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01-01-2015
Social representations about religion and spirituality
Revista Brasileira de Enfermagem. 2015;68(4):609-616
Abstract
Social representations about religion and spirituality
Revista Brasileira de Enfermagem. 2015;68(4):609-616
DOI 10.1590/0034-7167.2015680406i
Views0See moreABSTRACT
Objective:
to identify the social representations about the concepts of spirituality and religion of of health teachers.
Method:
exploratory and descriptive study, based on a qualitative approach. 25 subjects participated in it. The following instruments were used to collect data: questionnaire to identify the profile; questionnaire of free association, whose inducing words were religion and spirituality, and an interview based on the scale FICA (Puchalski, 2006).
Results:
the representations about religion and spirituality, for professors, are forged around the faith in God and it gives them meaning and purpose to deal with the challenges of personal and professional living.
Conclusion:
there are still barriers that need to be overcome with a view to a comprehensive care. For this, it is essential to incorporate spirituality in the process in the curricula of health courses.
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01-01-2015
Prevalence and factors associated with smoking among tobacco growers in southern Brazil
Revista Brasileira de Enfermagem. 2015;68(4):603-608
Abstract
Prevalence and factors associated with smoking among tobacco growers in southern Brazil
Revista Brasileira de Enfermagem. 2015;68(4):603-608
DOI 10.1590/0034-7167.2015680405i
Views0See moreABSTRACT
Objective:
identify the prevalence and factors associated with smoking in tobacco growers.
Method:
descriptive, cross-sectional research. Data collection occurred in 2012 through household survey and interviews, including application of a structured instrument and scale Fargeström.
Results:
there were 100 growers included, average age of 46,9 ± 10,8 years; 90(90%) married; 72(72%) white, average family composition 3,7±1,1 people; median number of children 3(1-3), and the average study time 6±2,5. The prevalence of smoking among tobacco growers was 17%, which had less education (p=0.010) and fewer people in the household (p=0.049).
Conclusion:
the prevalence of smoking among tobacco growers was higher than the national average, but the nicotine dependence was low, which can facilitate the smoking cessation process. Highlights the need to implement a program to control smoking among tobacco growers.
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01-01-2015
The family living the child recovery process after hospital discharge
Revista Brasileira de Enfermagem. 2015;68(4):594-602
Abstract
The family living the child recovery process after hospital discharge
Revista Brasileira de Enfermagem. 2015;68(4):594-602
DOI 10.1590/0034-7167.2015680404i
Views1See moreABSTRACT
Objective:
to understand the meaning attributed by the family to its experience in the recovery process of a child affected by an acute disease after discharge, and to develop a theoretical model of this experience. Symbolic interactionism was adopted as a theoretical reference, and grounded theory was adopted as a methodological reference.
Method:
data were collected through interviews and participant observation with 11 families, totaling 15 interviews. A theoretical model consisting of two interactive phenomena was formulated from the analysis: Mobilizing to restore functional balance and Suffering from the possibility of a child’s readmission.
Results:
the family remains alert to identify early changes in the child’s health, in an attempt to avoid rehospitalization.
Conclusion:
the effects of the disease and hospitalization continue to manifest in family functioning, causing suffering even after the child’s discharge and recovery.
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01-01-2015
Multiprofessional residency in health: a document analysis of political pedagogical projects
Revista Brasileira de Enfermagem. 2015;68(4):586-593
Abstract
Multiprofessional residency in health: a document analysis of political pedagogical projects
Revista Brasileira de Enfermagem. 2015;68(4):586-593
DOI 10.1590/0034-7167.2015680403i
Views0See moreABSTRACT
Objective:
To analyze MPRH political pedagogical projects (PPP) developed in the state of São Paulo and identify scenarios that are highly favorable to IPE.
Method:
This was a descriptive exploratory study conducted through document analysis.
Results:
The analysis revealed a heterogeneous scenario regarding the curricula, didactic and pedagogical organization, educational objectives, pedagogical matrices and evaluation systems employed. One of the programs was identified as providing a highly favorable setting for IPE.
Conclusion:
The analysis adequately evaluated IPE in educational settings and found a highly favorable scenario for it, identifying didactic, pedagogical, political and organizational MPRH elements.
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01-01-2015
Beliefs of older adults about their vulnerability to HIV/Aids, for the construction of nursing diagnoses
Revista Brasileira de Enfermagem. 2015;68(4):579-585
Abstract
Beliefs of older adults about their vulnerability to HIV/Aids, for the construction of nursing diagnoses
Revista Brasileira de Enfermagem. 2015;68(4):579-585
DOI 10.1590/0034-7167.2015680402i
Views0See moreABSTRACT
Objective:
to know the beliefs of older adults about their vulnerability to HIV/Aids, and to identify nursing diagnoses.
Method:
a field research implemented in Family Health Units, in João Pessoa, Brazil. The sample included 250 older adults of both genders with data collected from April to July of 2011. A Test of Free Word Association was applied using the term HIV/Aids. A content analysis and cross-mapping of the most frequent terms with the International Classification for Nursing Practice, 2011 were performed.
Results:
202 terms were identified in terms, with an overall frequency of 1156. Of the 202 terms, 16 were more frequent and were used to construct the nursing diagnoses. The diagnoses identified were knowledge about appropriate sexual behavior, ability for partial protection, fear of death and hopelessness.
Conclusion:
understanding these beliefs drew from knowledge about factors related to, vulnerability to HIV/Aids aimed at planning health care actions for this population segment.
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AUTHORS’S ANSWER01-01-2015
AUTHORS’S ANSWER
Revista Brasileira de Enfermagem. 2015;68(4):578-578
Abstract
AUTHORS’S ANSWERAUTHORS’S ANSWER
Revista Brasileira de Enfermagem. 2015;68(4):578-578
DOI 10.1590/0034-7167.20156804r
Views0Dear Dr Levent Tekin, Thank you very much for your relevant considerations about the manuscript.[…]See more -
LETTER TO THE EDITOR01-01-2015
Considerations about the manuscript published
Revista Brasileira de Enfermagem. 2015;68(4):577-577
Abstract
LETTER TO THE EDITORConsiderations about the manuscript published
Revista Brasileira de Enfermagem. 2015;68(4):577-577
DOI 10.1590/0034-7167.20156804c
Views0Re: Chinese auriculotherapy to improve quality of life of nursing team To the Editor,[…]See more -
01-01-2015
Research in nursing and new pathways based on SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
Abstract
Research in nursing and new pathways based on SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
DOI 10.1590/0034-7167.2015680401i
Views1Almost half a century after the beginning of nursing research in Brazil, there is still a need for investment before it can be considered consolidated. The truth of this statement can be seen in the national seminars that discuss research in the field through 17 events that present results and participation of nursing researchers and […]See more
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01-01-2016
Public actions for control of breast cancer in Brazil: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):793-803
Abstract
Public actions for control of breast cancer in Brazil: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):793-803
DOI 10.1590/0034-7167.2016690424i
Views0See moreABSTRACT
Objective:
to analyze the scientific production on “breast cancer” in the period from 2002 to 2013 and determine the public policies for screening and early diagnosis of breast cancer.
Method:
this is an integrative literature review conducted in the databases MEDLINE, LILACS, SciELO and Google Scholar. Inclusion criteria: year and period of publication; availability of the full article; publication in Brazil; and the cross-check of the keywords Breast Cancer, Primary Health Care, Screening Programs, and Early Detection of Cancer.
Results:
after analysis, four thematic categories were obtained: breast self-examination, clinical examination of breast, mammography, and factors that hinder the adherence to the screening.
Conclusion:
health professionals have deficits of knowledge on the area, indicating the need for other studies on the subject addressed and greater investment in continuing education of professionals.
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01-01-2016
Nursing diagnoses in patients with cerebral vascular accident: an integrative review
Revista Brasileira de Enfermagem. 2016;69(4):785-792
Abstract
Nursing diagnoses in patients with cerebral vascular accident: an integrative review
Revista Brasileira de Enfermagem. 2016;69(4):785-792
DOI 10.1590/0034-7167.2016690423i
Views0See moreABSTRACT
Objective:
to verify the nursing diagnoses in patients affected by CVAs.
Method:
this is an integrative review of the literature. The search was conducted on LILACS, Scielo, Medline, CINAHL, and Scopus databases between February and March 2015, using the following keywords: “Enfermagem”, “Acidente Vascular Cerebral”, “Diagnóstico de Enfermagem”; and “Nursing”, “Stroke”, and “Nursing Diagnosis”.
Results:
we found 9 articles published between 2009 and 2015; most of them were Brazilian, cross-sectional, and exploratory, with a level of evidence of 6. The evidence from the publications was classified as: “Evaluation and validation of specific nursing diagnoses for subjects affected by CVAs” and “Application of the nursing process on subjects affected by CVAs”.
Conclusion:
we noticed the publications focused on nursing diagnoses related to motor disorders, such as risk of falls and impaired physical mobility. Domains regarding safety/protection (domain 11) and sleep/resting (domain 4) were present in most evaluated publications.
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01-01-2016
Impact of educational interventions in reducing diabetic complications: a systematic review
Revista Brasileira de Enfermagem. 2016;69(4):773-784
Abstract
Impact of educational interventions in reducing diabetic complications: a systematic review
Revista Brasileira de Enfermagem. 2016;69(4):773-784
DOI 10.1590/0034-7167.2016690422i
Views0See moreABSTRACT
Objective:
To identify in the literature evidence of the effectiveness and efficacy of educational interventions in reducing metabolic and/or vascular complications in adults with diabetes mellitus.
Method:
A systematic review performed in LILACS, IBECS, CUMED, CINAHL and Medline databases and in the online library SciELO with studies published from 2004 to 2014.
Results:
Eleven studies were included (5 randomized clinical trials and 6 quasi-experimental). We only identified studies that analyzed vascular complications.
Conclusion:
Two clinical trials demonstrated efficacy in reducing cardiovascular complications, of cataract or retinopathy and nephropathy and all the quasi-experimental studies showed effectiveness in reducing feet ulcers, peripheral neuropathy and vasculopathy, and maintenance of kidney function.
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01-01-2016
The communication process in Telenursing: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):765-772
Abstract
The communication process in Telenursing: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):765-772
DOI 10.1590/0034-7167.2016690421i
Views0See moreABSTRACT
Objective:
to identify scientific evidence about the communication process in Telenursing and analyze them.
Method:
integrative review performed in March 2014. The search strategy, structured with the descriptors “telenursing” and “communication”, was implemented in the databases Medline, Bireme, Cinahl, Scopus, Web of Science, Scielo, and Cochrane.
Results:
ten studies were selected after inclusion and exclusion criteria. The main challenges were: the clinical condition of patients, the possibility for inadequate communication to cause misconduct, the absence of visual references in interactions without video, and difficulty understanding nonverbal communication.
Conclusion:
distance imposes communicative barriers in all elements: sender, recipient and message; and in both ways of transmission, verbal and nonverbal. The main difficulty is to understand nonverbal communication. To properly behave in this context, nurses must receive specific training to develop abilities and communication skills.
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01-01-2016
Health care for patients with acute coronary syndrome according to quality indicators
Revista Brasileira de Enfermagem. 2016;69(4):757-764
Abstract
Health care for patients with acute coronary syndrome according to quality indicators
Revista Brasileira de Enfermagem. 2016;69(4):757-764
DOI 10.1590/0034-7167.2016690420i
Views0See moreABSTRACT
Objective:
to assess in-hospital care for patients with Acute Coronary Syndrome according to quality indicators.
Method:
a longitudinal quantitative study was performed between November 2012 and March 2013 with 94 patients, including interviews and medical records.
Results:
a total of 39.4% of patients had unstable angina and 60.6% had myocardial infarction, of which 34% had ST segment elevation. Patients with TIMI and GRACE scores higher than four and 140 (p<0.05) respectively died. Admission to the intensive care unit totaled 2.1%; assessment of left ventricular (LV) ejection fraction, 83.0%; ASA within 24 hours of admission, 77.8%; statins, 72.7%; angiotensin-converting enzyme inhibitor, 62.8%; anti-smoking counseling, 53.3%; and timely reperfusion, 62.5%. Of all participants, 12.0% underwent an invasive strategy in 24h and 50.0% in 72h. Door-to-ECG time was 68.3±104.3 min and door-to-balloon time, 122±54.5 min.
Conclusions:
health care protocols are required to standardize practice and improve these indicators.
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01-01-2016
Quality of working life of call-center workers
Revista Brasileira de Enfermagem. 2016;69(4):751-756
Abstract
Quality of working life of call-center workers
Revista Brasileira de Enfermagem. 2016;69(4):751-756
DOI 10.1590/0034-7167.2016690419i
Views0See moreABSTRACT
Objective:
to analyze the profile and quality of working life (QWL) of call-center workers.
Method:
quantitative research, conducted in one call-center of the city of São José do Rio Preto – SP, using the QVP-35 questionnaire.
Results:
profile was composed by: 80.2% women; 66.3% were single, with high school diploma and 6 hours of daily working hours; mean age of 28 years; 92.9% had only one job with mean working experience of 3 years. Positive aspects of QWL: intrinsic motivation, working ability, available resources and social support. Negative aspects of QWL: workload and organizational support.
Conclusion:
the data obtained indicate the need for better organization of call-center working processes in the company and suggests other researches in this context.
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01-01-2016
Stressors perceived by patients in the immediate postoperative of cardiac surgery
Revista Brasileira de Enfermagem. 2016;69(4):741-750
Abstract
Stressors perceived by patients in the immediate postoperative of cardiac surgery
Revista Brasileira de Enfermagem. 2016;69(4):741-750
DOI 10.1590/0034-7167.2016690418i
Views0See moreABSTRACT
Objective:
to investigate stressors perceived by patients in the immediate postoperative of cardiac surgery and their association with sociodemographic and clinical characteristics.
Method:
a prospective correlational study conducted in a city in São Paulo, between August 2013 and December 2014. A non-probabilistic sample included patients submitted to their first coronary artery bypass graft or mitral valve surgery. The “Environmental Stressor Questionnaire” adapted to Portuguese was used.
Results:
105 patients participated in the study. The item “being thirsty” was evaluated as the most stressful and “the nursing staff member does not introduce himself/herself by the name” as the least stressful. Among sociodemographic and clinical variables (gender, age, type and time of surgery, pain, intubation time, use of psychotropic medications and length of stay in the intensive care unit), only pain presented a significant association with the stressors.
Conclusion:
knowing stressors can help implement practices associated with their reduction, favoring patients’ recovery.
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01-01-2016
Concepts and practices of teaching and exercise of leadership in Nursing
Revista Brasileira de Enfermagem. 2016;69(4):733-740
Abstract
Concepts and practices of teaching and exercise of leadership in Nursing
Revista Brasileira de Enfermagem. 2016;69(4):733-740
DOI 10.1590/0034-7167.2016690417i
Views0See moreABSTRACT
Objective:
to identify, describe and analyze characteristics of leadership, head nurses and participants in the teaching-learning process of leadership in Nursing, according to nurse professors who performed studies on this theme and taught such content between 1972 and 1994 in nursing schools of the state of São Paulo, southeastern Brazil.
Methods:
Thematic Oral History was used. A total of four nurse professors were interviewed, whose reports were submitted to content analysis.
Results:
the following aspects were approached in this study: the context in which students developed leadership, the influence of previous experiences on leadership qualification, its attributes, the importance of leadership, the value of teaching it, the possibilities of emancipation of a head nurse, the repercussions of teaching leadership for one’s professional life, the relationships between qualification and job market, the aspects of teaching qualification and students’ characteristics.
Conclusion:
although not essential for nursing qualification, leadership had a symbolic capital.
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01-01-2015
Ineffective airway clearance: accuracy of clinical indicators in asthmatic children
Revista Brasileira de Enfermagem. 2015;68(5):862-868
Abstract
Ineffective airway clearance: accuracy of clinical indicators in asthmatic children
Revista Brasileira de Enfermagem. 2015;68(5):862-868
DOI 10.1590/0034-7167.2015680514i
Views0See moreABSTRACT
Objective:
to analyze the accuracy measurements of clinical indicators of the nursing diagnosis Ineffective airway clearance.
Method:
cross-sectional study with 205 asthmatic children treated in the emergency unit of a hospital in the city of Fortaleza, Ceará. An interview script and pulmonary evaluation were used for data collection.
Results:
the diagnosis of Ineffective airway clearance was present in 89.3% of the sample. The most prevalent clinical indicators were dyspnea, change in respiratory rate, change in respiratory rhythm, orthopnea, adventitious respiratory sounds and ineffective cough. The clinical indicators with highest sensitivity were dyspnea, change in respiratory rate, change in respiratory rhythm, orthopnea and adventitious respiratory sounds. Ineffective cough and adventitious respiratory sounds were the indicators with best specifi city.
Conclusion:
the clinical indicator adventitious respiratory sounds was the best predictor of Ineffective airway clearance in asthmatic children treated in emergency units.
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01-01-2015
Mortality from external causes in Pernambuco, 2001-2003 and 2011-2013
Revista Brasileira de Enfermagem. 2015;68(5):855-861
Abstract
Mortality from external causes in Pernambuco, 2001-2003 and 2011-2013
Revista Brasileira de Enfermagem. 2015;68(5):855-861
DOI 10.1590/0034-7167.2015680513i
Views0See moreABSTRACT
Objective:
to describe the mortality from external causes, by Health Regions in Pernambuco, during the periods of2001-2003 and 2011-2013.
Method:
descriptive study with data from the Mortality Information System. For data analysis we used percentage, percentage variation and proportion ratio.
Results:
mortality from external causes reduced in Pernambuco, however, mortality increased in some health regions of the countryside. Increased numbers of deaths from accidents and event of undetermined intent were registered. There was an increase of deaths classified as “other/unspecified” event of undetermined intent.
Conclusion:
there was a change in the spatial distribution of mortality from external causes moving to Pernambuco countryside regions. We found necessity for data classification regarding deaths from external causes and strengthening of the monitoring.
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01-01-2015
Evaluation of scientific production, patents and human resources training in the Brazilian nursing
Revista Brasileira de Enfermagem. 2015;68(5):846-854
Abstract
Evaluation of scientific production, patents and human resources training in the Brazilian nursing
Revista Brasileira de Enfermagem. 2015;68(5):846-854
DOI 10.1590/0034-7167.2015680512i
Views0See moreABSTRACT
Objective:
to evaluate scientifi c production, patents and human resources training of nursing researchers with scholarships of research productivity (PQ) in National Counsel for Technological and Scientific Development (CNPq) in the 2000-2012 historic series; to verify the association between this production and characteristics of the researchers regarding gender, education and origin.
Methods:
this analytic cross-sectional study whose inclusion criterion was to be a nursing PQ/CNPq researcher during the period in question. We analyzed curriculum lattes of 208 researchers with scholarships between 2000 and 2012. For statistical analyses we used the SPSS® software.
Results:
the study points to female predominance, concentration in the Southeast region and existence of an association between scientific production, patents and human resources training and education, gender and origin of the researcher.
Conclusion:
the study presents a significant participation of nursing PQ/CNPq researchers in scientific production and in human resources training, and a modest involvement in the production of patents.
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01-01-2015
Structure, process and outcomes of organ and tissue donation for transplantation
Revista Brasileira de Enfermagem. 2015;68(5):837-845
Abstract
Structure, process and outcomes of organ and tissue donation for transplantation
Revista Brasileira de Enfermagem. 2015;68(5):837-845
DOI 10.1590/0034-7167.2015680511i
Views0See moreABSTRACT
Objective:
to analyze the factors related to the structure, process and outcomes of organ and tissue donation for transplantation.
Method:
analytic, longitudinal and quantitative study, conducted in six hospitals in Natal/RN, between August 2010 and February 2011, with 65 potential donors (PD), by means of no participant observation structured script.
Results:
regarding the donation structure, there was deficiencies of physical resources (temperature control), materials (mobile radiology) human resources (nurse technicians) and lack of adequate records and care protocols. In the process of donation, the biggest problems were related to the evaluation stages, brain death diagnosis, maintenance and documentation, with greater proportion of care for the non-donor.
Conclusion:
the structure and process possibly determined the result of 72.3% no donation implementation of potential donors, indices compatible with the national data, but contradictory to those of Spain, which manages to transplant organs of 86.7% of its donors.
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01-01-2015
The nurse in the area of collective health: conceptions and competencies
Revista Brasileira de Enfermagem. 2015;68(5):830-836
Abstract
The nurse in the area of collective health: conceptions and competencies
Revista Brasileira de Enfermagem. 2015;68(5):830-836
DOI 10.1590/0034-7167.2015680510i
Views0See moreABSTRACT
Objective:
to learn coordinators and professors’ conceptions from undergraduate Nursing courses of public universities in northern Brazil regarding collective health and to know the necessary competencies to work in the area.
Method:
data were collected through semi-structured interviews and subjected to thematic analysis.
Results:
the participants consider population health as an essential area for the training of nurses, where professionals have autonomy and confidence. It is an interdisciplinary, intersectoral and multidisciplinary field, with extensive scope, that studies the Unified Health System (SUS). The competencies to work in collective health identified were: to work at the SUS, to understand the health and disease process and its determinants and to develop actions towards integrality, to conduct health education, researches and systematization of the nursing care.
Conclusion:
the variety of conceptions about collective health among participants might reflect in training of nurses and their working area.
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01-01-2015
Level of dependence among patients in a surgical unit
Revista Brasileira de Enfermagem. 2015;68(5):824-829
Abstract
Level of dependence among patients in a surgical unit
Revista Brasileira de Enfermagem. 2015;68(5):824-829
DOI 10.1590/0034-7167.2015680509i
Views0See moreABSTRACT
Objective:
to identify the complexity of the nursing care of inpatient surgical unit patients, using the Perroca patients classification scale.
Method:
a descriptive, cross-sectional study with 546 reviews of 187 patients between October and December of 2012. Data were analyzed using SPSS 18.0 and the Kappa test, to measure interrater agreement.
Results:
a predominance of patients in the categories of semi-intensive (46.5%) and intermediate care (44.0%) was found, with a prevalence of unassisted bath (58.4%) in the total sample, and bed bath (69.3%) in the semi-intensive care patients. The level of agreement between two pairs of raters was considered good.
Conclusion:
the systematic application of the instrument was useful as a complementary measure of the level of patient dependence, and may contribute to the improvement of the working process, refl ecting on management decision-making with regard to nursing workload
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01-01-2015
Psychological violence in the nursing work
Revista Brasileira de Enfermagem. 2015;68(5):817-823
Abstract
Psychological violence in the nursing work
Revista Brasileira de Enfermagem. 2015;68(5):817-823
DOI 10.1590/0034-7167.2015680508i
Views0See moreABSTRACT
Objective:
to investigate and characterize psychological violence practices within teams in the relationship between patients, caregivers and other professionals with the nursing staff of the public hospital network of Caxias, in the State of Maranhão, Brazil.
Method:
descriptive, quantitative, cross-sectional study with data collected by form between November/2013-May/2014.
Results:
verbal aggression is the most common psychological violence subtype 95% (84), followed by bullying 27% (24). Emergency rooms 51% (45) are the most frequent place; patients 60% (53) are the main aggressors; nurses 76% (19) suffer more violence, being mostly female, young and inexperienced.
Conclusion:
the largest number of occurrences was of verbal aggression perpetrated by patients against nurses in the emergency room. Workers try to pretend that nothing happened or are inert in the face of violence. Employers do little about the case, referring to the need for strategies to control violence.
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01-01-2015
Dietary intake and stress in patients with acute coronary syndrome
Revista Brasileira de Enfermagem. 2015;68(5):810-816
Abstract
Dietary intake and stress in patients with acute coronary syndrome
Revista Brasileira de Enfermagem. 2015;68(5):810-816
DOI 10.1590/0034-7167.2015680507i
Views0See moreABSTRACT
Objective:
to assess whether dietary intake of patients with acute coronary syndrome (ACS) meets national and international recommendations and whether there is a relationship with the levels of stress.
Method:
a cross-sectional study with 150 patients with ACS, who were interviewed with the Food Frequency Questionnaire and the Perceived Stress Scale-10.
Results:
daily intake above the recommendations: cholesterol (92%), fiber (42.7%) and protein (68%); intake below the recommendations: potassium (88%) and carbohydrates (68.7%); intake according to the recommendations: sodium (53.3%) and lipids (53.3%). Most patients with inadequate dietary intake (54%) were stressed or highly stressed. There was a signifi cant association between a lower stress level and a higher fi ber intake.
Conclusion:
in patients with ACS, dietary intake did not meet the guideline recommendations, and a lower fi ber intake occurs concomitantly with higher stress levels. Educational efforts can support patients in dietary intake adequacy and stress control.
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