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ORIGINAL ARTICLE06-17-2024
Quality of life associated with nursing professionals’ individual resources and work
Revista Brasileira de Enfermagem. 2024;77(3):e20230476
Abstract
ORIGINAL ARTICLEQuality of life associated with nursing professionals’ individual resources and work
Revista Brasileira de Enfermagem. 2024;77(3):e20230476
DOI 10.1590/0034-7167-2023-0476
Views0See moreABSTRACT
Objectives:
to assess the physical and mental components of nursing professionals’ quality of life and associate them with individual, health and work characteristics.
Methods:
cross-sectional research, with nursing professionals from a university hospital in São Paulo. Own questionnaire and validated instruments were applied.
Results:
the overall quality of life was compromised. The physical component was lower in relation to low family income and among those who perceived greater control/pressure at work, and better for those who practiced physical activity and had support of leader and organization. The mental component was lower in professionals who reported dissatisfaction with work, worse self-rated physical health and were older. Scores for both components reduced due to work-related illnesses, worse work ability and increased daytime sleepiness.
Conclusions:
quality of life was statistically associated with controllable institutional factors and individual resources that, except age, can be promoted.
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ORIGINAL ARTICLE06-17-2024
Social protection in areas vulnerable to tuberculosis: a mixed methods study in São Luís, Maranhão
Revista Brasileira de Enfermagem. 2024;77(3):e20230428
Abstract
ORIGINAL ARTICLESocial protection in areas vulnerable to tuberculosis: a mixed methods study in São Luís, Maranhão
Revista Brasileira de Enfermagem. 2024;77(3):e20230428
DOI 10.1590/0034-7167-2023-0428
Views0See moreABSTRACT
Objectives:
to analyze the risk areas for tuberculosis and the influences of social protection on the development of treatment for the disease in the municipality of São Luís, Maranhão.
Methods:
this is explanatory sequential mixed method research. In the quantitative phase, the data were obtained from the Notifiable Diseases Information System from 2010 to 2019, with georeferencing being carried out to identify areas vulnerable to tuberculosis. In the qualitative phase, semi-structured interviews were carried out with individuals who received social benefits.
Results:
7,381 cases were geocoded, and, from the purely spatial scanning analysis, it was possible to identify 13 spatial clusters of risk. As for the interviews, there was a positive relationship between patient improvement and receiving benefits.
Conclusions:
geographic space and social determinants are relevant for reorienting monitoring actions for the conditions that generate the health-disease process.
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ORIGINAL ARTICLE06-17-2024
Giving meaning to internalized violence throughout life by older adults living in rural areas
Revista Brasileira de Enfermagem. 2024;77(3):e20230163
Abstract
ORIGINAL ARTICLEGiving meaning to internalized violence throughout life by older adults living in rural areas
Revista Brasileira de Enfermagem. 2024;77(3):e20230163
DOI 10.1590/0034-7167-2023-0163
Views0See moreABSTRACT
Objectives:
to understand the meanings of violence internalized throughout life by older adults living in rural areas.
Methods:
a qualitative study, anchored in the Symbolic Interactionism theoretical framework and the Grounded Theory methodological framework in the constructivist aspect. Data collection occurred through individual interviews. Data were coded using the Atlas.ti software.
Results:
it was possible to identify that the context of rural areas strengthens patriarchy culture as well as contributing to violence silence and naturalization. It was also found that violence is a product of social inequality and gender inequality.
Final Considerations:
older adults living in rural areas internalized the violence suffered in a unique way, and this scenario’s specific aspects can increase intra-family abuse, as there is a patriarchal culture that promotes social and gender inequality.
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ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
DOI 10.1590/0034-7167.20247702e06
Views0In the article “Is there scientific relevance to the plot of films and documentaries about eating disorders?”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(1):e20220547, page 7:Where it read:[…]See more -
ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e05
DOI 10.1590/0034-7167.20247702e05
Views0In the article “Educational technologies used to promote self-care for people with diabetes mellitus: integrative review”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 4):e20230049, in the title:Where it read:[…]See more -
REVIEW06-14-2024
Lean and/or Six Sigma for process optimization in the perioperative period: an integrative review
Revista Brasileira de Enfermagem. 2024;77(2):e20230431
Abstract
REVIEWLean and/or Six Sigma for process optimization in the perioperative period: an integrative review
Revista Brasileira de Enfermagem. 2024;77(2):e20230431
DOI 10.1590/0034-7167-2023-0431
Views0See moreABSTRACT
Objective:
To analyze the evidence on the influence of Lean and/or Six Sigma for process optimization in the perioperative period.
Methods:
Integrative review carried out in the MEDLINE (PubMed), Web of Science, EMBASE, CINAHL, Scopus and LILACS databases on the use of Lean and/or Six Sigma to optimize perioperative processes. The studies included were analyzed in three thematic categories: flow of surgical patients, work process and length of stay.
Results:
The final sample consisted of ten studies, which covered all operative periods. Lean and/or Six Sigma make a significant contribution to optimizing perioperative processes.
Final considerations:
Lean and/or Six Sigma optimize perioperative processes to maximize the achievement of system stability indicators, making it possible to identify potential problems in order to recognize them and propose solutions that can enable the institution of patient-centered care.
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ORIGINAL ARTICLE06-14-2024
Strategies used by nurses regarding underreporting of rural work accidents due to pesticide use
Revista Brasileira de Enfermagem. 2024;77(2):e20230384
Abstract
ORIGINAL ARTICLEStrategies used by nurses regarding underreporting of rural work accidents due to pesticide use
Revista Brasileira de Enfermagem. 2024;77(2):e20230384
DOI 10.1590/0034-7167-2023-0384
Views0See moreABSTRACT
Objective:
To learn the strategies used regarding underreporting of pesticide use in rural areas.
Methods:
A qualitative study was carried out in eight primary healthcare units in rural areas and two emergency care units in a municipality in southern Brazil. Data collection took place in 2023 through interviews. Twenty professional nurses participated. The data was submitted to content analysis.
Results:
The strategies identified were lifelong and continuing education for the professionals who carry out the notification, active search and training of workers who deal directly with this type of substance, computerizing the notification by filling in the forms online, and carrying out research on the subject.
Final considerations:
Nurses play an important role in reporting occupational accidents caused by the use of pesticides, improving occupational safety in rural areas.
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06-14-2024
Teoria de médio alcance do diagnóstico de enfermagem sobrepeso
Revista Brasileira de Enfermagem. 2024;77(2):e20230372
Abstract
Teoria de médio alcance do diagnóstico de enfermagem sobrepeso
Revista Brasileira de Enfermagem. 2024;77(2):e20230372
DOI 10.1590/0034-7167-2023-0372
Views0See moreRESUMEN
Objetivo:
Construir una teoría de rango medio para el diagnóstico de enfermería Sobrepeso en adolescentes y adultos jóvenes.
Métodos:
Estudio metodológico a la luz de los marcos teóricos de Roy y de Lopes, Silva y Herdman. Un total de 3.925 artículos fueron recuperados y evaluados utilizando el software State of the Art Through Systematic Review. La muestra final fue de 28 artículos.
Resultados:
Los resultados convergieron en 3 atributos esenciales, 13 antecedentes y 7 consecuencias. Se construyó una teoría de rango medio compuesta por un diagrama ilustrado, 11 proposiciones y 12 relaciones causales.
Consideraciones finales:
A partir de la creación de la teoría, fue posible comprender mejor el diagnóstico de enfermería Sobrepeso en el contexto de adolescentes y adultos jóvenes. La comprensión de los fenómenos de enfermería contribuye para el avance y fortalecimiento de la ciencia de enfermería.
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01-01-2016
Perfil dos pacientes com tumores cerebrais e o papel do enfermeiro
Revista Brasileira de Enfermagem. 2016;69(1):150-155
Abstract
Perfil dos pacientes com tumores cerebrais e o papel do enfermeiro
Revista Brasileira de Enfermagem. 2016;69(1):150-155
DOI 10.1590/0034-7167.2016690120i
Views0See moreRESUMEN
Objetivo:
describir el perfil de los 200 pacientes con tumores del sistema nervioso central (TSNC) y el papel de la enfermería.
Método:
análisis prospectivo, cuantitativo y descriptivo de los registros médicos de 200 pacientes con TSNC.
Resultados:
61% de los pacientes tenían TSNC benignos y 39% tumores malignos. El grado de la dependencia de los pacientes según la Escala de Karnofsky fue significativamente mayor en los pacientes con tumores malignos (P <0,05), lo que indica que estos pacientes necesitan más apoyo en las actividades diarias.
Conclusión:
los pacientes con tumores cerebrales requieren atención especializada, con directrices específicas sobre su enfermedad y aspectos de la vida diaria después del tratamiento. Por lo tanto, los enfermeros pueden ser un elemento clave para la eficacia de la atención prestada a los pacientes y sus familias con el objetivo de mejorar la calidad de vida de las personas afectadas por la enfermedad.
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01-01-2016
Profile of patients with brain tumors and the role of nursing care
Revista Brasileira de Enfermagem. 2016;69(1):150-155
Abstract
Profile of patients with brain tumors and the role of nursing care
Revista Brasileira de Enfermagem. 2016;69(1):150-155
DOI 10.1590/0034-7167.2016690120i
Views0See moreABSTRACT
Objective:
to describe the profile of 200 patients with central nervous system tumors (CNST), and the role of the nursing care.
Method:
prospective, quantitative and descriptive analysis of medical records of 200 patients with TSNC.
Results:
a total of 61% of our patients had benign CNST and 39% had malignant tumors. The extent of patient dependence, according to the Karnofsky Performance Status scale, was significantly greater for patients with malignant CNST (p < .05), indicating that these patients needed more support with their activities of daily living.
Conclusion:
patients with CNST need specialized care, with specific guidance regarding their disease and aspects of daily living after treatment. Thus, the nurse can function as a key element for the effectiveness of care provided to patients and family members with the aim of enhancing the quality of life of all those affected, directly or indirectly, by the disease.
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01-01-2016
Clinical competences of nursing assistants: a strategy for people management
Revista Brasileira de Enfermagem. 2016;69(1):142-149
Abstract
Clinical competences of nursing assistants: a strategy for people management
Revista Brasileira de Enfermagem. 2016;69(1):142-149
DOI 10.1590/0034-7167.2016690119i
Views0See moreABSTRACT
Objective:
to identify the clinical competences of nursing assistants in a hospital organization and to understand how professional acquired these competences.
Method:
an exploratory study of a qualitative approach, performed at a private hospital in southern Brazil, through a semi-structured interview, in May and June 2013 with 20 nursing assistants.
Results:
the nursing assistantswho worked longer in the same work unit had a higher list of clinical competences. The acquisition of clinical competences occurred through interaction with other professionals; in daily nursing practice; in previous experiences and in formal learning.
Final considerations:
the identification of clinical competences and the way nursing assistants acquire these competences can be important resources for managing people, which can be used by nurse managers to better allocate these professionals and provide th e opportunity for their professional development.
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01-01-2016
Quality of life and accession to the pharmacological treatment among elderly hypertensive
Revista Brasileira de Enfermagem. 2016;69(1):134-141
Abstract
Quality of life and accession to the pharmacological treatment among elderly hypertensive
Revista Brasileira de Enfermagem. 2016;69(1):134-141
DOI 10.1590/0034-7167.2016690118i
Views0See moreABSTRACT
Objective:
to compare variables obtained in adherence and non-adherence to drug treatment for hypertension, according to socioeconomic situation, time of diagnosis, self-reported morbidities, indicative of depression and quality of life.
Method:
cross-sectional analytical study of 524 elderly with adherence and 505 non-adherence to the treatment. A descriptive analysis, Chi-square test and Student t test (p < 0.05) were held.
Results:
there was higher proportion of older subjects, indicative of morbidity and depression among those with adherence. Non-adherence subjects had lower scores in all domains and quality of life facets.
Conclusion:
actions favoring the adherence to pharmacological treatment should be recommended, to minimize the impact of comorbidities and improve quality of life.
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01-01-2016
Exposure and sun protection practices of university students
Revista Brasileira de Enfermagem. 2016;69(1):126-133
Abstract
Exposure and sun protection practices of university students
Revista Brasileira de Enfermagem. 2016;69(1):126-133
DOI 10.1590/0034-7167.2016690117i
Views0See moreABSTRACT
Objective:
to learn exposure and sun protection practices for university students.
Method:
a descriptive, cross-sectional study performed at a university in São Paulo.
Results:
the sample consisted of 385 young and data collection conducted through a form. Of the total, 239 (62%) young people were classified as skin type III and IV and 69 (17.9%) affirmed to have a history of skin cancer in the family. Most affirmed exposure to the sun between 10 a.m and 04 p.m and for more than one hour; 112 (29.1%) informed not employ safeguards. Among those who use sunscreen, the minority does so regularly.
Conclusion:
although the sample was made up of people with greater access to information, it was found exposure and sunscreen improperly. Education, individual and collective actions should be strengthened and prioritized given the incidence of skin cancer in the country.
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01-01-2016
Hospitalizations sensitive to primary health care at a regional hospital in the Federal District
Revista Brasileira de Enfermagem. 2016;69(1):118-125
Abstract
Hospitalizations sensitive to primary health care at a regional hospital in the Federal District
Revista Brasileira de Enfermagem. 2016;69(1):118-125
DOI 10.1590/0034-7167.2016690116i
Views0See moreABSTRACT
Objective:
to characterize hospitalizations for sensitive conditions to primary care of a regional hospital in the Federal District.
Method:
this is a descriptive study, such as case series that considered users admitted between 2008 and 2012 in the Regional Hospital of Ceilândia. The selection of hospitalizations was based on the Brazilian List, and the data were obtained from the Hospital information System. The descriptive statistics was used in the data processing and analysis.
Results:
ACSC (Ambulatory Care Sensitive Conditions) showed a growth tendency, mainly due to cerebrovascular diseases, lung diseases and infections in the kidney and urinary tract. Female and elderly patients showed a higher frequency of hospitalizations.
Conclusion:
the results may help managers and health professionals to implement actions that aim higher solvability of primary care, and contribute to the systematization of nursing care and improved health care.
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01-01-2016
Significations of being the caregiver of the companion with cancer: an existential look
Revista Brasileira de Enfermagem. 2016;69(1):110-117
Abstract
Significations of being the caregiver of the companion with cancer: an existential look
Revista Brasileira de Enfermagem. 2016;69(1):110-117
DOI 10.1590/0034-7167.2016690115i
Views0See moreABSTRACT
Objective:
to unveil the significances of women who experience being the caregiver of their companion with cancer.
Method:
a Heidegger’s phenomenological research, performed with ten women who are caregivers of their companions with cancer in a town in the northwest of the state of Paraná, Brazil, from December 2013 to February 2014. The following guiding question was used: “How has it been for you to care for your companion with cancer?”.
Results:
from the analysis of the speeches the following ontological themes emerged: “Taking responsibility of caring for the companion with cancer”, “Learning to live with the intimacy changes” and “Learning to live with the feelings related to care”. The data revealed the wives’ sense of responsibilities for caring and the influence of feelings in the act of caring, including the impact on the couple’s intimacy.
Conclusion:
in the midst of difficulties, the feelings of affection are the driving force behind these women to continue their actions as wife-caregivers.
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01-01-2016
Defining characteristics of the nursing diagnosis “ineffective airway clearance”
Revista Brasileira de Enfermagem. 2016;69(1):102-109
Abstract
Defining characteristics of the nursing diagnosis “ineffective airway clearance”
Revista Brasileira de Enfermagem. 2016;69(1):102-109
DOI 10.1590/0034-7167.2016690114i
Views1See moreABSTRACT
Objective:
to analyze the defining characteristics of the nursing diagnosis “ineffective airway clearance” in children with acute respiratory infection.
Method:
cross-sectional descriptive study, developed in two hospitals specialized in care for children. It was held a detailed respiratory evaluation of the child to identify the defining characteristics of the diagnosis under study.
Results:
a total of 249 children were evaluated, 55.8% were male and the median age was 13.76 months. Ineffective airway clearance was identified in 222 children (89.2%). The following defining characteristics presented statistically significant associations: dyspnea, expectoration, orthopnea, respiratory adventitious sounds, decreased breath sounds and ineffective cough. Decreased breath sounds, ineffective cough and respiratory adventitious sounds composed the logistic regression model.
Conclusion:
the characteristics decreased breath sounds, ineffective cough and respiratory adventitious sounds have better predictive capacity for the diagnosis “ineffective airway clearance” in children with acute respiratory infection.
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01-01-2017
Assessing the adequacy of workload measurement tools using a quality-based methodology
Revista Brasileira de Enfermagem. 2017;70(1):39-46
Abstract
Assessing the adequacy of workload measurement tools using a quality-based methodology
Revista Brasileira de Enfermagem. 2017;70(1):39-46
DOI 10.1590/0034-7167-2016-0246
Views0See moreABSTRACT
Objective:
determine which tool (NEMS and NAS) is most suitable for use in intensive care units using a quality-based methodology.
Method:
after identifying the opportunity for improvement “Inadequacy of the NEMS for determining nursing workload in the intensive care unit (ICU)”, we assessed the NEMS and the NAS, as a proposed improvement to the NEMS, using quality improvement cycles methodology based on the following criteria: measurement of daily nursing workload on a daily and shift basis; the tool encompasses all nursing activities undertaken in the ICU; and workload assessed per patient and unit.
Results:
there was no significant difference in level of compliance for the NEMS (67%). The comparison NEMS-NAS showed that there was a statistically significant improvement for all criteria except criterion 1. The NEMS only assesses criterion 1 (64.22%); while the NAS assessed all four criteria, obtaining a compliance rate of 64.74% for criteria 1, 2, and 4, and 100% for criterion 3.
Conclusion:
the NAS is more suitable for measuring nursing workload in UCIs.
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01-01-2017
Educational nursing intervention to reduce the hyperphosphatemia in patients on hemodialysis
Revista Brasileira de Enfermagem. 2017;70(1):31-38
Abstract
Educational nursing intervention to reduce the hyperphosphatemia in patients on hemodialysis
Revista Brasileira de Enfermagem. 2017;70(1):31-38
DOI 10.1590/0034-7167-2016-0015
Views0See moreABSTRACT
Objective:
to evaluate the effectiveness of an educational nursing intervention to reduce hyperphosphataemia in chronic renal patients on hemodialysis.
Method:
quasi-experimental study with 63 hyperphosphatemic patients on hemodialysis. The intervention consisted of developing and providing a printed and illustrated manual to patients containing information on disease control. The participant was asked to complete a daily checklist with the aim to reinforce aspects provided in the manual. Laboratory tests and itching intensity were analyzed at the beginning of the study, and at 30 and 60 days after the educational intervention.
Results:
the mean age of participants was 58±13.1 years, with a treatment time of 51.1±44.7 months. A reduction in serum phosphorus values of 7.06 ± 1.43 to 5.80 ± 1.53 (p <0.001) and the intensity of itching after the intervention was observed.
Conclusion:
the educational nursing intervention was effective in reducing phosphate and decreasing itching in hyperphosphatemic patients.
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01-01-2017
Filial care and the relationship with the elderly in families of different nationalities
Revista Brasileira de Enfermagem. 2017;70(1):22-30
Abstract
Filial care and the relationship with the elderly in families of different nationalities
Revista Brasileira de Enfermagem. 2017;70(1):22-30
DOI 10.1590/0034-7167-2015-0050
Views0See moreABSTRACT
Objective:
identify how filial care and the relationship with the elderly occur in families of different nationalities.
Method:
qualitative study carried out in a town on the triple frontier of Paraná, comprising 33 elderly people of five different nationalities, adopting the Symbolic Interactionism and the Grounded Theory as theoretical-methodological strategy.
Results:
among Lebanese people, the Muslim religion teaches children to obey and respect parents; among French, distant family relationships and institutions for the elderly stand out. Paraguayans hold close family relationships; Chinese people consider filial care as a tacit obligation; Brazilians, in turn, tend to embrace and take care of their parents in old age.
Conclusion:
family care prevailed, but the traditions of each society lead the actions of that care, demanding health professionals’ capacity of recognizing in which context the elderly is inserted.
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01-01-2017
Excesso de volume de líquidos: análise clínica e sociodemográfica em pacientes de hemodiálise
Revista Brasileira de Enfermagem. 2017;70(1):15-21
Abstract
Excesso de volume de líquidos: análise clínica e sociodemográfica em pacientes de hemodiálise
Revista Brasileira de Enfermagem. 2017;70(1):15-21
DOI 10.1590/0034-7167-2015-0138
Views0See moreRESUMEN
Objetivo:
analizar las características definitorias y los factores relacionados con el diagnóstico enfermero de exceso de volumen líquido y su relación con variables sociodemográficas y clínicas en pacientes de hemodiálisis.
Método:
estudio transversal, realizado mediante un formulario y examen físico, con una muestra de 100 pacientes, entre diciembre de 2012 y abril de 2013 en un hospital universitario y una clínica de diálisis.
Resultados:
se encontraron 10 asociaciones estadísticamente significativas entre las características definitorias, factores relacionados de volumen de exceso de líquido y las variables sociodemográficas y clínicas.
Conclusión:
las características definitorias y los factores relacionados de exceso de volumen líquido podrían estar influenciados por variables sociodemográficas y clínicas en clientes de hemodiálisis.
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01-01-2017
Excess fluid volume: sociodemographic and clinical analysis in haemodialysis patients
Revista Brasileira de Enfermagem. 2017;70(1):15-21
Abstract
Excess fluid volume: sociodemographic and clinical analysis in haemodialysis patients
Revista Brasileira de Enfermagem. 2017;70(1):15-21
DOI 10.1590/0034-7167-2015-0138
Views0See moreABSTRACT
Objective:
To analyse the defining characteristics and related factors in the nursing diagnosis Excess fluid volume and its relationship to sociodemographic and clinical variables in haemodialysis patients.
Method:
Cross-sectional study, conducted using a form and physical examination, with a sample of 100 patients, between December 2012 and April 2013 at a university hospital and a dialysis clinic.
Results:
It was found 10 significant statistical associations between the defining characteristics/ related factors of Excess fluid volume and the sociodemographic and clinical variables.
Conclusion:
The defining characteristics and related factors of Excess fluid volume could be influenced by sociodemographic and clinical variables in haemodialysis clientele.
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01-01-2017
Facing challenges in times of adversity
Revista Brasileira de Enfermagem. 2017;70(1):1-2
Abstract
Facing challenges in times of adversity
Revista Brasileira de Enfermagem. 2017;70(1):1-2
DOI 10.1590/0034-7167.2017700101
Views0At the confluence of tradition, respect for history and a critical approach to the issues inherent to the development of the nursing profession, the Brazilian Nursing Association (ABEn) has been consolidating an exemplary trajectory in Brazilian society. Throughout its history, the reflections, discussions and decisions on pertinent and urgent subjects of the profession have made […]See more -
01-01-2017
Enfrentando desafios em tempos de adversidades
Revista Brasileira de Enfermagem. 2017;70(1):1-2
Abstract
Enfrentando desafios em tempos de adversidades
Revista Brasileira de Enfermagem. 2017;70(1):1-2
DOI 10.1590/0034-7167.2017700101
Views0Na confluência da tradição, do respeito pela história e da abordagem crítica das questões inerentes ao desenvolvimento da profissão de enfermagem, a Associação Brasileira de Enfermagem (ABEn) vem consolidando uma trajetória exemplar na sociedade brasileira. Ao longo da sua história, as reflexões, discussões e decisões sobre assuntos pertinentes e prementes da profissão têm possibilitado intervenções […]See more -
01-01-2016
Epistemology of nursing care: a reflection on its foundations
Revista Brasileira de Enfermagem. 2016;69(6):1240-1245
Abstract
Epistemology of nursing care: a reflection on its foundations
Revista Brasileira de Enfermagem. 2016;69(6):1240-1245
DOI 10.1590/0034-7167-2016-0331
Views0See moreABSTRACT
Objective:
to reflect on nursing care and its epistemology from its historical, theoretical, philosophical, spiritual dimensions and as a social practice.
Method:
discussions originated in the discipline “Epistemology of caring”, from the graduate nursing program of the School of Nursing, Federal University of Minas Gerais, and in critical analysis of nursing literature together with the professional practice of the authors.
Results:
we identified the necessity of developing a critical conscience on health care provision, research, and teaching, as well as on challenges in maintaining high standards of working interpersonal relationships, which has a profound impact on population health.
Conclusion:
we suggest the rescue of integrality, humanization, unity, and spirituality in researches and practices of individual, familiar, and community care, as an advance in incorporating epistemology of caring in nursing.
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