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ORIGINAL ARTICLE11-13-2023
Elaboration and validity of the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias
- Cléton Salbego
, - Elisabeta Albertina Nietsche ,
- Patrícia Bitencourt Toscani Greco ,
- Nara Marilene Oliveira Girardon-Perlini ,
- Silvana Bastos Cogo , [ … ],
- Andrei Pompeu Antunes
Abstract
ORIGINAL ARTICLEElaboration and validity of the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias
Revista Brasileira de Enfermagem. 2023;76:e20230046
DOI 10.1590/0034-7167-2023-0046
- Cléton Salbego ,
- Elisabeta Albertina Nietsche ,
- Patrícia Bitencourt Toscani Greco ,
- Nara Marilene Oliveira Girardon-Perlini ,
- Silvana Bastos Cogo ,
- Tierle Kosloski Ramos ,
- Andrei Pompeu Antunes
Views0See moreABSTRACT
Objective:
to elaborate and validate the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias.
Methods:
a methodological study, developed in three stages: instrument structuring through documentary research and researchers’ expertise; instrument validity with a panel of 11 expert judge nurses; and instrument final composition.
Results:
the instrument, after validity by experts, consisted of 30 items, divided into the content (26 items) and appearance (four items) domains. In the initial instrument validity process, 11 items were modified and seven were withdrawn, as they had a percentage of agreement below 0.80. The instrument showed excellent internal consistency, with values greater than 0.90 in its psychometric criteria.
Conclusion:
the instrument produced and validated aimed at assessing research methodological models for technological development showed good reliability, and may contribute to the methodological rigor of technological development research in nursing.
- Cléton Salbego
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ORIGINAL ARTICLE11-13-2023
Educational technology on tuberculosis: construction shared with Primary Health Care nurses
- Aloma Sena Soares ,
- Laura Maria Vidal Nogueira ,
- Erlon Gabriel Rego de Andrade ,
- Élida Fernanda Rêgo de Andrade ,
- Ivaneide Leal Ataíde Rodrigues
Abstract
ORIGINAL ARTICLEEducational technology on tuberculosis: construction shared with Primary Health Care nurses
Revista Brasileira de Enfermagem. 2023;76:e20230025
DOI 10.1590/0034-7167-2023-0025
- Aloma Sena Soares ,
- Laura Maria Vidal Nogueira ,
- Erlon Gabriel Rego de Andrade ,
- Élida Fernanda Rêgo de Andrade ,
- Ivaneide Leal Ataíde Rodrigues
Views0See moreABSTRACT
Objective:
to develop, in a participatory way, an educational technology to assist nurses in the management of tuberculosis cases in Primary Health Care.
Methods:
methodological research with a qualitative approach. Data were collected between June and October 2022, in 25 Basic Health Units, with 41 nurses interviewed individually. Thematic content analysis was carried out to guide technology elaboration.
Results:
three empirical categories were organized, demonstrating the facilities and difficulties in tuberculosis management, the conceptions about educational technology as a facilitator of the teaching-learning process in Primary Health Care and participatory development of technology. Nurses were in favor of constructing an instructional guide technology, and made suggestions to encourage its creation and use in daily service routine.
Final considerations:
the participatory process made it possible to create technology to assist nurses in the teaching-learning process in Primary Health Care about caring for people with tuberculosis.
- Aloma Sena Soares
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ORIGINAL ARTICLE11-13-2023
Access of people with pulmonary tuberculosis to government programs: Primary Care professionals’ perceptions
- Hildegard Soares Barrozo de Lima ,
- Vitória Regina Domingues Sodré ,
- Cleide Aparecida Alves Souza ,
- Mirian Domingos Cardoso ,
- Crhistinne Cavalheiro Maymone Gonçalves , [ … ],
- Ethel Leonor Noia Maciel
Abstract
ORIGINAL ARTICLEAccess of people with pulmonary tuberculosis to government programs: Primary Care professionals’ perceptions
Revista Brasileira de Enfermagem. 2023;76:e20220716
DOI 10.1590/0034-7167-2022-0716
- Hildegard Soares Barrozo de Lima ,
- Vitória Regina Domingues Sodré ,
- Cleide Aparecida Alves Souza ,
- Mirian Domingos Cardoso ,
- Crhistinne Cavalheiro Maymone Gonçalves ,
- Laura Maria Vidal Nogueira ,
- Ivaneide Leal Ataíde Rodrigues ,
- Erlon Gabriel Rego de Andrade ,
- Alexandre Aguiar Pereira ,
- Maria Catarina Salvador da Motta ,
- Maria Helena do Nascimento Souza ,
- Regina Célia Gollner Zeitoune ,
- Ethel Leonor Noia Maciel
Views0See moreABSTRACT
Objective:
to analyze Primary Health Care professionals’ perceptions about the access of people with pulmonary tuberculosis to government social support and income transfer programs.
Methods:
multicenter/qualitative study, carried out in Family Health Units in four Brazilian capitals: Belém/Pará, Campo Grande/Mato Grosso do Sul, Recife/Pernambuco and Rio de Janeiro/Rio de Janeiro. Fifty-eight professionals participated (social workers, dentists, nurses, pharmacists, physicians and nursing technicians), who provided assistance to people with pulmonary tuberculosis. Individual interviews were conducted, and the content analysis technique was used.
Results:
among the participants, 45/77.6% were women and 33/56.9% were between 25 and 40 years old. Two thematic categories were organized, demonstrating the perceptions about the possibilities of access to government programs by people with pulmonary tuberculosis in vulnerable situations and the obstacles inherent to this context.
Final considerations:
it is necessary to move forward in improving patient access to social programs.
- Hildegard Soares Barrozo de Lima
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ORIGINAL ARTICLE11-13-2023
Vulnerability to physical inactivity: evidence of content validity and response processes
- Déborah Santana Pereira ,
- Raquel Sampaio Florêncio ,
- Virna Ribeiro Feitosa Cestari ,
- Thereza Maria Magalhães Moreira
Abstract
ORIGINAL ARTICLEVulnerability to physical inactivity: evidence of content validity and response processes
Revista Brasileira de Enfermagem. 2023;76:e20220563
DOI 10.1590/0034-7167-2022-0563
- Déborah Santana Pereira ,
- Raquel Sampaio Florêncio ,
- Virna Ribeiro Feitosa Cestari ,
- Thereza Maria Magalhães Moreira
Views0See moreABSTRACT
Objective:
To analyze content validity evidence and response processes of a bank of items for measuring vulnerability to physical inactivity in adults.
Method:
Methodological study, with 13 specialists and 46 representatives of the target population. The Content Validity Index (CVI) and binomial test were calculated; data obtained through validity based on response processes were collected through interviews.
Results:
Of the 105 constructed items, 16 were excluded (CVI<0.78); 89 items showed agreement <80% in the psychometric criteria, being modified. Of the 101 items that remained (CVI>0.78), 34 were changed and 4 were deleted after evaluating the evidence of response processes. In the end, 97 items remained, with a global CVI of 0.92, organized into two dimensions: Subject (CVI=0.91) and Social (CVI=0.94).
Conclusion:
The items presented adequate parameters and evidence of validity; and can subsidize the construction of instruments that consider the subject’s and social vulnerability in understanding physical inactivity.
- Déborah Santana Pereira
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REVIEW11-13-2023
Ocular dryness in intensive care: proposal for a new nursing diagnosis
- Jéssica Naiara de Medeiros Araújo ,
- Ana Paula Nunes de Lima Fernandes ,
- Ana Clara Dantas ,
- Marcos Antonio Ferreira Júnior ,
- Marcos Venícios de Oliveira Lopes , [ … ],
- Allyne Fortes Vitor
Abstract
REVIEWOcular dryness in intensive care: proposal for a new nursing diagnosis
Revista Brasileira de Enfermagem. 2023;76:e20220698
DOI 10.1590/0034-7167-2022-0698
- Jéssica Naiara de Medeiros Araújo ,
- Ana Paula Nunes de Lima Fernandes ,
- Ana Clara Dantas ,
- Marcos Antonio Ferreira Júnior ,
- Marcos Venícios de Oliveira Lopes ,
- Allyne Fortes Vitor
Views0See moreABSTRACT
Objective:
to analyze the concept associated with diagnostic proposition Ocular dryness in adult patients hospitalized in an Intensive Care Unit, identifying its attributes, antecedents and consequences.
Methods:
a methodological study carried out through concept analysis, operationalized by scoping review.
Results:
the analysis of 180 studies allowed the identification of two attributes, 32 antecedents and 12 consequences. The attributes were tear film deficiency and ocular signs and/or symptoms. The prevalent antecedents were incomplete eyelid closure (lagophthalmos) and blinking mechanism decrease. Major consequences included conjunctival hyperemia and decreased tear volume.
Conclusions:
this study allowed constructing nursing diagnosis Ocular dryness, part of domain 11, class 2, with 12 defining characteristics, 12 related factors, seven populations at risk and 13 associated conditions. This problem-focused proposal may provide targeted care by promoting early detection and implementing interventions that reduce the risk of ocular damage.
- Jéssica Naiara de Medeiros Araújo
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11-13-2023
Digital technology for the prevention of healthcare-related infections in critical care
- Letícia Pontes ,
- Bárbara Alessandra Tibério ,
- Jéssica de Fátima Gomes Pereira ,
- Renata Rodrigues da Luz
Abstract
Digital technology for the prevention of healthcare-related infections in critical care
Revista Brasileira de Enfermagem. 2023;76:e20220528
DOI 10.1590/0034-7167-2022-0528
- Letícia Pontes ,
- Bárbara Alessandra Tibério ,
- Jéssica de Fátima Gomes Pereira ,
- Renata Rodrigues da Luz
Views0See moreABSTRACT
Objective:
To develop digital technology for patient and family integration into the Intensive Care Unit care team, aiming to subsidize decision-making for the prevention of infections related to healthcare.
Method:
Methodological research of technological production in three phases: pre-production, production, and post-production in a teaching hospital in southern Brazil. Sixteen intensive care unit nurses participated.
Results:
The research produced six videos: general guidelines on the Intensive Care Unit, Preventing infections: hand hygiene; Pneumonia associated with mechanical ventilation; Catheter-associated primary bloodstream infection; Catheter-related urinary tract infection.
Final considerations:
The proposed technology was developed and aims to assist nurses in bringing patients and families closer to the routines of the intensive care environment to provide safety in the contact of the patient of intensive care units with family members and in the active participation for the prevention of infections related to healthcare.
- Letícia Pontes
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11-10-2023
A eficácia do uso de livros interativos multimodalidade em enfermagem pediátrica na implementação do programa Merdeka Belajar
Revista Brasileira de Enfermagem. 2023;76(5):e20220599
Abstract
A eficácia do uso de livros interativos multimodalidade em enfermagem pediátrica na implementação do programa Merdeka Belajar
Revista Brasileira de Enfermagem. 2023;76(5):e20220599
DOI 10.1590/0034-7167-2022-0599
Views0See moreRESUMEN
Objetivos:
analizar la efectividad del uso de libros interactivos multimodales en enfermería pediátrica sobre los resultados de aprendizaje de los estudiantes en la implementación del Programa Merdeka Belajar.
Métodos:
investigación cuasi-experimental con un diseño de grupo de control posterior a la prueba. En este estudio, la muestra incluyó 52 estudiantes de enfermería del cuarto semestre del Instituto de Ciencias de la Salud Suaka Insan Banjarmasin que recibieron el curso de Enfermería Pediátrica. Fue utilizada la técnica de muestreo total y la prueba t dependiente en el análisis de datos.
Resultados:
el libro interactivo multimodal de enfermería pediátrica fue efectivo en la mejora del logro de aprendizaje de los estudiantes de cuarto semestre con un valor de significancia de 0,015 < 0,05. Hay una diferencia en el valor promedio de los cursos de enfermería pediátrica para la clase A y la clase B, que es de 3,173.
Conclusiones:
el uso de libros multimodales interactivos es muy bueno para que los profesores los apliquen en la enseñanza para ayudar a los estudiantes a comprender el material que están aprendiendo.
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ERRATUM11-10-2023
ERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e04
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e04
DOI 10.1590/0034-7167.20237605e04
Views0In the article “First graduate of the Master of Nursing in Advanced Practice in Oncology in Chile”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023(Suppl 4):e76suppl401, in the second paragraph:Where it read:[…]See more
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ORIGINAL ARTICLE09-21-2020
The care provided by the family to the premature newborn: analysis under Leininger’s Transcultural Theory
- Ana Celi Silva Torres Nascimento ,
- Aisiane Cedraz Morais ,
- Rita da Cruz Amorim ,
- Deisy Vital dos Santos
Abstract
ORIGINAL ARTICLEThe care provided by the family to the premature newborn: analysis under Leininger’s Transcultural Theory
Revista Brasileira de Enfermagem. 2020;73:e20190644
DOI 10.1590/0034-7167-2019-0644
- Ana Celi Silva Torres Nascimento ,
- Aisiane Cedraz Morais ,
- Rita da Cruz Amorim ,
- Deisy Vital dos Santos
Views0See moreABSTRACT
Objective:
To analyze the care practices of family members of premature infants admitted to a Neonatal Intensive Care Unit in the light of Leininger’s transcultural theory.
Methods:
Qualitative, descriptive and exploratory study. Participant observation and semi-structured interviews were conducted with 16 family members of newborns, admitted to the neonatal unit of a public maternity hospital, during the months of May and June 2019. The software called Interface de R pour analyses Multidimensionnelles de Textes et de Questionnaire® and the Bardin Content Analysis technique.
Results:
Two thematic categories emerged: Family care in the neonatal unit; (in)effective support for shared care.
Conclusion:
The participation of families in the care of babies is still unstable, but it must be an inseparable element of culturally congruent care, thus collaborating with the full recovery of the premature.
- Ana Celi Silva Torres Nascimento
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ORIGINAL ARTICLE02-10-2020
Common mental disorders in nursing technicians of a university hospital
- Fabrício Ferreira dos Santos ,
- Maria Fernanda Santos Figueiredo Brito ,
- Lucinéia de Pinho ,
- Franciele Ornelas Cunha ,
- João Felício Rodrigues Neto , [ … ],
- Carla Silvana de Oliveira e Silva
Abstract
ORIGINAL ARTICLECommon mental disorders in nursing technicians of a university hospital
Revista Brasileira de Enfermagem. 2020;73(1):e20180513
DOI 10.1590/0034-7167-2018-0513
- Fabrício Ferreira dos Santos ,
- Maria Fernanda Santos Figueiredo Brito ,
- Lucinéia de Pinho ,
- Franciele Ornelas Cunha ,
- João Felício Rodrigues Neto ,
- Adélia Dayane Guimarães Fonseca ,
- Carla Silvana de Oliveira e Silva
Views0See moreABSTRACT
Objective:
To verify the prevalence of common mental disorders and associated factors in nursing technicians.
Method:
Cross-sectional analytical study conducted at a university hospital. A questionnaire with sociodemographic, educational and work-related variables and the Self Reporting Questionnaire-20 were used to verify the presence of common mental disorders. Association analysis was performed using the chi-squared test, with a significance level of 5%.
Results:
280 nursing technicians participated in the study. The prevalence of common mental disorders was 46.9%. The variables family income (p=0.021) and working exclusively in health area (p<0.001) were associated with the outcome. There was a higher prevalence of CMD among individuals with a family income below four minimum wages (PR=1.41) and among professionals who worked exclusively in the health area (PR=1.95).
Conclusion:
Approximately half of the nursing technicians of the university hospital presented common mental disorders, which were associated with economic and work-related variables.
- Fabrício Ferreira dos Santos
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REFLECTION10-19-2020
Contributions of Florence Nightingale as a social entrepreneur: from modern to contemporary nursing
Revista Brasileira de Enfermagem. 2020;73:e20200064
Abstract
REFLECTIONContributions of Florence Nightingale as a social entrepreneur: from modern to contemporary nursing
Revista Brasileira de Enfermagem. 2020;73:e20200064
DOI 10.1590/0034-7167-2020-0064
Views0See moreABSTRACT
Objective:
To reflect on the transformations of modern and contemporary nursing as well as on Florence Nightingale’s social entrepreneurship.
Method:
This is a logical-reflective exhibition, with an emphasis on the theoretical assumptions of social entrepreneurship and the legacy of Florence Nightingale, from modern to contemporary nursing, based on readings of texts extracted from electronic databases, especially periodicals, books and theses.
Results:
The logical-reflective exhibition focuses on two fundamental aspects: 1) Florence Nightingale’s legacy as a social entrepreneur; 2) The evolution of Brazilian nursing: from modernity to contemporaneity.
Final considerations:
Florence Nightingale’s legacy is undeniable with regard to the evolution of modern and contemporary nursing and transcends different areas of knowledge. In addition to being a precursor to modern nursing, it is distinguished by its visionary attitude, humanitarian social value and potential for transforming the paths and realities present in the Contemporary Era.
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ORIGINAL ARTICLE06-27-2019
Assessment of feedback for the teaching of nursing practice
Revista Brasileira de Enfermagem. 2019;72(3):663-670
Abstract
ORIGINAL ARTICLEAssessment of feedback for the teaching of nursing practice
Revista Brasileira de Enfermagem. 2019;72(3):663-670
DOI 10.1590/0034-7167-2018-0539
Views0See moreABSTRACT
Objective:
to analyze the self-reported knowledge of professors in the use of feedback in the teaching of nursing practice; train professors to use this process; and evaluate the results of this training.
Method:
a qualitative study of research-action type. The focus group technique was used with seven collaborators of a nursing technical school. For content analysis, the Bardin framework was used and, for intervention, the Problematization Methodology supported by Pendleton’s Rules.
Results:
most present in their curricula training to teach. It is pointed out that feedback is a simple and essential assessment tool, although universal discourse does not express the exact dimension of feedback potentialities. The intervention was effective to solidify feedback.
Final Consideration:
this study shows that feedback should be disseminated and consolidated among the teaching staff of nursing technical education.
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ORIGINAL ARTICLE05-03-2021
Nursing care for patient in postoperatory heart surgery in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(2):e20200163
Abstract
ORIGINAL ARTICLENursing care for patient in postoperatory heart surgery in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(2):e20200163
DOI 10.1590/0034-7167-2020-0163
Views0See moreABSTRACT
Objective:
To investigate the critical nodes related to nursing care for patients in the postoperative period of cardiac surgery.
Methods:
Exploratory study with a qualitative approach. Data collected through semi-structured interviews with 27 members of the nursing team working in the Intensive Care Unit. Material submitted to thematic analysis.
Results:
Three categories emerged: Flaws in the professional qualification for patient care in the postoperative period of cardiac surgery; Team challenges concerning specific patient care in the postoperative period of cardiac surgery; and (dis) organization of work in the Intensive Care Unit and its impact on nursing care for patients in the postoperative period of cardiac surgery.
Final considerations:
Given the identification of the critical nodes, the professionals presented suggestions to overcome daily difficulties: investments in strategies for Permanent Education in Health; creation of tools to guide patient assistance in the postoperative of cardiac surgery; and provision of adequate human resources.
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ORIGINAL ARTICLE12-13-2019
Factors associated with low Apgar in newborns in birth center
- Nágela Cristine Pinheiro Santos ,
- Sibylle Emilie Vogt ,
- Elysângela Dittz Duarte ,
- Adriano Marçal Pimenta ,
- Lélia Maria Madeira , [ … ],
- Mery Natali Silva Abreu
Abstract
ORIGINAL ARTICLEFactors associated with low Apgar in newborns in birth center
Revista Brasileira de Enfermagem. 2019;72:297-304
DOI 10.1590/0034-7167-2018-0924
- Nágela Cristine Pinheiro Santos ,
- Sibylle Emilie Vogt ,
- Elysângela Dittz Duarte ,
- Adriano Marçal Pimenta ,
- Lélia Maria Madeira ,
- Mery Natali Silva Abreu
Views1See moreABSTRACT
Objective:
to analyze factors associated with Apgar of 5 minutes less than 7 of newborns of women selected for care at the Center for Normal Birth (ANC).
Method:
a descriptive cross-sectional study with data from 9,135 newborns collected between July 2001 and December 2012. The analysis used absolute and relative frequency frequencies and bivariate analysis using Pearson’s chi-square test or the exact Fisher.
Results:
fifty-three newborns (0.6%) had Apgar less than 7 in the 5th minute. The multivariate analysis found a positive association between low Apgar and gestational age less than 37 weeks, gestational pathologies and intercurrences in labor. The presence of the companion was a protective factor.
Conclusion:
the Normal Birth Center is a viable option for newborns of low risk women as long as the protocol for screening low-risk women is followed.
- Nágela Cristine Pinheiro Santos
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REVIEW09-06-2022
Biosafety measures to prevent COVID-19 in healthcare professionals: an integrative review
- Olvani Martins da Silva ,
- Danielle Bezerra Cabral ,
- Sandra Mara Marin ,
- Julia Valeria de Oliveira Vargas Bitencourt ,
- Mara Ambrosina de Oliveira Vargas , [ … ],
- William Campo Meschial
Abstract
REVIEWBiosafety measures to prevent COVID-19 in healthcare professionals: an integrative review
Revista Brasileira de Enfermagem. 2022;75(1):e20201191
DOI 10.1590/0034-7167-2020-1191
- Olvani Martins da Silva ,
- Danielle Bezerra Cabral ,
- Sandra Mara Marin ,
- Julia Valeria de Oliveira Vargas Bitencourt ,
- Mara Ambrosina de Oliveira Vargas ,
- William Campo Meschial
Views0See moreABSTRACT
Objective:
to identify the main biosafety measures for preventing COVID-19 in healthcare professionals.
Methods:
this is an integrative literature review, with studies published between January and July 2020, on the MEDLINE/PubMed, Scopus, Embase, Web of Science, LILACS, SciELo, Wiley Online Library, Cochrane CINAHL databases. The selection of studies followed the PRISMA recommendations.
Results:
among the 2,208 publications identified, 12 studies comprised the sample, which enabled the analysis in four thematic categories: The importance of using recommendations about the use of personal protective equipment; The restructuring of new operational and clinical routines and flows in the practice of services; Monitoring professionals, especially testing; Conducting training.
Conclusions:
the phenomena involved are innumerable, covering operational management and the training of teams to deal with highly infectious pathogens and disease outbreaks.
- Olvani Martins da Silva
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ORIGINAL ARTICLE09-21-2020
Adolescents in situations of poverty: resilience and vulnerabilities to sexually transmitted infections
- Maria Isabelly Fernandes da Costa ,
- Raelson Ribeiro Rodrigues ,
- Rayssa Matos Teixeira ,
- Paulo Henrique Alexandre de Paula ,
- Izaildo Tavares Luna , [ … ],
- Patrícia Neyva da Costa Pinheiro
Abstract
ORIGINAL ARTICLEAdolescents in situations of poverty: resilience and vulnerabilities to sexually transmitted infections
Revista Brasileira de Enfermagem. 2020;73:e20190242
DOI 10.1590/0034-7167-2019-0242
- Maria Isabelly Fernandes da Costa ,
- Raelson Ribeiro Rodrigues ,
- Rayssa Matos Teixeira ,
- Paulo Henrique Alexandre de Paula ,
- Izaildo Tavares Luna ,
- Patrícia Neyva da Costa Pinheiro
Views0See moreABSTRACT
Objective:
To analyze the association between vulnerabilities to Sexually Transmitted Infections (STIs/HIV/AIDS) of adolescents in poverty and their level of resilience.
Method:
Cross-sectional study with 287 students between 11 and 17 years old in a school in the outskirts of Fortaleza-Ce. The study was conducted from August to October 2016. Three instruments related to characterization, vulnerability to STIs/HIV/AIDS and resilience were used. The association between the instruments was calculated using the Mann-Whitney and Kruskal-Wallis tests. Association between vulnerability to STIs/HIV/AIDS and resilience was assessed through the Spearman’s correlation coefficient. Statistical significance was set at p<0.05.
Results:
There was a significant association between the factors “housing” (p=0.022), “family income” (p=0.037) and vulnerability to STIs/HIV/AIDS. Adolescents whose father has completed high school (p=0.043) have moderately high resilience.
Conclusion:
Adolescents with low socioeconomic status and who live on less than a minimum wage tends to be more susceptible to vulnerabilities to STIs/HIV/AIDS and to have low resilience.
- Maria Isabelly Fernandes da Costa
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