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ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e05
DOI 10.1590/0034-7167.20247702e05
Views0In the article “Educational technologies used to promote self-care for people with diabetes mellitus: integrative review”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 4):e20230049, in the title: Where it read: […]See more
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ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
DOI 10.1590/0034-7167.20247702e06
Views0In the article “Is there scientific relevance to the plot of films and documentaries about eating disorders?”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(1):e20220547, page 7:Where it read:[…]See more -
ORIGINAL ARTICLE06-14-2024
Meanings attributed to health-related quality of life by caregivers of adolescents with diabetes
- Marina Saraiva de Araújo Pessoa
, - Elisabeth Luisa Rodrigues Ramalho ,
- Maria Elizabete de Amorim Silva Marinho ,
- Elenice Maria Cecchetti Vaz ,
- Lucila Castanheira Nascimento , [ … ],
- Neusa Collet
Abstract
ORIGINAL ARTICLEMeanings attributed to health-related quality of life by caregivers of adolescents with diabetes
Revista Brasileira de Enfermagem. 2024;77(2):e20230314
DOI 10.1590/0034-7167-2023-0314
- Marina Saraiva de Araújo Pessoa ,
- Elisabeth Luisa Rodrigues Ramalho ,
- Maria Elizabete de Amorim Silva Marinho ,
- Elenice Maria Cecchetti Vaz ,
- Lucila Castanheira Nascimento ,
- Valéria de Cássia Sparapani ,
- Neusa Collet
Views0See moreABSTRACT
Objective:
to interpret the meanings attributed to the health-related quality of life by caregivers of adolescents with type 1 diabetes mellitus.
Methods:
qualitative, descriptive-exploratory study of 14 caregivers of adolescents with diabetes developed at the reference outpatient clinic for endocrine diseases in a city in the state of Paraíba. Interviews were performed between May and September 2021. Inductive thematic analysis of the empirical material, and its interpretation in light of the concepts of health-related quality of life and family functioning were performed.
Results:
the meanings attributed by caregivers to the health-related quality of life of adolescents converged on the feeling of being healthy, healthy eating, satisfactory family income, family involvement in care and effective access to the care network.
Final Considerations:
knowledge of these meanings enables health professionals to develop strategies that meet the unique demands of caregivers experiencing this diagnosis.
- Marina Saraiva de Araújo Pessoa
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ORIGINAL ARTICLE06-14-2024
Teoria de médio alcance do diagnóstico de enfermagem sobrepeso
- Ana Carolina Costa Carino ,
- Renata Marinho Fernandes ,
- Anna Thays Dias Almeida ,
- Cecília Maria Farias de Queiroz Frazão ,
- Caroline Evelin Nascimento Kluczynik , [ … ],
- Ana Luisa Brandão de Carvalho Lira
Abstract
ORIGINAL ARTICLETeoria de médio alcance do diagnóstico de enfermagem sobrepeso
Revista Brasileira de Enfermagem. 2024;77(2):e20230372
DOI 10.1590/0034-7167-2023-0372
- Ana Carolina Costa Carino ,
- Renata Marinho Fernandes ,
- Anna Thays Dias Almeida ,
- Cecília Maria Farias de Queiroz Frazão ,
- Caroline Evelin Nascimento Kluczynik ,
- Ana Luisa Brandão de Carvalho Lira
Views0See moreRESUMEN
Objetivo:
Construir una teoría de rango medio para el diagnóstico de enfermería Sobrepeso en adolescentes y adultos jóvenes.
Métodos:
Estudio metodológico a la luz de los marcos teóricos de Roy y de Lopes, Silva y Herdman. Un total de 3.925 artículos fueron recuperados y evaluados utilizando el software State of the Art Through Systematic Review. La muestra final fue de 28 artículos.
Resultados:
Los resultados convergieron en 3 atributos esenciales, 13 antecedentes y 7 consecuencias. Se construyó una teoría de rango medio compuesta por un diagrama ilustrado, 11 proposiciones y 12 relaciones causales.
Consideraciones finales:
A partir de la creación de la teoría, fue posible comprender mejor el diagnóstico de enfermería Sobrepeso en el contexto de adolescentes y adultos jóvenes. La comprensión de los fenómenos de enfermería contribuye para el avance y fortalecimiento de la ciencia de enfermería.
- Ana Carolina Costa Carino
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REVIEW06-14-2024
Critical analysis of the scientific production on Jean Watson’s Theory of Human Care
- Shirley da Rocha Afonso ,
- Maria Itayra Padilha ,
- Vanessa Ribeiro Neves ,
- Noe Ramírez Elizondo ,
- Ricardo Quintão Vieira
Abstract
REVIEWCritical analysis of the scientific production on Jean Watson’s Theory of Human Care
Revista Brasileira de Enfermagem. 2024;77(2):e20230231
DOI 10.1590/0034-7167-2023-0231
- Shirley da Rocha Afonso ,
- Maria Itayra Padilha ,
- Vanessa Ribeiro Neves ,
- Noe Ramírez Elizondo ,
- Ricardo Quintão Vieira
Views0See moreABSTRACT
Objectives:
to analyze current scientific production on the use of the theoretical-methodological precepts of Jean Watson’s Theory of Human Care/Clinical Caritas Process.
Methods:
quantitative, exploratory, descriptive study using data from 1979 to 2023 in the Scopus database. Analysis was carried out using VOSviewer software.
Results:
the 73 studies included establish a network of collaboration among 221 authors from 155 institutions in 18 countries, who discuss the development of ethical behavior in nursing staff, through technical improvement, implementation, and validation of instrumental strategies capable of measuring and evaluating the quality of holistic and empathetic care. The Theory of Human Caring contributes to nursing training and care, and Process Clinical Caritas-Veritas is useful for the different possibilities of practice and education.
Conclusions:
it is important to strengthen with more empirical data a nursing work model centered on individual human care, supporting the evolution of scientific nursing knowledge.
- Shirley da Rocha Afonso
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ORIGINAL ARTICLE06-14-2024
Sleep duration and quality of Brazilian nursing staff who work in shifts
- Rosângela Marion da Silva ,
- Regina Célia Gollner Zeitoune ,
- Flávia Camef Dorneles Lenz ,
- Carolina Renz Pretto ,
- Katerine Moraes dos Santos , [ … ],
- Alexa Pupiara Flores Coelho Centenaro
Abstract
ORIGINAL ARTICLESleep duration and quality of Brazilian nursing staff who work in shifts
Revista Brasileira de Enfermagem. 2024;77(2):e20230167
DOI 10.1590/0034-7167-2023-0167
- Rosângela Marion da Silva ,
- Regina Célia Gollner Zeitoune ,
- Flávia Camef Dorneles Lenz ,
- Carolina Renz Pretto ,
- Katerine Moraes dos Santos ,
- Tânia Solange Bosi de Souza Magnago ,
- Alexa Pupiara Flores Coelho Centenaro
Views0See moreABSTRACT
Objective:
to analyze sleep duration and sleep quality in nursing professionals who work in shifts.
Method:
this is a cross-sectional, analytical research, carried out between September 2017 and April 2018, at a public hospital in southern Brazil, with the nursing team. A socio-occupational and health symptoms questionnaire, the Epworth Sleepiness Scale, and the Pittsburgh Sleep Quality Index were used. Data are presented as descriptive and inferential statistics, bivariate analysis, and binary logistic regression.
Results:
participants were 308 nursing professionals with a predominance of long-term sleep, absence of drowsiness, and poor sleep quality. Short-term sleep (<6h) was associated with day shift and poor sleep quality. Sleep quality was associated with presence excessive daytime sleepiness and work day shift.
Conclusion:
work shift, insomnia and headache were the main factors related short-term sleep for nursing professionals. The results may justify the development of intervention research for workers’ health.
- Rosângela Marion da Silva
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ORIGINAL ARTICLE06-14-2024
Duração e qualidade do sono da equipe de enfermagem brasileira que trabalha em turnos
- Rosângela Marion da Silva ,
- Regina Célia Gollner Zeitoune ,
- Flávia Camef Dorneles Lenz ,
- Carolina Renz Pretto ,
- Katerine Moraes dos Santos , [ … ],
- Alexa Pupiara Flores Coelho Centenaro
Abstract
ORIGINAL ARTICLEDuração e qualidade do sono da equipe de enfermagem brasileira que trabalha em turnos
Revista Brasileira de Enfermagem. 2024;77(2):e20230167
DOI 10.1590/0034-7167-2023-0167
- Rosângela Marion da Silva ,
- Regina Célia Gollner Zeitoune ,
- Flávia Camef Dorneles Lenz ,
- Carolina Renz Pretto ,
- Katerine Moraes dos Santos ,
- Tânia Solange Bosi de Souza Magnago ,
- Alexa Pupiara Flores Coelho Centenaro
Views0See moreRESUMEN
Objetivo:
analizar la duración y calidad del sueño en profesionales de enfermería que trabajan por turnos.
Método:
investigación analítica, transversal, realizada entre septiembre de 2017 y abril de 2018, en un hospital público del sur de Brasil, con el equipo de enfermería. Se utilizó el cuestionario sociolaboral y de síntomas de salud, la Escala de Somnolencia de Epworth y el Índice de Calidad del Sueño de Pittsburgh. Los datos se presentan como estadística descriptiva e inferencial, análisis bivariado y regresión logística binaria.
Resultados:
participaron 308 profesionales de enfermería, con predominio de sueño prolongado, ausencia de somnolencia y mala calidad del sueño. La duración corta del sueño (<6 h) se asoció con turnos de día y mala calidad del sueño. La calidad del sueño se asoció con la presencia de somnolencia diurna excesiva y con el trabajo diurno.
Conclusión:
los turnos de trabajo, el insomnio y la cefalea fueron los principales factores relacionados con la falta de sueño de los profesionales de enfermería. Los resultados pueden justificar el desarrollo de investigaciones de intervención para la salud de los trabajadores.
- Rosângela Marion da Silva
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ORIGINAL ARTICLE05-27-2024
Technology for nursing care in a Maternal Intensive Care Unit: a methodological study
- Fabíola Nunes de Sá ,
- Jéssica Lourenço Carneiro ,
- Linicarla Fabiole de Souza Gomes ,
- Joselany Afio Caetano ,
- Ana Karina Bezerra Pinheiro , [ … ],
- Ana Kelve de Castro Damasceno
Abstract
ORIGINAL ARTICLETechnology for nursing care in a Maternal Intensive Care Unit: a methodological study
Revista Brasileira de Enfermagem. 2024;77(2):e20230202
DOI 10.1590/0034-7167-2023-0202
- Fabíola Nunes de Sá ,
- Jéssica Lourenço Carneiro ,
- Linicarla Fabiole de Souza Gomes ,
- Joselany Afio Caetano ,
- Ana Karina Bezerra Pinheiro ,
- Ana Kelve de Castro Damasceno
Views0See moreABSTRACT
Objectives:
to develop and validate a nursing care plan in a Maternal Intensive Care Unit.
Methods:
a methodological study, developed in stages: integrative review; Nursing History construction; care plan restructuring; appearance and content validity by judges.
Results:
the history was organized into sections: Identification; Basic Human Needs; Physical Examination; and Assessment of Basic Human Needs. A care plan was restructured with 34 diagnoses, organized according to basic human needs. A satisfactory level of appearance validity of the history and care plan was obtained (Concordance Index varying between 86.3 and 100 for both instruments), and content validity with average indexes of 90.8 and 92.8, respectively. Thirty-four diagnoses, their interventions and nursing actions were consolidated.
Conclusions:
the instruments were considered relevant and pertinent in terms of appearance and content, and their use in the institution under study as well as in other similar services may be recommended.
- Fabíola Nunes de Sá
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REVIEW09-21-2020
Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
- Nathaly Bianka Moraes Fróes ,
- Marcos Venícios de Oliveira Lopes ,
- Cleide Maria Pontes ,
- Gabriele Lima Ferreira ,
- Priscila de Souza Aquino
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
- Nathaly Bianka Moraes Fróes ,
- Marcos Venícios de Oliveira Lopes ,
- Cleide Maria Pontes ,
- Gabriele Lima Ferreira ,
- Priscila de Souza Aquino
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.
- Nathaly Bianka Moraes Fróes
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ORIGINAL ARTICLE12-21-2020
Development of an appearance validity instrument for educational technology in health
Revista Brasileira de Enfermagem. 2020;73:e20190559
Abstract
ORIGINAL ARTICLEDevelopment of an appearance validity instrument for educational technology in health
Revista Brasileira de Enfermagem. 2020;73:e20190559
DOI 10.1590/0034-7167-2019-0559
Views1ABSTRACT
Objectives:
to develop and evaluate the convergence of the instrument for the appearance validity of educational technologies in health.
Methods:
methodological study conducted in two steps. In step 1, the instrument items were developed, with subsequent content validity by nine specialists in the development of educational technologies in health. In step 2, the convergent validity between another instrument and the appearance instrument was performed. Correlation results above r> 0.3 and p <0.05 were considered as plausible convergent validity.
Results:
the ten items of the initial version of the appearance instrument were submitted to content validity that resulted in a final version with 12 items (Content Validity Index = 0.93). The correlation indexes were strong with the objective and appearance domains; moderate with motivation, organization and total; and weak with writing style.
Conclusions:
the appearance instrument demonstrated content validity and convergent validity, in addition to a strong correlation with the other instrument.
Keywords:Educational TechnologyHealth EducationMethodological Research in NursingTechnological DevelopmentValidation StudiesSee more -
EXPERIENCE REPORT08-19-2019
Hypothermia post-cardiopulmonary resuscitation with low inputs: an experience report
- Maria Thereza Bugalho Lazzarini ,
- José Carlos Bonjorno Junior ,
- Márcio Pimentel Fernandes ,
- Ana Lúcia Gargione Galvão de Sant´Anna ,
- Regimar Carla Machado
Abstract
EXPERIENCE REPORTHypothermia post-cardiopulmonary resuscitation with low inputs: an experience report
Revista Brasileira de Enfermagem. 2019;72(4):1114-1118
DOI 10.1590/0034-7167-2017-0771
- Maria Thereza Bugalho Lazzarini ,
- José Carlos Bonjorno Junior ,
- Márcio Pimentel Fernandes ,
- Ana Lúcia Gargione Galvão de Sant´Anna ,
- Regimar Carla Machado
Views1ABSTRACT
Objective:
to report the experience of conducting directed temperature control of a post-cardiopulmonary resuscitation patient, with reduced and basic inputs available at the institution.
Method:
an experience report of directed temperature control in patient (age 15 years), after four hours of cardiopulmonary resuscitation in an Intensive Care Unit of a hospital in São Paulo State countryside in 2016, according to the protocol suggested by the American Heart Association, in 2015. There were applications of cold compresses, plastic bags with crushed ice and rectal temperature control.
Results:
after eight hours, temperature had reached 93.2 ºF. Body cooling was maintained for 24 hours. However, bags with crushed ice were used in the first 6 hours.
Conclusion:
conduct of nurses to obtain the body cooling with reduced and basic inputs was effective during the stay at the Intensive Care Unit.
Keywords:Body Temperature RegulationCardiopulmonary ResuscitationHeart ArrestHypothermia InducedIntensive Care UnitsSee more
- Maria Thereza Bugalho Lazzarini
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ORIGINAL ARTICLE05-28-2021
Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
- Camila Brito Borguezam ,
- Caroline Tolentino Sanches ,
- Silvia Paulino Ribeiro Albaneser ,
- Uiara Rodrigues de Oliveira Moraes ,
- Cintia Magalhães Carvalho Grion , [ … ],
- Gilselena Kerbauy
Abstract
ORIGINAL ARTICLEManaged clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
DOI 10.1590/0034-7167-2020-0282
- Camila Brito Borguezam ,
- Caroline Tolentino Sanches ,
- Silvia Paulino Ribeiro Albaneser ,
- Uiara Rodrigues de Oliveira Moraes ,
- Cintia Magalhães Carvalho Grion ,
- Gilselena Kerbauy
Views1See moreABSTRACT
Objectives:
to assess the impact of the implementation of a managed sepsis protocol on quality indicators of treatment for septic patients in an emergency department of a university hospital.
Methods:
an observational epidemiological study involving septic patients. The study was divided into two phases, pre-intervention and intervention, resulting from the implementation of the managed sepsis protocol. The study variables included sepsis treatment quality indicators. The results were statistically analyzed using the program Epi InfoTM.
Results:
the study sample included 631 patients, 95 from pre-intervention phase and 536 from intervention phases. Implementing the protocol increased patients’ chances of receiving the recommended treatment by 14 times. Implementing the protocol reduced the hospitalization period by 6 days (p <0.001) and decreased mortality (p <0.001).
Conclusions:
this study showed that implementing the managed protocol had an impact on the improvement of sepsis treatment quality indicators.
- Camila Brito Borguezam
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ORIGINAL ARTICLE05-28-2021
Prevalence and severity levels of post-radical prostatectomy incontinence: different assessment instruments
- Luciana Regina Ferreira da Mata ,
- Cissa Azevedo ,
- Lívia Cristina de Resende Izidoro ,
- Darkiane Fernandes Ferreira ,
- Fabrícia Eduarda Baia Estevam , [ … ],
- Tânia Couto Machado Chianca
Abstract
ORIGINAL ARTICLEPrevalence and severity levels of post-radical prostatectomy incontinence: different assessment instruments
Revista Brasileira de Enfermagem. 2021;74(2):e20200692
DOI 10.1590/0034-7167-2020-0692
- Luciana Regina Ferreira da Mata ,
- Cissa Azevedo ,
- Lívia Cristina de Resende Izidoro ,
- Darkiane Fernandes Ferreira ,
- Fabrícia Eduarda Baia Estevam ,
- Fabrícia Moreira Amorim Amaral ,
- Tânia Couto Machado Chianca
Views1See moreABSTRACT
Objectives:
to analyze urinary incontinence prevalence and severity in prostatectomized men assessed by three different instruments.
Methods:
a cross-sectional study was conducted with 152 men. The pad test, pad used, and International Consultation on Incontinence Questionnaire – Short Form (self-report) were considered. Data were analyzed using Spearman’s correlation, Kappa index, considering a significance level of 0.05.
Results:
urinary incontinence prevalence was 41.4%, 46.7% and 80.3% according to pad used, pad test and self-report. Positive correlations and moderate to poor agreement were found between the instruments. As for severity, most participants had mild incontinence. The largest number of cases of mild and severe incontinence was identified by self-report.
Conclusions:
the self-report showed higher values for prevalence of mild and severe severity levels. Through the identified differences, we propose that the objective assessment (pad used and pad test) be associated with individuals’ perception (self-report) to better estimate prevalence and severity.
- Luciana Regina Ferreira da Mata
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ORIGINAL ARTICLE05-28-2021
Cultural adaptation and validation of an instrument about nursing critical thinking skills
- Jacqueline Faria de Oliveira ,
- Esperanza Zuriguel Perez ,
- Maria Beatriz Guimarães Ferreira ,
- Patricia da Silva Pires ,
- Elizabeth Barichello , [ … ],
- Maria Helena Barbosa
Abstract
ORIGINAL ARTICLECultural adaptation and validation of an instrument about nursing critical thinking skills
Revista Brasileira de Enfermagem. 2021;74(2):e20200720
DOI 10.1590/0034-7167-2020-0720
- Jacqueline Faria de Oliveira ,
- Esperanza Zuriguel Perez ,
- Maria Beatriz Guimarães Ferreira ,
- Patricia da Silva Pires ,
- Elizabeth Barichello ,
- Maria Helena Barbosa
Views1See moreABSTRACT
Objectives:
to validate the Nursing Critical Thinking in Clinical Practice Questionnaire regarding cultural aspects and metric properties.
Methods:
a methodological research carried out through cross-cultural adaptation, face and content validity, dimensional construct and known groups validity, test-retest reliability and internal consistency. 511 nurses from four hospitals participated in the study, of which 54 participated in retest.
Results:
the instrument validation for Brazilian Portuguese maintained equivalences, according to the original version. The dimensional validity demonstrated adjustment to the tetrafactorial structure of the original version (GFI=0.69). There were statistically significant differences in critical thinking skills between nurses with graduate degrees and who undertook training, reading articles, developing research and working in an institution with a longer time implementation of the Nursing Process. The instrument showed temporal stability (ICC 073-0.84; p<0.001) and adequate internal consistency (α=0.97).
Conclusions:
the instrument proved to be valid and reliable for the studied population.
- Jacqueline Faria de Oliveira
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REVIEW07-09-2021
Breast cancer screening in Primary Health Care in Brazil: a systematic review
- Danila Cristina Paquier Sala ,
- Meiry Fernanda Pinto Okuno ,
- Monica Taminato ,
- Cristiane Pereira de Castro ,
- Marília Cristina Prado Louvison , [ … ],
- Oswaldo Yoshimi Tanaka
Abstract
REVIEWBreast cancer screening in Primary Health Care in Brazil: a systematic review
Revista Brasileira de Enfermagem. 2021;74(3):e20200995
DOI 10.1590/0034-7167-2020-0995
- Danila Cristina Paquier Sala ,
- Meiry Fernanda Pinto Okuno ,
- Monica Taminato ,
- Cristiane Pereira de Castro ,
- Marília Cristina Prado Louvison ,
- Oswaldo Yoshimi Tanaka
Views1See moreABSTRACT
Objectives:
to analyze care strategies for breast cancer screening in Primary Health Care in Brazil.
Methods:
this is a systematic review following the Cochrane Collaboration recommendations.
Results:
among 355 manuscripts, five were eligible. The patient navigation program by Community Health Agent stood out with the best result, among the strategies: flexibility of goals considering viability; community engagement; team training; active search of the target population by Community Health Agent; request for mammography by physicians; actions integrated to women’s health; monitoring of mammography results, absent users, and population coverage by physician and nurse; and assessment of criteria for requesting screening mammography by means of an information system. The population coverage rate in the program ranged from 23% to 88%.
Conclusions:
Primary Health Care in Brazil presents devices with potential to induce the production of care for breast cancer screening.
- Danila Cristina Paquier Sala
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ORIGINAL ARTICLE07-30-2021
Curricular reforms in the transformation of nursing teaching in a federal university
Revista Brasileira de Enfermagem. 2021;74(4):e20201242
Abstract
ORIGINAL ARTICLECurricular reforms in the transformation of nursing teaching in a federal university
Revista Brasileira de Enfermagem. 2021;74(4):e20201242
DOI 10.1590/0034-7167-2020-1242
Views1See moreABSTRACT
Objectives:
to discuss the curricular reforms adopted for nursing teaching in Brazil, from 1969 to 2019.
Methods:
historical, qualitative approach using the thematic oral history and document research. 13 interviews were carried out with graduation nursing professors from a federal university in the South of Brazil. The document sources were the political-pedagogical projects of the course and their associated documents. Minayo’s thematic analysis was used.
Results:
nursing curricula delineates the profile of the professional that must be formed and are reviewed in order to be adapted to social and educational changes, showing the scientific and professional potential of the nurse. Curricular reforms consider the quality of nursing formation.
Final Considerations:
the structure of the curriculum and the reforms that took place emerged according to the historical, political, epidemiological and social context demanded from the profession, to attend to the demands of society and to the work market.
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