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ORIGINAL ARTICLE03-11-2024
Ethnically distinct populations and coping with violence against children in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230350
Abstract
ORIGINAL ARTICLEEthnically distinct populations and coping with violence against children in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230350
DOI 10.1590/0034-7167-2023-0350
Views0See moreABSTRACT
Objective:
To identify policies and programs adopted by a Brazilian municipality to address violence against children during the COVID-19 pandemic.
Method:
A qualitative documentary study. The study setting was the municipality of Ananindeua, Pará, Brazil. Data was collected from official websites between November 2021 and February 2022. Thematic content analysis was used with the support of webQDA software.
Results:
Three empirical categories emerged: a) Impacts of the COVID-19 pandemic on violence against children; b) Action strategies for tackling violence against children in the COVID-19 pandemic; c) Evaluation indicators and targets for action strategies for tackling violence against children.
Final considerations:
The documents revealed few direct mentions of children, especially traditional populations; they presented superficial and ineffective evaluations of the policies and programs adopted, using exclusively quantitative indicators.
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ORIGINAL ARTICLE03-11-2024
Experiences of women with physical disabilities in labor and delivery assistance
Revista Brasileira de Enfermagem. 2024;77:e20230290
Abstract
ORIGINAL ARTICLEExperiences of women with physical disabilities in labor and delivery assistance
Revista Brasileira de Enfermagem. 2024;77:e20230290
DOI 10.1590/0034-7167-2023-0290
Views0See moreABSTRACT
Objective:
To understand the meaning attributed by women with physical disabilities to the health care received and expected during labor and delivery.
Methods:
Qualitative study, based on Social Network Theory, conducted through an online workshop in April 2022, with the participation of six women with physical disabilities. Data, collected through the focus group technique, underwent thematic content analysis with the assistance of the IRaMuTeQ tool.
Results:
Three thematic categories emerged: Challenges experienced during pregnancy; The experience within the maternity ward; and, The importance of social networks. The assistance provided by healthcare professionals sometimes differed between what was expected and what was received by women with physical disabilities during labor and delivery.
Final Considerations:
Experiences were predominantly negative, resulting from inappropriate professional conduct due to ableist attitudes. Support from members of social networks is crucial for preventing stressors.
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03-11-2024
O uso da ultrassonografia point-of-care na prática clínica do enfermeiro como alicerce para a segurança do paciente
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
Abstract
O uso da ultrassonografia point-of-care na prática clínica do enfermeiro como alicerce para a segurança do paciente
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
DOI 10.1590/0034-7167.202477suppl0201pt
Views0Recentemente, mais um caso de dano grave associado ao cuidado em saúde foi reportado pela mídia. Uma jovem grávida teve a mão e o punho amputados depois de dar à luz ao terceiro filho em um hospital do Rio de Janeiro(). Após o incidente ocasionado pelo acesso vascular, a mulher apresentou hemorragia e foi reinternada.Os […]See more -
REVIEW03-11-2024
Continuing nursing education actions in the face of homophobia: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230094
Abstract
REVIEWContinuing nursing education actions in the face of homophobia: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230094
DOI 10.1590/0034-7167-2023-0094
Views0See moreABSTRACT
Objectives:
to analyze continuing nursing education actions in the scientific literature in the face of homophobia.
Methods:
an integrative literature review with structured search in June 2022 in eight databases, using the descriptors Nursing Education, Homophobia, Sexual and Gender Minorities. Final sample consisted of six primary studies.
Results:
continuing nursing education actions are supported by strategies such as use of teaching materials, lectures, case studies and focus groups, addressing content such as gender identity issues and affective-sexual orientation, health disparities and their relationship with homophobia in healthcare settings.
Final considerations:
carried out in various healthcare settings, continuing education actions proved to be successful in raising nurses’ awareness in facing homophobia in health services, however, their expansion is necessary to create health spaces that meet the specific needs of these people.
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03-11-2024
The use of point-of-care ultrasound in nurses’ clinical practice as a foundation for patient safety
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
Abstract
The use of point-of-care ultrasound in nurses’ clinical practice as a foundation for patient safety
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
DOI 10.1590/0034-7167.202477suppl0201
Views0Recently, another case of serious harm associated with healthcare was reported by the media. A young pregnant woman had her hand and wrist amputated after giving birth to her third child in a hospital in Rio de Janeiro(). After the incident caused by vascular access, the woman suffered hemorrhage and was readmitted.The harm caused to […]See more -
03-08-2024
A enfermagem como protagonista no enfrentamento da hesitação e recusa vacinal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
A enfermagem como protagonista no enfrentamento da hesitação e recusa vacinal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
DOI 10.1590/0034-7167.202477suppl101pt
Views0Desde a década de 1970, o Ministério da Saúde do Brasil instituiu o Programa Nacional de Imunização (PNI), que precedeu o Sistema Único de Saúde e que lhe foi incorporado e fortalecido, devido ao modelo descentralizado aos municípios, mas de comando único ao nível central. Seu objetivo era e ainda é coordenar as ações de […]See more -
03-08-2024
Nursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
Nursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
DOI 10.1590/0034-7167.202477suppl101
Views1Since the 1970s, the Brazilian Ministry of Health established the Brazilian National Immunization Program (PNI – Programa Nacional de Imunização), which preceded the Brazilian Health System and which was incorporated and strengthened due to the decentralized model to municipalities, but under single command at central level. Its objective was and still is to coordinate vaccination […]See more -
02-26-2024
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
Abstract
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
DOI 10.1590/0034-7167.2024770201
Views0The professional practice of patient navigation is incipient in Brazil and, therefore, a broad discussion with various sectors of society is essential, which is the main purpose of this editorial. Shall we start with the story.Patient navigation was defined in 1989 as a community-based service delivery intervention aimed at appropriately promoting access to diagnosis and […]See more
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ORIGINAL ARTICLE08-08-2022
Social and territorial inequalities in the mortality of children and adolescents due to COVID-19 in Brazil
Revista Brasileira de Enfermagem. 2022;75(6):e20210482
Abstract
ORIGINAL ARTICLESocial and territorial inequalities in the mortality of children and adolescents due to COVID-19 in Brazil
Revista Brasileira de Enfermagem. 2022;75(6):e20210482
DOI 10.1590/0034-7167-2021-0482
Views0See moreABSTRACT
Objective:
To analyze the mortality rate of COVID-19 among children and adolescents aged 0 to 14 years.
Methods:
Ecological and exploratory study of children’s mortality rate by COVID-19 in Brazil, from February to October 2020. The study used the Severe Acute Respiratory Syndrome database to collect the data and made the analysis using descriptive spatial statistics by age and race/color classification.
Result:
The mortality rate due to COVID-19 represented 1.34 deaths per one hundred thousand in the total group evaluated. The age group with the highest frequency and mortality rate was 1 to 4 years of age. There is a higher frequency of deaths in the brown and Indigenous population.
Conclusion:
The distribution of deaths due to COVID-19 is unequal in the national territory, and there is a wide variation in the mortality rate by age and race/color groups.
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ORIGINAL ARTICLE12-08-2023
Construction and validity of educational technology about the human papillomavirus vaccine for adolescents
Revista Brasileira de Enfermagem. 2023;76:e20230048
Abstract
ORIGINAL ARTICLEConstruction and validity of educational technology about the human papillomavirus vaccine for adolescents
Revista Brasileira de Enfermagem. 2023;76:e20230048
DOI 10.1590/0034-7167-2023-0048
Views1See moreABSTRACT
Objectives:
to construct and validate an educational technology in comic book format about the human papillomavirus vaccine aimed at adolescents.
Methods:
a methodological study, with a quantitative approach, through the agreement method. It was carried out in two phases: educational technology construction and content validity. Participants are expert judges in the health field. Data collection took place in a virtual environment, through a questionnaire. Data analysis was performed by calculating the Content Validity Index. A Content Validity Index of at least 80% was accepted.
Results:
the comic book’s overall Content Validity Index was 82%, reaching the minimum limit established to be validated.
Conclusions:
comics are fundamental in the teaching-learning process, aiming to catch adolescents’ attention. Therefore, it is characterized as a valid tool to inform, in a playful manner, about the human papillomavirus vaccine.
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ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
DOI 10.1590/0034-7167.20247701e03
Views2In the article “Nurses in the labor market: professional insertion, competencies and skills”, with DOI number: , published in Revista Brasileira de Enfermagem, 2017;70(6):1220-6, on page 1225:Include before REFERENCES:[…]See more -
ORIGINAL ARTICLE01-10-2024
Nursing care management strategies to address the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230254
Abstract
ORIGINAL ARTICLENursing care management strategies to address the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230254
DOI 10.1590/0034-7167-20230254
Views1See moreABSTRACT
Objective:
To characterize nursing care management strategies for addressing the COVID-19 pandemic.
Method:
A descriptive, qualitative study conducted with 22 nurse professionals at a University Hospital in Southern Brazil. Data collection through interviews in June and August 2021, analyzed according to Bardin’s Content Analysis and the theoretical framework of complex thinking.
Results:
The identified strategies were organized into four categories: Reorganization of health services; People management and emergency admission; Multiprofessional articulation; and Bedside nursing care.
Final Considerations:
Professional performance revealed a complex interplay between leadership and care management practices, even in the face of working condition restrictions, and were understood as crucial in the pandemic scenario.
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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
Views1See 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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01-01-2016
Nursing care in Specialized HIV/Aids Outpatient Services
Revista Brasileira de Enfermagem. 2016;69(3):515-521
Abstract
Nursing care in Specialized HIV/Aids Outpatient Services
Revista Brasileira de Enfermagem. 2016;69(3):515-521
DOI 10.1590/0034-7167.2016690314i
Views1See moreABSTRACT
Objective:
to analyze the discourses about the care provided by nurses operating in Specialized HIV/Aids Outpatient Services in four public institutions of the city of Fortaleza, Ceará, Brazil.
Method:
descriptive and exploratory study with a qualitative approach, which used as a method the discourse analysis.
Results:
when titling the “care as negative”, such title came from the analogy proposed by Freud (1912) with the photographic negative, represented by what that care can configure from the unconscious movement, since nurses did not perceive themselves in the care actions developed by supporting the work of other occupational categories, contributing to maintain the ideology of biomedicine.
Conclusion:
it is necessary to justify and theorize a nursing clinical practice from epistemological issues of the profession, in such a way that nurses can understand their relevance within the care provided.
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ORIGINAL ARTICLE04-16-2021
Practices used by a home care team: implications for caregivers
Revista Brasileira de Enfermagem. 2021;74(2):e20190794
Abstract
ORIGINAL ARTICLEPractices used by a home care team: implications for caregivers
Revista Brasileira de Enfermagem. 2021;74(2):e20190794
DOI 10.1590/0034-7167-2019-0794
Views0See moreABSTRACT
Objectives:
to analyze the practices of a home care team and their implications for caregivers’ performance.
Methods:
qualitative study with data obtained from observation of 21 users, 30 caregivers and 6 professionals from the home health care service in a municipality in Minas Gerais, from February to June 2018. The material was analyzed from the perspective of discourse analysis according to Michel Foucault.
Results:
team interference upon caregivers is exercised by disciplinary practices and prescriptive, authoritative and surveilling behaviors. The team’s knowledge-power relationship determines caregivers’ acceptance through convincing or through difficulty of understanding assigned orientations. Educational practices would enable caregivers to be constituted as active, participative, empowered and reflective subjects.
Final Considerations:
team practices interfere with caregivers’ ways of acting and being and they have implications in objectification and subjectification processes.
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08-16-2021
Pregnant women’s contribution in the construction and evaluation of an educational technology: the “Comics for Pregnant Women”
Revista Brasileira de Enfermagem. 2021;74:e20201243
Abstract
Pregnant women’s contribution in the construction and evaluation of an educational technology: the “Comics for Pregnant Women”
Revista Brasileira de Enfermagem. 2021;74:e20201243
DOI 10.1590/0034-7167-2020-1243
Views1See moreABSTRACT
Objectives:
to describe the contribution of pregnant women to the construction and evaluation of educational technology.
Methods:
a participatory study developed in three stages, which occurred between March 2018 and June 2019 for identifying the content, construction, and evaluation of the comic. Non-directive interviews were conducted in educational groups with 34 pregnant women. After the comic was built by a team, including a designer, an instrument was applied to 41 pregnant women to evaluate the items Objectives, Organization, Writing style, Appearance, and Motivation.
Results:
the comic contains 40 pages of contents, illustrations, and quizzes (word search, cross-puzzle, seven mistakes, etc). The pregnant women evaluated it as easy to understand, self-explanatory, aesthetically attractive, and capable of motivating good care practices during pregnancy, obtaining a minimum agreement of 92.1%.
Final Considerations:
the innovation of the educational technology consisted of incorporating the voices of pregnant women in prenatal care, with the potential to stimulate reflections and the learning process of this target audience.
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ORIGINAL ARTICLE02-05-2021
Homeless people: health aspects and experiences with health services
Revista Brasileira de Enfermagem. 2021;74(1):e20190200
Abstract
ORIGINAL ARTICLEHomeless people: health aspects and experiences with health services
Revista Brasileira de Enfermagem. 2021;74(1):e20190200
DOI 10.1590/0034-7167-2019-0200
Views0See moreABSTRACT
Objectives:
to analyze the understanding of homeless people living in a city in the countryside of São Paulo about what health is and about their experiences in health services.
Methods:
a qualitative exploratory study developed through interviews with homeless people and a field diary. The data were organized by themes and the findings were compared to a collective health framework.
Results:
the explored themes were: “Being healthy for the homeless population”, “The search for health services” and “Being a user of health services from the perspective of homeless people”. We present the interviewees’ understanding of health and their experiences in healthcare services. Along this path, we outline aspects that show the network’s weaknesses, permeated by prejudices and discrimination.
Final Considerations:
this population has conceptions about health and needs that need to be singularly taken into consideration to facilitate access and care.
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09-16-2019
Leprosy educational practices with adolescents: an integrative literature review
Revista Brasileira de Enfermagem. 2019;72(5):1397-1404
Abstract
Leprosy educational practices with adolescents: an integrative literature review
Revista Brasileira de Enfermagem. 2019;72(5):1397-1404
DOI 10.1590/0034-7167-2017-0458
Views0See moreABSTRACT
Objectives:
to identify scientific evidence in the literature regarding educational actions on leprosy developed with adolescents.
Method:
an integrative review of the literature, with the following research question: what are the leprosy educational practices currently being developed with adolescents? The search was performed in the following databases: MEDLINE, Scopus, LILACS, CINAHL, BVS Hanseníase and other sources, using “adolescent”; “leprosy”; “health education”; “public health”, and “public health practice” as keywords. Results: the sample was comprised of nine studies. Leprosy educational practices with adolescents verifiably promote change in knowledge when they are based on constructivist methodologies. The nurse is recognized as a professional with potential for developing these educational practices. Final considerations: actions for leprosy education with adolescents do lead to changes in knowledge, but new research is needed to evaluate their effectiveness in further improving this knowledge as well as changing behaviors and practices.
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ORIGINAL ARTICLE07-18-2022
Cultural adaptation and content validity evidence of the Nutritional Literacy Scale Brazilian version
Revista Brasileira de Enfermagem. 2022;75(6):e20210657
Abstract
ORIGINAL ARTICLECultural adaptation and content validity evidence of the Nutritional Literacy Scale Brazilian version
Revista Brasileira de Enfermagem. 2022;75(6):e20210657
DOI 10.1590/0034-7167-2021-0657
Views0See moreABSTRACT
Objective:
To investigate the evidence of content validity and reliability of the Brazilian version of the Nutritional Literacy Scale (NLS) after the cultural adaptation process.
Methods:
Psychometric study of 1,197 users of the National Health Service (Brazilian SUS). The NLS was culturally adapted to Brazilian Portuguese and six items of the original scale were modified to improve its understanding, giving rise to the Brazilian version of the scale named NLS-BR. The analysis of evidence of content validity of the NLS-BR was performed using the Item Response Theory (IRT).
Results:
The final version of the NLS-BR had 23 items and proved to be adequate to assess nutritional literacy in adults assisted by the Brazilian SUS.
Final considerations:
The NLS-BR proved to be of adequate understanding and demonstrated evidence of content validity and reliability for users of the Brazilian SUS.
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ORIGINAL ARTICLE12-13-2019
Factors related to quilombola attendance to child follow-up appointments
Revista Brasileira de Enfermagem. 2019;72:9-16
Abstract
ORIGINAL ARTICLEFactors related to quilombola attendance to child follow-up appointments
Revista Brasileira de Enfermagem. 2019;72:9-16
DOI 10.1590/0034-7167-2017-0605
Views0See moreABSTRACT
Objective:
To understand factors interfering with the attendance of quilombola children to growth and development follow-up appointments.
Method:
It is a qualitative research based on Symbolic interactionism, during which 14 mothers of children bellow 1 year-old were interviewed, who attended to the Family Health Unit at Ilha de Maré, Bahia, Brazil.
Results:
Appointment attendance is affected by factors intrinsic to mothers (meaning of child health follow-up; association between appointments and children falling ill; personal issues) and extrinsic factors, related to the service (availability, long waiting time for appointments and its quality).
Final considerations:
An administration prioritizing the service’s organization is required, which can prioritize attendances and the reduction of waiting time, specially given the personal issues that compromise going to the unit.
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ORIGINAL ARTICLE02-02-2022
The Healthcare Failure Mode and Effect Analysis as a tool to evaluate care protocols
Revista Brasileira de Enfermagem. 2022;75(3):e20210153
Abstract
ORIGINAL ARTICLEThe Healthcare Failure Mode and Effect Analysis as a tool to evaluate care protocols
Revista Brasileira de Enfermagem. 2022;75(3):e20210153
DOI 10.1590/0034-7167-2021-0153
Views0See moreABSTRACT
Objectives:
to identify, classify, and analyze modes of failure in the medication process.
Methods:
evaluative research that used the Healthcare Failure Mode and Effect Analysis (HFMEA) in a service of bone marrow transplant from June to September 2018, with the participation of 35 health workers.
Results:
207 modes of failure were identified and classified as mistakes in verification (14%), scheduling (25.6%), administration (29%), dilution (16.4%), prescription (2.4%), and identification (12.6%). The analysis of risk showed a moderate (51.7%) and high (30.9%) need of intervention, leading to the creation of an internal quality assurance group and of continued education activities.
Conclusions:
the Healthcare Failure Mode and Effect Analysis showed itself to be a tool to actively identify, classify, and analyze failures in the process of medication, contributing for the proposal of actions aimed at patient safety.
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ORIGINAL ARTICLE07-06-2020
Prevention of infections associated with peripheral catheters: construction and validation of clinical scenario
Revista Brasileira de Enfermagem. 2020;73(5):e20190390
Abstract
ORIGINAL ARTICLEPrevention of infections associated with peripheral catheters: construction and validation of clinical scenario
Revista Brasileira de Enfermagem. 2020;73(5):e20190390
DOI 10.1590/0034-7167-2019-0390
Views0See moreABSTRACT
Objectives:
to describe the process of construction and content validation of a clinical setting for teaching and learning the recommended practices for preventing bloodstream infection, associated with peripheral venous catheters, for nursing professionals.
Methods:
methodological study of the construction of the scenario based on the National League Nursing Jeffries Simulation Theory, International Nursing Association for Clinical Simulation and Learning, and the Brazilian Health Regulatory Agency. Twelve experts performed content validation. We used to assess the degree of agreement between them, the Content Validity Index, and a descriptive analysis of the suggestions presented.
Results:
all the requirements of the simulated clinical scenario reached an agreement between judges of more than 80% in terms of clarity and relevance.
Conclusions:
the steps adopted in the construction and validation of the clinical scenario proved to be adequate and relevant, and the scenario is suitable for training professionals.
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ORIGINAL ARTICLE07-01-2020
Perceptions of pharmaceutical services among elderly people on polymedication
Revista Brasileira de Enfermagem. 2020;73(5):e20190305
Abstract
ORIGINAL ARTICLEPerceptions of pharmaceutical services among elderly people on polymedication
Revista Brasileira de Enfermagem. 2020;73(5):e20190305
DOI 10.1590/0034-7167-2019-0305
Views0See moreABSTRACT
Objectives:
Describe the importance of guidelines provided during pharmaceutical consultation about compliance with medication therapy based on interviews with polymedicated elderly patients.
Methods:
A qualitative methodological study carried out during consultations with 40 elderly patients of both genders at the Health Care Center for Elderly Patients and Caregivers. The study used the technique of content analysis, applying a questionnaire with two open questions.
Results:
Two categories and eight subcategories emerged after the transcription of interviews and exhaustive reading of the data. The category “Pharmaceutical consultation as an education instrument for the self-care of polymedicated elderly patients” presented the highest frequency. The subcategory with the highest frequency was “Concern of elderly patients about self-care”.
Final Considerations:
In the case of polymedicated elderly patients, pharmaceutical consultation is an important education instrument which, through the provision of pharmaceutical guidelines, allows the minimization of concerns about pharmacotherapy, contributing to compliance and self-care.
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07-05-2021
Factors associated with urinary tract infection in a Nursing Home
Revista Brasileira de Enfermagem. 2021;74:e20200813
Abstract
Factors associated with urinary tract infection in a Nursing Home
Revista Brasileira de Enfermagem. 2021;74:e20200813
DOI 10.1590/0034-7167-2020-0813
Views1See moreABSTRACT
Objective:
to analyze the factors associated with urinary tract infection occurrence in institutionalized elderly.
Methods:
this is a cross-sectional, analytical, quantitative study with 116 elderly people from a Nursing Home. Urinary tract infection diagnosis was carried out through urine culture and clinical assessment. Demographic data and associated factors were obtained from medical records. Statistical analysis included bivariate analysis and logistic regression models.
Results:
the factors associated with urinary tract infection (p<0.05) were being female; wheelchair user; diaper use; diuretic use; urinary and bowel incontinence; type 1 diabetes; benign prostatic hyperplasia; dehydration.
Conclusion:
this study revealed that it is important to consider non-modifiable factors such as sex and clinical comorbidities; however, dehydration, a modifiable factor, increased the chances of developing urinary tract infections by 40 times among institutionalized elderly and demands greater attention from the health team.
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