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ORIGINAL ARTICLE12-16-2024
Respectful care for postpartum women with sickle cell disease: a netnographic study
- Zannety Conceição Silva do Nascimento Souza
, - Luana Gabriella Pinheiro Barrêto ,
- Paulo Roberto Lima Falcão do Vale ,
- Elysangela Dittz Duarte ,
- Cristiane dos Santos Silva , [ … ],
- Evanilda Souza de Santana Carvalho
Abstract
ORIGINAL ARTICLERespectful care for postpartum women with sickle cell disease: a netnographic study
Revista Brasileira de Enfermagem. 2024;77(6):e20230545
DOI 10.1590/0034-7167-2023-0545
- Zannety Conceição Silva do Nascimento Souza ,
- Luana Gabriella Pinheiro Barrêto ,
- Paulo Roberto Lima Falcão do Vale ,
- Elysangela Dittz Duarte ,
- Cristiane dos Santos Silva ,
- Evanilda Souza de Santana Carvalho
Views1See moreABSTRACT
Objectives:
to analyze principles of respectful maternity care in narratives of postpartum women with sickle cell disease, relating them to Sustainable Development Goals.
Methods:
netnographic study, with two videos published in 2020. Deductive iconographic and thematic analysis by Respectful Maternity Care Charter, organized in MAXQDA.
Results:
principles identified were the right to: freedom from harm and ill-treatment; information, informed consent, refusal of medical procedures, and respect for their choices and preferences including companion; be considered a person from birth, with dignified and respectful treatment; health at the highest possible level; newborns being with their parents or guardians. The Sustainable Development Goals for women by 2030 were not positively contemplated in postpartum women’s experience.
Final Considerations:
it is appropriate that health workers qualify themselves to provide respectful maternity care, with qualified listening, understanding, and resolution of unique demands of postpartum women with sickle cell disease, seeking equality in care for women.
- Zannety Conceição Silva do Nascimento Souza
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12-16-2024
GerenciaDOR™: development of digital technology by nurses for the assessment of patients with chronic pain
Revista Brasileira de Enfermagem. 2024;77(6):e20240050
Abstract
GerenciaDOR™: development of digital technology by nurses for the assessment of patients with chronic pain
Revista Brasileira de Enfermagem. 2024;77(6):e20240050
DOI 10.1590/0034-7167-2024-0050
Views0See moreABSTRACT
Objectives:
to develop a digital technological solution (prototype) for assessing patients with chronic pain.
Methods:
this is a methodological and technological development study based on the Human-Centered Design framework and the principles of Patient-Centered Care. The prototype guides patients through a body diagram and directs them to an evaluation using specific instruments that address the multidimensional aspects of chronic pain.
Results:
the GerenciaDOR* project enables navigation through the Web App screens, providing access to pain assessment features up to the presentation of results.
Final Considerations:
the study describes a systematic approach to pain assessment and expands nurses’ knowledge in pain management. Additionally, it can promote the development of other digital technologies for chronic pain assessment and contribute to a multidisciplinary, patient centered treatment.
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ORIGINAL ARTICLE12-16-2024
Psychometric analysis of ProQOL-BR in nursing: building hospital safety and protection
- Frederico Marques Andrade ,
- Lanuza Borges Oliveira ,
- Igor Monteiro Lima Martins ,
- Maria Eduarda Borges Rodrigues ,
- Carla Silvana de Oliveira e Silva
Abstract
ORIGINAL ARTICLEPsychometric analysis of ProQOL-BR in nursing: building hospital safety and protection
Revista Brasileira de Enfermagem. 2024;77(6):e20240085
DOI 10.1590/0034-7167-2024-0085
- Frederico Marques Andrade ,
- Lanuza Borges Oliveira ,
- Igor Monteiro Lima Martins ,
- Maria Eduarda Borges Rodrigues ,
- Carla Silvana de Oliveira e Silva
Views0See moreABSTRACT
Objectives:
to analyze the psychometric properties of the ProQOL-BR instrument in hospital nursing professionals.
Methods:
a methodological study to validate the ProQOL-BR. Confirmatory factor analysis, assessment of local and global adjustment quality, Pearson hypothesis testing and Cronbach’s alpha internal consistency analysis were used.
Results:
a total of 490 professionals participated. The model presents adequate quality due to factor weights (λ≥ 0.40), acceptable overall fit quality and adequate chi-square ratio and degrees of freedom (χ2/g.1=2.51) for the parameters of CFI (0.923), GFI (0.902), TLI (0.914) and RMSEA (0.042). In terms of validity, it was shown to be adequate with CC=0.89. The internal consistency obtained by standardized Cronbach’s alpha was 0.761. Criterion validity was shown to be favorable with significant correlations (0.001).
Conclusions:
the instrument was validated regarding content, criteria and reliability. Three questions were removed from the original instrument, ProQOL-BR, leaving the final instrument with 25 questions.
- Frederico Marques Andrade
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REVIEW12-16-2024
Recommendations for guidelines for promoting mental health in the workplace: an umbrella review
- Evelin Daiane Gabriel Pinhatti ,
- Amanda Salles Margatho do Nascimento ,
- Regina Celia Bueno Rezende Machado ,
- Rosangela Aparecida Pimenta ,
- André Estevam Jaques , [ … ],
- Maria do Carmo Fernandez Lourenço Haddad
Abstract
REVIEWRecommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
DOI 10.1590/0034-7167-2024-0086
- Evelin Daiane Gabriel Pinhatti ,
- Amanda Salles Margatho do Nascimento ,
- Regina Celia Bueno Rezende Machado ,
- Rosangela Aparecida Pimenta ,
- André Estevam Jaques ,
- Maria do Carmo Fernandez Lourenço Haddad
Views1See moreABSTRACT
Objectives:
to summarize the recommendations of guidelines for promoting mental health in the workplace.
Methods:
an umbrella review, according to Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses methodological assumptions. Data collection was carried out in January 2021 and updated in July 2023 in the American Psychological Association, Cochrane Library, EMBASE, National Library of Medicine, and Scopus databases. Systematic reviews that assessed guidelines with recommendations for mental health care for workers were included. PROSPERO registration CRD42023461845.
Results:
four systematic reviews published between 2015 and 2018 were identified. The abstracts highlighted actions that facilitate and inhibit the recommendations as well as three categories of intervention: primary prevention – worker protection; secondary prevention – promoting workers’ mental health; and tertiary prevention – supporting, monitoring and rehabilitating workers upon returning to work.
Conclusions:
the interventions are based on prevention, promotion and early recognition, support and rehabilitation of mental health problems.
- Evelin Daiane Gabriel Pinhatti
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ORIGINAL ARTICLE12-16-2024
Analysis of omission of antimicrobial doses in Intensive Care Units
- Isabelle Ribeiro Machado ,
- Danielle de Mendonça Henrique ,
- Flávia Giron Camerini ,
- Vanessa Galdino de Paula ,
- Cintia Silva Fassarella , [ … ],
- Lucas Rodrigo Garcia de Mello
Abstract
ORIGINAL ARTICLEAnalysis of omission of antimicrobial doses in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(6):e20240102
DOI 10.1590/0034-7167-2024-0102
- Isabelle Ribeiro Machado ,
- Danielle de Mendonça Henrique ,
- Flávia Giron Camerini ,
- Vanessa Galdino de Paula ,
- Cintia Silva Fassarella ,
- Lucas Rodrigo Garcia de Mello
Views0See moreABSTRACT
Objectives:
to analyze the rate of antimicrobial dose omission in intensive care units.
Methods:
cross-sectional study carried out between March 1 and September 30, 2023, in intensive care units of a University Hospital in Rio de Janeiro.
Results:
the sample consisted of 452 prescriptions and 1467 antimicrobial doses. The dose omission rate was 4.29%. Each antimicrobial prescribed increased the chance of omission by 51%. The strategy of double-checking prescriptions helped prevent 30% of antimicrobial dose omissions (p=0.0001).
Conclusions:
monitoring the omission of antimicrobial doses can guide nursing actions to improve quality and patient safety, contributing to the prevention of medication errors, antimicrobial stewardship and the fight against antimicrobial resistance.
- Isabelle Ribeiro Machado
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ORIGINAL ARTICLE12-16-2024
Health literacy development of Primary Health Care patients: qualitative research
Revista Brasileira de Enfermagem. 2024;77(6):e20240154
Abstract
ORIGINAL ARTICLEHealth literacy development of Primary Health Care patients: qualitative research
Revista Brasileira de Enfermagem. 2024;77(6):e20240154
DOI 10.1590/0034-7167-2024-0154
Views0See moreABSTRACT
Objectives:
to identify the process of health literacy development among primary care patients, relating it to their self-care practices.
Methods:
qualitative, prospective research with 22 patients from two Family Health Strategy units. Data were obtained through individual semi-structured interviews, examined through descriptive statistics and thematic content analysis.
Results:
the results discuss how participants learn about health and how this resonates in their behaviors, culminating in two thematic categories: “Health knowledge construction”; and “Dialogue between health knowledge construction and patient care actions”.
Final Considerations:
health knowledge is developed mainly through interpersonal relationships, mediated by health professionals through bonding and communication. Community educational actions and training of health professionals in communication can promote health literacy and self-care among patients.
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ORIGINAL ARTICLE12-16-2024
Bladder ultrasound: evidence of content validity of a checklist for training nurses
- Filipe Utuari de Andrade Coelho ,
- Sabrina Martins Reigota ,
- Flávia Manfredi Cavalcanti ,
- Dejanira Aparecida Regagnin ,
- Beatriz Murata Murakami , [ … ],
- Vinícius Batista Santos
Abstract
ORIGINAL ARTICLEBladder ultrasound: evidence of content validity of a checklist for training nurses
Revista Brasileira de Enfermagem. 2024;77(6):e20230183
DOI 10.1590/0034-7167-2023-0183
- Filipe Utuari de Andrade Coelho ,
- Sabrina Martins Reigota ,
- Flávia Manfredi Cavalcanti ,
- Dejanira Aparecida Regagnin ,
- Beatriz Murata Murakami ,
- Vinícius Batista Santos
Views0See moreABSTRACT
Objectives:
to develop and analyze evidence of content validity of a checklist for training nurses in measuring bladder volume through ultrasound.
Methods:
a methodological study, consisting of three stages: literature review; instrument item preparation; and analysis of evidence of content validity. The Content Validity Index (CVI) and Gwet’s AC2 were used for content validity analyses.
Results:
the checklist consisted of 23 items. The CVIs for clarity, relevance and dimensionality were 0.99, 0.99 and 0.98 respectively, and the CVIs for Gwet’s AC2 with coefficients for clarity, relevance and dimensionality were 0.89, 0.97 and 0.95, respectively, with p<0.001.
Conclusions:
the checklist developed for training nurses in measuring bladder volume through ultrasound achieved adequate evidence of content validity, and can be used to train nurses in clinical practice and future research.
- Filipe Utuari de Andrade Coelho
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12-16-2024
A relação entre gênero, formação educacional e ambiente de aprendizagem com a ansiedade do estudante de enfermagem
- Amelia Margaretha Simbolon ,
- Jesika Sari Munthe ,
- Mikar Syah Idaman Daeli ,
- Ineke Patrisia ,
- Chriska Roully Adeline Sinaga
Abstract
A relação entre gênero, formação educacional e ambiente de aprendizagem com a ansiedade do estudante de enfermagem
Revista Brasileira de Enfermagem. 2024;77(6):e20220615
DOI 10.1590/0034-7167-2022-0615
- Amelia Margaretha Simbolon ,
- Jesika Sari Munthe ,
- Mikar Syah Idaman Daeli ,
- Ineke Patrisia ,
- Chriska Roully Adeline Sinaga
Views1See moreRESUMEN
Objetivos:
identificar las variables asociadas a la práctica clínica relacionadas con la ansiedad de los estudiantes de enfermería.
Métodos:
se utilizó un diseño descriptivo, cuantitativo, correlacional con las recomendaciones STROBE, EQUATOR. La población fue de 233 estudiantes de enfermería con una muestra de 135 personas. Los datos se recopilaron de marzo a abril de 2022 utilizando instrumentos validados.
Resultados:
la prueba de chi-cuadrado y razón de verosimilitud significativa para género, formación académica y entorno de aprendizaje son superiores a 0.05, por lo que no existe una relación significativa entre las variables y la ansiedad de los estudiantes.
Conclusiones:
los estudiantes necesitan prepararse nuevamente antes de ingresar al campo de la práctica. Investigaciones cualitativas también son necesarias.
- Amelia Margaretha Simbolon
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REVIEW06-24-2020
Cost and effectiveness of Platelet Rich Plasma in the healing of varicose ulcer: Meta-analysis
- Beatriz Guitton Renaud Baptista de Oliveira ,
- Magali Rezende de Carvalho ,
- Andrea Pinto Leite Ribeiro
Abstract
REVIEWCost and effectiveness of Platelet Rich Plasma in the healing of varicose ulcer: Meta-analysis
Revista Brasileira de Enfermagem. 2020;73(4):e20180981
DOI 10.1590/0034-7167-2018-0981
- Beatriz Guitton Renaud Baptista de Oliveira ,
- Magali Rezende de Carvalho ,
- Andrea Pinto Leite Ribeiro
Views0See moreABSTRACT
Objectives:
to analyze the evidence on the cost and effectiveness of Plaque Rich Plasma in the treatment of venous ulcers compared to other topical therapies.
Methods:
systematic review, with search in the databases: COCHRANE, EMBASE, MEDLINE via PubMed, LILACS, CINAHL, SCOPUS, without temporal cut and in the English, Portuguese and Spanish languages.
Results:
fifteen articles were included, a cost-minimization analysis showed that the cost of Plaque Rich Plasma is € 163.00 ± 65.90, slightly higher than the cost of standard dressing. Regarding effectiveness, the results of the studies associated with the meta-analysis suggest a tendency that Plaque Rich Plasma is effective in the healing of venous ulcers.
Conclusions:
it is concluded that there are few studies about the cost of Platelet Rich Plasma and this product tends to be effective in the healing of venous ulcers. However, more controlled and randomized clinical studies are necessary in order to establish a stronger recommendation.
- Beatriz Guitton Renaud Baptista de Oliveira
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ORIGINAL ARTICLE06-01-2020
Nursing entrepreneur care in social inequity contexts
- Dirce Stein Backes ,
- Amanda Ruiz Forgiarini ,
- Lenise Dutra da Silva ,
- Martha Helena Teixeira Souza ,
- Marli Terezinha Stein Backes , [ … ],
- Andreas Büscher
Abstract
ORIGINAL ARTICLENursing entrepreneur care in social inequity contexts
Revista Brasileira de Enfermagem. 2020;73(4):e20190014
DOI 10.1590/0034-7167-2019-0014
- Dirce Stein Backes ,
- Amanda Ruiz Forgiarini ,
- Lenise Dutra da Silva ,
- Martha Helena Teixeira Souza ,
- Marli Terezinha Stein Backes ,
- Andreas Büscher
Views0See moreABSTRACT
Objectives:
to identify emancipatory strategies to strengthen the social protagonism of recyclable materials collectors in the light of entrepreneurial Nursing care.
Methods:
qualitative study carried out in two stages: field approach from healthcare interventions in a Recycling Materials Association, and individual interviews conducted between October and December 2018.
Results:
the analysis resulted in three thematic categories: Social contribution of recyclable materials collectors; From the assistentialist perception to entrepreneurial Nursing care; Emancipatory strategies of recycling work.
Final Considerations:
the emancipatory strategies to strengthen the social protagonism of recyclable materials collectors in the light of entrepreneurial Nursing care are related to the appreciation, recognition and enhancement of social work that has been already performed by these professionals, and to the creation of spaces for the socialization of experiences, expectations and perspectives.
- Dirce Stein Backes
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ORIGINAL ARTICLE10-21-2019
Premature mortality caused by the main chronic noncommunicable diseases in the Brazilian states
- Susana Cararo Confortin ,
- Selma Regina de Andrade ,
- Viviana Mariá Draeger ,
- Vandrize Meneghini ,
- Ione Jayce Ceola Schneider , [ … ],
- Aline Rodrigues Barbosa
Abstract
ORIGINAL ARTICLEPremature mortality caused by the main chronic noncommunicable diseases in the Brazilian states
Revista Brasileira de Enfermagem. 2019;72(6):1588-1594
DOI 10.1590/0034-7167-2018-0701
- Susana Cararo Confortin ,
- Selma Regina de Andrade ,
- Viviana Mariá Draeger ,
- Vandrize Meneghini ,
- Ione Jayce Ceola Schneider ,
- Aline Rodrigues Barbosa
Views0See moreABSTRACT
Objective:
To verify the variation of the premature mortality rate caused the group of the main chronic noncommunicable diseases.
Method:
This is a time-series ecological study, which used secondary data of the Mortality Information System, from 2006 to 2014, from the 26 federal units and from the Federal District. Deaths caused by circulatory system diseases, cancer, diabetes and chronic respiratory diseases were included. The trend of adjusted mortality rate was analyzed by segmented linear regression.
Results:
Premature mortality tended to be reduced in most states, except for Maranhão and Rio Grande do Norte, which presented a stable premature mortality rate. Bahia, Pernambuco, Sergipe, Roraima and all the states from the South, Southeast and Central-West Regions reached the goal of reducing 2% per year in premature mortality caused by main diseases.
Conclusion:
Most of the states showed a reduced mortality rate and are reaching the proposed target.
- Susana Cararo Confortin
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ORIGINAL ARTICLE06-01-2020
Primary care quality and its effects on leprosy monitoring indicators
Revista Brasileira de Enfermagem. 2020;73(4):e20190038
Abstract
ORIGINAL ARTICLEPrimary care quality and its effects on leprosy monitoring indicators
Revista Brasileira de Enfermagem. 2020;73(4):e20190038
DOI 10.1590/0034-7167-2019-0038
Views0See moreABSTRACT
Objectives:
to evaluate the quality of primary care in leprosy control actions, to correlate effects on monitoring indicators.
Methods:
a cross-sectional study, conducted in Belo Horizonte, from July to September 2014. Interviews with 408 professionals were conducted through the application of a tool that assesses attributes of primary care in leprosy control actions, and monitoring indicators were calculated. Spearman correlation was used, significance level p < 0.05.
Results:
the overall score correlated with the percentage of cases treated in primary care and of family health staff coverage. The derived score correlated with the percentage of cases treated in primary care, and the essential score correlated with the proportion and rate of cases diagnosed, with grade 2 physical disability.
Conclusions:
the quality of leprosy control actions performed by primary care professionals produces impacts on health indicators, and developing strategies consistent with the reality of the territory is necessary.
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ORIGINAL ARTICLE08-19-2019
Learning experiences in community health of nursing students
- Gladys Carmela Santos Falcón ,
- Santa Dolores Torres Alvarez ,
- Luz Elena Capcha Caso ,
- Gladys Filomena García Arias ,
- María Virginia Infante Contreras , [ … ],
- Alacoque Lorenzini Erdmann
Abstract
ORIGINAL ARTICLELearning experiences in community health of nursing students
Revista Brasileira de Enfermagem. 2019;72(4):841-847
DOI 10.1590/0034-7167-2017-0410
- Gladys Carmela Santos Falcón ,
- Santa Dolores Torres Alvarez ,
- Luz Elena Capcha Caso ,
- Gladys Filomena García Arias ,
- María Virginia Infante Contreras ,
- Alacoque Lorenzini Erdmann
Views0See moreABSTRACT
Objective:
Understand the learning experiences on health promotion and prevention of nursing interns during their community practice.
Method:
This is a descriptive-interpretative study, with a qualitative approach, obtaining data from 19 nursing interns from a public university in Lima-Perú, using 3 focus groups.
Results:
Three categories were structured: considering the importance of the nursing teacher in their training; experiencing complexity in training for the prevention and promotion of health in the community; and considering the preventive-promotional area as a future professional practice.
Final Considerations:
The students perceived the complexity of community practice in the prevention and promotion of health. They stated that teachers and students should know the context where they develop their practices and that teacher’s exercise leadership in the community. The inclination of some nursing interns for their future professional practice in this area was also evident.
- Gladys Carmela Santos Falcón
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ORIGINAL ARTICLE08-19-2019
Guidebook for renal dialysis patients: care of central venous catheters and arteriovenous fistula
- Larissa Rodrigues de Freitas ,
- Viviane Peixoto dos Santos Pennafort ,
- Ana Elza Oliveira de Mendonça ,
- Francisco José Maia Pinto ,
- Letícia Lima Aguiar , [ … ],
- Rita Mônica Borges Studart
Abstract
ORIGINAL ARTICLEGuidebook for renal dialysis patients: care of central venous catheters and arteriovenous fistula
Revista Brasileira de Enfermagem. 2019;72(4):896-902
DOI 10.1590/0034-7167-2018-0131
- Larissa Rodrigues de Freitas ,
- Viviane Peixoto dos Santos Pennafort ,
- Ana Elza Oliveira de Mendonça ,
- Francisco José Maia Pinto ,
- Letícia Lima Aguiar ,
- Rita Mônica Borges Studart
Views0See moreABSTRACT
Objective:
To design and validate the content and format of a guidebook for chronic renal failure patients about the care with venous access for hemodialysis at home.
Method:
Methodological study, in which the steps for the guidebook design were: project planning, literature search, material content, and qualification selection.
Results:
After analysis of the articles, the content to be included in the guidebook was selected. The first draft of the guidebook was submitted for content and format validation, with the participation of 12 specialists. The necessary adjustments for the design of the final version were made with the help of an illustrator.
Conclusion:
The designed guidebook, “Hemodialysis: Care of Venous Accesses and Intercurrences at Home,” consists of educational material to help hemodialysis patients with daily care with central venous catheter and arteriovenous fistula practices in case of intercurrences.
- Larissa Rodrigues de Freitas
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ORIGINAL ARTICLE07-01-2020
Knowledge of primary health care professionals on health policies for the riverside population
- Leandro Barreto da Silva ,
- Ivaneide Leal Ataíde Rodrigues ,
- Laura Maria Vidal Nogueira ,
- Ingrid Fabiane Santos da Silva ,
- Felipe Valino dos Santos
Abstract
ORIGINAL ARTICLEKnowledge of primary health care professionals on health policies for the riverside population
Revista Brasileira de Enfermagem. 2020;73(5):e20190080
DOI 10.1590/0034-7167-2019-0080
- Leandro Barreto da Silva ,
- Ivaneide Leal Ataíde Rodrigues ,
- Laura Maria Vidal Nogueira ,
- Ingrid Fabiane Santos da Silva ,
- Felipe Valino dos Santos
Views0See moreABSTRACT
Objectives:
to analyze the knowledge of health professionals on the health policies for the riverside population; identify how health practices with this group are developed; and discuss facilitators and barriers for the implementation of these policies.
Methods:
qualitative and descriptive study with 24 professionals from the Riverside Family Health Strategy Teams in the city of Belém-Pará. Data were collected in individual interviews and analyzed by Content Analysis.
Results:
although professionals demonstrate knowledge about public health policies, there is a need to expand and strengthen knowledge about health policies for the riverside population. The activities directed to the communities took place in the Unit itself, and some did not occur due to insufficient material and human resources.
Final Considerations:
the greatest barrier for the organization of health care is the lack of material and human resources, and the most prominent facilitator was the union and cohesion of the health team.
- Leandro Barreto da Silva
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REVIEW10-28-2020
Costs of nursing procedures/interventions: an integrative literature review
- Paula Buck de Oliveira Ruiz ,
- Caroline Rife Nobrega ,
- Cínthia Prates Vigna ,
- Antônio Fernandes Costa Lima
Abstract
REVIEWCosts of nursing procedures/interventions: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20190351
DOI 10.1590/0034-7167-2019-0351
- Paula Buck de Oliveira Ruiz ,
- Caroline Rife Nobrega ,
- Cínthia Prates Vigna ,
- Antônio Fernandes Costa Lima
Views0See moreABSTRACT
Objectives:
to analyze the scientific production of nurses regarding the costs of procedures/interventions performed by nursing professionals.
Methods:
integrative literature review with a sample of 17 primary articles selected from the CINAHL, Scopus, EMBASE databases and the PubMed portal.
Results:
all studies were conducted in hospitals, with quantitative, exploratory-descriptive studies, considering the case study method, with the description of costs method adopted, and the number of Brazilian publications stood out (12; 70.58%). The calculation of direct costs was most common due to the absence/difficulty of accessing information in the studied hospitals. This made it impossible to obtain the indirect costs that would be necessary for the composition of the total cost.
Conclusions:
it was shown that studies about the cost of procedures/interventions are still scarce, often covering only the calculation of direct costs. Nurses need to develop studies on such costs using the same methodology in different contexts of health care.
- Paula Buck de Oliveira Ruiz
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