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ORIGINAL ARTICLE01-10-2024
Nursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
Abstract
ORIGINAL ARTICLENursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
DOI 10.1590/0034-7167-2023-0459
Views0See moreABSTRACT
Objectives:
to identify how first-year nursing students use cyberspace and propose an orientation guide with criteria guiding the use of cyberspace.
Methods:
qualitative and descriptive research, carried out with 24 nursing students from a federal public institution in Rio de Janeiro. Data collection was carried out through semi-structured interviews. Data analysis occurred using IRAMUTEQ®. The research was approved by the institution’s Research Ethics Committee.
Results:
students use cyberspace to communicate, study, find “cool things”, share photos and memories. Furthermore, they are concerned about hate speech, intolerance and fake news. The good and bad sides and the types of technologies most used were also portrayed.
Final considerations:
the moral and ethical values of physical coexistence, together with awareness of individual responsibility, are the pillars for using cyberspace. The guide comes as an awareness tool.
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ORIGINAL ARTICLE01-10-2024
Maternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
Abstract
ORIGINAL ARTICLEMaternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
DOI 10.1590/0034-7167-2022-0576
Views0See moreABSTRACT
Objective:
to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection.
Method:
qualitative research with an ethnographic approach, developed in two women’s prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category.
Results:
three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization.
Final Considerations:
the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.
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ORIGINAL ARTICLE01-10-2024
Self-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
Abstract
ORIGINAL ARTICLESelf-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
DOI 10.1590/0034-7167-2024-0289
Views0See moreABSTRACT
Objective:
to analyze occurrence of self-harm, sociodemographic profile of victims and referrals in the first 24 months of the COVID-19 pandemic in São Paulo.
Method:
cross-sectional study carried out by the Notifiable Diseases Information System with data on self-harm in São Paulo. The period outlined was March 2020 to February 2022. R (4.0.2) software and chi-square test were used.
Results:
there were 15,946 incidents. Victims were young, white, single, heterosexual women. There was high incidence of people with previous mental disorders more than once and without clear motivation. The method used was poisoning/intoxication. There was a considerable number of referrals to the health network, although not totalitarian.
Conclusion:
the years of greater insecurity in relation to the pandemic have given rise to self-harm cases with peculiar characteristics. Agile health policies must be applied in atypical conditions, such as pandemics, especially for adolescents/young people with previous mental disorders.
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REVIEW01-10-2024
Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
Abstract
REVIEWHealth of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
DOI 10.1590/0034-7167-2024-0106
Views0See moreABSTRACT
Objective:
to map the literature on quilombola children’s health and its relationship with the Sustainable Development Goals.
Method:
a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework.
Results:
eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed.
Final considerations:
the study provided an extremely important mapping of the theme of quilombola children’s health and themes related to the Sustainable Development Goals.
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REVIEW01-10-2024
Prevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
Abstract
REVIEWPrevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
DOI 10.1590/0034-7167-2024-0052
Views0See moreABSTRACT
Objectives:
To identify in the scientific literature the prevalence, diagnostic methods, and exposure variables of latent infection by Mycobacterium tuberculosis in healthcare workers.
Methods:
An integrative review of the scientific literature based on the following review question: What are the available scientific evidence in the literature that address the prevalence of latent infection by Mycobacterium tuberculosis in healthcare workers and its association with possible risk factors among these workers?
Results:
Being a physician or nurse, being older, and being male were generally associated with higher prevalences. The study also showed that interferon-gamma release assays were more commonly used as a diagnostic method compared to skin tests.
Conclusions:
More studies are needed regarding the epidemiology of latent infection by Mycobacterium tuberculosis in the context of healthcare workers, aiming for higher impact actions that contribute to the reduction of tuberculosis worldwide.
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ORIGINAL ARTICLE12-04-2023
Effect of cardiovascular biofeedback on nursing staff stress: a randomized controlled clinical trial
Revista Brasileira de Enfermagem. 2023;76(6):e20230069
Abstract
ORIGINAL ARTICLEEffect of cardiovascular biofeedback on nursing staff stress: a randomized controlled clinical trial
Revista Brasileira de Enfermagem. 2023;76(6):e20230069
DOI 10.1590/0034-7167-2023-0069
Views0See moreABSTRACT
Objective:
to assess the effect of cardiovascular biofeedback on nursing staff stress when compared to an activity without self-monitoring.
Method:
a randomized controlled clinical trial, carried out with nursing professionals from a university hospital. The intervention group (n=58) performed cardiovascular biofeedback, and the control (n=57) performed an online puzzle without self-monitoring, totaling nine meetings over three weeks. The outcome was assessed using the Stress Symptoms and Work-Related Stress scales, and the biological marker heart rate variability. The generalized estimating equations method was used.
Results:
the intervention had no effect on self-reported instruments (p>0.050). However, there was an effect of time (p<0.050) on all heart rate variability indicators, demonstrating changes over the sessions.
Conclusion:
cardiovascular biofeedback showed promising results in the biological marker, suggesting that it can be used in nursing staff as a complementary therapy by promoting better autonomic nervous system regulation.
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Transition of Care for Individuals with Mental Disorders in Brazil: A Contextual Analysis
Revista Brasileira de Enfermagem. 2023;76(6):e20230063
Abstract
Transition of Care for Individuals with Mental Disorders in Brazil: A Contextual Analysis
Revista Brasileira de Enfermagem. 2023;76(6):e20230063
DOI 10.1590/0034-7167-2023-0063
Views0See moreABSTRACT
Objective:
To describe the contexts of care transition for individuals with mental disorders in the Brazilian setting.
Methods:
A contextual analysis was conducted through a scoping review. The search for studies was conducted in databases and thesis and dissertation portals, and the analysis was based on immediate, specific, general, and meta-contexts.
Results:
The sample, consisting of eight studies, indicated that the following factors are present in the contexts where care transition occurs: Peculiarities of care transition for individuals with mental disorders; Perspectives that can strengthen or weaken this transition; Approaches proposed in the past for the development of care transition; and Elements related to Brazilian legislation.
Final Considerations:
It is observed that the transition of care for individuals with mental disorders in Brazil takes place in various contexts of care levels. These variations present significant potentials and barriers in the care scenarios.
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ORIGINAL ARTICLE12-04-2023
Feelings about birth by a group of high-risk pregnant women
Revista Brasileira de Enfermagem. 2023;76(6):e20230059
Abstract
ORIGINAL ARTICLEFeelings about birth by a group of high-risk pregnant women
Revista Brasileira de Enfermagem. 2023;76(6):e20230059
DOI 10.1590/0034-7167-2023-0059
Views0See moreABSTRACT
Objective:
to understand feelings about birth among a group of high-risk pregnant women.
Method:
a descriptive and qualitative study, using Alfred Schütz’s social phenomenology as a philosophical theoretical framework. The study included 25 pregnant women undergoing high-risk prenatal care. The interview had the following guiding questions: tell me about your feelings regarding the moment of birth/childbirth; How do you deal with the high-risk diagnosis? What are your expectations for birth/childbirth?
Results:
five categories emerged: Fear of obstetric care; Fear of complications with the baby; Fear of cesarean section; Resilience in the face of high-risk pregnancy; and Expectations for birth.
Considerations:
high-risk pregnant women are afraid of the care they will receive, the risks and concern about the baby’s vitality at birth. The importance of care is emphasized, with a welcoming environment, bonding and communication between health team and pregnant woman.
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Sobrecarga entre cuidadores cônjuges e não cônjuges de idosos dependentes por AVC: estudo longitudinal
Revista Brasileira de Enfermagem. 2023;76(6):e20230052
Abstract
Sobrecarga entre cuidadores cônjuges e não cônjuges de idosos dependentes por AVC: estudo longitudinal
Revista Brasileira de Enfermagem. 2023;76(6):e20230052
DOI 10.1590/0034-7167-2023-0052
Views0See moreRESUMEN
Objetivo:
evaluar la carga de los cuidadores conyugales y no conyugales de ancianos con dependencia inducida por ictus después del alta de la Unidad de Atención Especializada en Ictus de un hospital del sur de Brasil.
Métodos:
una encuesta longitudinal, con 48 cuidadores (20 cónyuges). Datos fueron recolectados entre mayo/2016 y julio/2018. Una semana después del alta, se aplicó la Medida de Independencia Funcional a los ancianos y la Caregiver Burden Scale a los cuidadores. Los datos se analizaron mediante análisis multivariado de varianza.
Resultados:
en tiempo 1, los cónyuges experimentaron mayor carga en relación al aislamiento social (p=0,01). Los cónyuges sintieron una tensión general y sensación de aislamiento mucho mayor (p=0,01; p=0,04).
Conclusión:
las diferencias estadísticamente significativas en la carga a lo largo del tiempo resaltan la importancia de evaluar la carga del cuidador después del alta y la necesidad de un programa de apoyo formal.
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ORIGINAL ARTICLE12-04-2023
A longitudinal study of burden among spouse and non-spouse caregivers of older adults with stroke-induced-dependency
Revista Brasileira de Enfermagem. 2023;76(6):e20230052
Abstract
ORIGINAL ARTICLEA longitudinal study of burden among spouse and non-spouse caregivers of older adults with stroke-induced-dependency
Revista Brasileira de Enfermagem. 2023;76(6):e20230052
DOI 10.1590/0034-7167-2023-0052
Views0See moreABSTRACT
Objective:
to assess the burden of spouse and non-spouse caregivers of older adults with stroke-induced-dependency after discharge from a university hospital’s Specialized Care Stroke Unit in southern Brazil.
Methods:
a longitudinal survey. The sample consisted of 48 consenting caregivers, among which 20 were spouse caregivers. Data were collected between May 2016 and July 2018. One week after discharge, caregivers completed a sociodemographic profile, the Functional Independence Measure, and the Caregiver Burden Scale. Burden was also measured two months after discharge. Data were analyzed using Multivariate Analyses of Variance.
Results:
regarding time 1, non-spouse caregivers experienced greater burden with respect to social isolation (p = .01). Along with a persistently greater sense of isolation (p=.04), non-spouse caregivers felt far greater general strain (p =.01).
Conclusion:
statistically significant differences in burden over time highlight the importance of assessing caregiver burden after discharge and the need for a formal support program.
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Simulation training of caregivers at hospital discharge of patients with chronic diseases: an integrative review
Revista Brasileira de Enfermagem. 2023;76(6):e20230043
Abstract
Simulation training of caregivers at hospital discharge of patients with chronic diseases: an integrative review
Revista Brasileira de Enfermagem. 2023;76(6):e20230043
DOI 10.1590/0034-7167-2023-0043
Views0See moreABSTRACT
Objective:
to identify evidence about the use and effects of clinical simulation for preparing caregivers for discharging patients with chronic conditions.
Methods:
an integrative peer review in the Scopus, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, ScienceDirect and Virtual Health Library databases, from July to September 2022.
Results:
3,218 studies were identified, with a final sample consisting of four national and two international articles. Using simulation as an educational technology contributed to caregiver preparation in home care. In most studies, using clinical simulation included using other strategies to complement training: expository dialogued class, conversation circle and audiovisual resources.
Final considerations:
simulation proved to be efficient for training caregivers, with the active participation of family members and nurses in health education actions.
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Alterações na composição corporal de pacientes queimados durante as fases de resposta ao trauma
Revista Brasileira de Enfermagem. 2023;76(6):e20230039
Abstract
Alterações na composição corporal de pacientes queimados durante as fases de resposta ao trauma
Revista Brasileira de Enfermagem. 2023;76(6):e20230039
DOI 10.1590/0034-7167-2023-0039
Views0RESUMEN
Objetivo:
evaluar alteraciones en la composición corporal de pacientes quemados mediante bioimpedancia eléctrica en las fases de respuesta al trauma.
Métodos:
estudio observacional longitudinal, realizado de octubre de 2019 a marzo de 2020. Se recogieron datos sociodemográficos, clínicos, epidemiológicos, antropométricos y de composición corporal. El análisis estadístico se realizó mediante SPSS, considerando una significancia del 5%. La comparación entre variables se realizó mediante la prueba de la t de Student pareada.
Resultados:
la muestra estuvo compuesta por 58 pacientes adultos quemados, con una edad media de 38,2±12,5 años. El área de superficie corporal media (ASC) con quemaduras fue de 10,8±7,3%. La evaluación nutricional mostró disminución del peso corporal, índice de masa corporal, masa magra y masa muscular en las fases de respuesta al trauma (p<0,005).
Conclusión:
los cambios metabólicos en las diferentes fases de la respuesta metabólica al trauma llevaron a la disminución del estado nutricional de los pacientes quemados de ambos sexos durante la hospitalización.
Keywords:Avaliação NutricionalComposição CorporalEstado NutricionalImpedância BioelétricaQueimadurasSee more -
ORIGINAL ARTICLE12-04-2023
Changes in body composition of burn patients during the phases of response to trauma
Revista Brasileira de Enfermagem. 2023;76(6):e20230039
Abstract
ORIGINAL ARTICLEChanges in body composition of burn patients during the phases of response to trauma
Revista Brasileira de Enfermagem. 2023;76(6):e20230039
DOI 10.1590/0034-7167-2023-0039
Views0See moreABSTRACT
Objective:
To assess the changes in body composition of burn patients through electrical bioimpedance in the phases of response to trauma.
Methods:
a longitudinal observational study, carried out from October 2019 to March 2020. Sociodemographic, clinical, epidemiological, anthropometric and body composition data were collected. Statistical analysis was performed with SPSS, considering a significance of 5%. The comparison between variables was performed using the paired Student’s t test.
Results:
the sample consisted of 58 adult burn patients, with a mean age of 38.2±12.5 years. The mean body surface area (BSA) with burns was 10.8±7.3%. Nutritional assessment demonstrated a depletion of body weight, Body Mass Index, fat-free mass and muscle mass in the phases of response to trauma (p<0.005).
Conclusion:
metabolic alterations in the different phases of the metabolic response to trauma led to a depletion of the nutritional status of burn patients of both sexes during hospitalization.
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Stimulus-response time to alarms of the intra-aortic balloon pump: safe care practices
Revista Brasileira de Enfermagem. 2017;70(6):1206-1211
Abstract
Stimulus-response time to alarms of the intra-aortic balloon pump: safe care practices
Revista Brasileira de Enfermagem. 2017;70(6):1206-1211
DOI 10.1590/0034-7167-2016-0432
Views0See moreABSTRACT
Objective:
To characterize the sound alarms of the Intra-Aortic Balloon Pump (IABP) during aortic counterpulsation therapy; to measure the stimulus-response time of the team to these; and to discuss the implications of increasing this time for patient safety from the alarm fatigue perspective.
Method:
This is an observational and descriptive study with quantitative and qualitative approach, case study type, carried out in a Cardiac Surgical Intensive Care Unit.
Results:
The most audible IABP alarm was the one of high priority increased-reduced diastolic blood pressure. The stimulus-response time was 33.9 seconds on average.
Conclusion:
Managing the alarms of these equipment is essential to minimize the occurrence of the alarm fatigue phenomenon and to offer a safer assistance to patients who rely on this technology.
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Possibilities of care for serodiscordant couples for HIV who got pregnant
Revista Brasileira de Enfermagem. 2017;70(6):1199-1205
Abstract
Possibilities of care for serodiscordant couples for HIV who got pregnant
Revista Brasileira de Enfermagem. 2017;70(6):1199-1205
DOI 10.1590/0034-7167-2016-0344
Views0See moreABSTRACT
Objective:
Understanding the meaning of pregnancy for heterosexual couples facing serodiscordant situation for HIV, aiming at construction of care possibilities based on subjectivity.
Method:
Phenomenological research, theoretical-philosophical-methodological framework by Martin Heidegger. Research was conducted in a University Hospital in the countryside of Southern Brazil, from September 2013 to May 2014 through a phenomenological interview, with participation of eleven couples.
Results:
For the couples, pregnancy is part of life when they wish to have a child, even when one or both of them already have children from previous relationships. In addition, it is part of life when they consider the risks and do not want to have children in such circumstances anymore, but it happened unexpectedly.
Conclusion:
Understanding reproductive needs and demands of these couples is an aid for qualification and improvement of care as a contribution to nursing care planning towards reproductive health of these couples.
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Interactive Theory of Breastfeeding: creation and application of a middle-range theory
Revista Brasileira de Enfermagem. 2017;70(6):1191-1198
Abstract
Interactive Theory of Breastfeeding: creation and application of a middle-range theory
Revista Brasileira de Enfermagem. 2017;70(6):1191-1198
DOI 10.1590/0034-7167-2016-0523
Views0See moreABSTRACT
Objective:
To describe a breastfeeding theory based on King’s Conceptual System.
Method:
Theoretical study that used analysis of concept, assertion synthesis, and derivation of theory for the creation of a new theory.
Results:
King’s system components were associated with elements of the breastfeeding process and a middle-range theory was created, which describes, explains, predicts, and prescribes breastfeeding by analyzing factors that precede and affect it, as well as their consequences on the breastfeeding process.
Conclusion:
The Breastfeeding Interactive Model is abstract enough to be applied in different social, cultural, political, and economic contexts, because it conceptualizes breastfeeding in systemic, dynamic, and procedural aspects. Based on a conceptual model of nursing, it contributes to the scientific construction of the subject; however it can also potentially be applied by other professionals involved in breastfeeding assistance.
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Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods
Revista Brasileira de Enfermagem. 2017;70(6):1176-1183
Abstract
Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods
Revista Brasileira de Enfermagem. 2017;70(6):1176-1183
DOI 10.1590/0034-7167-2016-0608
Views0ABSTRACT
Objective:
to assess the correlation among the ATP-bioluminescence assay, visual inspection and microbiological culture in monitoring the efficiency of cleaning and disinfection (C&D) of high-touch clinical surfaces (HTCS) in a walk-in emergency care unit.
Method:
a prospective and comparative study was carried out from March to June 2015, in which five HTCS were sampled before and after C&D by means of the three methods. The HTCS were considered dirty when dust, waste, humidity and stains were detected in visual inspection; when ≥2.5 colony forming units per cm2 were found in culture; when ≥5 relative light units per cm2 were found at the ATP-bioluminescence assay.
Results:
720 analyses were performed, 240 per method. The overall rates of clean surfaces per visual inspection, culture and ATP-bioluminescence assay were 8.3%, 20.8% and 44.2% before C&D, and 92.5%, 50% and 84.2% after C&D, respectively (p<0.001). There were only occasional statistically significant relationships between methods.
Conclusion:
the methods did not present a good correlation, neither quantitative nor qualitatively.
Keywords:Equipment ContaminationHealth Facility EnvironmentHousekeepingInfectious Disease TransmissionNursing AuditSee more -
Cultural adaptation of The End-Stage Renal Disease Adherence Questionnaire for hemodialysis patients
Revista Brasileira de Enfermagem. 2017;70(6):1169-1175
Abstract
Cultural adaptation of The End-Stage Renal Disease Adherence Questionnaire for hemodialysis patients
Revista Brasileira de Enfermagem. 2017;70(6):1169-1175
DOI 10.1590/0034-7167-2016-0519
Views0ABSTRACT
Objective:
To describe the stages in the cultural adaptation of “The End-Stage Renal Disease Adherence Questionnaire” for use in Brazil.
Method:
A descriptive, transversal study with a quantitative approach. The cultural adaptation followed the steps of translation, professional committee, back translation, panel of patients and pretest.
Results:
the translation stage created a version in Portuguese that was analyzed by specialists, who suggested alterations in the title, seven sentences in the questions and three sets of answers. In the panel of patients phase, two questions were altered. The back translation considered the original characteristics of the instrument were maintained, likewise there were no modifications in the pretest phase. The third version written in Portuguese was considered to be the final version of the questionnaire.
Conclusion:
this instrument should facilitate nursing care management in hemodialysis, enabling the monitoring of adherence among these patients and also contribute to improving the indicators of morbidity and mortality.
Keywords:Adherence to MedicationChronic Renal InsufficiencyHemodialysisNephrology NursingPatient CooperationSee more -
Revalidation of game for teaching blood pressure auscultatory measurement: a pilot study
Revista Brasileira de Enfermagem. 2017;70(6):1159-1168
Abstract
Revalidation of game for teaching blood pressure auscultatory measurement: a pilot study
Revista Brasileira de Enfermagem. 2017;70(6):1159-1168
DOI 10.1590/0034-7167-2016-0578
Views0ABSTRACT
Objective:
To adapt a pre-existing educational game, making it specific to the teaching of blood pressure auscultatory measurement, and to apply this game in a pilot study.
Method:
The original game cards were altered by the authors and submitted to content validation by six experts in the field. After redesigns, the game was applied to 30 subjects, who answered a questionnaire (pre-test and post-test) on auscultatory measurement. Data were analyzed descriptively and by the paired Student’s t-test and paired Wilcoxon test.
Results:
Throughout the content validation process, 17 of the 28 original cards were modified. Of these 17 cards, 13 obtained 80% agreement, and the rest were modified according to the judges’ suggestions. The obtained grades significantly increased between pre- and the post-test.
Conclusion:
It was concluded that the reformulated game presented satisfactory evidence of content validity. Its use as a teaching-learning method was effective for this sample.
Keywords:Determination of Blood PressureEducation in NursingEducational TechnologyExperimental GamesGames and ToysSee more -
Validation of Family Management Measure for the Brazilian culture
Revista Brasileira de Enfermagem. 2017;70(6):1151-1158
Abstract
Validation of Family Management Measure for the Brazilian culture
Revista Brasileira de Enfermagem. 2017;70(6):1151-1158
DOI 10.1590/0034-7167-2016-0326
Views0See moreABSTRACT
Etjective:
To validate the Family Management Measure (FaMM) for Brazilian culture.
Method:
Quantitative research excerpt, following the recommendations for validation studies. The data presented refer to the last stage of the process.
Results:
The internal consistency of the items was analyzed through Cronbach’s alpha of the six domains: Child’s Daily Life (0.78); Condition Management Effort (0.51); Condition Management Ability (0.55); Family Life Difficulty (0.86); View of Condition Impact (0.56); and Parental Mutuality (0.80). Exploratory factorial analysis of the instrument was carried out, obtaining an acceptable adjustment, according to validation standards.
Conclusion:
The FaMM presents evidence of validation and can be used in the Brazilian culture under the name of Instrumento de Medida de Manejo Familiar, which was adjusted in eight domains, providing varied aspects of family management and a good evaluation of the fundamental aspects of family life in the context of childhood chronic conditions.
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