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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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Nurses’ managerial knowledge in the hospital setting
Revista Brasileira de Enfermagem. 2016;69(4):676-683
Abstract
Nurses’ managerial knowledge in the hospital setting
Revista Brasileira de Enfermagem. 2016;69(4):676-683
DOI 10.1590/0034-7167.2016690409i
Views0See moreABSTRACT
Objective:
to analyze nurses’ managerial skills in the hospital setting, their perception of their own education and the relevance of training for their professional practice.
Method:
qualitative study based on the dialectical hermeneutics framework. Thirty-two nurses from three hospitals in the Brazilian state of Minas Gerais contributed to the study by taking part in six focus groups. Records were transcribed and three categories emerged from content analysis.
Results:
results evidenced the following managerial skills: supervision, leadership, decision making, planning and organization, as well as the relevance of education centers for their improvement and the continuing development of the nurses’ managerial skills.
Conclusion:
the authors believe this investigation will contribute for the improvement of nurses’ necessary managerial skills and also to identify gaps in this area of their education.
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Analysis of obstetric care provided by the Mobile Emergency Care Service
Revista Brasileira de Enfermagem. 2016;69(4):669-675
Abstract
Analysis of obstetric care provided by the Mobile Emergency Care Service
Revista Brasileira de Enfermagem. 2016;69(4):669-675
DOI 10.1590/0034-7167.2016690408i
Views1ABSTRACT
Objective:
analyze the pertinence of calls made by obstetric users of the Mobile Emergency Care Service (SAMU 192) of Botucatu-SP.
Method:
retrospective and analytical research. All records of prehospital obstetric care delivered by the SAMU 192 in 2012 were analyzed. To be considered responsive, calls should lead to referral to a reference obstetric hospital or be classified with the colors red, orange and yellow, according to risk criteria defined by the Ministry of Health.
Results:
considering the two outcomes evaluated: referral to a reference hospital and risk criteria defined by the Ministry of Health, 6.7% and 75.6% of the calls were not pertinent, respectively. There was no matching between outcomes, neither variation between primiparas and multiparas as regards the call pertinence.
Conclusion:
this study ratifies the need for implementing a risk classification protocol in obstetrics, and support managers in the organization, qualification and effective implementation of the Rede Cegonha.
Keywords:Emergence Medical ServicesEmergency NursingObstetric NursingPregnant WomenPrehospital ServicesSee more -
Experiences with severe maternal morbidity: a qualitative study on the perception of women
Revista Brasileira de Enfermagem. 2016;69(4):662-668
Abstract
Experiences with severe maternal morbidity: a qualitative study on the perception of women
Revista Brasileira de Enfermagem. 2016;69(4):662-668
DOI 10.1590/0034-7167.2016690407i
Views0See moreABSTRACT
Objective:
to know and analyze the experiences of women who developed an episode of Severe Maternal Morbidity.
Method:
this is a qualitative study, in which we interviewed 16 women admitted to a tertiary level hospital, as a result of this morbid state. We used content analysis in data processing.
Results:
two categories were identified: “Understanding maternal morbidity as a negative presence” and “Moving ahead: on constant alert”. The interviewees mentioned negative aspects, such as treatment difficulties and hospitalization, feelings of fear, concern for the fetus, frustration with the idealized pregnancy, trauma; and positive aspects, such as learning and the expression of the divine will in the experience of illness.
Conclusion:
effective care during the prenatal period, delivery and postpartum period should provide adequate support for the prevention and assistance in Severe Maternal Morbidity.
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Dialogue: network that intertwines the pedagogical relationship into the practical-reflective teaching
Revista Brasileira de Enfermagem. 2016;69(4):654-661
Abstract
Dialogue: network that intertwines the pedagogical relationship into the practical-reflective teaching
Revista Brasileira de Enfermagem. 2016;69(4):654-661
DOI 10.1590/0034-7167.2016690406i
Views0See moreABSTRACT
Objective:
to understand how dialogue occurs in the pedagogical relation in the practical reflective teaching in an undergraduate program in nursing.
Method:
qualitative research, case study. Data collection was conducted from May 2013 to September 2014 with eight professors of Nursing, by means of observation and interviews. Data analysis followed the operational proposal constituted by the exploratory stage and the interpretive stage.
Results:
point the dialogue established within the pedagogical relation as a challenge to be faced in practical-reflective teaching, so professor and student build a relationship that foster thought and action in the theoretical context and in the field of practice.
Conclusion:
in establishing a dialogic-reflective tone in the pedagogical relationship, the professor opens paths to new discoveries, enabling the creation of teaching-learning spaces that stimulate autonomy, abilities, and critical and reflective attitudes of students along their education.
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Nursing care through the perception of hospitalized children
Revista Brasileira de Enfermagem. 2016;69(4):646-653
Abstract
Nursing care through the perception of hospitalized children
Revista Brasileira de Enfermagem. 2016;69(4):646-653
DOI 10.1590/0034-7167.2016690405i
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Objective:
to describe the perception of hospitalized children of school age, on nursing care and understand what are, from their perspective, the best ways to address it to when performing such care.
Method:
qualitative, descriptive, exploratory research, with concepts of Vygotsky used as theoretical framework. The data collection occurred through interviews mediated by drawings and was performed with ten school children, with the interview later transcribed and submitted to a thematic analysis.
Results:
showed the importance of playing during hospitalization, of a friendly and caring approach and providing explanations regarding the performed procedures.
Conclusion:
nursing professionals need to consider how the children would like to receive the care being provided, so that their singularities are respected, characterizing nursing actions according to a perspective of the whole human being.
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Cost of dressings for prevention of sacral pressure ulcers
Revista Brasileira de Enfermagem. 2016;69(4):641-645
Abstract
Cost of dressings for prevention of sacral pressure ulcers
Revista Brasileira de Enfermagem. 2016;69(4):641-645
DOI 10.1590/0034-7167.2016690404i
Views0See moreABSTRACT
Objective:
to identify costs of dressings to prevent sacral pressure ulcers in an adult intensive care unit in Paraná, Brazil.
Methods:
secondary analysis study with 25 patients admitted between October 2013 and March 2014, using transparent polyurethane film (n=15) or hydrocolloid dressing (n=10) on the sacral region. The cost of each intervention was based on the unit amount used in each type of dressing, and its purchase price (transparent film = R$15.80, hydrocolloid dressing = R$68.00).
Results:
the mean cost/patient was R$23.17 for use of transparent film and R$190.40 for use of hydrocolloid dressing. The main reason for changing the dressing was detachment.
Conclusion:
the transparent film was the most economically advantageous alternative to prevent sacral pressure ulcers in critical care patients. However, additional studies should be carried out including assessment of the effectiveness of both dressings.
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Health practices: the view of the black elderly population in a terreiro community
Revista Brasileira de Enfermagem. 2016;69(4):633-640
Abstract
Health practices: the view of the black elderly population in a terreiro community
Revista Brasileira de Enfermagem. 2016;69(4):633-640
DOI 10.1590/0034-7167.2016690403i
Views1See moreABSTRACT
Objective:
to understand health practices of black, elderly people in a terreiro community (community of followers of traditional African-Brazilian religions).
Method:
qualitative descriptive study under the Black-African paradigm of civilization constituted by the Black-African cultural complex and the structuring elements of the African cosmovision. Semi-structured interviews were carried out from July to September 2013, with six black older people from a terreiro community in Porto Alegre, RS.
Results:
thematic content analysis resulted in the following categories: Ancestry; Belonging: the way to know and practice health; Health knowledge and practices in terreiro communities; and Complementarity: promoting health in the terreiro and traditional medicine and its respective subcategories.
Conclusion:
the study understood the importance of having a knowledge of the practices of African traditions in both the lifestyle and health of the older black population to help with nursing planning and interventions in response to their needs.
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Social representations of citizenship by inpatients: implications for hospital care
Revista Brasileira de Enfermagem. 2016;69(4):625-632
Abstract
Social representations of citizenship by inpatients: implications for hospital care
Revista Brasileira de Enfermagem. 2016;69(4):625-632
DOI 10.1590/0034-7167.2016690402i
Views0See moreABSTRACT
Objective:
examine the social representations of citizenship by inpatients receiving hospital care.
Method:
qualitative approach, using the Theory of Social Representations as a framework, with 31 inpatients in the internal medicine sector of a public university hospital. Semi-structured interviews were conducted, whose data were submitted to the Alceste program, with application of lexical analysis.
Results:
patients understand their rights, and citizenship in the care process is understood based on the right to health, to receive good care from a technical and human standpoint.
Conclusion:
being well treated as a person and the provision of technical-procedural care are rights of patients; the absence of one or the other implies, therefore, lack of respect for their citizenship.
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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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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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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
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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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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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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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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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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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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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