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ORIGINAL ARTICLE10-07-2024
Consequences of the legislation issued for nursing education in times of COVID-19 (2020-2022)
Revista Brasileira de Enfermagem. 2024;77(5):e20230375
Abstract
ORIGINAL ARTICLEConsequences of the legislation issued for nursing education in times of COVID-19 (2020-2022)
Revista Brasileira de Enfermagem. 2024;77(5):e20230375
DOI 10.1590/0034-7167-2023-0375
Views0See moreABSTRACT
Objectives:
to analyze the legislation issued during the COVID-19 pandemic for nursing education and immediate consequences.
Methods:
documentary research, whose source was the legislation issued for nursing education during the COVID-19 pandemic. Thirty-two documents were analyzed and submitted to a collection instrument.
Results:
contradictions and consequences for nursing education following the guidelines and law of guidelines and bases were revealed. The consequences of the law affected the quality of teaching, equal access, exemption from minimum school days and course abbreviation. Regarding the guidelines, there was a lack of conditions for developing skills, in addition to the attempt to update them. Concerning internships, acting during the pandemic put students at risk, and their abbreviation prevented them from consolidating knowledge and skills.
Final Considerations:
remote teaching did not guarantee the quality and equality of teaching, weakened the development of skills, not taking into account nursing’s educational needs.
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ORIGINAL ARTICLE09-30-2024
Giving new meaning to the impact of touch in Shantala massage: mothers’ perceptions of maternal and child well-being
Revista Brasileira de Enfermagem. 2024;77:e20240012
Abstract
ORIGINAL ARTICLEGiving new meaning to the impact of touch in Shantala massage: mothers’ perceptions of maternal and child well-being
Revista Brasileira de Enfermagem. 2024;77:e20240012
DOI 10.1590/0034-7167-2024-0012
Views0See moreABSTRACT
Objectives:
to understand maternal perceptions of maternal and child well-being based on Shantala massage and discuss its association with the third Sustainable Development Goal.
Methods:
a descriptive-exploratory study in the light of Symbolic Interactionism. Eight women, mothers of infants, participated in five online meetings to teach Shantala massage, collected in focus groups, between November and December 2021. The data was subjected to thematic content analysis and lexical analysis with IRAMUTEQ®.
Results:
two categories emerged, 1) Maternal perceptions of Shantala massage and its promotion of child well-being and 2) Maternal perceptions of Shantala massage and its impact on their well-being, interconnected with subcategories.
Final Considerations:
Shantala massage promoted mutual impacts on maternal and child well-being, working together to achieve the third Sustainable Development Goal.
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ORIGINAL ARTICLE09-30-2024
Educational video for adherence to vaginal pessary in pelvic organ prolapse treatment
Revista Brasileira de Enfermagem. 2024;77:e20230515
Abstract
ORIGINAL ARTICLEEducational video for adherence to vaginal pessary in pelvic organ prolapse treatment
Revista Brasileira de Enfermagem. 2024;77:e20230515
DOI 10.1590/0034-7167-2023-0515
Views0ABSTRACT
Objectives:
to construct and assess an educational video to promote the adherence of women with pelvic organ prolapse to vaginal pessary use.
Methods:
this is a methodological study, with a longitudinal design and quantitative analysis. The pre-production (synopsis, argument, script, storyboard), production and post-production stages were covered. Content and technical assessments were carried out by judges from the health and communication areas, respectively, and appearance assessment by the target audience.
Results:
the video was the first to be developed on the topic on the national scene, considered assessed from the point of view of appearance and content, presenting an overall Content Validity Index of 0.99 and a level of agreement among judges of 91.1% to 100%. Assessment by the target audience reached a percentage of 96% to 100%.
Conclusions:
the educational video is an instrument capable of promoting adherence to pessary in women indicated for this therapeutic approach.
Keywords:Health CommunicationInstructional Film and VideoPelvic Organ ProlapsePessariesTreatment Adherence and ComplianceSee more -
EXPERIENCE REPORT09-30-2024
Health promotion of long-haul truck drivers and their families
Revista Brasileira de Enfermagem. 2024;77:e20230511
Abstract
EXPERIENCE REPORTHealth promotion of long-haul truck drivers and their families
Revista Brasileira de Enfermagem. 2024;77:e20230511
DOI 10.1590/0034-7167-2023-0511
Views0ABSTRACT
Objectives:
to describe the development of a Health Information and Communication Technology for the health care of long-haul truck drivers and their families.
Methods:
this is a description of the development of an Information and Communication Technology, developed from March to September 2023, following the systematization of the experience in five steps: 1) starting point, 2) initial questions, 3) recovery of the lived process, 4) background reflection, and 5) arrival points.
Results:
the technology called “Work-Family Balance,” electronically available, presents resources for the health care of long-haul truck drivers. It is anchored in studies on the health of long-haul truck drivers, notes from the International Labor Organization, the Strategic Action Plan for Confronting Chronic Diseases and Non-Communicable Diseases in Brazil, 2021-2030, and the Declaration by the International Association of Family Nursing.
Final Considerations:
the theoretical improvement of nursing can potentially improve the health care of long-haul truck drivers, prevent Chronic Non-Communicable Diseases, and promote work-life balance to achieve the goals of Agenda 2030.
Keywords:Family HealthInformation TechnologyNoncommunicable DiseasesSustainable DevelopmentWork-Life BalanceSee more -
EDITORIAL09-23-2024
Política Nacional de Cuidados Paliativos: reflexões a partir da Agenda 2030 para o Desenvolvimento Sustentável
Revista Brasileira de Enfermagem. 2024;77(6):e770601
Abstract
EDITORIALPolítica Nacional de Cuidados Paliativos: reflexões a partir da Agenda 2030 para o Desenvolvimento Sustentável
Revista Brasileira de Enfermagem. 2024;77(6):e770601
DOI 10.1590/0034-7167.2024770601pt
Views0A Agenda 2030 para o Desenvolvimento Sustentável, um plano de ação para as pessoas, para o planeta e para a prosperidade, é um plano de ação global adotado por representantes de todos os 193 Estados-Membros das Nações Unidas, reunidos na sede das Nações Unidas, em Nova York, de 25 a 27 de setembro de 2015. […]See more -
EDITORIAL09-23-2024
Brazilian National Palliative Care Policy: reflections based on the 2030 Agenda for Sustainable Development
Revista Brasileira de Enfermagem. 2024;77(6):e770601
Abstract
EDITORIALBrazilian National Palliative Care Policy: reflections based on the 2030 Agenda for Sustainable Development
Revista Brasileira de Enfermagem. 2024;77(6):e770601
DOI 10.1590/0034-7167.2024770601
Views0The 2030 Agenda for Sustainable Development, an action plan for people, planet and prosperity, is a global action plan adopted by representatives of all 193 United Nations Member States, meeting at United Nations Headquarters, in New York, from September 25 to 27, 2015. By achieving 17 sustainable objectives, the Agenda aims to promote sustainable development […]See more -
ORIGINAL ARTICLE09-20-2024
Middle-range theory for nursing for care in the context of cardiovascular risk
Revista Brasileira de Enfermagem. 2024;77(4):e20240190
Abstract
ORIGINAL ARTICLEMiddle-range theory for nursing for care in the context of cardiovascular risk
Revista Brasileira de Enfermagem. 2024;77(4):e20240190
DOI 10.1590/0034-7167-2024-0190
Views0ABSTRACT
Objectives:
to develop a middle-range nursing theory for care in the context of cardiovascular risk.
Methods:
a theoretical development study, through induction through research and ICNP® practice standards, carried out in six stages: concept analysis; ICNP® terminological subset structuring; theory contextualization and purpose; proposition construction; modeling; and assumption construction.
Results:
the Theory of Care in the Context of Cardiovascular Risk has a middle-range scope, describing care, prescribing actions to promote health and reduce cardiovascular risk. Thirteen propositions were constructed in three categories (nursing metaparadigm, central and factorial concepts), two models and 16 assumptions.
Final Considerations:
the theory contributes to the construction of knowledge arising from the nursing process for care in the context of cardiovascular risk, generating propositions, assumptions and modeling, which will enable theoretical testing.
Keywords:Concept FormationHeart Disease Risk FactorsNursing TheoriesStandardized Nursing TerminologyTheoretical ModelsSee more -
ORIGINAL ARTICLE09-20-2024
Content validity of guidance on self-care in the post-operative period for breast cancer
Revista Brasileira de Enfermagem. 2024;77(4):e20240188
Abstract
ORIGINAL ARTICLEContent validity of guidance on self-care in the post-operative period for breast cancer
Revista Brasileira de Enfermagem. 2024;77(4):e20240188
DOI 10.1590/0034-7167-2024-0188
Views0See moreABSTRACT
Objectives:
to validate the content of a guidance guide on self-care in the postoperative period of breast surgery for breast cancer.
Methods:
a methodological study with content validity, carried out with 15 expert nurses and physiotherapists, between May and July 2022. Recruitment took place from the Lattes Platform, using snowball sampling. The level of relevance and representativeness for each item was verified using the Content Validity Index (CVI). It was considered valid when CVI was equal to or greater than 78% (0.78).
Results:
from the initial total of 37 items, two were excluded, as they had insufficient practical relevance and theoretical relevance, and another five items which, although presenting a CVI lower than the established cut-off, were suggested to be rewritten and grouped with other similar items.
Conclusions:
thirty items were considered valid and demonstrated important and significant characteristics, constituting suitable material for application in clinical practice.
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RESEARCH01-01-2016
Leads for potentializing groups in Primary Health Care
Revista Brasileira de Enfermagem. 2016;69(5):964-971
Abstract
RESEARCHLeads for potentializing groups in Primary Health Care
Revista Brasileira de Enfermagem. 2016;69(5):964-971
DOI 10.1590/0034-7167-2015-0102
Views0ABSTRACT
Objective:
to analyze the aspects that potentialize groups in Primary Health Care according to their coordinators and participants.
Method:
This is a descriptive study with a qualitative approach, conducted with a health promotion group affiliated with a Family Health Unit. The data were collected by means of focus groups with participants and community workers who were submitted to thematic content analysis.
Results:
the analysis gave rise to three thematic categories: The group is our medicine; Healthy living and learning; and Priceless leadership.
Conclusion:
the leads identified during the study were as follows: group organization involves investment in motivation and leadership by the coordinators; production of grouping and cohesion is a result of participants and coordinators meeting together, interspersed with dialog, things said and left unsaid that the subjects expressed in the group dynamic; the sense of belonging guarantees their placement in the group based on the recognition of their knowledge and affective, social and health needs.
Keywords:Group ProcessesGroup StructureHealth PromotionNursing in Community HealthPrimary Health CareSee more -
RESEARCH01-01-2016
Intimate partner violence in adolescence: an analysis of gender and generation
Revista Brasileira de Enfermagem. 2016;69(5):946-955
Abstract
RESEARCHIntimate partner violence in adolescence: an analysis of gender and generation
Revista Brasileira de Enfermagem. 2016;69(5):946-955
DOI 10.1590/0034-7167-2016-0408
Views0ABSTRACT
Objective:
to analyze the intimate partner violence in adolescence from the perspective of gender and generation.
Method:
Quantitative, descriptive, and exploratory research. 111 adolescents participated in this study, with ages from 15 to 19 years old.
Results:
We found that 91% of participants have perpetrated and 90.1% have undergone at least one of the natures of violence. The intimate partner violence in adolescence constitutes a form of gender violence, and gender constructions have determined the suffered and perpetrated aggressions, possibly also determining the naturalization and legitimization of such aggressions. The inequality of power between generations may determine greater vulnerability of youngsters to the phenomenon.
Conclusion:
The historical and social construction of masculinity and femininity and the power inequalities set by these constructions converge with the power inequality between generations. Thus, gender and generation are determinants of intimate partner violence in adolescence, as well as of the vulnerability of adolescents to this phenomenon.
Keywords:AdolescentAdolescent HealthGender and HealthIntimate Partner ViolenceViolence Against WomenSee more -
RESEARCH01-01-2016
Hospitalization anxiety in children: conceptual analysis
Revista Brasileira de Enfermagem. 2016;69(5):940-945
Abstract
RESEARCHHospitalization anxiety in children: conceptual analysis
Revista Brasileira de Enfermagem. 2016;69(5):940-945
DOI 10.1590/0034-7167-2015-0116
Views0See moreABSTRACT
Objective:
to analyze the concept “hospitalization anxiety in children”, identifying its antecedents, attributes, and consequences, with the objective of clarifying its meaning.
Method:
we used a conceptual analysis model, whose objective is to clarify the meaning of terms.
Results:
we identified the concept antecedents and its attributes, classified as biological and psychological needs, which are essential characteristics of “hospitalization anxiety in children”. This process consequences have also been identified. We proceeded to the analysis of the characteristics with emphasis on the impacts of the hospitalization process on the child and on the family.
Conclusion:
based on the conceptual analysis of the phenomenon, it was possible to identify the antecedents, attributes, and consequences of Hospitalization Anxiety in children. We recommend the continuation of the study validating the essential characteristics presently identified as a way to join knowledge gathered and professional practice.
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RESEARCH01-01-2016
Stroke: patient characteristics and quality of life of caregivers
Revista Brasileira de Enfermagem. 2016;69(5):933-939
Abstract
RESEARCHStroke: patient characteristics and quality of life of caregivers
Revista Brasileira de Enfermagem. 2016;69(5):933-939
DOI 10.1590/0034-7167-2015-0064
Views0See moreABSTRACT
Objective:
to investigate the association between the domains of health-related quality of life of family caregivers and sociodemographic characteristics of individuals with stroke sequelae.
Method:
descriptive, cross-sectional, quantitative research, conducted with 136 family caregivers of individuals with stroke sequelae by means of home interviews from April to June 2013.
Results:
we found that caregivers of individuals aged under 65 years, married, with 10 to 12 years of formal education, presented higher scores, respectively, in the domains ‘Social aspects’, ‘Emotional aspects’, and ‘Mental health’. However, caregivers of patients with higher degree of disability obtained lower score in the ‘Mental Health’ domain.
Conclusion:
the results foster reflection on the need of including the family caregivers of individuals with stroke sequelae in the planning of care provided by health professionals.
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RESEARCH01-01-2016
A quasi-experimental nursing study on pain in comatose patients
Revista Brasileira de Enfermagem. 2016;69(5):927-932
Abstract
RESEARCHA quasi-experimental nursing study on pain in comatose patients
Revista Brasileira de Enfermagem. 2016;69(5):927-932
DOI 10.1590/0034-7167-2015-0121
Views0See moreABSTRACT
Objective:
to verify whether comatose patients feel pain during the bed bath nursing procedure.
Method:
nineteen patients aged 61 ± 17.39 years participated in the study. A quantitative analysis was conducted on the P substance (PS) in the saliva collected before and during a bed bath, using the ELISA method. Program Graph Pad Prisma 6 was used to analyze the data. The verification of normality was made through the Shapiro Wilk test, which determined the choice for the Wilcoxon nonparametric test.
Results:
the study showed a statistically significant increase (∆= 5.62%, p<0.001) in the PS level of the patients studied during the nursing procedure.
Conclusion:
when caring for comatose patients during a bed bath, professionals cause or add painful stimuli; therefore, they feel pain.
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RESEARCH01-01-2016
Quality of nursing care: instrument development and validation
Revista Brasileira de Enfermagem. 2016;69(5):920-926
Abstract
RESEARCHQuality of nursing care: instrument development and validation
Revista Brasileira de Enfermagem. 2016;69(5):920-926
DOI 10.1590/0034-7167-2015-0151
Views0See moreABSTRACT
Objectives:
to describe the development and validation process of a scale to measure the nurses’ perception of the activities that contribute to nursing care quality.
Method:
methodological study based on a literature review, the opinion of experts and the experience of study investigators. An instrument was designed containing six dimensions and 25 items, applied as a questionnaire to 775 nurses from a hospital in northern Portugal, from May to July 2014. The instrument validation used an exploratory factor analysis and an internal consistency assessment of each factor/dimension.
Results:
the factor analysis indicated the need to adjust the original composition of the scale, which then received one more dimension, totaling seven dimensions and the same 25 items, and presented a high internal consistency (Cronbach’s alpha of 0.940).
Conclusion:
the final version of the scale presents adequate psychometric properties, with potential use in future studies.
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RESEARCH01-01-2016
Factors associated with inconsistent condom use among people living with HIV/Aids
Revista Brasileira de Enfermagem. 2016;69(1):47-53
Abstract
RESEARCHFactors associated with inconsistent condom use among people living with HIV/Aids
Revista Brasileira de Enfermagem. 2016;69(1):47-53
DOI 10.1590/0034-7167.2016690106i
Views0See moreABSTRACT
Objective:
to analyze the prevalence and factors associated with inconsistent use of condoms among people living with HIV/ Aids (PLWHA).
Method:
it is a cross-sectional study with 228, with individual interviews conducted in 2011. A multivariate analysis was performed with a logistic regression model.
Results:
143 participants met the inclusion criteria, and the prevalence of inconsistent condom use was 28.7%. However, there was greater adherence among men (79.3%). In the multivariate analysis, the independent variable daily use of alcohol (OR=11.02; 95% CI 1.84, 65.92; p = 0.021) was associated with inconsistent condom use. The chance of men making consistent condom use was higher than women (OR = 0.36, 95% CI 0.15, 0.81; p = 0.015).
Conclusion:
the prevalence of inconsistent condom male use among PLWHA was low, however, evidenced greater compliance among men over women with a statistically significant difference and the daily use of alcohol was associated with inconsistent condom use.
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RESEARCH01-01-2016
Influence of sociodemographic and clinical characteristics at the impact of valvular heart disease
Revista Brasileira de Enfermagem. 2016;69(1):40-46
Abstract
RESEARCHInfluence of sociodemographic and clinical characteristics at the impact of valvular heart disease
Revista Brasileira de Enfermagem. 2016;69(1):40-46
DOI 10.1590/0034-7167.2016690105i
Views0See moreABSTRACT
Objective:
to analyze the sociodemographic and clinical characteristics of patients with valvular heart disease and to verify the influence of these variables on the impact of valve disease in daily life.
Method:
the study involved 86 outpatients. Data collection was performed in two stages – face-to-face interview for sociodemographic and clinical characterization and through telephone contact for the application of the Instrument to Measure the Impact of Valvular Heart Disease on Patient’s Everyday Life (IDCV). Data were analyzed through descriptive statistics and multiple regression analysis.
Results:
it was noticed that the total score of IDCV and its domains were influenced by age, schooling, presence or absence of symptoms, use or not of diuretic.
Conclusion:
The impact of the disease was influenced by sociodemographic and clinical variables. The results provide subsidies for the design of nursing interventions aimed at reducing the impact of the disease on the patient’s daily life with valve disease.
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RESEARCH01-01-2016
Health indicators of workers of the hospital area
Revista Brasileira de Enfermagem. 2016;69(1):30-39
Abstract
RESEARCHHealth indicators of workers of the hospital area
Revista Brasileira de Enfermagem. 2016;69(1):30-39
DOI 10.1590/0034-7167.2016690104i
Views0ABSTRACT
Objective:
to analyze the health indicators of workers of hospital area for exposure to workloads, wear processes and its consequences.
Method:
a retrospective, descriptive and exploratory study performed in a hospital in southern Brazil. The population consisted of 1,050 workers notifications of registered in the Monitoring System of Nursing Workers Health, in 2011.
Results:
80.8% of the records were female workers, with 34.2% aged between 31 to 40 years old, corresponding to 2478 working lost days. The results subsidized the implementation of nine indicators that showed the prevalence of respiratory and osteoarticular problems.
Conclusion:
the results allow the reflection and redirection of actions for workers’ health, as the processes of becoming ill are compounded by exposure to psychic burdens. These indicators, when monitored, can contribute to the transformation of the profile of morbidity of these workers.
Keywords:Epidemiological SurveillanceHealth Basics IndicatorsHospital Human ResourcesNursingOccupational HealthSee more -
RESEARCH01-01-2016
Evaluation of environmentally sustainable actions in the medication process
Revista Brasileira de Enfermagem. 2016;69(1):23-29
Abstract
RESEARCHEvaluation of environmentally sustainable actions in the medication process
Revista Brasileira de Enfermagem. 2016;69(1):23-29
DOI 10.1590/0034-7167.2016690103i
Views0See moreABSTRACT
Objective:
to analyze sustainable actions from an environmental point of view in the medication process, from the reception of the prescription of the pharmacy to waste discard by nursing.
Method:
study before and after performed through Lean Six Sigma methodology. The sample consisted of the amount and type of waste resulting from the pharmacy and nursing services of a medical-surgical clinical unit.
Results:
after the intervention was obtained at the pharmacy a reduction of 74.8% of chemical, infectious and sharps waste, an increase of 33.3% of common recyclable and 20% of common non-recyclable. In nursing, there was a reduction of 22.5% of chemical, infectious and sharps waste, an increase of 22.9% of common recyclable and an increase of 20% of common non-recyclable.
Conclusion:
the practice of sustainable actions in the hospital is possible, contributing to the optimization of resources and waste production with benefits to the institution, environment, and health.
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RESEARCH01-01-2016
Nursing education: training evaluation by graduates, employers and teachers
Revista Brasileira de Enfermagem. 2016;69(1):16-22
Abstract
RESEARCHNursing education: training evaluation by graduates, employers and teachers
Revista Brasileira de Enfermagem. 2016;69(1):16-22
DOI 10.1590/0034-7167.2016690102i
Views0ABSTRACT
Objective:
to support the assessment and the necessary changes in the curriculum of an undergraduate degree in Nursing.
Methods:
it is a descriptive study developed in two stages as an action research. In the first stage, the speeches of 19 graduates and 15 employers were interviewed and analyzed; in the second stage, five teachers participated in the focus group. For processing the data, the content analysis was adopted.
Results:
based on the assessment of the actors, an action plan was created with suggestions regarding the curriculum flexibility, content resizing, continuing education, practice enhancement, active methodologies and autonomy of the student.
Conclusion:
the participation of actors participants of the training process and performance of professional nurses in the evaluation of a curriculum pointed aspects to realignment and provided concrete benefits to improving the quality of undergraduate course curriculum, scenario of this study.
Keywords:CurriculumGraduate Programs in NursingNursing EducationNursing StudentsResearch in Nursing EducationSee more -
EDITORIAL01-01-2016
The challenge of the 67th Brazilian Conference of Nursing: In what direction is the Brazilian Nursing going?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
Abstract
EDITORIALThe challenge of the 67th Brazilian Conference of Nursing: In what direction is the Brazilian Nursing going?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
DOI 10.1590/0034-7167.2016690101i
Views0Bringing together about 3,700 participants among conference participants, speakers, support staff, organizers and exhibitors, the 67th Brazilian Conference of Nursing extraordinary presented São Paulo with deep and meaningful reflections in an attempt to answer the question “In what direction is the Brazilian Nursing going?”.From the submission of the proposal to host the event until its […]See more -
EDITORIAL01-01-2016
O desafio do 67º Congresso Brasileiro de Enfermagem: para onde caminha a Enfermagem brasileira?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
Abstract
EDITORIALO desafio do 67º Congresso Brasileiro de Enfermagem: para onde caminha a Enfermagem brasileira?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
DOI 10.1590/0034-7167.2016690101i
Views0Reunindo cerca de 3.700 participantes entre congressistas, palestrantes, equipe de apoio, organizadores e expositores, o 67º Congresso Brasileiro de Enfermagem agraciou São Paulo com reflexões profundas e significativas, na tentativa de dar sua resposta à questão “Para onde caminha a enfermagem brasileira?”.Desde a apresentação da proposta de sediar o evento até sua realização, o que […]See more -
REVIEW06-01-2015
Anticipated directives and living will for terminal patients: an integrative review
Revista Brasileira de Enfermagem. 2015;68(3):524-534
Abstract
REVIEWAnticipated directives and living will for terminal patients: an integrative review
Revista Brasileira de Enfermagem. 2015;68(3):524-534
DOI 10.1590/0034-7167.2015680321i
Views0See moreABSTRACT
Objective:
characterizing the national and international scientifi c literature about the advanced directives of living will as applied to the terminally ill patient.
Method:
integrative review considering the articles published in Portal Capes, SciELO, LILACS, MEDLINE, Journal of Bioethics and Bioethikos, with the descriptors: Advanced directives, Wills regarding life and Advance Directives, Living Will and Terminally Ill, totaling 44 articles submitted to content analysis.
Results:
three categories emerged: Students and professionals facing the advance directives of living will: Perceptions, opinions and practices; Patient’s receptivity to the Advance Directives of Living Will; The family facing the advance directives of living will.
Conclusion:
the relevance of the topic became evident as a guarantee of respect for the dignity and autonomy of the patient, as well as to reduce ethical confl icts faced by families and health professionals facing care at the end of life.
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