-
01-01-2016
Avaliação do risco de úlceras por pressão em pacientes hospitalizados com HIV/Aids
Revista Brasileira de Enfermagem. 2016;69(1):96-101
Abstract
Avaliação do risco de úlceras por pressão em pacientes hospitalizados com HIV/Aids
Revista Brasileira de Enfermagem. 2016;69(1):96-101
DOI 10.1590/0034-7167.2016690113i
Views0See moreRESUMEN
Objetivo:
evaluar el riesgo de desarrollar úlceras por presión en pacientes hospitalizados con VIH/SIDA.
Método:
estudio cuantitativo descriptivo con 35 pacientes. Caracterización epidemiológica y clínica de los pacientes en un instrumento mediante la Escala de Braden. Las variables se realizaron en forma descriptiva simple, por números absolutos.
Resultados:
la incidencia de la PU observada en 2 pacientes, y las comorbilidades fueron neumocistosis pneumocisti carinii y tuberculosis pulmonar. Se reveló que la subescala de fricción y fuerza de deslizamiento obtuvo una puntuación más baja, seguido por actividad y la nutrición, la movilidad y la humedad. La percepción sensorial obtuvo la puntuación más alta. Dos pacientes fueron clasificados como de “alto riesgo” a 6 de “alto riesgo”, 3 para “bajo riesgo” y el otro “ningún riesgo”.
Conclusión:
la calificación de riesgo, mediante el uso de escalas proporciona información objetiva para la toma de decisione de enfermería a un modo específico.
-
01-01-2016
Assessment of the risk of pressure ulcer development among hospitalized HIV/Aids patients
Revista Brasileira de Enfermagem. 2016;69(1):96-101
Abstract
Assessment of the risk of pressure ulcer development among hospitalized HIV/Aids patients
Revista Brasileira de Enfermagem. 2016;69(1):96-101
DOI 10.1590/0034-7167.2016690113i
Views0See moreABSTRACT
Objective:
to assess the risk of pressure ulcer development among hospitalized HIV/Aids.
Metod:
study quantitative descriptive with 35 patients admitted to an infectious diseases hospital in Curitiba-PR-BR. Characterized clinical and epidemiological of patients using a data collection instrument and the Braden Scale. Data was compiled using Excel® and a simple descriptive analysis.
Results:
two patients were found to have pressure ulcers and the most common comorbidities associated with HIV/Aids were pneumocystis pneumonia, caused by pneumocisti cariini (16), and pulmonary tuberculosis (13). The lowest scores were obtained in the friction and shear subscale, followed by the activity, nutrition, mobility and moisture subscales. The highest score was obtained in the sensory perception subscale. Two patients were classified as ‘very high risk’, six as ‘high risk’, three as ‘low risk’, and the rest as ‘no risk’.
Conclusion:
risk assessment using scales provides objective information to assist with systemized and targeted nursing decision-making.
-
01-01-2016
Children with special health needs and family: implications for Nursing
Revista Brasileira de Enfermagem. 2016;69(1):88-95
Abstract
Children with special health needs and family: implications for Nursing
Revista Brasileira de Enfermagem. 2016;69(1):88-95
DOI 10.1590/0034-7167.2016690112i
Views0See moreABSTRACT
Objective:
to understand the family experience of children and adolescents with myelomeningocele by the discovery of chronic illness and their daily life in the realization of needed care to these people.
Method:
qualitative study, developed from October 2013 to February 2014, with family, in a pediatric hospital in Fortaleza. Data were collected through interviews and checked by analysis thematic category.
Results:
it was found that the diagnosis after the birth of the child caused fear and anguish to the families in front of the unknown and the unexpected and that over the years they started to deal with many challenges conducting the daily care due to the disease sequelae.
Conclusion:
nursing plays an important role in the lives of families, children and adolescents, through emotional support, guidelines and care inserted in the health care network.
-
01-01-2016
Evaluation of the care program implementation to people with high blood pressure
Revista Brasileira de Enfermagem. 2016;69(1):79-87
Abstract
Evaluation of the care program implementation to people with high blood pressure
Revista Brasileira de Enfermagem. 2016;69(1):79-87
DOI 10.1590/0034-7167.2016690111i
Views0See moreABSTRACT
Objective:
to evaluate the implementation of the care program for people with hypertension in Maringá-PR.
Method:
it is an evaluative research of cross-sectional design. Data were collected through structured interviews with 63 nurses between April and June 2013.
Results:
as missing or insufficient, there were: transportation for outside activities; work equipment; educational materials; training resources; inclusion of the family in the care plan; risk classification of individuals; determination of therapy from the risk classification and referral of the patient to medical and/or specialized tests.
Conclusion:
in addition to qualifying structure, there are: the need to identify people with hypertension as risk factors, perform risk stratification and systematic care planning, establishing an advanced clinical practice, such as support for self-care and management cases, accomplish with existing protocols and develop collective actions based on information systems.
-
01-01-2016
Evaluation of quality of life of visually impaired
Revista Brasileira de Enfermagem. 2016;69(1):72-78
Abstract
Evaluation of quality of life of visually impaired
Revista Brasileira de Enfermagem. 2016;69(1):72-78
DOI 10.1590/0034-7167.2016690110i
Views0See moreABSTRACT
Objective:
to evaluate the quality of life of visually impaired using WHOQOL-100.
Method:
exploratory, descriptive, and quantitative study, performed between April and May 2013 with 20 visually impaired of the Blind Association of Ceará, through interviews.
Results:
the analysis showed that males predominated (80%), 41-55 years (40%), students (50%) and personal income than the minimum wage (70%). Participants were self-rated with good quality of life (68.75%). The facets with the highest rates were personal relationships (74.06%), sexual activity (66.88%) and spirituality/religion/personal beliefs (65%). With lower rates were financial (43.44%), physical environment: pollution/noise/traffic/climate (46.88%), physical security and protection (37.19%), transport (35.63%) and medication or treatment dependency (8.25%).
Conclusion:
these results reflect the importance of the nurse to perform health education actions promoting the empowerment, autonomy and guaranteed of access in society for this clientele.
-
01-01-2016
Coping strategies for oncology nurses in high complexity
Revista Brasileira de Enfermagem. 2016;69(1):67-71
Abstract
Coping strategies for oncology nurses in high complexity
Revista Brasileira de Enfermagem. 2016;69(1):67-71
DOI 10.1590/0034-7167.2016690109i
Views0See moreABSTRACT
Objective:
to identify the coping strategies of oncology services of nurses in highly complex hospital care before the person with cancer.
Method:
it is a qualitative research, with 18 nurses in inpatient oncology units and/or outpatient chemotherapy in two cities in southern Brazil, sampled by a snowball and carrying out semi-structured interviews. Data were submitted to thematic analysis.
Results:
three categories emerged that show strategies such as denial and resignation in care, for support in the health team and the plurality and multiplicity of perspectives on the care, including the patient and his family and the search for personal and professional improvement.
Conclusion:
coping strategies are expressed in the cultural understanding of what it means to have cancer or not and management of health institutions for nurses to work with satisfaction. The service in education is a major factor in the development of ethical competence.
-
01-01-2016
Implementation of fast tests for syphilis and HIV in prenatal care in Fortaleza – Ceará
Revista Brasileira de Enfermagem. 2016;69(1):62-66
Abstract
Implementation of fast tests for syphilis and HIV in prenatal care in Fortaleza – Ceará
Revista Brasileira de Enfermagem. 2016;69(1):62-66
DOI 10.1590/0034-7167.2016690108i
Views0See moreABSTRACT
Objective:
to describe the implementation of the Fast Test (FT) of syphilis and HIV in prenatal care in primary healthcare units in Fortaleza, Ceará.
Method:
a descriptive study with a quantitative approach. There were training supervisions carried out in 24 units between May and August 2014, and the inclusion criterion was to have at least one trained professional.
Results:
the physical space, the availability, validity and the performance of FT in prenatal were analyzed. The data were presented in simple frequency tables. It was identified adequate space in 79.2% of the units, availability of FT in 62.5%, performing the tests in 37.5%, and of these, 55.6% doing these procedures in routine prenatal care.
Conclusion:
the primary units have difficulties in implementing FT in syphilis and HIV in the prenatal routine. This activity is seen as an effective strategy to reduce vertical transmission of these infections.
-
01-01-2016
Evaluating child care in the Family Health Strategy
Revista Brasileira de Enfermagem. 2016;69(1):54-61
Abstract
Evaluating child care in the Family Health Strategy
Revista Brasileira de Enfermagem. 2016;69(1):54-61
DOI 10.1590/0034-7167.2016690107i
Views0See moreABSTRACT
Objective:
to evaluate the healthcare provided to children under two years old by the Family Health Strategy.
Method:
evaluative, quantitative, cross-sectional study that used the Primary Care Assessment Tool – Child Version for measuring the access, longitudinality, coordination, integrality, family orientation and community orientation.
Results:
a total of 586 adults responsible for children under two years old and linked to 33 health units in eleven municipalities of the state of Minas Gerais, Brazil, were interviewed. The evaluation was positive for the attributes longitudinality and coordination, and negative for access, integrality, Family orientation and community orientation.
Conclusion:
there are discrepancies between health needs of children and what is offered by the service; organizational barriers to access; absence of counter-reference; predominance of curative and long-standing and individual preventive practices; verticalization in organization of actions; and lack of good communication between professionals and users.
-
01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):206-206
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):206-206
DOI 10.1590/0034-7167.20166901e02
Views0In the article “Conceptions of mid-level nursing professionals facing those with a chemical dependency”, with the number of DOI: 10.1590/0034-7167.2015680610i, published in the journal Revista Brasileira de Enfermagem, v68(6):755-60, page 760 that read:“8. Vargas D, Soares J. Knowledge and attitudes of nurses towards alcohol and related problems: the impact of an educational intervention. Rev Esc […]See more -
01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):205-205
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):205-205
DOI 10.1590/0034-7167.20166901e01
Views0In the article “Using the theory of meaningful learning in nursing education”, with the number of DOI: 10.1590/0034-7167.2015680420i, published in the journal Revista Brasileira de Enfermagem, v68(4):626-35, page 627 that read:“Ausubel was descended from Jewish, born in New York in 1918 and died in 1994 at the age of 75. He thought and wrote until […]See more -
01-01-2016
Nursing process documentation: rationale and methods of analytical study
Revista Brasileira de Enfermagem. 2016;69(1):197-204
Abstract
Nursing process documentation: rationale and methods of analytical study
Revista Brasileira de Enfermagem. 2016;69(1):197-204
DOI 10.1590/0034-7167.2016690126i
Views0See moreABSTRACT
Objective:
to describe the methods used to analyze the associations between variables of service, nursing and the nursing process documentation in institutions of the Department of Health of the State of São Paulo.
Method:
multilevel analytical study with data obtained in the domains of institution, units of the institution and nursing professionals who work there, using standardized instruments. The analyses had as axis the degree of completeness of the nursing process documentation in units or institutions and their association with variables of nursing personnel, of units and of institutions.
Conclusion:
This study will provide important empirical evidence on the factors involved in the nursing process documentation.
-
01-01-2016
Qualitative methodologies in health research: interpretive referential of Patricia Benner
Revista Brasileira de Enfermagem. 2016;69(1):192-196
Abstract
Qualitative methodologies in health research: interpretive referential of Patricia Benner
Revista Brasileira de Enfermagem. 2016;69(1):192-196
DOI 10.1590/0034-7167.2016690125i
Views0See moreABSTRACT
Objective:
this article reports on the experience of using the interpretive phenomenological framework of Patricia Benner in a Brazilian context. Benner’s interpretive phenomenology, based on existential and interpretative philosophy, aims to understand human experiences in the particular worlds of research participants. Data were collected through interviews with nine nurses in November and December 2014.
Results:
data analysis process according to Benner’s framework consisted of: transcription, coding, thematic analysis, and search for paradigmatic cases and examples. Therefore, the prior knowledge of the researcher is an important part of the study, consisting in manners of the research conduction.
Conclusion:
The use of this methodological framework entailed a great challenge for the researcher, however, it also enabled a unique opportunity to illuminate important existential phenomena related to the daily lives of research participants.
-
01-01-2016
Nurses’ performance on primary care in the National Health Service in England
Revista Brasileira de Enfermagem. 2016;69(1):182-191
Abstract
Nurses’ performance on primary care in the National Health Service in England
Revista Brasileira de Enfermagem. 2016;69(1):182-191
DOI 10.1590/0034-7167.2016690124i
Views0See moreABSTRACT
Objective:
To analyze the expansion of nursing roles in primary care in the English National Health Service and the implications for professional practice.
Method:
qualitative research in case study format, held in London, England, in six primary care units. Data were obtained through interviews with nine nurses. After the thematic data analysis, two units emerged: the nurses’ performance characteristics and effects of the expansion of nursing roles.
Results:
expansion of nurses’ roles: consultation, diagnosis and drug therapy, case management and monitoring of chronic conditions. Repercussions: for the user, there was improved access, communication and comprehensive care, increased duration of consultations, resulting in greater adherence; for nurses, there was the expansion of professional skills, knowledge and professional recognition; to the health care system, it resulted in cost savings.
Conclusion:
benefits in expanding nursing roles, were visible, contributing to primary care quality.
-
01-01-2016
Meleis’ Nursing Theories Evaluation: integrative review
Revista Brasileira de Enfermagem. 2016;69(1):174-181
Abstract
Meleis’ Nursing Theories Evaluation: integrative review
Revista Brasileira de Enfermagem. 2016;69(1):174-181
DOI 10.1590/0034-7167.2016690123i
Views0See moreABSTRACT
Objective:
to analyze the application of the theory evaluation model proposed by Meleis in Brazilian studies.
Method:
integrative review of online articles published from 2002 to 2012 in the databases LILACS and BDENF.
Results:
the 16 selected studies confirmed the use of only three of the five stages proposed for Meleis’ theories analysis: Description of the Theory, Criticism of the Theory and Analysis of the Theory, with a predominance of a single unit of analysis in each.
Conclusion:
the analysis of nursing theories provides support to nurses in the practice, research, education and administration of the different dimensions of care. Meleis’ model figures as very important by contributing to the development of knowledge of nursing discipline, considering that its use as a method allows several reflections on theories in order that they be revalidated to support a more theoretical and practical applicability.
-
01-01-2016
Clinical indicators of sexual dysfunction in pregnant women: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(1):165-173
Abstract
Clinical indicators of sexual dysfunction in pregnant women: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(1):165-173
DOI 10.1590/0034-7167.2016690122i
Views0See moreABSTRACT
Objective:
to identify the nursing diagnosis clinical indicators of sexual dysfunction in pregnant women.
Method:
it is an integrative literature review, with research in databases using the keywords “sexual*”, “pregnan*” and “function*”. Studies included had an abstract available for analysis, referring to pregnant women over 18 years old, written in Portuguese, French, Spanish and English, with publication date between 2010 and 2014. Studies that reporting pregnant women with an associated pathology were excluded.
Results:
sexual dysfunction in pregnant women is consistent in the literature. Nine defining characteristics were identified and 16 related factors, some not classified in NANDA International.
Conclusion:
clinical indicators can be added to the nursing diagnosis to favor an accurate diagnosis and effective interventions in the surveillance of pregnancy as a period of healthy sexual experience.
-
01-01-2016
Conditions of functional health literacy of an elderly diabetics group
Revista Brasileira de Enfermagem. 2016;69(1):156-164
Abstract
Conditions of functional health literacy of an elderly diabetics group
Revista Brasileira de Enfermagem. 2016;69(1):156-164
DOI 10.1590/0034-7167.2016690121i
Views0See moreABSTRACT
Objective:
to evaluate the conditions of functional health literacy of an elderly diabetics group.
Method:
cross-sectional and descriptive study, with diabetic’s elderly assisted in the SUS (N = 114). The social and health conditions were evaluated as well as functional health literacy by S-TOFHLA test (short version); the simple proportions, average, standard deviation and Pearson’s Chi-square were described by SPSS software (20.0) with α = 5% value.
Results:
the mean age was 67.4 years, 74.0% of the elderly were women, had up to four years of schooling; 29.8% had a long-standing illness, 64.0% reported having high blood pressure, 47.4% smoke or were smokers, 73.7% had low functional health literacy, which was associated with schooling p = 0.001.
Conclusions:
the low functional health literacy could be a self-care conditioning and can be influenced by low schooling because it implies to have skills to understand and make decisions aimed at self-management of health.
-
01-01-2016
Discoveries of Biological Sciences and their implications for nursing practice
Revista Brasileira de Enfermagem. 2016;69(4):619-620
Abstract
Discoveries of Biological Sciences and their implications for nursing practice
Revista Brasileira de Enfermagem. 2016;69(4):619-620
DOI 10.1590/0034-7167.2016690401i
Views1For the longest time, the production of knowledge in the field of biological sciences was viewed as the exclusive responsibility and competence of medical professionals. This scenario has changed in light of the worldwide trend of improvements in other health professions, which includes the need to implement the use of evidence-based methodology in nursing practice. […]See more -
01-01-2016
Descobertas das Ciências Biológicas e as implicações para a prática da Enfermagem
Revista Brasileira de Enfermagem. 2016;69(4):619-620
Abstract
Descobertas das Ciências Biológicas e as implicações para a prática da Enfermagem
Revista Brasileira de Enfermagem. 2016;69(4):619-620
DOI 10.1590/0034-7167.2016690401i
Views1A produção de conhecimento na área das ciências biológicas, durante muito tempo, foi vista como de responsabilidade e competência exclusivamente de profissionais médicos. Esse cenário alterou-se frente à tendência mundial de aperfeiçoamento dos demais profissionais de saúde, incluindo-se a necessidade de se concretizar a utilização da metodologia da prática baseada em evidência na atuação do […]See more -
01-01-2016
The importance of civilian nursing organizations: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(3):610-618
Abstract
The importance of civilian nursing organizations: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(3):610-618
DOI 10.1590/0034-7167.2016690326i
Views0See moreABSTRACT
Objective:
to identify and analyze evidence from studies about the importance of civilian nursing organizations.
Method:
an integrative literature review, for which searches were conducted in the databases LILACS, PubMed/MEDLINE, SciELO, BDENF, and Scopus.
Results:
sixteen articles published between the years 2004-2013 were selected, 68.75% of which were sourced from Brazilian journals and 31.25% from American journals.
Conclusion:
civilian nursing organizations are important and necessary, because they have collaborated decisively in nursing struggles in favor of the working class and society in general, and these contributions influence different axes of professional performance.
-
01-01-2016
Effects from acupuncture in treating anxiety: integrative review
Revista Brasileira de Enfermagem. 2016;69(3):602-609
Abstract
Effects from acupuncture in treating anxiety: integrative review
Revista Brasileira de Enfermagem. 2016;69(3):602-609
DOI 10.1590/0034-7167.2016690325i
Views0See moreABSTRACT
Objective:
to evaluate the scientific evidence that is available in the literature on the effects of acupuncture for treating anxiety and on the quality of such studies.
Method:
the study is an integrative review of CINAHL, LILACS, PUBMED-PICO, SciELO, and The Cochrane Library between 2001 and 2014. Keywords anxiety, acupuncture therapy, acupuncture, and anxiety disorders were combined among themselves to ensure a wide search of primary studies.
Results:
among 514 articles, 67 were selected to be fully read and 19 were included. Among these, 11 were found to have strong evidence levels. Among the six articles about randomized clinical studies, five were found to be of reasonable quality. Two studies used acupuncturist nurses to perform their interventions. Its results showed positive and statistically significant effects from using acupuncture for treating subjects with anxiety.
Conclusion:
acupuncture seems to be a promising treatment for anxiety; however, there is a need for improving the methodological quality of the research on this field.
-
01-01-2016
Palliative care and spirituality: an integrative literature review
Revista Brasileira de Enfermagem. 2016;69(3):591-601
Abstract
Palliative care and spirituality: an integrative literature review
Revista Brasileira de Enfermagem. 2016;69(3):591-601
DOI 10.1590/0034-7167.2016690324i
Views0See moreABSTRACT
Objective:
to analyze scientifi c articles published in international online journals about palliative care and spirituality.
Methods:
an integrative literature review with data collected in September 2014 from the LILACS, SCIELO, MEDLINE/PubMed, and IBECS databases.
Results:
thirty-nine publications were identifi ed and their textual analysis facilitated through four thematic approaches: the meaning of spirituality in the context of palliative care; palliative care and spiritual support; spirituality and relief of pain and other symptoms in patients under palliative care; and instruments to evaluate the spiritual dimension of the scope of palliative care.
Conclusion:
this study examined the relevance of the spiritual dimension in the care of patients with palliative care and the need for developing new studies to disseminate knowledge about this topic.
Descriptors:
Palliative Care; Palliative Care at End of Live; Spirituality; Religion; Health.
-
01-01-2016
Educational technologies to encourage (self) care in postpartum women
Revista Brasileira de Enfermagem. 2016;69(3):582-590
Abstract
Educational technologies to encourage (self) care in postpartum women
Revista Brasileira de Enfermagem. 2016;69(3):582-590
DOI 10.1590/0034-7167.2016690323i
Views0See moreABSTRACT
Objective:
to evaluate national and international literature regarding the use of educational technologies to encourage self care in postpartum women.
Method:
an integrative review of the literature. The articles were collected from the CINAHL, SCOPUS, PubMed, SciELO, LILACS and Cochrane databases; the time period for the articles referred to January/2004 to July/2014; the languages used in the articles were Portuguese, English, Spanish and French; the articles were selected from the following descriptors: postpartum care period, educational technology, nursing and self care. Twenty-seven articles were selected for analysis
Results:
based on the information found, the scales, counseling and home visits were among the most recommended educational technologies.
Conclusion:
the technologies promote communication, but are sometimes dependent on computer and internet access, which hinder their use by low-income women.
-
01-01-2016
Patients with HIV/Aids and ulcer risk: nursing care demands
Revista Brasileira de Enfermagem. 2016;69(3):574-581
Abstract
Patients with HIV/Aids and ulcer risk: nursing care demands
Revista Brasileira de Enfermagem. 2016;69(3):574-581
DOI 10.1590/0034-7167.2016690322i
Views0See moreABSTRACT
Objective:
to analyze the demand for nursing care and the risk of pressure ulcers (PU) of patients with HIV/Aids.
Method:
quantitative survey, carried out from December 2012 to March 2013 in a public hospital of Teresina, state of Piauí, Brazil.
Results:
the sample of 31 patients was predominantly male, mean age 36.6 years, average care demand 49.4%, most showing some risk of developing PU. The variables correlated with PU risk were care demand and clinical outcome (death). Those associated with care demand were age and clinical outcome (death).
Conclusion:
the results showed that patients require moderate nursing care needs and most of them present risk of developing PU.
-
01-01-2016
Lack of anticipated support for care for community-dwelling older adults
Revista Brasileira de Enfermagem. 2016;69(3):566-573
Abstract
Lack of anticipated support for care for community-dwelling older adults
Revista Brasileira de Enfermagem. 2016;69(3):566-573
DOI 10.1590/0034-7167.2016690321
Views0See moreABSTRACT
Objective:
to identify the factors associated with lack of anticipated support for care for community-dwelling older adults.
Method:
this study presents comparison and logistic regression analyses of data from 671 individuals who took part of the multicentric study entitled “Frailty in older Brazilians” – a quantitative, epidemiologic and transversal investigation carried out between 2008 and 2009.
Results:
the subjective evaluation of anticipated support for care for community-dwelling older adults was a good indicator of risk for lack of anticipated support for care in women, older adults who live alone and those with poor self-rated health.
Conclusion:
it is necessary to reflect upon the formal support system currently available for older people in Brazil, considering that those who most frequently presented lack of anticipated support for care are an increasing population. The study also highlights the importance of using subjective methods for the evaluation of the adequacy of older adults’ support network.
Search
Search in:
Nuvem de Tags
Adolescente (85) Atenção Primária à Saúde (239) COVID-19 (91) Criança (91) Cuidados de Enfermagem (269) Educação em Enfermagem (151) Educação em Saúde (139) Enfermagem (930) Enfermagem Pediátrica (86) Estudantes de Enfermagem (77) Estudos de Validação (131) Família (87) Idoso (208) Promoção da Saúde (99) Qualidade de Vida (104) Saúde do Trabalhador (86) Saúde Mental (145) Saúde Pública (82) Segurança do Paciente (150) Tecnologia Educacional (100)