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01-01-2015
Nursing actions in primary care and the control of diseases preventable through vaccines
Revista Brasileira de Enfermagem. 2015;68(5):803-809
Abstract
Nursing actions in primary care and the control of diseases preventable through vaccines
Revista Brasileira de Enfermagem. 2015;68(5):803-809
DOI 10.1590/0034-7167.2015680506i
Views0See moreABSTRACT
Objective:
to discuss the actions performed by nurses in the control and eradication of diseases preventable with vaccines in healthcare setting, according to the National Primary Health Care Policy.
Method:
qualitative research supported by the social phenomenology of Schutz. It had as its setting a Family Health Clinic, located in the city of Rio de Janeiro (Brazil), with ten nurses. The data collection occurred through interviews.
Results:
nurses’ actions aimed at the control and eradication of preventable diseases mainly involve updating a vaccination card, administering the vaccine, and guiding the user of the Health Unit, with the purpose of preventing diseases. The National Primary Care Policy and all manuals from the Ministry of Health recognize the importance of focusing on the service user.
Conclusion:
the user’s lifestyle must be considered, and his access to services aiming at the expansion of the control of diseases preventable with vaccines should be promoted.
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01-01-2015
Children with neuropsychomotor development delay: music therapy promoting quality of life
Revista Brasileira de Enfermagem. 2015;68(5):797-802
Abstract
Children with neuropsychomotor development delay: music therapy promoting quality of life
Revista Brasileira de Enfermagem. 2015;68(5):797-802
DOI 10.1590/0034-7167.2015680505i
Views0See moreABSTRACT
Objective:
to identify the influence of music therapy on the behavior and quality of life of children with neuropsychomotor development delay (NPMDD).
Method:
experimental research, with applications of music therapy (in a group of children) held in the specialized association in Cruz das Almas – Bahia, composed of 17 children with NPMDD aged 5 to 12 years. The behavior of children involving emotional, physical, social and school aspects was observed.
Results:
there was an evolution in all aspects, being this improvement significant to Emotional Capacity and School Capacity domains, showing the beneficial effects of music therapy.
Conclusion:
music therapy becomes a treatment option for children with NPMDD, improving their quality of life.
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01-01-2015
Spirituality, religion and personal beliefs of adolescents with cancer
Revista Brasileira de Enfermagem. 2015;68(5):791-796
Abstract
Spirituality, religion and personal beliefs of adolescents with cancer
Revista Brasileira de Enfermagem. 2015;68(5):791-796
DOI 10.1590/0034-7167.2015680504i
Views0See moreABSTRACT
Objective:
to examine adolescents’ perception about spirituality, religion and personal beliefs in their lives due to cancer and a possible strategy for coping with the disease.
Method:
qualitative research, both descriptive and exploratory. The data were collected by means of a personal semi-structured interview, and the categories were analyzed by content analyzes.
Results:
nine adolescents who were undergoing cancer treatment at one of the two institutions located Uberaba, Brazil, participated in the study. Based on the analysis and interpretation of results, it was possible to systematize them according to four categories: spiritual history of the individual; faith and belief; importance of spirituality in their lives, and the community acting as a spiritual supporter. Most adolescents referred to spirituality as being an important tool for dealing with the disease, especially concerning religious rituals and community support.
Conclusion:
spirituality creates hope for adolescents, which helps them to cope with cancer-related diffi culties and contribute to the search for the meaning of life.
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01-01-2015
Coping strategies of nursing students for dealing with university stress
Revista Brasileira de Enfermagem. 2015;68(5):783-790
Abstract
Coping strategies of nursing students for dealing with university stress
Revista Brasileira de Enfermagem. 2015;68(5):783-790
DOI 10.1590/0034-7167.2015680503i
Views0See moreABSTRACT
Objective:
to identify the coping strategies used by nursing students in a university in southern Brazil, establishing the relationship between the sociodemographic and academic variables examined.
Method:
an exploratory, descriptive, quantitative study, carried out with 146 nursing students, through application of the Coping Strategies Inventory. For the data analysis, descriptive statistics, analysis of variance and regression analysis were used.
Results:
it was found that the coping strategy most used by nursing students is escape. A connection was also detected between the academic dissatisfaction variable and the use of negative coping strategies.
Conclusion:
it was noted that students satisfi ed with the course used positive coping strategies targeting the problem, whereas dissatisfi ed students used negative strategies focusing on the emotion.
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01-01-2015
Unemployment and psychological distress in nurses
Revista Brasileira de Enfermagem. 2015;68(5):775-782
Abstract
Unemployment and psychological distress in nurses
Revista Brasileira de Enfermagem. 2015;68(5):775-782
DOI 10.1590/0034-7167.2015680502i
Views0See moreABSTRACT
Objective:
to assess psychological distress in nurses searching for their first job, especially symptoms of depression, and identify the factors that caused mental suffering, and how these nurses cope with the situation.
Method:
this was a qualitative study carried out with unemployed nurses who had graduated less than two years before the time of the study, and were residents of the town of Assis in the Brazilian state of São Paulo. Data were gathered by means of semi-structured interviews, content analysis, and application of the Beck Depression Inventory psychometric scale.
Results:
of the 14 nurses that participated, three had scores on the psychometric scale indicative of depression. Participants reported psychological distress related to unemployment, poor university education, and surplus labor due to the large number of graduates and lack of jobs, as well as a culture of employment centered on professionals’ social networks. The unemployed nurses did not have effective ways of coping.
Conclusion:
unemployment promoted psychological distress among the new nurses, especially symptoms of depression, without effective means of coping.
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01-01-2015
Newborn blood spot screening: to expand or not to expand?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
Abstract
Newborn blood spot screening: to expand or not to expand?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
DOI 10.1590/0034-7167.2015680501i
Views0“The principal constraint on what we can detect in newborn screening is fast becoming what we choose to detect: rather than what is limited for us by technical feasibility or cost”().Technological advances are providing the medical world an opportunity to extend the number of conditions newborn babies are screened for. Tandem mass spectrometry (TMS, also […]See more -
01-01-2015
Teste de triagem neonatal: expandir ou não expandir?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
Abstract
Teste de triagem neonatal: expandir ou não expandir?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
DOI 10.1590/0034-7167.2015680501i
Views0“A principal restrição sobre o que podemos detectar no teste de triagem neonatal está rapidamente se tornando o que escolhemos detectar em vez daquilo que nos é limitado por razão de viabilidade técnica ou custo”().Os avanços tecnológicos estão conferindo ao mundo médico uma oportunidade de aumentar o número de patologias para as quais os recém-nascidos […]See more -
01-01-2015
International Classification for Nursing Practice – ICNP®: application to the Brazilian reality
Revista Brasileira de Enfermagem. 2015;68(4):730-731
Abstract
International Classification for Nursing Practice – ICNP®: application to the Brazilian reality
Revista Brasileira de Enfermagem. 2015;68(4):730-731
DOI 10.1590/0034-7167.2015680422i
Views0The author and organizer, Telma Ribeiro Garcia, added her theoretical and practical knowledge to those of a dozen other authors for the creation of the book “International Classification for Nursing Practice – ICNP®: application to the Brazilian reality”. She is a retired professor of the Department of Public Health Nursing and Psychiatry at the Federal […]See more
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01-01-2016
Association between self-care and hospital readmissions of patients with heart failure
Revista Brasileira de Enfermagem. 2016;69(3):500-506
Abstract
Association between self-care and hospital readmissions of patients with heart failure
Revista Brasileira de Enfermagem. 2016;69(3):500-506
DOI 10.1590/0034-7167.2016690312i
Views0See moreABSTRACT
Objective:
to assess the association between self-care and the number of hospital readmissions of patients with heart failure (ADHF) and test the applicability of two self-care assessment tools. longitudinal study, performed in a cardiology reference hospital in southern Brazil.
Method:
it included 82 patients with a mean age of 61.85±12.33 years, 57.3% male. The mean score of self-care assessment found the scales European Heart Failure Self-care Behavior Scale and Self-care Scale for Patients with Heart Failure was unsatisfactory.
Results:
it was observed an average of 2.57±1.66 rehospitalization last year for decompensated heart failure. There was a correlation between self-care scores with the number of hospital readmissions for decompensated HF. Education and age were associated to self-care of HF patients.
Conclusion:
both scales assess self-care in a relevant way, and correlated their indexes.
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01-01-2016
Knowledge management in Portuguese healthcare institutions
Revista Brasileira de Enfermagem. 2016;69(3):492-499
Abstract
Knowledge management in Portuguese healthcare institutions
Revista Brasileira de Enfermagem. 2016;69(3):492-499
DOI 10.1590/0034-7167.2016690311i
Views0See moreABSTRACT
Objective:
to evaluate the perception of healthcare institution collaborators in relation to knowledge management in the institution where they operate and analyze the existence of differences in this perception, based on the institution’s management model.
Method:
a study conducted in a sample consisting of 671 collaborators from 10 Portuguese healthcare institutions with different models of management. In order to assess the knowledge management perception, we used a score designed from and based on items from the scores available in the literature.
Results:
the perception of moderate knowledge management on the healthcare institutions and the statistically significant differences in knowledge management perception were evidenced in each management model.
Conclusion:
management knowledge takes place in healthcare institutions, and the current management model determines the way staff at these institutions manage their knowledge.
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01-01-2016
Social impairment of patients undergoing hematopoietic stem cell transplant
Revista Brasileira de Enfermagem. 2016;69(3):484-491
Abstract
Social impairment of patients undergoing hematopoietic stem cell transplant
Revista Brasileira de Enfermagem. 2016;69(3):484-491
DOI 10.1590/0034-7167.2016690310i
Views0See moreABSTRACT
Objective:
to evaluate the impairment of social and emotional domains of hospitalized patients undergoing hematopoietic stem cells transplantation.
Method:
an observational, longitudinal study with 25 participants evaluated in the period of pre-transplant, pancytopenia and pre-hospital discharge between September 2013 and September 2014, in a reference hospital for this treatment modality in Brazil. Two international instruments were used, both of which translated and adapted to Portuguese (Brazil): Quality of Life Questionnaire-Core 30 and Functional Assessment Cancer Therapy – Bone Marrow Transplantation.
Results:
patients have shown a statistically significant decrease in the social domain, and stability of the emotional function along the course of treatment.
Conclusion:
hematopoietic stem cell transplantation changes the social function of patients with hematologic cancer during hospitalization stage. Thus, patients should receive guidance addressing the social domain in order that it can be less affected.
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01-01-2016
Frailty and quality of life in elderly primary health care users
Revista Brasileira de Enfermagem. 2016;69(3):478-483
Abstract
Frailty and quality of life in elderly primary health care users
Revista Brasileira de Enfermagem. 2016;69(3):478-483
DOI 10.1590/0034-7167.2016690309i
Views1See moreABSTRACT
Objective:
to investigate the association between physical frailty and quality of life in elderly users of primary health care in the capital of the state of Paraná.
Method:
a cross-sectional, quantitative study with 203 elders. Data collected included: physical activity questionnaires, weight loss, fatigue/exhaustion, quality of life, performance of gait speed tests, and handgrip strength.
Results:
of the 203 older adults, 115 were pre-frail, 49 were non-frail, and 39 were frail, with a significant association with functional capacity and quality of life in all groups. The dimensions resulting from physical aspects, pain, and vitality were associated with those that were non-frail.
Conclusion:
in this study, frailty syndrome was inversely proportional to the quality of life, and significantly associated with functional capacity of older adults. Physical frailty is a manageable condition which can be targeted through geriatric nursing interventions.
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01-01-2016
Impact of home visits on the functional capacity of patients with venous ulcers
Revista Brasileira de Enfermagem. 2016;69(3):468-477
Abstract
Impact of home visits on the functional capacity of patients with venous ulcers
Revista Brasileira de Enfermagem. 2016;69(3):468-477
DOI 10.1590/0034-7167.2016690308i
Views0See moreABSTRACT
Objective:
to assess the impact of protocol home visits on the functional capacity of adult and elderly patients with venous ulcers, before and after guidance received at home.
Method:
clinical experimental, randomized, nonblinded and controlled study, developed with 32 patients (case and control groups). Fields of research were the Wound Outpatient Care Unit of the Antônio Pedro University Hospital and households of patients treated in the outpatient unit. Data collection occurred from February to June 2014, by means of an assessment tool of the health care unit, the TINETTI index and a script for directions to be provided to study participants who received home visits.
Results:
participants in the case group showed significant and differentiated improvement post-intervention when compared to the control group, which remained stable.
Conclusion:
directions provided in the home context were beneficial to the members of the case group.
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01-01-2016
Pressure ulcers in critically ill patients: incidence and associated factors
Revista Brasileira de Enfermagem. 2016;69(3):460-467
Abstract
Pressure ulcers in critically ill patients: incidence and associated factors
Revista Brasileira de Enfermagem. 2016;69(3):460-467
DOI 10.1590/0034-7167.2016690307i
Views0See moreABSTRACT
Objective:
to identify the incidence and describe the associated factors for pressure ulcers in critically ill patients.
Method:
this was a prospective cohort study with 77 patients, using a clinical, metabolic assessment and the associated factors for pressure ulcer, applying the risk scales (Braden and Waterlow) and assigning ulcers to categories.
Results:
an incidence of 22% (95% CI 12.6 – 31.5), with 17 patients with 32 pressure ulcers in the sacral region (47%), and of Class I (72%). The length of stay was greater than ten days (71%), most admissions were surgical (53%) or for congestive heart failure (24%), and were high risk on the Braden Scale (59%).
Conclusion:
the study highlights the high incidence of pressure ulcers, clinical and metabolic characteristics and associated factors, as well as the outcome of death, requiring, therefore, preventive measures.
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01-01-2016
Accreditation in a public hospital: perceptions of a multidisciplinary team
Revista Brasileira de Enfermagem. 2016;69(3):451-459
Abstract
Accreditation in a public hospital: perceptions of a multidisciplinary team
Revista Brasileira de Enfermagem. 2016;69(3):451-459
DOI 10.1590/0034-7167.2016690306i
Views1See moreABSTRACT
Objective:
to analyze the perceptions of the multidisciplinary team on Accreditation in a public hospital.
Method:
descriptive, exploratory, qualitative research, performed in May 2014, using recorded individual interviews. In total, 28 employees of a public hospital, Accredited with Excellence, answered the guiding question: “Tell me about the Accreditation system used in this hospital”. The interviews were transcribed and subjected to content analysis.
Results:
of the speeches, three categories emerged: Advantages offered by the Accreditation; Accredited public hospital resembling a private hospital; Pride/satisfaction for acting in an accredited public hospital.
Conclusion:
participants perceived Accreditation as a favorable system for a quality management in the public service because it promotes the development of professional skills and improves cost management, organizational structure, management of assistance and perception of job pride/satisfaction.
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01-01-2016
Health status and the return to work after traffic accidents
Revista Brasileira de Enfermagem. 2016;69(3):443-450
Abstract
Health status and the return to work after traffic accidents
Revista Brasileira de Enfermagem. 2016;69(3):443-450
DOI 10.1590/0034-7167.2016690305i
Views0See moreABSTRACT
Objective:
to compare the health status of traffic accident victims, at hospital discharge and after six months, and to analyze the predictive variables of their health status and return to work.
Method:
observational, longitudinal study. Data were collected through interviews and medical records of 102 patients with a mean age of 33 years; with the majority being men and victims of motorcycle accidents. The variables were analyzed by means of validated tools, student’s t-test, multiple linear regression, and logistic regression.
Results:
there was an improvement of perception in the patients’ health status six months after hospital discharge and functional capacity. The individuals who returned to work showed better health-related quality of life evaluation.
Conclusion:
improvement of the perceived health status six months after hospital discharge was found. Factors that influenced the patients’ return to work were not identified.
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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
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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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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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