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01-01-2016
Epistemology of nursing care: a reflection on its foundations
Revista Brasileira de Enfermagem. 2016;69(6):1240-1245
Abstract
Epistemology of nursing care: a reflection on its foundations
Revista Brasileira de Enfermagem. 2016;69(6):1240-1245
DOI 10.1590/0034-7167-2016-0331
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Objective:
to reflect on nursing care and its epistemology from its historical, theoretical, philosophical, spiritual dimensions and as a social practice.
Method:
discussions originated in the discipline “Epistemology of caring”, from the graduate nursing program of the School of Nursing, Federal University of Minas Gerais, and in critical analysis of nursing literature together with the professional practice of the authors.
Results:
we identified the necessity of developing a critical conscience on health care provision, research, and teaching, as well as on challenges in maintaining high standards of working interpersonal relationships, which has a profound impact on population health.
Conclusion:
we suggest the rescue of integrality, humanization, unity, and spirituality in researches and practices of individual, familiar, and community care, as an advance in incorporating epistemology of caring in nursing.
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01-01-2016
Health needs and nursing care
Revista Brasileira de Enfermagem. 2016;69(6):1236-1239
Abstract
Health needs and nursing care
Revista Brasileira de Enfermagem. 2016;69(6):1236-1239
DOI 10.1590/0034-7167-2016-0128
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Objective:
to present the concept of needs according to different approaches to discuss the possibility of health care that incorporates a broader view of human vulnerabilities in health services.
Methods:
the arguments are founded on nursing theorists who worked on the construction of frameworks relevant to care, based on needs and on philosophers who show the possibility of identifying the vulnerabilities of human beings, defending art as a therapeutic instrument that can promote health care.
Conclusion:
although care can acquire a new dimension with the introduction of art, according to certain perspectives, philosophical studies on ethics and aesthetics should be resumed to identify human vulnerabilities that can in fact be compensated by sensible understanding of the outer world. To incorporate art in nursing care requires studies from theorists to be recovered, deepening concepts and working on empirical investigations for their adequate use.
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01-01-2016
Case studies and role play: learning strategies in nursing
Revista Brasileira de Enfermagem. 2016;69(6):1231-1235
Abstract
Case studies and role play: learning strategies in nursing
Revista Brasileira de Enfermagem. 2016;69(6):1231-1235
DOI 10.1590/0034-7167-2016-0277
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Objective:
to report professors’ experience in a public university of Southern region of Brazil using case studies and role play as learning strategies for nursing care of hospitalized adults.
Method:
learning experience report from the Nursing Care of Adults I class of nursing undergraduate course.
Results
the development of case studies and role play considered health care needs from epidemiological profile of chronic noncommunicable diseases morbidity and mortality, nursing as an assisting method, and social aspects of hospitalized individuals. Role play planning was made by creating a stage in laboratory of practices and dialogues comprising students and professors interaction.
Conclusion
case studies and role play encouraged students to active search for learning and brought theory closer to real health care situations.
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01-01-2016
Politicy of care in the criticism towards gender stereotypes
Revista Brasileira de Enfermagem. 2016;69(6):1223-1230
Abstract
Politicy of care in the criticism towards gender stereotypes
Revista Brasileira de Enfermagem. 2016;69(6):1223-1230
DOI 10.1590/0034-7167-2016-0441
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Objectives:
analyze gender inequalities among Brazilian women in Portugal and in contemporary nursing based on care politicity in the light of gender; disclose oppression of the female produced by the stereotypes that look upon women as natural caregivers; point out politicity to deconstruct gender stereotypes.
Method:
theoretical reflection with narrative review of literature to analyze classic references in the feminist epistemology combined with the care politicity thesis.
Results:
the similarities between the stereotypes of the Brazilian Eves and the Portuguese Maries as either the sexualized or sanctified nurse are inserted in the Jewish-Christian moral genealogy that reaffirms the subservience of the female to the male.
Conclusion:
by attaching priority to care that needs non-care to expand the possibilities of care giving, the theoretical assumption of politicy of care can contribute to subvert the stereotypical images of Brazilian women in Portuguese lands and in contemporary nursing.
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01-01-2016
Strategies for thirst relief: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(6):1215-1222
Abstract
Strategies for thirst relief: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(6):1215-1222
DOI 10.1590/0034-7167-2016-0317
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Objective:
to analyze the strategies used to relieve the thirst of hospitalized patients.
Method:
an integrative review, for which the databases PubMed, LILACS, CINAHL and the group of references organized by the Group for Study and Research of Thirst were selected for the search of primary studies, with the keywords: thirst, ice, cold, intervention, nursing care, artificial saliva.
Results:
the review sample was composed of ten primary studies. The strategies found were: low temperature using frozen gauze, ice chips, and cold water, menthol associated with cold strategies, chewing gum, acupressure, and the use of a thin straw, substitute saliva, and early fluid ingestion.
Conclusion:
the temperature was presented as a predominant and effective strategy to relieve the thirst for surgical patients in intensive care and hemodialysis treatment.
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01-01-2016
Care of the self and power relations: female nurses taking care of other women
Revista Brasileira de Enfermagem. 2016;69(6):1204-1214
Abstract
Care of the self and power relations: female nurses taking care of other women
Revista Brasileira de Enfermagem. 2016;69(6):1204-1214
DOI 10.1590/0034-7167-2016-0021
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Objective:
to analyze the care of self of female nurses and the power relations established by them in the care of other women.
Method:
integrative review of literature published between 2005 and 2015. There were 25 publications in the sample.
Results:
qualitative state of the art with reference domain of a liberating perspective, based on humanization, autonomy and empowerment as a risk reduction strategy in the practice of care to women. The findings suggest solidified power relations among female nurses and women, focused on professional domain concentrated on nurse education under the patriarchal and society’s normalization discourse. Some studies consider the importance of understanding power in a capillary way, operating on the bodies of individuals.
Conclusion:
there is little discussion about the care of self of nurses and the effects on their professional practice, indicating gaps in knowledge in this field.
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01-01-2016
Nursing competencies in promoting the health of individuals with chronic diseases
Revista Brasileira de Enfermagem. 2016;69(6):1195-1203
Abstract
Nursing competencies in promoting the health of individuals with chronic diseases
Revista Brasileira de Enfermagem. 2016;69(6):1195-1203
DOI 10.1590/0034-7167-2016-0312
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Objective:
to identify nurse’s competencies related to health promotion of individuals with chronic cardiac disease, in the light of the Galway consensus.
Method:
integrative literature review was conducted to search for studies published between 2010 and 2014 in the databases LILACS, BDENF, IBECS; and PubMed in February 2015. The 21 included studies were analyzed according to the eight domains of competence: Catalyzing change, Leadership, Evaluation, Planning, Implementation, Assessment, Advocacy and Partnerships.
Results:
all domains of competence were included in the nursing interventions in health promotion of chronic cardiac patients, and the Planning and Evaluation were the most evident competences.
Conclusion:
the results of this research highlighted the nurse as an agent capable of operating care management, in order to improve coordination of the latter with work and education and, thus, the health care of the population.
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01-01-2016
Assisted therapy with dogs in pediatric oncology: relatives’ and nurses’ perceptions
Revista Brasileira de Enfermagem. 2016;69(6):1188-1194
Abstract
Assisted therapy with dogs in pediatric oncology: relatives’ and nurses’ perceptions
Revista Brasileira de Enfermagem. 2016;69(6):1188-1194
DOI 10.1590/0034-7167-2016-0243
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Objective:
to understand the perception of nursing staff professionals and legal guardians of children and adolescents with cancer regarding Assisted Therapy with dogs.
Method:
qualitative study based on participant observation conducted with 16 participants in a reference hospital of child cancer. We applied an in-depth interview and interpreted the data according to a content analysis technique.
Results:
the practice is admittedly beneficial to participants despite the fact they do not understand its true objectives and therapeutic applications. Participants only associate it with something distracting and entertaining without realizing the occurrence of a more complex process behind it, which comprises changes besides the emotional ones (more easily perceived).
Conclusion:
the perceptions of participants reinforce recommendations that can be applied in the hospital environment, also showing that the therapy in question can become an effective technology to promote the health of children and adolescents with cancer.
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ERRATUM04-22-2020
ERRATUM
Revista Brasileira de Enfermagem. 2020;73(3):202073n3e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2020;73(3):202073n3e05
DOI 10.1590/0034-7167.202073n3e05
Views0Article “Concept formation of ambience for labor and normal institutionalized delivery”, with number of DOI: , published in the journal Revista Brasileira de Enfermagem, 72(Suppl 3):348-59, on page 357:Include after Final Considerations the information:[…]See more -
ORIGINAL ARTICLE04-09-2020
Health promotion in schools: speeches, representations, and approaches
Revista Brasileira de Enfermagem. 2020;73(3):e20180774
Abstract
ORIGINAL ARTICLEHealth promotion in schools: speeches, representations, and approaches
Revista Brasileira de Enfermagem. 2020;73(3):e20180774
DOI 10.1590/0034-7167-2018-0774
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Objectives:
to analyze speeches, representations, and approaches on health and health promotion in schools, materialized in the speech of teachers.
Methods:
a qualitative study, of the case study type, carried out with 17 teachers from the municipal and state educational network. The data were obtained from interviews and analyzed by the Content-Oriented Discourse Analysis.
Results:
medical-sanitary and clinical-biological discourses predominated. Health is represented as the absence of disease, reflecting approaches that prioritize healthy habits and changes in behavior. Problematization of social determinants occurs in projects, in an intersectorial partnership.
Final Considerations:
carrying out projects of health promotion in schools ignores the solidification of partnerships and the construction of new speeches that represent it as quality of life conditioned by social, economic, and cultural factors as well as strategies for the ideological repositioning of those actors who act in this setting.
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ORIGINAL ARTICLE04-09-2020
Nursing work and competence in hemotherapy services: an ergological approach
Revista Brasileira de Enfermagem. 2020;73(3):e20180775
Abstract
ORIGINAL ARTICLENursing work and competence in hemotherapy services: an ergological approach
Revista Brasileira de Enfermagem. 2020;73(3):e20180775
DOI 10.1590/0034-7167-2018-0775
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Objetives:
to analyze the ingredients of the competence that the nurses use in the performance of their work in hemotherapy.
Methods:
qualitative study with 22 nurses, accomplished through documentary study, observation and semi-structured interview, with resources of Atlas.ti software based on the foundations of Historical Materialism Dialectic and Ergology. Performed Content Analysis.
Results:
the domain of specific knowledge of hemotherapy and the time of experience in the area, allied to the motivation of the worker and the ability to work in a team favor the competent action in the work activities. On the other hand, the lack of adequate work conditions, especially in relation to adequate materials, equipment and structure, impairs the work of the nurse in hemotherapy.
Final Considerations:
experience gained is critical to successful decision making. In addition, adequate working conditions, updating of knowledge and ability in teamwork favor a scenario of safe practices.
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ORIGINAL ARTICLE04-22-2020
Happiness as a strength in the promotion of adolescent and adult young health
Revista Brasileira de Enfermagem. 2020;73(3):e20190064
Abstract
ORIGINAL ARTICLEHappiness as a strength in the promotion of adolescent and adult young health
Revista Brasileira de Enfermagem. 2020;73(3):e20190064
DOI 10.1590/0034-7167-2019-0064
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Objectives:
to assess the relation between sociodemographic characteristics of young people associated with the subjectivity of being happy; to evaluate the relationship between the subjectivity of being happy and the perception of health status; to evaluate the relationship between the subjectivity of being happy and the school and family environments and peer groups at school.
Methods:
this is an observational study, with an intentional sample of 1,069 young Portuguese people, with ages varying from 14 to 24, most of them women, attending secondary education. The self-filling questionnaire was used.
Results:
there are statistically significant associations between the subjectivity of being happy and schooling, perception of health status, family APGAR, school and family involvement, absence of problems or teasing by peers at school.
Conclusions:
a positive and holistic care coupled with the potential of obtaining and consolidating healthy lifestyles for young people will enable health professionals to perceive them as agents of individual and social change.
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ORIGINAL ARTICLE04-22-2020
Preventing vertical HIV virus transmission: hospital care assessment
Revista Brasileira de Enfermagem. 2020;73(3):e20190491
Abstract
ORIGINAL ARTICLEPreventing vertical HIV virus transmission: hospital care assessment
Revista Brasileira de Enfermagem. 2020;73(3):e20190491
DOI 10.1590/0034-7167-2019-0491
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Objectives:
assess the implementation of actions to prevent vertical transmission of HIV.
Methods:
a retrospective cohort study conducted in two maternity hospitals in the city of Montes Claros, State of Minas Gerais. All women admitted for childbirth diagnosed with HIV and their respective newborns were included from 2014 to 2017. Data were collected from medical records and analyzed descriptively.
Results:
population consisted of 46 pairs of mothers and newborns. Management was considered inadequate in 30 cases of parturient/postpartum women (65.2%) and 14 cases of newborns (30.4%). The main reasons for inadequate maternal management were lack of pharmacological inhibition of lactation (53.3%) and counseling/consent for HIV testing (43.3%). For newborns, late onsetoffirst dose ofZidovudine (50.0%) and no prescriptionofNevirapine (28.6%).
Conclusions:
important prevention opportunities were missed, pointing to the need for improved care.
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ORIGINAL ARTICLE06-08-2020
Maternal-child nursing care for adolescent mothers: health education
Revista Brasileira de Enfermagem. 2020;73(4):e20180769
Abstract
ORIGINAL ARTICLEMaternal-child nursing care for adolescent mothers: health education
Revista Brasileira de Enfermagem. 2020;73(4):e20180769
DOI 10.1590/0034-7167-2018-0769
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Objectives:
to develop an educational intervention through a game that addresses aspects related to adolescent motherhood and child care.
Methods:
this is an action research based on diagnosis, intervention and apprehension stages.
Results:
the situational diagnosis was based on a literature review on adolescent motherhood and child care. In the intervention stage, the educational game’s first version was elaborated. In the third stage constituted by apprehension, the game was submitted to assessment of interdisciplinary experts. Suggestions of experts were adopted and the game had its second version.
Final Considerations:
the educational intervention in the present study appears a care technology that adds knowledge and practices to the work of nurses in Primary Health Care, focusing on adolescent women and children health care.
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REVIEW06-01-2020
Access of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
Abstract
REVIEWAccess of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
DOI 10.1590/0034-7167-2018-0834
Views1See moreABSTRACT
Objectives:
demonstrate and discuss how the black population’s access to health services occurs
Methods:
integrative literature review with the following question: How does the black population’s access to health services occur? The search was carried out in the Scholar, LILACS and SciELO databases and used the descriptor “access to health services” and the term “population,” resulting in a sample with twelve articles.
Results:
studies show that the difficulty of access is a fundamental factor for the quality of life of people, directly compromising preventive services, especially for women’s health and, in addition, it has significant impact on the illness process of the black population within its particularities.
Final Considerations:
several limiting factors compromise the black population’s access to health services, including institutional and structural factors
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ORIGINAL ARTICLE05-18-2020
Militancy of nurses in the institutionality field: printed media versions
Revista Brasileira de Enfermagem. 2020;73(4):e20180835
Abstract
ORIGINAL ARTICLEMilitancy of nurses in the institutionality field: printed media versions
Revista Brasileira de Enfermagem. 2020;73(4):e20180835
DOI 10.1590/0034-7167-2018-0835
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Objectives:
to analyze nurses’ professional militancy in the institutionality field, presented by the printed media from Bahia State in the 1970s and 1980s.
Methods:
a historical and qualitative research under Social History’s perspective, whose data source was the newspaper A Tarde. The temporal cut-off encompasses milestones such as professional body restructuring and creation.
Results:
the Associação Brasileira de Enfermagem democratization movement was reported in a superficial way, highlighting the struggle for power spaces. With respect to Conselhos Federal e Regional de Enfermagem daBahia, the newspaper notified creation and function of bodies, however, there was no visibility to the newspaper’s performance. Concerning the union, there was political fragility of nurses against the creation and union participation in the fight for labor rights.
Final Considerations:
organization of political action occurred from isolated groups mobilization of professionals who were already traveling in political spaces, not the large mass of professionals.
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ORIGINAL ARTICLE06-16-2021
Patient participation in care safety: Primary Health Care professionals’ perception
Revista Brasileira de Enfermagem. 2021;74(2):e20200773
Abstract
ORIGINAL ARTICLEPatient participation in care safety: Primary Health Care professionals’ perception
Revista Brasileira de Enfermagem. 2021;74(2):e20200773
DOI 10.1590/0034-7167-2020-0773
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Objectives:
to analyze health professionals’ perception about the meaning and practice of patient involvement in care safety in Primary Health Care.
Methods:
this is an exploratory, qualitative study, developed with 22 professionals in the Federal District, Brazil. A semi-structured interview was conducted between October and November/2018. Content analysis was carried out according to Bardin.
Results:
nurses, physicians, dentists, among others, participated. The following categories emerged: Meaning of patient involvement in care safety; Factors intervening in patient involvement in care safety; Strategies for patient involvement in care safety; Qualification for patient involvement in care safety.
Final Considerations:
the meaning of patient involvement for care safety was associated with co-responsibility and patient-centered care. Professionals’ practice revealed intervening factors and the use of involvement strategies. A gap was identified in training on patient involvement in care safety.
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REVIEW03-30-2020
Internet influence on the biopsychosocial health of adolescents: an integratitive review
Revista Brasileira de Enfermagem. 2020;73(2):e20180766
Abstract
REVIEWInternet influence on the biopsychosocial health of adolescents: an integratitive review
Revista Brasileira de Enfermagem. 2020;73(2):e20180766
DOI 10.1590/0034-7167-2018-0766
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Objectives:
To identify scientific evidence on the influence of internet use on adolescents’ biopsychosocial health.
Methods:
Integrative review, with database search, using the descriptors “internet”, “adolescent health” and “adolescent behavior”. After applying the inclusion and exclusion criteria, 16 articles were selected.
Results:
Knowledge convergence produced for three main themes was demonstrated: “Internet exposure time and possible damages to adolescent health”; “Internet, adolescent and cyberbullying”; and “Internet as a source of information for adolescent health”.
Final considerations:
The network involves an intricate network of interactions, providing varied behaviors and attitudes that reflect on adolescent health. Therefore, it is important to articulate nursing actions with the school community and the family, in order to carry out health education.
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REFLECTION07-10-2020
Psychosocial risks and the health of health workers: reflections on Brazilian labor reform
Revista Brasileira de Enfermagem. 2020;73:e20190092
Abstract
REFLECTIONPsychosocial risks and the health of health workers: reflections on Brazilian labor reform
Revista Brasileira de Enfermagem. 2020;73:e20190092
DOI 10.1590/0034-7167-2019-0092
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Objective:
to reflect on the psychosocial risks and their impacts on the health of health workers in light of the Brazilian economic context and Labor Reform.
Method:
reflective study on the Brazilian Labor Reform and its impacts on health of health workers.
Results:
although the changes observed in the labor sphere have contributed to improvements in health and safety policies for, these changes have also contributed to the emergence of new risks arising from work activities, including psychosocial risks, which affect all occupational categories.
Final considerations:
we understand that the Brazilian Labor Reform carried out in 2017 leads to the weakening of labor relations, increases workers’ exposure to risks in the workplace, increases the risk of illness, and opposes the global movement of international organizations aimed at the prevention of aggravation in workers’ health and also at preserving their health.
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REVIEW06-17-2020
The role of the nurse in caring for the critical patient with sepsis
Revista Brasileira de Enfermagem. 2020;73(4):e20190031
Abstract
REVIEWThe role of the nurse in caring for the critical patient with sepsis
Revista Brasileira de Enfermagem. 2020;73(4):e20190031
DOI 10.1590/0034-7167-2019-0031
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Objectives:
to know the nursing interventions in the identification, prevention and control of sepsis in critical patients.
Methods:
integrative review of the literature, with two parallel researches using different MesH terms, using the EBSCO database and Google Scholar. Nine studies were included in the sample.
Results:
nursing interventions are centered on the creation/implementation of protocols for the early recognition of sepsis, the training of teams to ensure a safe and effective approach and the adoption of measures for infection prevention and control as a way to prevent sepsis.
Final Considerations:
the evidence shows that nurses are fundamental in the early identification, control and prevention of sepsis, preventing disease progression and contributing to decreased morbidity and mortality.
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ORIGINAL ARTICLE05-15-2020
Configuration of power relations in physicians and nurses’ professional practices
Revista Brasileira de Enfermagem. 2020;73:e20180629
Abstract
ORIGINAL ARTICLEConfiguration of power relations in physicians and nurses’ professional practices
Revista Brasileira de Enfermagem. 2020;73:e20180629
DOI 10.1590/0034-7167-2018-0629
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Objective:
to analyze the configuration of power relations constituted in and by the knowledge and daily practices of physicians and nurses in an Intensive Care Unit (ICU).
Method:
qualitative study in which data were collected through interviews with physicians and nurses from an ICU of a hospital in Belo Horizonte, Minas Gerais. A semi-structured script was used. Data were analyzed through discourse analysis in a Foucaultian perspective.
Results:
three categories were developed – Professional Identity: self-recognition in the profession; Discipline: individualizing attitudes or collective need?; and Circularity of knowledge and power in the constitution of daily practices.
Final considerations:
the identity, discipline and circulation of power are connected in a continuous movement of subjectivation of the subject, which, in turn, uses discourse as a persuasion strategy to modify the position taken over in different situations thereby causing the circulation of power.
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ORIGINAL ARTICLE02-10-2020
Theater of the Oppressed and bullying: nursing performance in school adolescent health
Revista Brasileira de Enfermagem. 2020;73(1):e20170910
Abstract
ORIGINAL ARTICLETheater of the Oppressed and bullying: nursing performance in school adolescent health
Revista Brasileira de Enfermagem. 2020;73(1):e20170910
DOI 10.1590/0034-7167-2017-0910
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Objective:
to assess the effects of an intervention based on the Theater of the Oppressed in reducing school bullying.
Method:
a quasi-experimental study with 232 first-year high school students from two public schools in the city of Cuiabá, Mato Grosso State, Brazil. An intervention was performed with the Theater of the Oppressed, a theatrical methodology created by Augusto Boal and inspired by Paulo Freire’s “Pedagogy of the Oppressed”, in which one school composed the intervention group, and another school, the comparison group. Both groups were assessed for involvement in bullying situations before and after intervention. For data analysis, Poisson Regression models with random effect were used.
Results:
intervention group presented a significant decrease in direct victimization (physical and verbal aggression).
Conclusion:
the Theater of the Oppressed represents an important strategy in reducing bullying victimization among school adolescents.
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ORIGINAL ARTICLE02-10-2020
Common Mental Disorders and Contemporary Factors: 1982 Birth Cohort
Revista Brasileira de Enfermagem. 2020;73(1):e20180162
Abstract
ORIGINAL ARTICLECommon Mental Disorders and Contemporary Factors: 1982 Birth Cohort
Revista Brasileira de Enfermagem. 2020;73(1):e20180162
DOI 10.1590/0034-7167-2018-0162
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Objective:
To describe the association between common mental disorders and socio-demographic variables, smoking habits and stressful events among the 30-year-old members of a 1982 cohort.
Method:
Mental disorder was analyzed by the Self-Reporting Questionnaire (SRQ-20). Poisson regression was used to analyze the unadjusted and adjusted associations.
Results:
Low level of education and stressful events increased the prevalence of mental disorders for both genders. Lower income for women and unemployment for men also remained associated with CMD.
Conclusion:
It was possible to describe the association between contemporary factors and mental disorders in a young population, to which prevention and control measures, through public policies proposed to the areas of Primary Care, Mental Health and Education, can represent a better quality of life and health.
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REVIEW12-21-2020
Lean Six Sigma methodology application in health care settings: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190861
Abstract
REVIEWLean Six Sigma methodology application in health care settings: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190861
DOI 10.1590/0034-7167-2019-0861
Views0See moreABSTRACT
Objective:
to analyze the scientific production on the results of Lean Six Sigma methodology in health care institutions.
Methods:
an integrative literature review, with the following question: what are the results in health institutions using Lean Six Sigma and Six Sigma methodology? The search was carried out at MEDLINE, LILACS, BDENF, CINAHL, Web of Science, and Scopus, with no time frame.
Results:
thirty-four articles were included, published between 2005 and 2019, of which 52.9% came from the United States of America. The most commonly found improvements were in hospital institutions and from the perspective of customers and internal processes.
Conclusion:
using Lean Six Sigma methodology proved to be effective in the different health care settings, evidencing a gap in its application regarding people engagement and training.
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