origin, comorbidities, invasive mechanical ventilation, prone maneuver, renal replacement therapy, pressure injury, Braden, Nursing Activities Score, diagnoses, and nursing care. Descriptive statistical analysis, associations between clinical variables and age group.
Results:
Male (55.3%); mean age, 59 years; hypertensive (57.3%); obese (50.6%); diabetic (34%); invasive mechanical ventilation (66.7%); pronated (20.6%); hemodialysis (15.3%); Nursing Activities Score average, 86%. Twenty-eight nursing diagnoses and 73 cares were found.
Conclusion:
Patients required highly complex support. There was a significant association between pressure injury and workload with the prone maneuver. Nursing diagnoses and care reflect the needs of critical patients.
- Marina Raffin Buffon
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ORIGINAL ARTICLE06-01-2020
Factors associated with occupational stress among nursing professionals in health services of medium complexity
Revista Brasileira de Enfermagem. 2020;73:e20180913
Abstract
ORIGINAL ARTICLEFactors associated with occupational stress among nursing professionals in health services of medium complexity
Revista Brasileira de Enfermagem. 2020;73:e20180913
DOI 10.1590/0034-7167-2018-0913
Views0See moreABSTRACT
Objective:
To analyze the factors associated with occupational stress among nursing workers in health services of medium complexity.
Methods:
Epidemiological, cross-sectional, exploratory study. A randomly selected sample of 126 nursing professionals from medium complexity services in three cities in the state of Bahia (Santo Antônio de Jesus, Feira de Santana and Itabuna) was investigated. Data were collected in 2011 and 2012. The demand-control model proposed by Karasek was used to assess occupational stress. Simultaneous analysis of occupational stressors was performed using Poisson regression with robust variance.
Results:
The prevalence of occupational stress among nursing professionals was 77%. Occupational stress was associated with the professional category of nursing technician (p=0.01).
Conclusion:
The data indicates a concerning situation of exposure to occupational stressors, which requires coping strategies in order to protect the health of the worker.
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REVIEW07-06-2020
Patient safety challenges in primary health care: a scoping review
Revista Brasileira de Enfermagem. 2020;73(5):e20190209
Abstract
REVIEWPatient safety challenges in primary health care: a scoping review
Revista Brasileira de Enfermagem. 2020;73(5):e20190209
DOI 10.1590/0034-7167-2019-0209
Views1See moreABSTRACT
Objectives:
to identify the patient safety challenges described by health professionals in Primary Health Care.
Methods:
a scoping review was conducted on the LILACS, MEDLINE, IBECS, BDENF, and CINAHL databases, and on the Cochrane, SciELO, Pubmed, and Web of Science libraries in January 2019. Original articles on patient safety in the context of Primary Health Care by health professionals were included.
Results:
the review included 26 studies published between 2002 and 2019. Four categories resulted from the analysis: challenges of health professionals, administration challenges of health services, challenges with the patient and family, and the potential enhancing resources for patient safety.
Conclusions:
patient safety challenges for Primary Care professionals are multiple and complex. This study provides insight into resources to improve patient safety for health care professionals, patients, administrators, policy makers, educators, and researchers.
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ORIGINAL ARTICLE11-26-2022
Factors associated with suicide ideation of healthcare university students
- Girliani Silva de Sousa ,
- Barbara Moreira Duarte Ramos ,
- Luis Antônio Batista Tonaco ,
- Amanda Márcia dos Santos Reinaldo ,
- Maria Odete Pereira , [ … ],
- Nadja Cristiane Lappann Botti
Abstract
ORIGINAL ARTICLEFactors associated with suicide ideation of healthcare university students
Revista Brasileira de Enfermagem. 2022;75:e20200982
DOI 10.1590/0034-7167-2020-0982
- Girliani Silva de Sousa ,
- Barbara Moreira Duarte Ramos ,
- Luis Antônio Batista Tonaco ,
- Amanda Márcia dos Santos Reinaldo ,
- Maria Odete Pereira ,
- Nadja Cristiane Lappann Botti
Views0See moreABSTRACT
Objectives:
to analyze the factors associated with suicidal ideation in students from healthcare graduation courses.
Methods:
quantitative, cross-sectional study, with 251 students from the courses of radiology, speech-language therapy, medicine, nutrition, health service management, and nursing, from a federal higher education institution in the Southeast of Brazil. Data were collected from August to October 2019, using an electronic questionnaire.
Results:
the prevalence of suicidal ideation among participants was 26.33%. In the final logistic regression model, only depressive symptoms were associated with suicidal ideation. Having symptoms of depression increased the chances of suicidal ideation 2.6 times.
Conclusion:
the high prevalence of suicidal ideation and its associated factors constitutes a situational diagnosis that demands the elaboration of public and institutional policies, focused on the promotion and attention to the mental health of the students.
- Girliani Silva de Sousa
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REVIEW01-20-2021
Psychosocial factors in nursing work and occupational risks: a systematic review
Revista Brasileira de Enfermagem. 2021;74:e20200198
Abstract
REVIEWPsychosocial factors in nursing work and occupational risks: a systematic review
Revista Brasileira de Enfermagem. 2021;74:e20200198
DOI 10.1590/0034-7167-2020-0198
Views0See moreABSTRACT
Objective:
to identify, in international scientific production, the main psychosocial factors in nursing work, found through the Copenhagen Psychosocial Questionnaire (COPSOQ) application.
Methods:
a systematic review study of psychosocial factors at work among nursing professionals, who used COPSOQ in the assessment of work environments.
Results:
fifteen articles were identified, which highlighted as main psychosocial dimensions of nursing work demands, work organization, social relationships and leadership, work-home interface, workplace health and well-being and offensive behaviors.
Conclusion:
the high demands for cognitive, emotional work and work pace were identified in the nursing routine. Management support had a positive impact. Physical and psychological violence and shift work interfere in family life, aggravating the fatigue of these professionals. Interventions for reducing work stress presuppose the identification of psychosocial factors involved in nursing work.
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ORIGINAL ARTICLE08-10-2020
Eliot Freidson’s sociology of professions: an interpretation for Health and Nursing
Revista Brasileira de Enfermagem. 2020;73(6):e20180950
Abstract
ORIGINAL ARTICLEEliot Freidson’s sociology of professions: an interpretation for Health and Nursing
Revista Brasileira de Enfermagem. 2020;73(6):e20180950
DOI 10.1590/0034-7167-2018-0950
Views0See moreABSTRACT
Objectives:
to analyze theoretical conceptions of Eliot Freidson’s Sociology of Professions scoped on health and nursing professions.
Methods:
Eight nurses were interviewed, all involved in the development of the professional Council on the timeframe from 1975 to 1986. Documental resources were Laws, Ordinances, Resolutions, Reports, Meeting Minutes and Public Deeds. Information was organized as from literature and Eliot Freidson’s conceptions, and thematic content analysis was carried out.
Results:
the concepts authored by Eliot Freidson allowed for the development of a concept chart that portrays the nursing profession and that may be expanded for the other occupations in the health field, in consonance with professional organization in the country.
Final Considerations:
Eliot Freidson’s framework, in interpretation for nursing, consolidates the profession with relative autonomy, expertise by Nursing Care Systematization and credentialism by professional normalizations.
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07-16-2021
Sleep quality and its association with menopausal and climacteric symptoms
- Mariana Alvina dos Santos ,
- Aline Nascimento Vilerá ,
- Anneliese Domingues Wysocki ,
- Flávia Helena Pereira ,
- Deíse Moura de Oliveira , [ … ],
- Vinícius Batista Santos
Abstract
Sleep quality and its association with menopausal and climacteric symptoms
Revista Brasileira de Enfermagem. 2021;74:e20201150
DOI 10.1590/0034-7167-2020-1150
- Mariana Alvina dos Santos ,
- Aline Nascimento Vilerá ,
- Anneliese Domingues Wysocki ,
- Flávia Helena Pereira ,
- Deíse Moura de Oliveira ,
- Vinícius Batista Santos
Views0See moreABSTRACT
Objective:
to assess sleep quality in menopausal women and its association with symptoms related to this period.
Method:
this is a cross-sectional, analytical and correlational study. Sleep was assessed using the Pittsburgh Sleep Quality Index; and climacteric symptoms, according to the Menopause Rating Scale. To compare the total score and each Menopause Rating Scale domain with the PSQI classification, the Mann-Whitney U non-parametric test was used. P<0.05 was considered significant.
Results:
261 women (67.8%) were classified as bad sleepers. There was a positive and significant correlation between the sleep scale scores and the total menopause score and its domains. Women categorized as poor sleepers had worse scores on the menopause symptom scale.
Conclusion:
women with worse sleep quality revealed greater severity of symptoms related to menopause.
- Mariana Alvina dos Santos
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ORIGINAL ARTICLE12-05-2019
Aging, sexuality and nursing care: the elderly woman’s look
- Cinoélia Leal de Souza ,
- Vanda Santana Gomes ,
- Roberta Lopes da Silva ,
- Elaine Santos da Silva ,
- Jaqueline Pereira Alves , [ … ],
- Simone Aline Ferreira
Abstract
ORIGINAL ARTICLEAging, sexuality and nursing care: the elderly woman’s look
Revista Brasileira de Enfermagem. 2019;72:71-78
DOI 10.1590/0034-7167-2018-0015
- Cinoélia Leal de Souza ,
- Vanda Santana Gomes ,
- Roberta Lopes da Silva ,
- Elaine Santos da Silva ,
- Jaqueline Pereira Alves ,
- Núbia Rêgo Santos ,
- Victor Neves Reis ,
- Simone Aline Ferreira
Views0See moreABSTRACT
Objective:
to analyze the perception of elderly women about sexuality and practice of nursing care in this context.
Method:
a descriptive qualitative study. Fifty elderly women from Guanambi City – Bahia State were interviewed in 2016. Data collection technique was direct interview by using an unstructured script. Analysis of the semantic content described was carried out, and two empirical categories: the elderly woman’s view of nursing care in the promotion of sexual health and experience of sexuality in the elderly; and nursing care in the context of women’s aging.
Results:
it has been noted that the elderly women are afraid to talk about sexuality, especially with health professionals. By influences of society, they often exclude this issue of health care for elderly women.
Final considerations:
changes must be thought about assistance provided in relation to sexuality.
- Cinoélia Leal de Souza
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