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REFLECTION01-01-2017
Trascendencia, historicidad y temporalidad del ser adulto mayor: reflexión enfermera en Heidegger
Revista Brasileira de Enfermagem. 2017;70(4):891-895
Abstract
REFLECTIONTrascendencia, historicidad y temporalidad del ser adulto mayor: reflexión enfermera en Heidegger
Revista Brasileira de Enfermagem. 2017;70(4):891-895
DOI 10.1590/0034-7167-2016-0275
Views0See moreRESUMEN
El objetivo es reflexionar en la historicidad y temporalidad como caminos para la trascendencia del ser adulto mayor, basado en los conceptos fenomenológicos de Martín Heiddeger. Se llevó a cabo una revisión de los conceptos de trascendencia, historicidad y temporalidad en la obra de Martín Heidegger, realizando su integración en la perspectiva de enfermería al adulto mayor. La trascendencia del ser adulto mayor es factible accediendo a la temporalidad del mismo en el camino de su historicidad para llegar a la comprensión de sí a la que ha llegado: trascendiendo, que no es sino un proceso del mismo ser. El ser es el tiempo en sí mismo existiendo en el mundo, existencia dada por el encuentro del pasado (haber sido), presente y futuro (devenir), mismo encuentro que determina la historicidad del ser. El encuentro se ha consumado y el ser es trascendencia, como punto supremo la comprensión del ser mismo.
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EXPERIENCE REPORT01-01-2017
Scenario approximation in a phenomenological study in Mexico: experience report
Revista Brasileira de Enfermagem. 2017;70(4):885-890
Abstract
EXPERIENCE REPORTScenario approximation in a phenomenological study in Mexico: experience report
Revista Brasileira de Enfermagem. 2017;70(4):885-890
DOI 10.1590/0034-7167-2016-0601
Views0See moreABSTRACT
Objective:
To report our experience using scenario approximation in a phenomenological study of nursing in Mexico.
Method:
Experience report on scenario approximation to coexist with elderly in order to select the participants of a phenomenological study.
Results:
During a four-month period in 2016, visits were carried out two groups of elderly individuals where several activities were carried out. Coexistence with the elderly throughout accompaniment in the groups’ activities together with joint dialogue allowed selection of those who corresponded to the characteristics of the study objective.
Conclusion:
Scenario approximation is necessary in phenomenological studies, not only for creating empathy among the participants but also for the researchers to immerse themselves in the phenomenon under study, as shown by the first approaches of the researcher.
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EXPERIENCE REPORT01-01-2017
Acercamiento al escenario de estudio fenomenológico en México: relato de experiencia
Revista Brasileira de Enfermagem. 2017;70(4):885-890
Abstract
EXPERIENCE REPORTAcercamiento al escenario de estudio fenomenológico en México: relato de experiencia
Revista Brasileira de Enfermagem. 2017;70(4):885-890
DOI 10.1590/0034-7167-2016-0601
Views0See moreRESUMEN
Objetivo:
Relatar la experiencia del acercamiento al escenario de un estudio fenomenológico en enfermería en México.
Método:
Relato de experiencia sobre el acercamiento al escenario de estudio para convivir con adultos mayores con la finalidad de seleccionar a los participantes de un estudio fenomenológico.
Resultados:
Se llevaron a cabo visitas durante el año 2016, en un periodo de cuatro meses a dos grupos de adultos mayores en donde se realizaron diversas actividades. La convivencia con los adultos mayores a través del acompañamiento en las actividades que realizaban en los grupos y el diálogo conjunto permitió seleccionar a aquellos que respondían a las características del objeto de estudio.
Conclusión:
Es necesaria la aproximación al escenario de estudios fenomenológicos, no sólo con la finalidad de ganar empatía de los participantes sino para sumergirse en el fenómeno de estudio, mismo que se va mostrando desde los primeros acercamientos del investigador.
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REVIEW01-01-2017
Functional health literacy and adherence to the medication in older adults: integrative review
Revista Brasileira de Enfermagem. 2017;70(4):868-874
Abstract
REVIEWFunctional health literacy and adherence to the medication in older adults: integrative review
Revista Brasileira de Enfermagem. 2017;70(4):868-874
DOI 10.1590/0034-7167-2016-0625
Views1See moreABSTRACT
Objective:
to characterize the national and international scientific production on the relationship of Functional Health Literacy and the adherence to the medication in older adults.
Method:
integrative review of literature, searching the following online databases: Scientific Electronic Library Online (SCIELO); Latin American and Caribbean Health Sciences Literature (LILACS); Medical Literature Analysis and Retrieval System Online (MEDLINE); and Cumulative Index to Nursing & Allied Health Literature (CINAHL), in June 2016. We selected 7 articles that obeyed the inclusion criteria.
Results:
all articles are from the USA. The inappropriate Functional Health Literacy affects the non-adherence to medication; however, there are several strategies and interventions that can be practiced to change this relationship.
Conclusion:
nursing needs to explorefurther this theme, since it can exert a differentiated care for adherence to medication in older adults, considering the literacy.
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RESEARCH01-01-2017
Evaluation of the safety of hospitalized older adults as for the risk of falls
Revista Brasileira de Enfermagem. 2017;70(4):860-867
Abstract
RESEARCHEvaluation of the safety of hospitalized older adults as for the risk of falls
Revista Brasileira de Enfermagem. 2017;70(4):860-867
DOI 10.1590/0034-7167-2017-0098
Views0See moreABSTRACT
Objective:
To evaluate the safety of hospitalized older adults as for the risk of falls according to the parameters of the Morse Fall Scale.
Method:
Epidemiological, cross-sectional, prospective and descriptive study with n=75.
Results:
Average age of 71.3 years (SD±8.2); 58.7% male; 44% with low educational level; 38.7% hospitalized for cardiovascular diseases; average hospitalization of 10 days (SD±9.38); 78.7% with comorbidities; 61.3% with the calf circumference ≥ 31 cm; 62.7% were former smokers for more than 10 years; 65% did not drink alcohol; 100% did not have identification bracelet; 22.7% had similar names in the infirmary; 48% took up to five medicines; and 93.3% received some invasive procedure, especially the vessel puncture (65.3%). There was a high risk of falls in 52% of older adults.
Conclusion:
The results pointed to imminent risk of breach of patient safety, emphasizing the need for implementation of protocols and predictive scales such as the Morse scale.
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RESEARCH01-01-2017
Quality of life of elderly people with chronic kidney disease in conservative treatment
Revista Brasileira de Enfermagem. 2017;70(4):851-859
Abstract
RESEARCHQuality of life of elderly people with chronic kidney disease in conservative treatment
Revista Brasileira de Enfermagem. 2017;70(4):851-859
DOI 10.1590/0034-7167-2017-0103
Views0See moreABSTRACT
Objective:
To describe the quality of life (QOL) of elderly people with Chronic Kidney Disease (CKD) in conservative treatment, correlating it with sociodemographic and health-related aspects.
Method:
This is a quantitative, cross-sectional, and descriptive study that used: a previously validated instrument for data collection; the WHOQOL-BREF and WHOQOL-OLD QOL scales; and the Mini-Mental State Examination.
Results:
Thirty-five elderly people (54.30% females), with mean age of 68.26 years, took part in the study. They reported, on average, 3.70 comorbidities and 5.60 complications related to CKD. Regarding QOL, the “psychological” domain (54.40±16.29) and the “death and dying” facet (37.32±23.79) were considered the most damaged ones; the most strengthened were “social relationships” (70.36±18.32) and “intimacy” (66.61±16.80). A positive correlation was verified between comorbidities and complications (p = 0.015), and an inverse correlation between the number of complications and QOL (p = 0.004).
Conclusion:
These results, if considered during the care planning, may help improving the quality of the care provided for elderly people with CKD.
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RESEARCH01-01-2017
Hospitalization of people 50 years old or older living with HIV/AIDS
Revista Brasileira de Enfermagem. 2017;70(4):845-850
Abstract
RESEARCHHospitalization of people 50 years old or older living with HIV/AIDS
Revista Brasileira de Enfermagem. 2017;70(4):845-850
DOI 10.1590/0034-7167-2017-0113
Views0See moreABSTRACT
Objective:
Identify the rate and predictive factors of the hospitalization of people living with HIV/AIDS (PLHA), aged 50 years or older.
Method:
A quantitative, cross-sectional study was conducted at two inpatient units specialized in infectious diseases in a teaching hospital. Data were gathered through individual interviews between August 2011 and February 2015. All ethical precepts were followed.
Results:
Of the 532 admitted patients, 95 were PLHA 50 years old or older; 30.5% were admitted 3 to 4 times after being diagnosed with HIV/AIDS.
Conclusion:
Rate of hospitalization was 17.8%, and being 50 to 60 years old was a protective factor against hospitalization.
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ORIGINAL ARTICLE03-09-2020
Quality of life at work in a central sterile processing department
Revista Brasileira de Enfermagem. 2020;73(2):e20180792
Abstract
ORIGINAL ARTICLEQuality of life at work in a central sterile processing department
Revista Brasileira de Enfermagem. 2020;73(2):e20180792
DOI 10.1590/0034-7167-2018-0792
Views1See moreABSTRACT
Objectives:
to evaluate the quality of life of nursing professionals who work in a central sterile processing department.
Methods:
a descriptive, quantitative, exploratory study, conducted with 82 nursing professionals working in the Central Sterile Processing Department of a University Hospital, from September to November 2017. A semi-structured instrument and the questionnaire “Medical Outcomes Study Short-Form 36” were used. Results: most of the participants were female, married, aged 31-40 years; 47.6% with 6-10 years of profession, and 82.9% reported working in CSPD for 1-5 years. The most affected quality of life domains were Pain, Vitality, General Health Status and Social Aspects.
Conclusions:
This study showed a need for rethinking and re-creating the labor dynamics in CSPD to improve the quality of life of these nursing professionals.
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ORIGINAL ARTICLE07-06-2020
Nurses’ work process in an emergency hospital service
Revista Brasileira de Enfermagem. 2020;73(5):e20180923
Abstract
ORIGINAL ARTICLENurses’ work process in an emergency hospital service
Revista Brasileira de Enfermagem. 2020;73(5):e20180923
DOI 10.1590/0034-7167-2018-0923
Views1ABSTRACT
Objectives:
to analyze the nurses’ work process in an Emergency Hospital Service.
Methods:
a qualitative, exploratory and descriptive research conducted with 17 nurses from the emergency service of a high complexity hospital in southern Brazil. Data were collected through interviews, focus group and document analysis. Data analysis followed the thematic content analysis framework.
Results:
four categories emerged: Work environment characteristics; Assistance dimension; Management dimension; Care management.
Final Considerations:
the nurses’ work process in Emergency Hospital Service is characterized by the peculiarities of the setting, with centrality in care and care management aiming at quality care and safety to patients.
Keywords:Emergency NursingEmergency Service, HospitalHealth ManagementNurse's RoleProfessional PracticeSee more -
REVIEW07-13-2020
The quality of life of family health professionals: a systematic review and meta-synthesis
Revista Brasileira de Enfermagem. 2020;73(5):e20190645
Abstract
REVIEWThe quality of life of family health professionals: a systematic review and meta-synthesis
Revista Brasileira de Enfermagem. 2020;73(5):e20190645
DOI 10.1590/0034-7167-2019-0645
Views1See moreABSTRACT
Objectives:
to perform a systematic review and meta-synthesis of qualitative studies about the work-related quality of life of Family Health Strategy professionals.
Methods:
this systematic review was developed to answer the following PVO question: “Which factors (variables) are associated with the work-related quality of life (outcome) of Family Health Strategy professionals (population)?” The PubMed, Scopus, Embase, SciELO, Web of Science, LILACS, Science Direct, OpenThesis, OpenGrey, and OATD databases were selected. The meta-synthesis analyzed the main codes and secondary codes of all included studies.
Results:
the database search resulted in 1,744 reports; six were considered eligible for the meta-synthesis. Four factors were considered for the quality of work life: working conditions; work processes; interpersonal relationships; and personal aspects.
Conclusions:
although this study confirms the adequacy of aspects commonly related to the quality of work life, other factors are important in the case of FHS professionals, especially work context.
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REVIEW11-06-2020
Transitional care to caregivers of dependent older people: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20200394
Abstract
REVIEWTransitional care to caregivers of dependent older people: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20200394
DOI 10.1590/0034-7167-2020-0394
Views1See moreABSTRACT
Objective:
To identify the needs of caregivers of dependent older people related to self-care in the transition from hospital to home.
Methods:
Integrative literature review that followed a predefined protocol, carried out from March to May 2019 in the platforms EBSCO, B-On, Scopus, Web of Science, and Joanna Briggs Institute. Descriptors and eligibility criteria were defined for the bibliographic sample, which was ten articles. The search was limited to articles published between 2015 and 2019 to guarantee evidence topicality.
Results:
The needs of caregivers related to transitional care can be grouped into five categories: needs in the transition into the role of caregiver; needs related to self-care of caregivers themselves; health needs; economic needs; and social and collective needs.
Final considerations:
The work developed by nurses regarding transitional care of caregivers must have two focuses: managing care provided to dependent older people and managing the needs of caregivers and the care offered to them.
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REVIEW09-21-2020
Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
Abstract
REVIEWMiddle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
DOI 10.1590/0034-7167-2019-0334
Views1See moreABSTRACT
Objective:
To stablish a middle range theory for the understanding of the causal mechanisms and clinical consequentes of the nursing diagnosis Excess Fluid Volume (00026) among pregnant women.
Method:
The Middle Range Theory was constructed in five stages: defining of construction approach, establishing main concepts, elaborating propositions, developing a pictorial diagram, and establishing the causal relationships and evidence for practice of the Middle Range Theory.
Results:
We identified 14 clinical indicators and 6 causal factors of Excess Fluid Volume. A pictorial diagram was developed and relationships between Excess Fluid Volume elements were established with 6 propositions for them.
Conclusion:
The Middle Range Theory included both physiological and pathological conditions to explain Excess Fluid Volume. This Middle Range Theory might help in the better understanding of interactions between causal factors and clinical indicators of Excess Fluid Volume.
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Real and illusory perceptions of patients in induced coma
Revista Brasileira de Enfermagem. 2019;72(3):818-824
Abstract
Real and illusory perceptions of patients in induced coma
Revista Brasileira de Enfermagem. 2019;72(3):818-824
DOI 10.1590/0034-7167-2017-0906
Views1See moreABSTRACT
Objective:
To identify, in the scientific literature, real and illusory perceptions of adult patients in induced coma.
Methods:
This is an integrative review of 15 primary studies from the Medline, Web of Science, LILACS, CINAHL and SCOPUS databases.
Results:
The main memories reported after induced coma were thirst, cold, and pain. In some studies, patients reported they were unable to tell whether they were awake or dreaming, whether it was real or unreal. Satisfactory memories were reported by patients related to the care received and the use of bedside journals.
Conclusion:
Evidence showed a number of studies aiming to identify delirium, but without a focus on analyzing real or illusory perceptions of patients after induced coma. Thus, this integrative review identified scientific evidence of memories related to perceptions of sedated patients in the intensive care unit.
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REVIEW12-21-2020
Communication between pre-hospital and intra-hospital emergency medical services: literature review
Revista Brasileira de Enfermagem. 2020;73:e20190817
Abstract
REVIEWCommunication between pre-hospital and intra-hospital emergency medical services: literature review
Revista Brasileira de Enfermagem. 2020;73:e20190817
DOI 10.1590/0034-7167-2019-0817
Views1ABSTRACT
Objectives:
to analyze, according to the scientific literature, communication strategies in the transfer of cases between pre-hospital and in-hospital services and their contributions to patient safety.
Methods:
this is a literature review study, that is, one that aims to gather and synthesize research results on the subject in a systematic and orderly manner.
Results:
ten articles were published, published between 2010 and 2018, and two points of discussion emerged: use of mnemonics; and barriers to transferring a case.
Conclusions:
studies point to the need to standardize the case transfer process, as well as integrative training of professionals, regular assessment of the teams involved in emergency medical services and the need for research on the subject.
Keywords:AmbulanceCommunicationEmergency Medical ServicesReviewTransfer of Responsibility by the PatientSee more -
ORIGINAL ARTICLE03-24-2021
Health promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
Abstract
ORIGINAL ARTICLEHealth promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
DOI 10.1590/0034-7167-2019-0769
Views1See moreABSTRACT
Objectives:
to compare health promotion actions carried out by Family Health teams in Ceará, linked to the School Health Program.
Methods:
a cross-sectional study involving the first and second cycles of an external assessment of 910 and 1,626 teams from 184 municipalities, which joined the Brazilian National Program for Improvement of Access and Quality of Primary Care. Eight clinical assessment and seven health promotion indicators were assessed, together with health professionals working in schools.
Results:
the interviewees were nurses (95.6% and 98.3%). Between the cycles, there was an increase in clinical assessment (78.7% and 91.3%), health promotion and disease prevention (82.5% and 89.3%) and survey of students for follow-up (41.4% and 66.4%) in schools.
Conclusions:
health actions at school advanced between cycles, with nurses as protagonists in school health, which can reduce vulnerabilities in children and adolescents and qualify Primary Care.
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ORIGINAL ARTICLE12-13-2019
Hammock and nesting in preterm infants: randomized controlled trial
Revista Brasileira de Enfermagem. 2019;72:96-102
Abstract
ORIGINAL ARTICLEHammock and nesting in preterm infants: randomized controlled trial
Revista Brasileira de Enfermagem. 2019;72:96-102
DOI 10.1590/0034-7167-2018-0099
Views0See moreABSTRACT
Objective:
To compare the physiological variables and the sleep-wake pattern presented by preterm in nesting and hammock positions after diaper change.
Method:
This is a crossover randomized controlled trial. It was conducted with 20 preterm infants who, after diaper change, were placed in nests or hammocks. These preterm infants were evaluated for physiological variables (heart rate and oxygen saturation) and behavioral variables (sleep and wakefulness).
Results:
There was no statistically significant difference in the studied variables between nesting and hammock positions. However, regarding the categorical variable sleep, the comparison between the research phases for the hammock position showed differences between the baseline phase and the immediate recovery (p=0.00), baseline and late recovery (p=0.00), response and immediate recovery (p=0.00), response and late recovery (p=0.00).
Conclusion:
No differences were identified between the nest and the hammock; however, the use of the hammock favored the sleep of preterm infants compared to its non-use.
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ORIGINAL ARTICLE10-21-2019
Educational hypermedia in nursing assistance at birth: building and validation of content and appearance
Revista Brasileira de Enfermagem. 2019;72(6):1471-1478
Abstract
ORIGINAL ARTICLEEducational hypermedia in nursing assistance at birth: building and validation of content and appearance
Revista Brasileira de Enfermagem. 2019;72(6):1471-1478
DOI 10.1590/0034-7167/2018-0163
Views0See moreABSTRACT
Objective:
to build an educational hypermedia about nursing care at usual risk birth and to perform validation of content and appearance.
Method:
methodological research carried out following the following stages: content and planning of modules; media production and organization of tutorial units; organization of student space, tutor and communication between them; availability of hypermedia; assessment by experts in nursing and informatics; and implementation of proposed suggestions.
Results:
educational hypermedia showed to be a validated material, since it presented an optimum index of global content of 0.97 and statistical significance in the binomial test for the content and appearance.
Conclusion:
it is believed that the use of this material with undergraduate students in nursing will contribute to the quality of obstetric care, considering that it is an illustrated technology capable of favoring teaching-learning about normal humanized childbirth.
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REVIEW03-30-2020
Nursing care in mental health based on the TIDAL MODEL: an integrative review
Revista Brasileira de Enfermagem. 2020;73(2):e20180177
Abstract
REVIEWNursing care in mental health based on the TIDAL MODEL: an integrative review
Revista Brasileira de Enfermagem. 2020;73(2):e20180177
DOI 10.1590/0034-7167-2018-0177
Views0See moreABSTRACT
Objectives:
to identify the applicability of the Phil Barker’s Tidal Model in mental health nursing care.
Methods:
an integrative literature review carried out by LILACS, MEDLINE, Scopus and Web of Science. Data were collected from December 2017 to March 2018. After selecting the studies, the sample totaled 24 articles.
Results:
the articles are in English (91.7%), were published in nursing journals (87.5%), are reflective and/or theoretical (50%) and have level of evidence VII (79.2%). The model brings contributions to nursing science, enabling person-centered care, with an emphasis on interdisciplinary work, nurses’ protagonism and the empowerment of subjects in mental suffering.
Final considerations:
the use of the Tidal Model enables changes in nurses practice working in the context of mental health. Its application by nurses who work in mental health services in Brazil is recommended.
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ORIGINAL ARTICLE12-13-2019
Cervical cancer: knowledge, attitude and practice on the prevention examination
Revista Brasileira de Enfermagem. 2019;72:25-31
Abstract
ORIGINAL ARTICLECervical cancer: knowledge, attitude and practice on the prevention examination
Revista Brasileira de Enfermagem. 2019;72:25-31
DOI 10.1590/0034-7167-2017-0645
Views0ABSTRACT
Objective:
to evaluate the knowledge, attitude and practice of women on the cervical-uterine cancer screening and to investigate their association with sociodemographic variables.
Method:
a cross-sectional study, carried out from July to September 2015, with 500 women enrolled in the Basic Health Units of the Health District V, of the city of Recife-PE. For data collection, a semi-structured form was used. In statistical analysis, the Chi-square test and Fisher’s Exact Test were applied and, in the multivariate analysis, the Poisson model and Wald statistic.
Results:
the prevalence of adequate knowledge, attitude and practice was 35.2%, 98% and 70.6%, respectively. Adequate knowledge was associated with having no children, having a family income of two minimum wages and Spiritist/Afro-Brazilian religion.
Conclusion:
women carry out the examination, deem it necessary, but do not have adequate knowledge, which demonstrates the need for educational actions by nurses and other health professionals.
Keywords:Knowledge, Attitudes and Practice in HealthNursingPapanicolaou TestUterine Cervical NeoplasmsWomen's HealthSee more -
REVIEW09-29-2022
Nursing students’ learning from involvement in research projects: an integrative literature review
Revista Brasileira de Enfermagem. 2022;75(1):e20210053
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
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.
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ORIGINAL ARTICLE12-05-2019
Quality of life related to health for heart failure patients
Revista Brasileira de Enfermagem. 2019;72:140-146
Abstract
ORIGINAL ARTICLEQuality of life related to health for heart failure patients
Revista Brasileira de Enfermagem. 2019;72:140-146
DOI 10.1590/0034-7167-2018-0368
Views0See moreABSTRACT
Objective:
To assess the quality of life related to health for heart failure patients and to relate sociodemographic and clinical data.
Method:
It is an observational and transversal study, with quantitative approach, carried out in a heart failure ambulatory in the state of Pernambuco.
Results:
In the sample (n=101), there was prevalence of men older than 60 years old, married and professionally inactive. The quality of life related to health, based on the Minnesota Living With Heart Failure Questionnaire, was considered moderate (34.3±21.6), being significantly related to age (p=0.004), functional class (p<0.001), and patients with chagasic cardiopathy (p=0.02).
Conclusion:
The quality of life in the HF group of chagasic etiology was more compromised, specially in the emotional dimension. It is suggested that studies on the hypothesis that longer ambulatory follow-up improves quality of life and that having Chagas disease interferes negatively with the quality of life of heart failure patients.
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