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ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):206-206
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):206-206
DOI 10.1590/0034-7167.20166901e02
Views0In the article “Conceptions of mid-level nursing professionals facing those with a chemical dependency”, with the number of DOI: 10.1590/0034-7167.2015680610i, published in the journal Revista Brasileira de Enfermagem, v68(6):755-60, page 760 that read: “8. Vargas D, Soares J. Knowledge and attitudes of nurses towards alcohol and related problems: the impact of an educational intervention. Rev […]See more
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ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):205-205
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):205-205
DOI 10.1590/0034-7167.20166901e01
Views0In the article “Using the theory of meaningful learning in nursing education”, with the number of DOI: 10.1590/0034-7167.2015680420i, published in the journal Revista Brasileira de Enfermagem, v68(4):626-35, page 627 that read:“Ausubel was descended from Jewish, born in New York in 1918 and died in 1994 at the age of 75. He thought and wrote until […]See more -
Nursing process documentation: rationale and methods of analytical study
Revista Brasileira de Enfermagem. 2016;69(1):197-204
Abstract
Nursing process documentation: rationale and methods of analytical study
Revista Brasileira de Enfermagem. 2016;69(1):197-204
DOI 10.1590/0034-7167.2016690126i
Views0See moreABSTRACT
Objective:
to describe the methods used to analyze the associations between variables of service, nursing and the nursing process documentation in institutions of the Department of Health of the State of São Paulo.
Method:
multilevel analytical study with data obtained in the domains of institution, units of the institution and nursing professionals who work there, using standardized instruments. The analyses had as axis the degree of completeness of the nursing process documentation in units or institutions and their association with variables of nursing personnel, of units and of institutions.
Conclusion:
This study will provide important empirical evidence on the factors involved in the nursing process documentation.
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Qualitative methodologies in health research: interpretive referential of Patricia Benner
Revista Brasileira de Enfermagem. 2016;69(1):192-196
Abstract
Qualitative methodologies in health research: interpretive referential of Patricia Benner
Revista Brasileira de Enfermagem. 2016;69(1):192-196
DOI 10.1590/0034-7167.2016690125i
Views0See moreABSTRACT
Objective:
this article reports on the experience of using the interpretive phenomenological framework of Patricia Benner in a Brazilian context. Benner’s interpretive phenomenology, based on existential and interpretative philosophy, aims to understand human experiences in the particular worlds of research participants. Data were collected through interviews with nine nurses in November and December 2014.
Results:
data analysis process according to Benner’s framework consisted of: transcription, coding, thematic analysis, and search for paradigmatic cases and examples. Therefore, the prior knowledge of the researcher is an important part of the study, consisting in manners of the research conduction.
Conclusion:
The use of this methodological framework entailed a great challenge for the researcher, however, it also enabled a unique opportunity to illuminate important existential phenomena related to the daily lives of research participants.
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Nurses’ performance on primary care in the National Health Service in England
Revista Brasileira de Enfermagem. 2016;69(1):182-191
Abstract
Nurses’ performance on primary care in the National Health Service in England
Revista Brasileira de Enfermagem. 2016;69(1):182-191
DOI 10.1590/0034-7167.2016690124i
Views0See moreABSTRACT
Objective:
To analyze the expansion of nursing roles in primary care in the English National Health Service and the implications for professional practice.
Method:
qualitative research in case study format, held in London, England, in six primary care units. Data were obtained through interviews with nine nurses. After the thematic data analysis, two units emerged: the nurses’ performance characteristics and effects of the expansion of nursing roles.
Results:
expansion of nurses’ roles: consultation, diagnosis and drug therapy, case management and monitoring of chronic conditions. Repercussions: for the user, there was improved access, communication and comprehensive care, increased duration of consultations, resulting in greater adherence; for nurses, there was the expansion of professional skills, knowledge and professional recognition; to the health care system, it resulted in cost savings.
Conclusion:
benefits in expanding nursing roles, were visible, contributing to primary care quality.
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Meleis’ Nursing Theories Evaluation: integrative review
Revista Brasileira de Enfermagem. 2016;69(1):174-181
Abstract
Meleis’ Nursing Theories Evaluation: integrative review
Revista Brasileira de Enfermagem. 2016;69(1):174-181
DOI 10.1590/0034-7167.2016690123i
Views0See moreABSTRACT
Objective:
to analyze the application of the theory evaluation model proposed by Meleis in Brazilian studies.
Method:
integrative review of online articles published from 2002 to 2012 in the databases LILACS and BDENF.
Results:
the 16 selected studies confirmed the use of only three of the five stages proposed for Meleis’ theories analysis: Description of the Theory, Criticism of the Theory and Analysis of the Theory, with a predominance of a single unit of analysis in each.
Conclusion:
the analysis of nursing theories provides support to nurses in the practice, research, education and administration of the different dimensions of care. Meleis’ model figures as very important by contributing to the development of knowledge of nursing discipline, considering that its use as a method allows several reflections on theories in order that they be revalidated to support a more theoretical and practical applicability.
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Clinical indicators of sexual dysfunction in pregnant women: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(1):165-173
Abstract
Clinical indicators of sexual dysfunction in pregnant women: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(1):165-173
DOI 10.1590/0034-7167.2016690122i
Views0ABSTRACT
Objective:
to identify the nursing diagnosis clinical indicators of sexual dysfunction in pregnant women.
Method:
it is an integrative literature review, with research in databases using the keywords “sexual*”, “pregnan*” and “function*”. Studies included had an abstract available for analysis, referring to pregnant women over 18 years old, written in Portuguese, French, Spanish and English, with publication date between 2010 and 2014. Studies that reporting pregnant women with an associated pathology were excluded.
Results:
sexual dysfunction in pregnant women is consistent in the literature. Nine defining characteristics were identified and 16 related factors, some not classified in NANDA International.
Conclusion:
clinical indicators can be added to the nursing diagnosis to favor an accurate diagnosis and effective interventions in the surveillance of pregnancy as a period of healthy sexual experience.
Keywords:Physiological Sexual Dysfunction, Psychogenic Sexual DysfunctionPregnant WomenReviewSexual BehaviorSee more
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Conditions of functional health literacy of an elderly diabetics group
Revista Brasileira de Enfermagem. 2016;69(1):156-164
Abstract
Conditions of functional health literacy of an elderly diabetics group
Revista Brasileira de Enfermagem. 2016;69(1):156-164
DOI 10.1590/0034-7167.2016690121i
Views0See moreABSTRACT
Objective:
to evaluate the conditions of functional health literacy of an elderly diabetics group.
Method:
cross-sectional and descriptive study, with diabetic’s elderly assisted in the SUS (N = 114). The social and health conditions were evaluated as well as functional health literacy by S-TOFHLA test (short version); the simple proportions, average, standard deviation and Pearson’s Chi-square were described by SPSS software (20.0) with α = 5% value.
Results:
the mean age was 67.4 years, 74.0% of the elderly were women, had up to four years of schooling; 29.8% had a long-standing illness, 64.0% reported having high blood pressure, 47.4% smoke or were smokers, 73.7% had low functional health literacy, which was associated with schooling p = 0.001.
Conclusions:
the low functional health literacy could be a self-care conditioning and can be influenced by low schooling because it implies to have skills to understand and make decisions aimed at self-management of health.
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Leads for potentializing groups in Primary Health Care
Revista Brasileira de Enfermagem. 2016;69(5):964-971
Abstract
Leads 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
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The path to crack addiction: perceptions of people under treatment
Revista Brasileira de Enfermagem. 2016;69(5):956-963
Abstract
The path to crack addiction: perceptions of people under treatment
Revista Brasileira de Enfermagem. 2016;69(5):956-963
DOI 10.1590/0034-7167-2016-0045
Views0ABSTRACT
Objective:
the objective of this study was to understand the meaning of the harmful use of crack by people undergoing addiction treatment.
Method:
qualitative approach of social research on strategic modality was used. Field observation, preparation of field diary and focus groups, and data analysis through the method of interpreting meaning were carried out.
Results:
the results contributed to the construction of three thematic categories: “The discovery of crack and other drugs” that describes the experimentation with crack and other drugs; “The pain of the pleasure”, key category that describes the moments after crack experimentation and that, many times, turns into addiction, which leads the person into a cycle of short periods of attempts at abstinence, relapse, and relentless consumption; and “Return to normal life”.
Conclusion:
treating people with crack addiction must be carried out in ways that narrow the distance between these people and their families, society and health care.
Keywords:Cocaine-Related DisordersCrack CocaineHealth VulnerabilityNursingSubstance-Related DisordersSee more -
Intimate partner violence in adolescence: an analysis of gender and generation
Revista Brasileira de Enfermagem. 2016;69(5):946-955
Abstract
Intimate 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 -
Hospitalization anxiety in children: conceptual analysis
Revista Brasileira de Enfermagem. 2016;69(5):940-945
Abstract
Hospitalization 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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Stroke: patient characteristics and quality of life of caregivers
Revista Brasileira de Enfermagem. 2016;69(5):933-939
Abstract
Stroke: 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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A quasi-experimental nursing study on pain in comatose patients
Revista Brasileira de Enfermagem. 2016;69(5):927-932
Abstract
A 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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Quality of nursing care: instrument development and validation
Revista Brasileira de Enfermagem. 2016;69(5):920-926
Abstract
Quality 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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Network and social support in family care of children with diabetes
Revista Brasileira de Enfermagem. 2016;69(5):912-919
Abstract
Network and social support in family care of children with diabetes
Revista Brasileira de Enfermagem. 2016;69(5):912-919
DOI 10.1590/0034-7167-2015-0085
Views0See moreABSTRACT
Objective:
to understand the influence of network and social support in the care of a child with type 1 diabetes.
Method:
qualitative study, with assumptions of ethnonursing, conducted in a reference service specialized in the treatment of diabetes, in 2014, in the city of Fortaleza, state of Ceará, Brazil. Twenty-six members of the family and their respective school children participated in the study. The process of collection and analysis followed the observation-participation-reflection model.
Results:
the analytical categories showed that the social network in the care of children with diabetes helped sharing of information and experiences, moments of relaxation and aid in the acquisition of supplies for treatment, with positive repercussions in the family context, generating well-being and confidence in the care of children with diabetes.
Conclusion:
the cultural care provided by nurses strengthens the network and social support because it encourages autonomy in the promotion of the quality of life of children with type 1 diabetes and their families.
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Research lines in nursing: phylosophical and epistemological highlights
Revista Brasileira de Enfermagem. 2015;68(4):723-729
Abstract
Research lines in nursing: phylosophical and epistemological highlights
Revista Brasileira de Enfermagem. 2015;68(4):723-729
DOI 10.1590/0034-7167.2015680421p
Views0See moreRESUMEN
Objetivo:
elucidar destaques filosóficos y epistemológicos mediante consideraciones en favor de la casualidad de cuestiones en el interés de la Enfermería.
Método:
es fundamentado en las proposiciones teóricas de Johannes Hessen y de otros autores consagrados.
Resultados:
clareamiento de aspectos sustantivo e implicaciones adjetivas no sólo el interés de la investigación, resaltando los significados esenciales del asunto coincidido con las elaboraciones de disertaciones y tesis (Maestría y Doctorado de Enfermería).
Conclusión:
texto representa una contribución valiosa para esclarecer mejor detalles de la construcción del conocimiento en la temática y problemática del asunto puesto en causa.
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Linhas de pesquisa em enfermagem: destaques filosóficos e epistemológicos
Revista Brasileira de Enfermagem. 2015;68(4):723-729
Abstract
Linhas de pesquisa em enfermagem: destaques filosóficos e epistemológicos
Revista Brasileira de Enfermagem. 2015;68(4):723-729
DOI 10.1590/0034-7167.2015680421p
Views0See moreRESUMO
Objetivo:
elucidar destaques filosóficos e epistemológicos mediante considerações significativas, essenciais, em favor da causalidade de questões no interesse da Enfermagem.
Método:
abordagem fundamentada nas proposições teóricas de Johannes Hessen, com referência a outros autores expertos no tema.
Resultados:
esclarecimento de aspectos substantivos e implicações adjetivas não só no interesse da investigação, ressaltando os significados essenciais do assunto, condizente com as elaborações de dissertações de mestrado e teses de doutorado de Enfermagem.
Conclusão:
trata-se de uma contribuição valiosa para esclarecer melhor detalhes da construção do conhecimento na temática e problemática do assunto posto em causa, as linhas de pesquisa em enfermagem.
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Using the theory of meaningful learning in nursing education
Revista Brasileira de Enfermagem. 2015;68(4):713-722
Abstract
Using the theory of meaningful learning in nursing education
Revista Brasileira de Enfermagem. 2015;68(4):713-722
DOI 10.1590/0034-7167.2015680420i
Views0See moreABSTRACT
Objective:
to synthesize the scientific literature about the Theory of Meaningful Learning in the process of teaching and learning in nursing.
Method:
this is an integrative review conducted in the databases MEDLINE, LILACS, SciELO, BDENF and CINAHL with studies addressing the subject or aspects of the theory of meaningful learning of David Ausubel. Ten studies were included, from which six were written in Portuguese and four in English, published from 1998 to 2013.
Results:
five studies used the theory of meaningful learning, four studies cited Ausubel as the author of this theory and only two studies followed the framework for the application of the theory completely. There are only a few studies on this subject and those which explore it are not correlated with Ausubel’s theory.
Conclusion:
it is necessary to break with the dichotomy between theory and practice and promote the articulation of content with action, introducing the student as the author of their own knowledge.
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Nursing scientific production on health promotion, chronic condition, and aging
Revista Brasileira de Enfermagem. 2015;68(4):705-712
Abstract
Nursing scientific production on health promotion, chronic condition, and aging
Revista Brasileira de Enfermagem. 2015;68(4):705-712
DOI 10.1590/0034-7167.2015680419i
Views1See moreABSTRACT
Objective:
to characterize the scientific production of Postgraduate Programs Nursing in Brazil on health promotion with a focus on elderly people with chronic conditions in the period from 2006 to 2010.
Method:
integrative research developed by searching for dissertations and theses in the database of the Center for Nursing Studies and Research of the Brazilian Nursing Association published in the period from 2006 to 2010 and which focused on health promotion for elderly people with chronic conditions.
Results:
five themes emerged: “Living with the disease”; “Technologies of care”, “Potential for self-care” “Psycho-spiritual dimension”, and “Family caregiver”.
Conclusion:
it was possible to identify nursing care as a key element to promote the health of elderly people and make them more independent in their care so as to live with their limitations or disabilities, even when affected by chronic diseases.
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Longevity according to life histories of the oldest-old
Revista Brasileira de Enfermagem. 2015;68(4):697-704
Abstract
Longevity according to life histories of the oldest-old
Revista Brasileira de Enfermagem. 2015;68(4):697-704
DOI 10.1590/0034-7167.2015680418i
Views0See moreABSTRACT
Objective:
to interpret life histories of the oldest-old in a community, grounded on the perspective of the Active Aging and Life Course.
Method:
this is a qualitative research. Participants included twenty seniors 80 years and older, users of a Basic Health Unit. Life histories were collected and analyzed according to the proposition of the Autobiographical Narrative Interview.
Results:
during the analytic process, elements found in the elders’ present and past arose, contributing to the development of a theoretical model: “Building longevity along the life course.”
Conclusion:
longevity is rooted in the past, strongly infl uenced by the family culture and life course; assumptions of the Active Aging are more meaningful in the informants’ present trajectory. The content of the narratives pointed to new possibilities of Gerontology Nursing intervention in Primary Care, aiming at health promotion and intervention, specially grounded on the respect to the oldest-elders’ culture.
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Accuracy in inference of nursing diagnoses in heart failure patients
Revista Brasileira de Enfermagem. 2015;68(4):690-696
Abstract
Accuracy in inference of nursing diagnoses in heart failure patients
Revista Brasileira de Enfermagem. 2015;68(4):690-696
DOI 10.1590/0034-7167.2015680417i
Views0See moreABSTRACT
Objective:
to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients.
Method:
descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating effi cacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected.
Results:
the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identifi ed by the nursing evaluators.
Discussion:
the search for improving diagnostic accuracy reaffi rms the need for continuous and specifi c training to improve the diagnosis capability of nurses.
Conclusion:
the training allowed the exercise of clinical judgment and better accuracy of nurses.
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Direct cost of development and documentation of the nursing process
Revista Brasileira de Enfermagem. 2015;68(4):683-689
Abstract
Direct cost of development and documentation of the nursing process
Revista Brasileira de Enfermagem. 2015;68(4):683-689
DOI 10.1590/0034-7167.2015680416i
Views0See moreABSTRACT
Objective:
identify the average direct cost (ADC) of the activities performed by nursing professionals in the nursing process development and documentation at the medical clinic of a teaching hospital.
Method:
1040 activities were observed and the ADC was calculated by multiplying the time spent by professionals by the unit cost of direct labor.
Results:
the ADC of patient admission was R$ 55.57 (SD=19.44); among the activities of patient follow-up, the assessment phase documentation had the most significant ADC (R$ 17.70 – SD=14.60); the ADC of descriptive records corresponded to R$ 1.21 (SD=1.21) and the ADC of the nursing team for shift change was R$ 54.23 (SD=28.95).
Conclusion:
the study promotes visibility of the work performed by nursing professionals in the development of the nursing process, providing financial data to ensure consistent arguments for proper resources to its feasibility.
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Health status and mental health in patients after percutaneous coronary intervention
Revista Brasileira de Enfermagem. 2015;68(4):676-682
Abstract
Health status and mental health in patients after percutaneous coronary intervention
Revista Brasileira de Enfermagem. 2015;68(4):676-682
DOI 10.1590/0034-7167.2015680415i
Views0See moreABSTRACT
Objective:
to assess the association between perceived health status and the mental health of patients submitted to percutaneous coronary intervention after hospital discharge.
Method:
a quantitative and cross-sectional study involving 101 participants. The following instruments were used: a sociodemographic and clinical characterization instrument, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). Participants were divided into three groups: no anxiety and no depression (G1); anxiety or depression (G2); and both (G3). The ANOVA test was used for the intergroup comparison of means on the SF-36 domains.
Results:
There was an association between perceived health status and mental health. The participants in G1 presented higher scores in all SF-36 domains in comparison with participants in G2 and G3.
Conclusion:
Participants with no anxiety and depression presented better-perceived health status in comparison with those with anxiety or depression, or both.
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