-
ORIGINAL ARTICLE11-22-2024
Safe practices for prevention and management of antineoplastic agent extravasation: development of an educational video
Revista Brasileira de Enfermagem. 2024;77(5):e20240172
Abstract
ORIGINAL ARTICLESafe practices for prevention and management of antineoplastic agent extravasation: development of an educational video
Revista Brasileira de Enfermagem. 2024;77(5):e20240172
DOI 10.1590/0034-7167-2024-0172
Views0ABSTRACT
Objectives:
to develop, validate, and evaluate an educational video on the prevention and management of antineoplastic agent extravasation, aimed at nursing professionals.
Methods:
this methodological study was developed according to Falkembach’s theoretical framework, which outlines five phases in the production of educational video materials: analysis and planning, modeling, implementation, evaluation, and distribution.
Results:
content validation demonstrated agreement above the minimum threshold stipulated. The overall Content Validity Index was 90.8%, and it was 94.2% among the content and technical evaluation judges, respectively. The target audience evaluated the video positively, highlighting the importance of the content, the clarity of the language used, and the understanding of the information pertinent to the topic.
Conclusions:
the video proved to be an appropriate strategy for instructing interventions on the prevention and management of extravasation, with the potential to improve educational practices among nursing professionals.
Keywords:Antineoplastic AgentsEducational TechnologyExtravasation of Diagnostic and Therapeutic MaterialsInstructional Film and VideoNursingSee more -
REVIEW11-22-2024
Telenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
Abstract
REVIEWTelenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
DOI 10.1590/0034-7167-2024-0093
Views1See moreABSTRACT
Objective:
to identify telenursing contributions in Primary Health Care during the COVID-19 pandemic.
Methods:
an integrative literature review, conducted between January and August 2022 in the PubMed, CINAHL, LILACS, BDENF, Scopus, WoS, EMBASE and SciELO databases. A total of 493 studies was found, 62 were read in full, and of these, 16 were selected. For analysis, a dynamic reading of the studies and synthesis of the main results were carried out.
Results:
the main results highlighted telenursing practice as a challenge for professionals and the population. Among the contributions and positive points and aspects that require improvement, practice showed promise when considered in a post-pandemic scenario.
Final considerations:
through telenursing, the population’s access to Primary Health Care was guaranteed in the face of the COVID-19 pandemic. However, a critical look at current technological advances in healthcare is necessary.
-
ORIGINAL ARTICLE11-22-2024
Percepções de pessoas com deficiência física sobre acessibilidade e condições sociais: intervenções para enfermagem de reabilitação
Revista Brasileira de Enfermagem. 2024;77(5):e20240005
Abstract
ORIGINAL ARTICLEPercepções de pessoas com deficiência física sobre acessibilidade e condições sociais: intervenções para enfermagem de reabilitação
Revista Brasileira de Enfermagem. 2024;77(5):e20240005
DOI 10.1590/0034-7167-2024-0005
Views0RESUMEN
Objetivos:
analizar las experiencias de personas con discapacidad física adquirida en cuanto a accesibilidad y condiciones sociales; identificar intervenciones de rehabilitación dirigidas por enfermeras para la accesibilidad y condiciones sociales; determinar indicadores sensibles a la enfermería para mejorar la accesibilidad y condiciones sociales.
Métodos:
estudio cualitativo descriptivo-exploratorio utilizó entrevistas semiestructuradas con personas con discapacidad física adquirida mediante muestreo intencionado en bola de nieve para cumplir con todos los objetivos. El análisis de datos siguió los principios del análisis de contenido de Bardin. Los objetivos 2 y 3 se lograron mediante un enfoque teórico reflexivo.
Resultados:
los 27 participantes informaron desafíos de accesibilidad, que impactan las actividades de la vida diaria y las condiciones sociales. Esto influye en la enfermería de rehabilitación, dando lugar a tres campos de intervención: Evaluar la capacidad para realizar actividades diarias y los factores que influyen; Desarrollar e implementar capacitación para la realización de actividades diarias; Promover la movilidad, la accesibilidad y la participación social.
Consideraciones Finales:
a partir de las experiencias de los participantes, identificamos intervenciones de rehabilitación dirigidas por enfermeras para promover la accesibilidad y condiciones sociales.
Keywords:Acessibilidade ArquitetónicaCondições SociaisEnfermagem em ReabilitaçãoObjetivos de Desenvolvimento SustentávelPessoas com DeficiênciaSee more -
ORIGINAL ARTICLE11-22-2024
Rondas a beira leito no ambiente hospitalar na perspectiva de equipes multiprofissionais de saúde
Revista Brasileira de Enfermagem. 2024;77(5):e20230493
Abstract
ORIGINAL ARTICLERondas a beira leito no ambiente hospitalar na perspectiva de equipes multiprofissionais de saúde
Revista Brasileira de Enfermagem. 2024;77(5):e20230493
DOI 10.1590/0034-7167-2023-0493
Views0RESUMEN
Objetivo:
Analizar la configuración de las relaciones de poder entre el equipo multiprofesional en el proceso de rondas de cabecera en el hospital.
Método:
Investigación cualitativa con datos analizados a través del análisis del discurso, basado en el marco teórico de Michel Foucault. De septiembre a diciembre de 2022, realizamos entrevistas y observaciones de campo con el equipo multiprofesional de un hospital de Belo Horizonte, Minas Gerais, Brasil, así como entrevistas cualitativas semiestructuradas con 37 profesionales.
Resultados:
Los participantes señalaron que las experiencias de los profesionales involucrados en las rondas de cabecera dependen de cómo el médico conduce el proceso, y el proceso centrado en el médico dificulta la participación de otros profesionales del equipo.
Consideraciones finales:
La forma en que los hospitales organizan las rondas de cabecera no promueve la articulación del conocimiento de sus profesionales. Además, dificulta la circulación del poder y perjudica el trabajo interdisciplinario en un proceso que mantiene al médico como actor principal de las decisiones clínicas.
Keywords:Conhecimentos, Atitudes e Prática em SaúdeEquipe de Assistência MultidisciplinarHospitaisPrática ProfissionalRelações InterprofissionaisSee more -
ORIGINAL ARTICLE11-22-2024
Bedside rounds in the hospital environment from the perspective of multiprofessional health teams
Revista Brasileira de Enfermagem. 2024;77(5):e20230493
Abstract
ORIGINAL ARTICLEBedside rounds in the hospital environment from the perspective of multiprofessional health teams
Revista Brasileira de Enfermagem. 2024;77(5):e20230493
DOI 10.1590/0034-7167-2023-0493
Views0ABSTRACT
Objective:
To analyze the configuration of power relations among the multiprofessional team in the bedside round process in the hospital.
Methods:
Qualitative research with data analyzed through discourse analysis, based on Michel Foucault’s theoretical framework. From September to December 2022, we conducted interviews and field observations with the multiprofessional team at a hospital in Belo Horizonte, Minas Gerais, Brazil, as well as qualitative, semi-structured interviews with 37 professionals.
Results:
The participants pointed out that the experiences of the professionals involved in bedside rounds depend on how the physician conducts the process, and the physician-centered process makes it difficult for other professionals in the team to participate.
Final considerations:
The way hospitals organize bedside rounds does not promote knowledge articulation for their professionals. It hinders the circulation of power and harms interdisciplinary work in a process that maintains the physician as the main actor in clinical decisions.
Keywords:Health Knowledge, Attitudes, PracticeHospitalsInterprofessional RelationsPatient Care TeamProfessional PracticeSee more -
REVIEW11-22-2024
Transition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
Abstract
REVIEWTransition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
DOI 10.1590/0034-7167-2023-0487
Views1See moreABSTRACT
Objectives:
to identify and summarize the elements that characterize the family transition process in relation to the first child.
Methods:
a scoping review was carried out based on JBI methodology, in six databases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results:
ten articles were included with factors characterizing the transition, such as hindering/facilitating conditions that influence the process, important support structures in adaptation and strategies/responses used in the transition process.
Final Considerations:
elements characterizing the transition process in relation to the first child were identified. However, no theoretical explanation for this was identified. Further research should be carried out to obtain a deeper understanding of this process.
-
RESEARCH01-01-2016
Prevalence and factors associated with frailty in non-institutionalized older adults
Revista Brasileira de Enfermagem. 2016;69(3):435-442
Abstract
RESEARCHPrevalence and factors associated with frailty in non-institutionalized older adults
Revista Brasileira de Enfermagem. 2016;69(3):435-442
DOI 10.1590/0034-7167.2016690304i
Views0See moreABSTRACT
Objective:
to investigate the prevalence and factors associated with frailty in non-institutionalized older adults living in northern Minas Gerais, Brazil.
Method:
data were collected in their homes, in 2013, based on a census cluster sampling. Demographic and socioeconomic variables, morbidities, utilization of health care services, and scores on the Edmonton Fragility Scale were analyzed. The adjusted prevalence ratios were obtained using the Poisson regression multiple analysis with robust variance.
Results:
the prevalence of frailty was 41.3%. The variables associated with frailty were: female gender, very old age, education of less than four years, not having been hospitalized in the last 12 months, having a caregiver, falling in the prior year, diabetes mellitus, cardiac disease, and osteoarticular disease.
Conclusion:
the prevalence of frailty was high. Some factors consist of modifiable conditions, which should encourage health actions aimed at this group.
-
RESEARCH01-01-2016
“To be a nurse”: a professional choice and the construction of identity processes in the 1970s
Revista Brasileira de Enfermagem. 2016;69(3):428-434
Abstract
RESEARCH“To be a nurse”: a professional choice and the construction of identity processes in the 1970s
Revista Brasileira de Enfermagem. 2016;69(3):428-434
DOI 10.1590/0034-7167.2016690303i
Views0See moreABSTRACT
Objective:
to analyze the factors that influenced the choice for nursing made by graduates from the first class of the Undergraduate Nursing and Obstetrics Course of the Federal University of Rio Grande do Norte in the 1970s and to understand the senses and meanings of being a nurse when choosing this profession.
Method:
a qualitative socio-historical study was performed, using oral history to collect data.
Results:
the analysis generated the following categories: “To be a nurse: a professional choice” and “The ideal of being a nurse: senses and meanings”. The senses of “being a nurse” are associated with graduates’ perspective of this profession and the meanings included the traditional conceptions that have historically affected it.
Conclusion:
professional choice was influenced by family and work expectations and the nursing course had an effect on the construction of nurses’ professional identity.
-
EDITORIAL01-01-2016
The challenges of USA nursing education to meet local, regional and global need
Revista Brasileira de Enfermagem. 2016;69(3):417-418
Abstract
EDITORIALThe challenges of USA nursing education to meet local, regional and global need
Revista Brasileira de Enfermagem. 2016;69(3):417-418
DOI 10.1590/0034-7167.2016690301i
Views1The National League for Nursing (NLN), the voice for nursing education, is committed to the education of an exemplary nursing workforce that values and incorporates the richness of difference and inclusion to advance the health of the nation and the global community. With its population of over 320 million people, the United States of America […]See more -
EDITORIAL01-01-2016
As dificuldades do ensino de enfermagem dos Estados Unidos para atender necessidades locais, regionais e globais
Revista Brasileira de Enfermagem. 2016;69(3):417-418
Abstract
EDITORIALAs dificuldades do ensino de enfermagem dos Estados Unidos para atender necessidades locais, regionais e globais
Revista Brasileira de Enfermagem. 2016;69(3):417-418
DOI 10.1590/0034-7167.2016690301i
Views0A Liga Nacional de Enfermagem (NLN, National League for Nursing), a voz do ensino de enfermagem, está comprometida com o preparo de profissionais de enfermagem exemplares que valorizam e incorporam a riqueza das diferenças e a inclusão com vistas à evolução da saúde da nação e da comunidade global. Com sua população acima de 320 […]See more -
REVIEW01-01-2016
Interventions that facilitate adherence to Pap smear exam: integrative review
Revista Brasileira de Enfermagem. 2016;69(2):404-414
Abstract
REVIEWInterventions that facilitate adherence to Pap smear exam: integrative review
Revista Brasileira de Enfermagem. 2016;69(2):404-414
DOI 10.1590/0034-7167.2016690226i
Views0See moreABSTRACT
Objective:
to identify scientific productions showing relevant interventions to implement the Cervical Uterine Cancer Prevention Program increasing adherence to exams.
Method:
integrative literature review through an online search in the following databases: LILACS, SciELO, and PubMed® comprising articles published from 2009 to 2014.
Results:
thirty-eight articles made up the study’s final sample. Results showed the following interventions: use of case manager; telephone call; invitation letter; educational activities; media outreach work; community health agents; partnerships; population database screening; and multiple interventions.
Conclusion:
studies are mainly focused on women from developing countries and interventions are efficacious to increase women’s knowledge about and adherence to prevention of cervical uterine cancer.
-
RESEARCH01-01-2016
Anxiety in the preoperative period of heart surgery
Revista Brasileira de Enfermagem. 2016;69(2):397-403
Abstract
RESEARCHAnxiety in the preoperative period of heart surgery
Revista Brasileira de Enfermagem. 2016;69(2):397-403
DOI 10.1590/0034-7167.2016690225i
Views0See moreABSTRACT
Objective:
to characterize the patients’ anxiety in the preoperative period of heart surgery.
Method:
We conducted a cross-sectional study in which 106 patients, between one and five days from the date of surgery, were interviewed using a socio-demographic questionnaire and the Beck Anxiety Inventory.
Results:
The evaluated patients accounted for 59.4% (63) in minimal anxiety and 19.8% (21) in the range considered severe, and the sample had a mean in the mild anxiety level (15.8±19.79). The women had scores (22.13±23.41) significantly (p=0.003) higher than men (10.76±14.71); as well as patients who had undergone previous heart surgery (24.4±28.05 X 13.14±15.74). There was no significant difference between older adults and younger patients, nor in terms of weight variations, presence of diabetes, or alcoholism.
Conclusion:
We reinforces the importance of nurses in recognizing the preoperative anxiety and intervene through strategies of health education and nursing visits.
-
EDITORIAL09-04-2023
Chronicity in the 21st century: facing the challenges of a changing society
Revista Brasileira de Enfermagem. 2023;76(4):e760401
Abstract
EDITORIALChronicity in the 21st century: facing the challenges of a changing society
Revista Brasileira de Enfermagem. 2023;76(4):e760401
DOI 10.1590/0034-7167.2023760401
Views0Currently, there is an increase in non-communicable diseases (NCDs), population aging and changes in lifestyle, which corroborates the increase in chronicity, one of the greatest challenges faced by contemporary society. In this editorial, we will examine chronicity in the 21st century and the need to address this problem in a comprehensive and sustainable way.In recent […]See more -
ORIGINAL ARTICLE09-04-2023
Impact of an educational intervention on standard precautions during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(4):e20220750
Abstract
ORIGINAL ARTICLEImpact of an educational intervention on standard precautions during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(4):e20220750
DOI 10.1590/0034-7167-2022-0750
Views0See moreABSTRACT
Objective:
To evaluate the impact of an educational intervention on the knowledge of nursing professionals regarding standard precautions.
Methods:
This is an almost experimental study conducted with 100 nursing professionals. Data collection was performed using a sociodemographic characterization instrument and the Standard Precautions Knowledge Questionnaire. The educational intervention was based on five moments, where the approach to questions with less than 70% accuracy was intensified.
Results:
There was a significant difference between the scores of healthcare professionals before (16.20 ± 1.51) and after (16.90 ± 1.31) the educational intervention (W=3.336; p < 0.05). Regarding knowledge about hand hygiene after glove use, an increase in knowledge from 83% to 93% was obtained.
Conclusions:
A positive effect on the professionals’ knowledge was recorded, demonstrating advances regarding the strengthening of already acquired knowledge and the understanding of new knowledge.
-
ORIGINAL ARTICLE09-04-2023
Financial toxicity in people with chronic kidney disease undergoing hemodialysis treatment
Revista Brasileira de Enfermagem. 2023;76(4):e20220671
Abstract
ORIGINAL ARTICLEFinancial toxicity in people with chronic kidney disease undergoing hemodialysis treatment
Revista Brasileira de Enfermagem. 2023;76(4):e20220671
DOI 10.1590/0034-7167-2022-0671
Views0See moreABSTRACT
Objective:
to assess the financial toxicity of people with chronic kidney disease undergoing hemodialysis treatment.
Method:
a descriptive analytical cross-sectional study, carried out with 214 people, between February and May 2022. For data collection, a sociodemographic and clinical instrument and the COmprehensive Score for financial Toxicity were used. For analysis, the Odds Ratio, ANOVA and Cronbach’s alpha tests were used.
Results:
the mean financial toxicity score was 20.30. Women with a monthly family income of at most two minimum wages are more likely to have some degree of financial toxicity (Odds Ratio: 0.85; 0.76).
Conclusion:
financial toxicity was identified to different degrees and varied according to sociodemographic and clinical characteristics. Measuring financial toxicity can help nurses plan care and develop strategies to avoid interrupting treatment.
-
ORIGINAL ARTICLE09-04-2023
Content validity evidence of the Brazilian version of the Cognitive Symptom Checklist-Work-21
Revista Brasileira de Enfermagem. 2023;76(4):e20220453
Abstract
ORIGINAL ARTICLEContent validity evidence of the Brazilian version of the Cognitive Symptom Checklist-Work-21
Revista Brasileira de Enfermagem. 2023;76(4):e20220453
DOI 10.1590/0034-7167-2022-0453
Views0See moreABSTRACT
Objective:
to cross-culturally adapt and assess the content validity evidence of the Cognitive Symptom Checklist-Work-21 for the Brazilian context.
Method:
a psychometric study of cross-cultural adaptation, covering the stages of translation, reconciliation, back-translation, intercultural equivalence assessment and content validity evidence analysis, considering Content Validity Ratio parameters in breast cancer survivors.
Results:
the translations were equivalent to the original version. Colloquial expressions were modified, tense, verbal adjusted, and two items containing multiple commands were separated. The final version now contains 22 items, presenting semantic, conceptual, idiomatic and experimental equivalences. The pre-test indicated good understanding and ease in the response process.
Conclusion:
the final version was defined as “Lista de verificação de sintomas cognitivos relacionados ao trabalho – 22 itens”, showing good linguistic equivalence and strong evidence of content validity in the Brazilian context.
-
ORIGINAL ARTICLE08-21-2023
Percepciones, maltrato y religión como predictores del impacto psicoemocional en enfermeros durante la pandemia COVID-19
Revista Brasileira de Enfermagem. 2023;76(3):e20220768
Abstract
ORIGINAL ARTICLEPercepciones, maltrato y religión como predictores del impacto psicoemocional en enfermeros durante la pandemia COVID-19
Revista Brasileira de Enfermagem. 2023;76(3):e20220768
DOI 10.1590/0034-7167-2022-0768es
Views0See moreRESUMEN
Objetivos:
analizar la relación entre percepciones, maltrato y religión con el impacto psicoemocional en enfermeros durante la pandemia por covid-19.
Métodos:
estudio transversal descriptivo-analítico. Fue realizado entre los años 2020 y 2021; se encuestó a 319 enfermeros asistenciales de Perú mediante DASS-21; se evaluaron asociaciones mediante Rho de Spearman y regresión múltiple.
Resultados:
el 18,5 % presentó algún grado de estrés; el 50,2 %, ansiedad y el 29,1 %, depresión. La experiencia de maltrato, la autopercepción de la salud mental y la religión fueron predictores de estrés, ansiedad y depresión. El tiempo de experiencia laboral predice el estrés y ansiedad. Además, la autopercepción de la información y el género fueron predictores de la depresión.
Conclusiones:
los enfermeros peruanos presentaron altos niveles de estrés, ansiedad y depresión; y este impacto psicoemocional estuvo asociado a las percepciones, experiencias de maltrato y la religión.
-
ORIGINAL ARTICLE08-21-2023
Perceptions, maltreatment and religion as predictors of the psycho-emotional impact on nurses during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(3):e20220768
Abstract
ORIGINAL ARTICLEPerceptions, maltreatment and religion as predictors of the psycho-emotional impact on nurses during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(3):e20220768
DOI 10.1590/0034-7167-2022-0768
Views0See moreABSTRACT
Objectives:
to analyze the relationship between perceptions, abuse and religion with the psycho-emotional impact on nurses during the COVID-19 pandemic.
Methods:
descriptive-analytical cross-sectional study. It took place between 2020 and 2021 and a total of 319 clinical nurses in Peru were interviewed using the DASS-21. Associations were assessed using Spearman’s Rho and multiple regression.
Results:
18.5% had some degree of stress; 50.2%, anxiety and 29.1%, depression. Experience of abuse, self-perception of mental health and religion were predictors of stress, anxiety and depression. The length of work experience predicts stress and anxiety. In addition, self-perception of information and gender were predictors of depression.
Conclusions:
peruvian nurses have high levels of stress, anxiety and depression, and this psycho-emotional impact was associated with perceptions, experiences of abuse and religion.
-
ORIGINAL ARTICLE08-21-2023
Assessment of the Psychosocial Care Center multidisciplinary team from users’ and family members’ perspective
Revista Brasileira de Enfermagem. 2023;76(3):e20220645
Abstract
ORIGINAL ARTICLEAssessment of the Psychosocial Care Center multidisciplinary team from users’ and family members’ perspective
Revista Brasileira de Enfermagem. 2023;76(3):e20220645
DOI 10.1590/0034-7167-2022-0645
Views0ABSTRACT
Objectives:
to assess the multidisciplinary team of a Psychosocial Care Center I from users’ and family members’ perspective.
Methods:
an evaluative study, anchored in the fourth generation evaluation theoretical-methodological framework, carried out in a Psychosocial Care Center I, from September 2021 to March 2022. Eleven users and 06 family members participated. Data were collected through non-participant observation, individual interviews and negotiation sessions, and analyzed using the Constant Comparative Method, using the MAXQDA software.
Results:
the team develops its care based on individual and collective care, with integrated and complementary work by professionals. They seek to facilitate treatment initiation and continuation, considering health needs and offering support, understanding and guidance to users and their families.
Final Considerations:
the multidisciplinary team’s work is based on the psychosocial paradigm, which can qualify care and strengthen the service role in the mental health network.
Keywords:Health Services EvaluationMental DisordersMental Health ServicesPatient Care TeamProfessional-Family RelationsSee more -
ORIGINAL ARTICLE08-21-2023
Effectiveness of educational intervention among seropositive women about knowledge about HIV sexual transmission
Revista Brasileira de Enfermagem. 2023;76(3):e20220371
Abstract
ORIGINAL ARTICLEEffectiveness of educational intervention among seropositive women about knowledge about HIV sexual transmission
Revista Brasileira de Enfermagem. 2023;76(3):e20220371
DOI 10.1590/0034-7167-2022-0371
Views0See moreABSTRACT
Objectives:
to assess the effectiveness of a group and telephone educational intervention with seropositive women about knowledge about HIV sexual transmission prevention.
Methods:
a quasi-experimental before-and-after study, carried out with 151 women living with HIV in a Specialized Care Service in a Brazilian capital. The educational intervention was carried out in three moments, with the assessment being carried out before the first and after the last moment.
Results:
97.4% of study participants were cisgender women aged between 18 and 58 years; 55.6% considered themselves brown; and 32.5% of interviewees had elementary school. Regarding knowledge about HIV sexual transmission, in 78.5% of items, there was an association (p<0.005) with increased participants’ knowledge after receiving the intervention.
Conclusions:
the educational intervention helped to increase the knowledge of women living with HIV about the sexual transmission of the infection.
Search
Search in:
Nuvem de Tags
Aged (144) Atenção Primária à Saúde (239) COVID-19 (104) Cuidados de Enfermagem (269) Educação em Enfermagem (151) Educação em Saúde (139) Enfermagem (930) Estudos de Validação (131) Health Education (144) Idoso (208) Mental Health (149) Nursing (987) Nursing Care (306) Patient Safety (151) Primary Health Care (284) Qualidade de Vida (104) Quality of Life (106) Saúde Mental (145) Segurança do Paciente (150) Validation Studies (108)