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ORIGINAL ARTICLE07-29-2024
Adaptation strategies for preparing for childbirth in the context of the pandemic: Roy’s Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230159
Abstract
ORIGINAL ARTICLEAdaptation strategies for preparing for childbirth in the context of the pandemic: Roy’s Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230159
DOI 10.1590/0034-7167-2023-0159
Views0See moreABSTRACT
Objectives:
to understand the process of adapting to childbirth during the COVID-19 pandemic from the perspective of a group of pregnant women.
Methods:
a qualitative, descriptive-exploratory study was conducted with 23 women. Data were collected between October and December 2021 through documentation and semi-structured interviews, which were analyzed using Minayo’s methodology and Roy’s Adaptation Model.
Results:
various types of stimuli – focal, contextual, and residual – were identified as influencing childbirth preparation. The online group was essential for facilitating pregnant women’s adaptation, offering significant support and generating positive feedback for childbirth preparation.
Final Considerations:
the importance of pregnant women’s groups as a strategy for improving adaptation to childbirth was identified, underscoring the effectiveness of this support among professionals and participants, as well as among pregnant women. This support network strengthened preparation for childbirth during a challenging period like the pandemic.
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ORIGINAL ARTICLE07-29-2024
Profile of patients in private home care who developed ventilator-associated pneumonia
Revista Brasileira de Enfermagem. 2024;77(3):e20230146
Abstract
ORIGINAL ARTICLEProfile of patients in private home care who developed ventilator-associated pneumonia
Revista Brasileira de Enfermagem. 2024;77(3):e20230146
DOI 10.1590/0034-7167-2023-0146
Views0See moreABSTRACT
Objectives:
to analyze the profile and clinical outcomes of patients who developed Ventilator-Associated Pneumonia (VAP) in private home care and to compare the incidence with national data.
Methods:
this was a retrospective study with data collected from July 2021 to June 2022 from patient records at a private clinic. Patients using intermittent ventilation or without ventilatory support were excluded.
Results:
the utilization rate of mechanical ventilation was 15.9%. The incidence density of pneumonia in pediatrics was 2.2 cases per 1000 ventilation-days and in adults was 1.7 cases per 1000 ventilation-days, figures lower than those reported by the National Health Surveillance Agency. There were 101 episodes of pneumonia in 73 patients, predominantly male (65.8%), adults (53.4%), and those with neurological diseases (57.5%). The treatment regimen predominantly took place at home (80.2%), and there was one death.
Conclusions:
patients in home care showed a low incidence and mortality rate from ventilator-associated pneumonia.
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ORIGINAL ARTICLE07-29-2024
Impact of educational intervention on understanding health recommendations after liver transplantation
Revista Brasileira de Enfermagem. 2024;77(3):e20230132
Abstract
ORIGINAL ARTICLEImpact of educational intervention on understanding health recommendations after liver transplantation
Revista Brasileira de Enfermagem. 2024;77(3):e20230132
DOI 10.1590/0034-7167-2023-0132
Views0See moreABSTRACT
Objectives:
to evaluate the impact of educational intervention on understanding health recommendations after liver transplantation.
Methods:
randomized and prospective clinical trial, with 68 liver transplant recipients in two institutions. The level of understanding was assessed using a statement agreement scale and the understanding score was classified. Chi-square test was used to compare groups.
Results:
the level of understanding was reasonable in 77.9% of patients, 73.5% in the Control Group and 82.3% in the Intervention Group (p=0.399). For topics covered after educational action, there were more than 80% correct answers regarding nutrition, frequent hydration, usage and function of immunosuppressants. However, there were less than 10% correct answers regarding hand hygiene, contact with animals and crowds of people. The use of the patient’s audio, visual and tactile resources led to improved understanding of skin care (p=0.014).
Conclusions:
the level of understanding acquired regarding health recommendations was only reasonable.
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ORIGINAL ARTICLE07-29-2024
Trends in cesarean section rates in Brazil by Robson classification group, 2014-2020
Revista Brasileira de Enfermagem. 2024;77(3):e20230099
Abstract
ORIGINAL ARTICLETrends in cesarean section rates in Brazil by Robson classification group, 2014-2020
Revista Brasileira de Enfermagem. 2024;77(3):e20230099
DOI 10.1590/0034-7167-2023-0099
Views0See moreABSTRACT
Objectives:
to evaluate the trends in cesarean sections from 2014 to 2020 across both public and private sectors, utilizing the Robson Classification.
Methods:
this time series study analyzed the proportion of women who underwent cesarean sections between 2014 and 2020, considering both the Robson classification and the type of healthcare service. Trend analysis was conducted using the Prais-Winsten regression.
Results:
higher proportions of cesarean sections were observed in all Robson groups within the private sector compared to the public sector. This was despite a decreasing trend in the private sector and an increasing trend in the public sector. Notably, elevated proportions of cesarean sections were recorded in groups that are typically favorable to normal childbirth (Robson 1, 4, and 5).
Conclusions:
although there was a decreasing trend in cesarean sections within the private sector, an increasing trend was observed in the public sector. Additionally, there was a high proportion of cesarean sections among women with conditions favorable to normal childbirth. It is crucial to continuously monitor these indicators to evaluate and implement interventions aimed at reducing unnecessary cesarean sections.
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ORIGINAL ARTICLE07-29-2024
Healthcare judicialization: an analysis of indicators and official data on medications
Revista Brasileira de Enfermagem. 2024;77(3):e20220413
Abstract
ORIGINAL ARTICLEHealthcare judicialization: an analysis of indicators and official data on medications
Revista Brasileira de Enfermagem. 2024;77(3):e20220413
DOI 10.1590/0034-7167-2022-0413
Views0See moreABSTRACT
Objectives:
to analyze judicial demands for medications in Campo Grande, Brazil, between July 2018 and June 2020.
Methods:
the four dimensions of the Manual of Indicators for Evaluation and Monitoring of Judicial Demands for Medications were examined.
Results:
676 judicial processes were identified, corresponding to 1006 requests for 284 different medications. In 92.74% of the processes, access to medications was granted, with 88.80% granted on an urgent basis. The median time between the decision and delivery of the medication was 146 days. The average monthly cost of acquiring medications was R$ 2,183.68 Brazilian reais. Among the identified medications, 90.22% had at least one therapeutic alternative available in the public healthcare system.
Conclusions:
characterizing and analyzing judicial demands related to medications can support discussions on updating medication lists and clinical protocols, organizing healthcare services, allocating resources, and implementing actions to reduce judicialization.
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ORIGINAL ARTICLE07-19-2024
Nursing students’ perception: Escape Room use in teaching leadership skills
Revista Brasileira de Enfermagem. 2024;77(2):e20230414
Abstract
ORIGINAL ARTICLENursing students’ perception: Escape Room use in teaching leadership skills
Revista Brasileira de Enfermagem. 2024;77(2):e20230414
DOI 10.1590/0034-7167-2023-0414
Views0See moreABSTRACT
Objectives:
to understand nursing students’ perception regarding Escape Room use to develop leadership skills.
Methods:
a qualitative exploratory-descriptive study, with 97 nursing students. Escape Room game sessions were held, totaling ten. Subsequently, a debriefing and analysis was carried out using the Discourse of the Collective Subject method, through the focus group technique. Ethical procedures were respected.
Results:
students’ perceptions about using this methodology to develop leadership skills were positive and significant. The effectiveness of the game in teaching and developing these skills in nursing practice stands out.
Final Considerations:
the game was an effective active methodology in approaching the proposed content, promoting satisfaction and easy assimilation.
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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for patient classification to support obstetric nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230401
Abstract
ORIGINAL ARTICLEValidation of an instrument for patient classification to support obstetric nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230401
DOI 10.1590/0034-7167-2023-0401
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Objectives:
to develop and validate an instrument for the classification of pregnant and postpartum women according to the demand for nursing care.
Methods:
a methodological study conducted in three stages: 1) construction of the instrument based on literature review; 2) content validation using the Delphi technique with 12 experts; and 3) Evaluation of the convergent construct validity through the correlation between the scores of the constructed instrument and the Fugulin instrument.
Results:
an instrument with ten indicators of specific care for pregnant and postpartum women was developed. A content validity index higher than 0.9 was obtained, requiring only one round of the Delphi technique. The Spearman coefficient was 0.64 between the instruments, indicating a strong correlation.
Conclusions:
the classification instrument specifically constructed for pregnant and postpartum women showed evidence of content validity and convergent construct validity with a widely used instrument in the national territory.
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ORIGINAL ARTICLE07-19-2024
The use of spirituality/religiosity by oncology nurse residents in nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230383
Abstract
ORIGINAL ARTICLEThe use of spirituality/religiosity by oncology nurse residents in nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230383
DOI 10.1590/0034-7167-2023-0383
Views0See moreABSTRACT
Objectives:
to analyze the use of spirituality/religiosity by oncology nurse residents in caring for patients with cancer.
Methods:
a census, descriptive, sectional study, with 46 nurse residents from three public hospitals in Rio de Janeiro. Data collection took place between August 2020 and January 2021, using a sociodemographic questionnaire, including a question about the use of spirituality/ religiosity to deal with work situations. Descriptive analysis was carried out using SPSS software version 22.0.
Results:
participants stated that they use religiosity/spirituality in work situations related to patients or themselves. In relation to patients, death was the most mentioned situation among professionals, and for themselves, everyday situations and emotional vulnerability were the most mentioned.
Final Considerations:
spirituality and religiosity are dimensions that guide oncology nurse residents’ attitudes.
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01-01-2016
Factors associated with inconsistent condom use among people living with HIV/Aids
Revista Brasileira de Enfermagem. 2016;69(1):47-53
Abstract
Factors associated with inconsistent condom use among people living with HIV/Aids
Revista Brasileira de Enfermagem. 2016;69(1):47-53
DOI 10.1590/0034-7167.2016690106i
Views0See moreABSTRACT
Objective:
to analyze the prevalence and factors associated with inconsistent use of condoms among people living with HIV/ Aids (PLWHA).
Method:
it is a cross-sectional study with 228, with individual interviews conducted in 2011. A multivariate analysis was performed with a logistic regression model.
Results:
143 participants met the inclusion criteria, and the prevalence of inconsistent condom use was 28.7%. However, there was greater adherence among men (79.3%). In the multivariate analysis, the independent variable daily use of alcohol (OR=11.02; 95% CI 1.84, 65.92; p = 0.021) was associated with inconsistent condom use. The chance of men making consistent condom use was higher than women (OR = 0.36, 95% CI 0.15, 0.81; p = 0.015).
Conclusion:
the prevalence of inconsistent condom male use among PLWHA was low, however, evidenced greater compliance among men over women with a statistically significant difference and the daily use of alcohol was associated with inconsistent condom use.
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01-01-2016
Influence of sociodemographic and clinical characteristics at the impact of valvular heart disease
Revista Brasileira de Enfermagem. 2016;69(1):40-46
Abstract
Influence of sociodemographic and clinical characteristics at the impact of valvular heart disease
Revista Brasileira de Enfermagem. 2016;69(1):40-46
DOI 10.1590/0034-7167.2016690105i
Views0See moreABSTRACT
Objective:
to analyze the sociodemographic and clinical characteristics of patients with valvular heart disease and to verify the influence of these variables on the impact of valve disease in daily life.
Method:
the study involved 86 outpatients. Data collection was performed in two stages – face-to-face interview for sociodemographic and clinical characterization and through telephone contact for the application of the Instrument to Measure the Impact of Valvular Heart Disease on Patient’s Everyday Life (IDCV). Data were analyzed through descriptive statistics and multiple regression analysis.
Results:
it was noticed that the total score of IDCV and its domains were influenced by age, schooling, presence or absence of symptoms, use or not of diuretic.
Conclusion:
The impact of the disease was influenced by sociodemographic and clinical variables. The results provide subsidies for the design of nursing interventions aimed at reducing the impact of the disease on the patient’s daily life with valve disease.
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01-01-2016
Health indicators of workers of the hospital area
Revista Brasileira de Enfermagem. 2016;69(1):30-39
Abstract
Health indicators of workers of the hospital area
Revista Brasileira de Enfermagem. 2016;69(1):30-39
DOI 10.1590/0034-7167.2016690104i
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Objective:
to analyze the health indicators of workers of hospital area for exposure to workloads, wear processes and its consequences.
Method:
a retrospective, descriptive and exploratory study performed in a hospital in southern Brazil. The population consisted of 1,050 workers notifications of registered in the Monitoring System of Nursing Workers Health, in 2011.
Results:
80.8% of the records were female workers, with 34.2% aged between 31 to 40 years old, corresponding to 2478 working lost days. The results subsidized the implementation of nine indicators that showed the prevalence of respiratory and osteoarticular problems.
Conclusion:
the results allow the reflection and redirection of actions for workers’ health, as the processes of becoming ill are compounded by exposure to psychic burdens. These indicators, when monitored, can contribute to the transformation of the profile of morbidity of these workers.
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01-01-2016
Evaluation of environmentally sustainable actions in the medication process
Revista Brasileira de Enfermagem. 2016;69(1):23-29
Abstract
Evaluation of environmentally sustainable actions in the medication process
Revista Brasileira de Enfermagem. 2016;69(1):23-29
DOI 10.1590/0034-7167.2016690103i
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Objective:
to analyze sustainable actions from an environmental point of view in the medication process, from the reception of the prescription of the pharmacy to waste discard by nursing.
Method:
study before and after performed through Lean Six Sigma methodology. The sample consisted of the amount and type of waste resulting from the pharmacy and nursing services of a medical-surgical clinical unit.
Results:
after the intervention was obtained at the pharmacy a reduction of 74.8% of chemical, infectious and sharps waste, an increase of 33.3% of common recyclable and 20% of common non-recyclable. In nursing, there was a reduction of 22.5% of chemical, infectious and sharps waste, an increase of 22.9% of common recyclable and an increase of 20% of common non-recyclable.
Conclusion:
the practice of sustainable actions in the hospital is possible, contributing to the optimization of resources and waste production with benefits to the institution, environment, and health.
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01-01-2016
Nursing education: training evaluation by graduates, employers and teachers
Revista Brasileira de Enfermagem. 2016;69(1):16-22
Abstract
Nursing education: training evaluation by graduates, employers and teachers
Revista Brasileira de Enfermagem. 2016;69(1):16-22
DOI 10.1590/0034-7167.2016690102i
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Objective:
to support the assessment and the necessary changes in the curriculum of an undergraduate degree in Nursing.
Methods:
it is a descriptive study developed in two stages as an action research. In the first stage, the speeches of 19 graduates and 15 employers were interviewed and analyzed; in the second stage, five teachers participated in the focus group. For processing the data, the content analysis was adopted.
Results:
based on the assessment of the actors, an action plan was created with suggestions regarding the curriculum flexibility, content resizing, continuing education, practice enhancement, active methodologies and autonomy of the student.
Conclusion:
the participation of actors participants of the training process and performance of professional nurses in the evaluation of a curriculum pointed aspects to realignment and provided concrete benefits to improving the quality of undergraduate course curriculum, scenario of this study.
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01-01-2016
The challenge of the 67th Brazilian Conference of Nursing: In what direction is the Brazilian Nursing going?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
Abstract
The challenge of the 67th Brazilian Conference of Nursing: In what direction is the Brazilian Nursing going?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
DOI 10.1590/0034-7167.2016690101i
Views0Bringing together about 3,700 participants among conference participants, speakers, support staff, organizers and exhibitors, the 67th Brazilian Conference of Nursing extraordinary presented São Paulo with deep and meaningful reflections in an attempt to answer the question “In what direction is the Brazilian Nursing going?”.From the submission of the proposal to host the event until its […]See more -
01-01-2016
O desafio do 67º Congresso Brasileiro de Enfermagem: para onde caminha a Enfermagem brasileira?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
Abstract
O desafio do 67º Congresso Brasileiro de Enfermagem: para onde caminha a Enfermagem brasileira?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
DOI 10.1590/0034-7167.2016690101i
Views0Reunindo cerca de 3.700 participantes entre congressistas, palestrantes, equipe de apoio, organizadores e expositores, o 67º Congresso Brasileiro de Enfermagem agraciou São Paulo com reflexões profundas e significativas, na tentativa de dar sua resposta à questão “Para onde caminha a enfermagem brasileira?”.Desde a apresentação da proposta de sediar o evento até sua realização, o que […]See more -
06-01-2015
Anticipated directives and living will for terminal patients: an integrative review
Revista Brasileira de Enfermagem. 2015;68(3):524-534
Abstract
Anticipated directives and living will for terminal patients: an integrative review
Revista Brasileira de Enfermagem. 2015;68(3):524-534
DOI 10.1590/0034-7167.2015680321i
Views0See moreABSTRACT
Objective:
characterizing the national and international scientifi c literature about the advanced directives of living will as applied to the terminally ill patient.
Method:
integrative review considering the articles published in Portal Capes, SciELO, LILACS, MEDLINE, Journal of Bioethics and Bioethikos, with the descriptors: Advanced directives, Wills regarding life and Advance Directives, Living Will and Terminally Ill, totaling 44 articles submitted to content analysis.
Results:
three categories emerged: Students and professionals facing the advance directives of living will: Perceptions, opinions and practices; Patient’s receptivity to the Advance Directives of Living Will; The family facing the advance directives of living will.
Conclusion:
the relevance of the topic became evident as a guarantee of respect for the dignity and autonomy of the patient, as well as to reduce ethical confl icts faced by families and health professionals facing care at the end of life.
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01-01-2017
Enfermagem em cardiologia: estado da arte e fronteiras do conhecimento
Revista Brasileira de Enfermagem. 2017;70(3):451-452
Abstract
Enfermagem em cardiologia: estado da arte e fronteiras do conhecimento
Revista Brasileira de Enfermagem. 2017;70(3):451-452
DOI 10.1590/0034-7167.2017700301
Views0As doenças cardíacas lideram o grupo das desordens clínicas de maiores taxas de hospitalização e mortalidade, além de apresentarem um progressivo aumento da incidência na população devido ao envelhecimento concomitante ao desenvolvimento das terapias e tecnologias em saúde. Uma estimativa obtida pelo DATASUS() acusa um gasto onerado ao sistema de saúde do país, no ano […]See more -
01-01-2017
Nursing in cardiology: state of the art and frontiers of knowledge
Revista Brasileira de Enfermagem. 2017;70(3):451-452
Abstract
Nursing in cardiology: state of the art and frontiers of knowledge
Revista Brasileira de Enfermagem. 2017;70(3):451-452
DOI 10.1590/0034-7167.2017700301
Views0Heart diseases lead the group of clinical disorders with higher rates of hospitalization and mortality and present a progressive increase in incidence due to population ageing, simultaneously to the development of new health therapies and technology. DATASUS() estimated a cost of nearly 700 million Reais for the country’s health care system in 2015, only for […]See more -
REFLECTION01-01-2017
Nursing care in early childhood: contributions from intersubjective recognition
Revista Brasileira de Enfermagem. 2017;70(2):446-450
Abstract
REFLECTIONNursing care in early childhood: contributions from intersubjective recognition
Revista Brasileira de Enfermagem. 2017;70(2):446-450
DOI 10.1590/0034-7167-2016-0319
Views0See moreABSTRACT
Objective:
to understand the elements composing intersubjective recognition that are relevant for nursing care in early childhood in favor of comprehensive child development.
Method:
reflexive study based on the Honnethian concept of intersubjective recognition in the dimensions of affection, defense of rights, and social esteem.
Results:
nursing knowledge and practices, permeated by the intersubjective recognition in the mentioned dimensions, contribute to the dynamism of interpersonal relations, the production of co-responsibility, and shared construction of health care in early childhood, with benefits to comprehensive development.
Conclusion:
a successful coordination of the three intersubjective dimensions enables the expansion of the understanding on childhood and nursing care in child health in the field of human development promotion, covering affection, defense of rights, and social esteem in the established relationships with future positive individual and social possibilities.
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REFLECTION01-01-2017
Hand hygiene as a caring practice: a reflection on professional responsibility
Revista Brasileira de Enfermagem. 2017;70(2):442-445
Abstract
REFLECTIONHand hygiene as a caring practice: a reflection on professional responsibility
Revista Brasileira de Enfermagem. 2017;70(2):442-445
DOI 10.1590/0034-7167-2016-0189
Views0See moreABSTRACT
Hand hygiene represents a fundamental nursing care practice and is traditionally considered the most important and effective measure in the prevention and control of healthcare-related infections. However, studies indicate that adherence to the procedure is unsatisfactory throughout the world, and show low adherence rates. In a context in which patient safety stands out as a priority, this text submits refl ections about professional responsibility when not adhering to hand hygiene practices, and ethical aspects related to this conduct.
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REFLECTION01-01-2017
Systematization of nursing care and the formation of professional identity
Revista Brasileira de Enfermagem. 2017;70(2):436-441
Abstract
REFLECTIONSystematization of nursing care and the formation of professional identity
Revista Brasileira de Enfermagem. 2017;70(2):436-441
DOI 10.1590/0034-7167-2016-0515
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The aim of this study is to explore arguments that broaden the understanding of possible links between the organization of nursing care and the structuring of professional identity. For that purpose, some aspects related to these themes are addressed, highlighting issues regarding differences in the concepts of the organization of nursing care and the nursing process, as well as the performance of this activity and its possible impact on the establishment of its relationship with the professional identity. Emphasis is given to the need to stimulate the debate on the subject by nursing professionals involved in the training of human resources and the provision of care, as well as in class entities, in order to deepen understanding of these concepts as significant elements for strengthening our professional identity.
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REFLECTION01-01-2017
Brazilian method for the development terminological subsets of ICNP®: limits and potentialities
Revista Brasileira de Enfermagem. 2017;70(2):430-435
Abstract
REFLECTIONBrazilian method for the development terminological subsets of ICNP®: limits and potentialities
Revista Brasileira de Enfermagem. 2017;70(2):430-435
DOI 10.1590/0034-7167-2016-0308
Views1See moreABSTRACT
Reflection on the limits and potentialities of a Brazilian method for the development of terminological subsets of ICNP®,(International Classification for Nursing Practice) based on the correlation between this method and international methods. This issue has been debated by the International Council of Nurses (ICN). Although the council propose a guideline for elaboration, they encourage and reinforce the use of various perspectives and processes in the development of subsets. Brazilian Nursing needs to propose a method and deepen reflections on the use of terminological subsets of ICNP® in the reality of the country. The development of subsets in Brazil is considered incipient and the proposed method needs to be used and deepened in order to spread the use of terminology through the application of subsets.
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EXPERIENCE REPORT01-01-2017
Focus group on qualitative research: experience report
Revista Brasileira de Enfermagem. 2017;70(2):424-429
Abstract
EXPERIENCE REPORTFocus group on qualitative research: experience report
Revista Brasileira de Enfermagem. 2017;70(2):424-429
DOI 10.1590/0034-7167-2016-0091
Views0See moreABSTRACT
Objective:
to report the experience of applying the focus group technique for production of data in qualitative research.
Method:
four group sessions were held from May to June 2015, with the participation of professionals from the public sector of PHC and from specialized service.
Results:
the way focus group was developed is described in steps: planning, recruitment, ambience, group sessions, and evaluation.
Conclusion:
we highlight that the focus group, as a technique to produce data in collective space, can contribute not only to the construction of knowledge in Nursing, but also to the research approach with the assistance practice.
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REVIEW01-01-2017
Patient with stroke: hospital discharge planning, functionality and quality of life
Revista Brasileira de Enfermagem. 2017;70(2):415-423
Abstract
REVIEWPatient with stroke: hospital discharge planning, functionality and quality of life
Revista Brasileira de Enfermagem. 2017;70(2):415-423
DOI 10.1590/0034-7167-2016-0166
Views0See moreABSTRACT
Objective:
analyze the strategies of hospital discharge planning for these patients, increasing the knowledge related to hospitalhome transition, discharge planning processes and the main impact on the quality of life and functionality.
Method:
integrative literature review using the PICOD criteria, with database research.
Results:
19 articles were obtained, using several approaches and contexts. For quality of life, the factors related to the patient satisfaction with care and the psychoemotional aspects linked with functionality are the most significant.
Conclusion:
during the hospitalization period, a careful hospital discharge planning and comprehensive care to patients and caregivers – in particular the functional and psychoemotional aspects – tend to have an impact on the quality of life of patients.
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