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ERRATUM01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1002-1002
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1002-1002
DOI 10.1590/0034-7167.20166905e01
Views0Article “Alcohol and alcoholism: attitudes of nursing students”, with number of DOI: http://dx.doi.org/10.1590/S0034-71672013000100013, published in the journal Revista Brasileira de Enfermagem, v66(1):84-9, page 89 that read: “18. Miranda SP, Vargas D. Satisfação de pacientes de um centro de atenção Psicossocial álcool e drogas com o atendimento do enfermeiro. SMAD, Rev Eletrônica Saúde Mental Alcool Drog […]See more -
REVIEW01-01-2016
Research methodology for nursing and health: a book review
Revista Brasileira de Enfermagem. 2016;69(5):1000-1001
Abstract
REVIEWResearch methodology for nursing and health: a book review
Revista Brasileira de Enfermagem. 2016;69(5):1000-1001
DOI 10.1590/0034-7167-2015-0135
Views0For those interested in nursing and health, the book entitled “Research methodology for nursing and health: from theory to practice”() was released in October 2015, at the 67th Brazilian Congress of Nursing, sponsored by National ABEn. The interest emerged from two organizers: Dr. Maria Ribeiro Lacerda (UFPR) and Dr. Regina Gema Santini Costerano (UNIFRA). Forty-seven […]See more -
REFLECTION01-01-2016
Violence in the workplace in Nursing: consequences overview
Revista Brasileira de Enfermagem. 2016;69(5):996-999
Abstract
REFLECTIONViolence in the workplace in Nursing: consequences overview
Revista Brasileira de Enfermagem. 2016;69(5):996-999
DOI 10.1590/0034-7167-2015-0133
Views0See moreABSTRACT
Objective:
to reflect on the consequences of workplace violence experienced by nursing professionals.
Methods:
this is a reflection paper based on recent publications related to the subject, particularly researches carried out in Brazil and in other countries.
Results:
exposure to workplace violence has been associated with health problems in nursing professionals, which may be physical damage, emotional manifestations, and psychic disorders. It also affects the employee performance, his or her family and social interactions.
Conclusion:
this phenomenon is potentially noxious and costly, for it leads to suffering, illness, absence from work, and even death. This reflection calls attention moreover to the importance of a safe and adequate health care work environment.
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REFLECTION01-01-2016
Construcción de la enfermera de práctica avanzada en Catalunya (España)
Revista Brasileira de Enfermagem. 2016;69(5):991-995
Abstract
REFLECTIONConstrucción de la enfermera de práctica avanzada en Catalunya (España)
Revista Brasileira de Enfermagem. 2016;69(5):991-995
DOI 10.1590/0034-7167.2016690507
Views0RESUMEN
El desarrollo de la enfermera de práctica avanzada (EPA) ha supuesto un reto para las enfermeras en países como EE.UU., Canadá, Gran Bretaña y Australia, entre otros, y desde hace escasos años está siendo considerada en Catalunya y España como un sistema para desarrollar nuevos roles que aporten eficacia y eficiencia al sistema sanitario. El presente artículo pretende conceptualizar la EPA y los modelos de referencia así como contextualizar y reflexionar sobre la EPA en Catalunya, desde el punto de vista de formación y de la implantación de los denominados nuevos roles de enfermería, asimilándolos a la práctica avanzada.
Keywords:Competencia ClínicaEnfermeríaEnfermería de Práctica AvanzadaPráctica ProfesionalRol de la EnfermeraSee more -
REFLECTION01-01-2016
Developing the Advanced Practice Nurse in Catalonia
Revista Brasileira de Enfermagem. 2016;69(5):991-995
Abstract
REFLECTIONDeveloping the Advanced Practice Nurse in Catalonia
Revista Brasileira de Enfermagem. 2016;69(5):991-995
DOI 10.1590/0034-7167.2016690507
Views0See moreABSTRACT
The development of advanced practice nurses (APN) has proved a challenge for nurses in countries such as the USA, Canada, Great Britain, and Australia among others. It is only in recent years that the system has been considered in Catalonia and Spain as a way to develop new roles to bring effectiveness and efficiency to the health system. From the standpoint of training and implementation of the above-mentioned new nursing roles, the following article aims to conceptualise APN and its reference models, as well as to contextualise and reflect on APN in Catalonia in order to assimilate them into advanced practice.
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EXPERIENCE REPORT01-01-2016
International academic mobility in nursing education: an experience report
Revista Brasileira de Enfermagem. 2016;69(5):986-990
Abstract
EXPERIENCE REPORTInternational academic mobility in nursing education: an experience report
Revista Brasileira de Enfermagem. 2016;69(5):986-990
DOI 10.1590/0034-7167-2015-0128
Views0See moreABSTRACT
Objective:
report the experience of international academic mobility in Ireland through the program Science Without Borders during undergraduate education in nursing.
Method:
a report of experience presented in chronological order, with a descriptive nature.
Results:
the opportunity to know and be able to discuss questions regarding health and nursing in Ireland allowed the review of concepts and a more reflective perspective regarding nursing practices. Additionally, the exchange promoted personal strengthening regarding the confrontation and solution of problems, development of technical and scientific abilities, improvement of linguistic competences and construction of personality, independence and maturity.
Conclusion:
regarding such constructive and enriching experience that this mobility provides to students, to the governing authorities, to the population and to Brazilian nursing, sharing this experience is expected to serve as encouragement for those who search for new horizons, with the objective of adding knowledge for their personal and professional life.
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EXPERIENCE REPORT01-01-2016
Online training for health professionals in three regions of Brazil
Revista Brasileira de Enfermagem. 2016;69(5):981-985
Abstract
EXPERIENCE REPORTOnline training for health professionals in three regions of Brazil
Revista Brasileira de Enfermagem. 2016;69(5):981-985
DOI 10.1590/0034-7167.2016690506
Views0See moreABSTRACT
Objective:
to describe online training experience aimed at professionals working in the public health service in 27 Neonatal and Pediatric Intensive Care Units, and to reflect concerning the training process and possible improvements in this process.
Method:
this is an experience report study about the online training with multidisciplinary content, planned from the situational diagnosis of 27 institutions. The training target set was 10 participants per institution and per module, including the following topics: Indicators of Quality as a Management Tool, Hand Hygiene, Patient Safety, Intravenous Therapy and Patients’ Chart Record.
Results:
a total of 2,071 active students in the modules, with 1,046 approved. The mean of 76 students per module exceeded the target set.
Conclusion:
experience has shown that online training is comprehensive as a potential tool for the professional technical development and digital inclusion. The online learning system becomes weakened if participants are unaware of the technological resources.
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REVIEW01-01-2016
Technologies in intensive care: causes of adverse events and implications to nursing
Revista Brasileira de Enfermagem. 2016;69(5):972-980
Abstract
REVIEWTechnologies in intensive care: causes of adverse events and implications to nursing
Revista Brasileira de Enfermagem. 2016;69(5):972-980
DOI 10.1590/0034-7167.2016690505
Views0See moreABSTRACT
Objective:
to identify the causes of adverse events affecting clients resulting from the use of equipment in intensive care services; to point out the main recommendations for clinical practice to minimize these events and, then, discuss the implications to nursing care.
Method:
integrative and descriptive review on the SciELO, Medline, LILACS, and PubMed databases. Articles were selected based on the inclusion criteria and the structured instrument was applied.
Results:
altogether, 11 articles were selected where three evidence units were outstanding: Equipment failure; inadequate use of equipment; and team failure. Permanent education of professionals; evaluation of production and availability of equipment; and use of checklists are recommended.
Conclusion:
preventing adverse events related to equipment is one of the nursing responsibilities and requires the establishment of defensive barriers to prevent these.
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RESEARCH01-01-2015
Risk classification in pediatrics: development and validation of a guide for nurses
Revista Brasileira de Enfermagem. 2015;68(5):913-922
Abstract
RESEARCHRisk classification in pediatrics: development and validation of a guide for nurses
Revista Brasileira de Enfermagem. 2015;68(5):913-922
DOI 10.1590/0034-7167.2015680521i
Views0See moreABSTRACT
Objective:
to develop and validate a short guide for the protocol to user embracement with risk classification in pediatrics.
Method:
methodological study developed in two stages: development of the guide, and face and content validation. The development involved the stratification of the protocol contents into five risk indicators according to the level of complexity; subsequently it was submitted to validation by nine experts divided in two groups: professors who were also researchers, and nurses.
Results:
in the face validation the experts considered the 25 items of the guide clear and understandable, with agreement levels above 70%. In the content validation, 17 (68%) items were considered relevant by 88.9% of the experts. The eight items considered irrelevant were changed according to suggestions of the experts, yielding an overall content validity index of 0.98.
Conclusion:
the study resulted in a guide for the classification of risks in pediatrics that is valid to assess children in emergency services.
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RESEARCH01-01-2015
Components of social learning theory in a tool for teaching Nursing
Revista Brasileira de Enfermagem. 2015;68(5):906-912
Abstract
RESEARCHComponents of social learning theory in a tool for teaching Nursing
Revista Brasileira de Enfermagem. 2015;68(5):906-912
DOI 10.1590/0034-7167.2015680520i
Views0See moreABSTRACT
Objective:
to identify key components of the social learning theory in a computational tool to aid in teaching the reasoning process for the preparation of a nursing diagnosis.
Method:
qualitative study that analyzed the statements collected through a focus group of 18 teachers and students from two Brazilian nursing schools.
Results:
the themes were grouped into four categories related to the components of the theory and into 13 subcategories.
Conclusion:
the meaning of learning can be extended by the teacher’s didactics and corroborated by the relationship between systematization and reasoning. To learn by doing, some prerequisites are required as is a process of motivation and qualification, which are also inherent to learning by forming an identity in the group. In the feeling of belonging to a particular group, aspects related to the profession become visible as opposed to the aspects of belonging to a community of practice of learning.
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RESEARCH01-01-2015
Telephone call for post-discharge surveillance: validation and application of tool for video-assisted surgery
Revista Brasileira de Enfermagem. 2015;68(5):899-905
Abstract
RESEARCHTelephone call for post-discharge surveillance: validation and application of tool for video-assisted surgery
Revista Brasileira de Enfermagem. 2015;68(5):899-905
DOI 10.1590/0034-7167.2015680519i
Views0See moreABSTRACT
Objective:
to validate an instrument for post-discharge surveillance by telephone for video assisted surgeries.
Method:
a multi-method study with development, validation and application of the instrument. The validation was performed by experts considering the relevance, clarity and completeness of the contents in the calculation of the content validity index and valid questions that demonstrated 80% agreement. For the application of the instrument, the sample consisted of 68 women undergoing video-assisted surgery, and we conducted a descriptive analysis.
Results:
there was disagreement among experts in the first evaluation, and the instrument was redesigned obtaining agreement in the second evaluation. The response rate to the telephone contact was 88.2% (60/68). Complaints of abdominal pain, bleeding and incisional edema were more frequent. No patients presented with infection.
Conclusion:
the questionnaire was validated and applied and is available for use.
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RESEARCH01-01-2015
Managerial competences of coordinators of undergraduate nursing courses
Revista Brasileira de Enfermagem. 2015;68(5):890-898
Abstract
RESEARCHManagerial competences of coordinators of undergraduate nursing courses
Revista Brasileira de Enfermagem. 2015;68(5):890-898
DOI 10.1590/0034-7167.2015680518i
Views0See moreABSTRACT
Objective:
to analyze the experiences of how the managerial competences of coordinators, ideal and real, of undergraduate nursing course coordinators from the city of Belo Horizonte, Minais Gerais.
Method:
the theoretical framework presented a conceptual model of eight managerial roles (director, producer, monitor, coordinator, mentor, facilitator, broker and innovator) and three specific competences to the exercise of each one of them. Descriptive and qualitative research with 14 interviews conducted using semi-structured scripts, whose data were subjected to content analysis.
Results:
we highlighted the roles: mentor, director and facilitator as the most prominent, whose competences can be continually improved as a result of differentiated and permanent demands which the subject face, in addition to the natural ambiguities and contradictions of management function.
Conclusion:
the higher education institution can adjust their selection and evaluation processes for this position, including the difficulties of professional competences training required in the exercise of managerial function.
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RESEARCH01-01-2015
Participação familiar para a reabilitação de idosos com fratura de fêmur
Revista Brasileira de Enfermagem. 2015;68(5):883-889
Abstract
RESEARCHParticipação familiar para a reabilitação de idosos com fratura de fêmur
Revista Brasileira de Enfermagem. 2015;68(5):883-889
DOI 10.1590/0034-7167.2015680517i
Views0See moreRESUMEN
Objetivo:
verificar si el modo de cuidar adoptado por los cuidadores favoreció la recuperación de la independencia funcional de los ancianos con y sin la presencia de enfermedad en el sistema nervioso y trastornos mentales y comportamentales y si enfermedades interfirieron en la independencia funcional.
Método:
estudio trasversal, con seguimiento por 12 meses de 89 ancianos brasileños (≥ 60 años), sometidos a cirugía de fémur proximal y sus cuidadores familiares.
Resultados:
los scores de la Medida de Independencia Funcional disminuyeron 0,7 puntos por año vivido y, en el caso de enfermedad en el sistema nervioso y trastorno mental y comportamental, esa pérdida aumentó para 20,5 puntos. El incentivo a la deambulación aumentó 18,9, al autocuidado 12,8 y al ocio 11,5 puntos de la Medida de Independencia Funcional.
Conclusión:
se recomienda el incentivo al movimiento y a la deambulación, al autocuidado y a las actividades de ocio, principalmente en aquellos ancianos con enfermedades en el sistema nervioso y trastorno mental y comportamental.
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RESEARCH01-01-2015
Family participation to elderly rehabilitation with femoral fracture
Revista Brasileira de Enfermagem. 2015;68(5):883-889
Abstract
RESEARCHFamily participation to elderly rehabilitation with femoral fracture
Revista Brasileira de Enfermagem. 2015;68(5):883-889
DOI 10.1590/0034-7167.2015680517i
Views0See moreABSTRACT
Objective:
verify if the mode of care adopted by caregivers favored functional independence recovery by elderly with and without the presence of nervous system disease and mental and behavioral disorders; and, if disease interfered with their functional independence.
Method:
transversal study, with 12-month follow-up of 89 Brazilian elders (≥ 60 years) after proximal femoral surgery, and their family caregiver.
Results:
the Functional Independence Measure scores decreased by 0.7 points per year of life, and in the case of presenting nervous system disease and mental and behavioral disorders, this loss amounted to 20.5 points.
Conclusion:
The incentive to ambulate increased by 18.8 for self-care, 12.8 for self-care, and 11.5 for leisure activities on the Functional Independence Measure. Encouraging movement and ambulation, self-care and leisure activities, especially with those elderly with nervous system diseases and mental and behavioral disorders, is recommended.
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RESEARCH01-01-2015
Absenteeism – illness of the nursing staff of a university hospital
Revista Brasileira de Enfermagem. 2015;68(5):876-882
Abstract
RESEARCHAbsenteeism – illness of the nursing staff of a university hospital
Revista Brasileira de Enfermagem. 2015;68(5):876-882
DOI 10.1590/0034-7167.2015680516i
Views0See moreABSTRACT
Objective:
to analyze absenteeism – illness of the nursing staff.
Method:
this was a retrospective study of a university hospital in the city of Goiânia, Goiás, Brazil, using a quantitative approach. Data were collected from functional records of the staff during the period from 2008 to 2012.
Results:
of 602 workers, 435 had 1574 medical certifi cates. Diseases of the musculoskeletal system and connective tissue, followed by mental and behavioral disorders were the major diseases for sick leave. The occupation with the highest number of medical certifi cates was the nursing technician. Females and the age group between 41-50 years prevailed in the sample. Ambulatory was the area with most frequent events, followed by the medical clinic and emergency room.
Conclusion:
absenteeism-illness affects the functioning of the service, the nursing staff and users, promoting work overload, and interfering in the quality of nursing care.
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RESEARCH01-01-2015
The nurse faced with early weaning in child nursing consultations
Revista Brasileira de Enfermagem. 2015;68(5):869-875
Abstract
RESEARCHThe nurse faced with early weaning in child nursing consultations
Revista Brasileira de Enfermagem. 2015;68(5):869-875
DOI 10.1590/0034-7167.2015680515i
Views0See moreABSTRACT
Objective:
analyze the role of the nurse regarding early weaning in children younger than 6 months old.
Method:
qualitative and descriptive study. The nurses who performed the study did nursing consultation to children programmatically in family health units in Cuiabá – Mato Grosso. Data were collected in January and February 2012, through participant observation of nursing consultations. For data analysis, content analysis was used.
Results:
that nurses, in most cases, used appropriate strategies for the management of common problems in breastfeeding, although some behaviors have not yet proven scientifi c evidence about the benefi ts and/or damage to its practice.
Conclusion:
nurses addressed important aspects of breastfeeding during consultations and worked for the promotion and resumption of exclusive breastfeeding.
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ERRATUM01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):206-206
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):206-206
DOI 10.1590/0034-7167.20166901e02
Views0In the article “Conceptions of mid-level nursing professionals facing those with a chemical dependency”, with the number of DOI: 10.1590/0034-7167.2015680610i, published in the journal Revista Brasileira de Enfermagem, v68(6):755-60, page 760 that read:“8. Vargas D, Soares J. Knowledge and attitudes of nurses towards alcohol and related problems: the impact of an educational intervention. Rev Esc […]See more -
ERRATUM01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):205-205
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):205-205
DOI 10.1590/0034-7167.20166901e01
Views0In the article “Using the theory of meaningful learning in nursing education”, with the number of DOI: 10.1590/0034-7167.2015680420i, published in the journal Revista Brasileira de Enfermagem, v68(4):626-35, page 627 that read:“Ausubel was descended from Jewish, born in New York in 1918 and died in 1994 at the age of 75. He thought and wrote until […]See more -
EXPERIENCE REPORT01-01-2016
Nursing process documentation: rationale and methods of analytical study
Revista Brasileira de Enfermagem. 2016;69(1):197-204
Abstract
EXPERIENCE REPORTNursing process documentation: rationale and methods of analytical study
Revista Brasileira de Enfermagem. 2016;69(1):197-204
DOI 10.1590/0034-7167.2016690126i
Views0See moreABSTRACT
Objective:
to describe the methods used to analyze the associations between variables of service, nursing and the nursing process documentation in institutions of the Department of Health of the State of São Paulo.
Method:
multilevel analytical study with data obtained in the domains of institution, units of the institution and nursing professionals who work there, using standardized instruments. The analyses had as axis the degree of completeness of the nursing process documentation in units or institutions and their association with variables of nursing personnel, of units and of institutions.
Conclusion:
This study will provide important empirical evidence on the factors involved in the nursing process documentation.
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EXPERIENCE REPORT01-01-2016
Qualitative methodologies in health research: interpretive referential of Patricia Benner
Revista Brasileira de Enfermagem. 2016;69(1):192-196
Abstract
EXPERIENCE REPORTQualitative methodologies in health research: interpretive referential of Patricia Benner
Revista Brasileira de Enfermagem. 2016;69(1):192-196
DOI 10.1590/0034-7167.2016690125i
Views0See moreABSTRACT
Objective:
this article reports on the experience of using the interpretive phenomenological framework of Patricia Benner in a Brazilian context. Benner’s interpretive phenomenology, based on existential and interpretative philosophy, aims to understand human experiences in the particular worlds of research participants. Data were collected through interviews with nine nurses in November and December 2014.
Results:
data analysis process according to Benner’s framework consisted of: transcription, coding, thematic analysis, and search for paradigmatic cases and examples. Therefore, the prior knowledge of the researcher is an important part of the study, consisting in manners of the research conduction.
Conclusion:
The use of this methodological framework entailed a great challenge for the researcher, however, it also enabled a unique opportunity to illuminate important existential phenomena related to the daily lives of research participants.
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REVIEW01-01-2016
Nurses’ performance on primary care in the National Health Service in England
Revista Brasileira de Enfermagem. 2016;69(1):182-191
Abstract
REVIEWNurses’ performance on primary care in the National Health Service in England
Revista Brasileira de Enfermagem. 2016;69(1):182-191
DOI 10.1590/0034-7167.2016690124i
Views0See moreABSTRACT
Objective:
To analyze the expansion of nursing roles in primary care in the English National Health Service and the implications for professional practice.
Method:
qualitative research in case study format, held in London, England, in six primary care units. Data were obtained through interviews with nine nurses. After the thematic data analysis, two units emerged: the nurses’ performance characteristics and effects of the expansion of nursing roles.
Results:
expansion of nurses’ roles: consultation, diagnosis and drug therapy, case management and monitoring of chronic conditions. Repercussions: for the user, there was improved access, communication and comprehensive care, increased duration of consultations, resulting in greater adherence; for nurses, there was the expansion of professional skills, knowledge and professional recognition; to the health care system, it resulted in cost savings.
Conclusion:
benefits in expanding nursing roles, were visible, contributing to primary care quality.
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REVIEW01-01-2016
Meleis’ Nursing Theories Evaluation: integrative review
Revista Brasileira de Enfermagem. 2016;69(1):174-181
Abstract
REVIEWMeleis’ Nursing Theories Evaluation: integrative review
Revista Brasileira de Enfermagem. 2016;69(1):174-181
DOI 10.1590/0034-7167.2016690123i
Views0See moreABSTRACT
Objective:
to analyze the application of the theory evaluation model proposed by Meleis in Brazilian studies.
Method:
integrative review of online articles published from 2002 to 2012 in the databases LILACS and BDENF.
Results:
the 16 selected studies confirmed the use of only three of the five stages proposed for Meleis’ theories analysis: Description of the Theory, Criticism of the Theory and Analysis of the Theory, with a predominance of a single unit of analysis in each.
Conclusion:
the analysis of nursing theories provides support to nurses in the practice, research, education and administration of the different dimensions of care. Meleis’ model figures as very important by contributing to the development of knowledge of nursing discipline, considering that its use as a method allows several reflections on theories in order that they be revalidated to support a more theoretical and practical applicability.
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REVIEW01-01-2016
Clinical indicators of sexual dysfunction in pregnant women: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(1):165-173
Abstract
REVIEWClinical indicators of sexual dysfunction in pregnant women: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(1):165-173
DOI 10.1590/0034-7167.2016690122i
Views0ABSTRACT
Objective:
to identify the nursing diagnosis clinical indicators of sexual dysfunction in pregnant women.
Method:
it is an integrative literature review, with research in databases using the keywords “sexual*”, “pregnan*” and “function*”. Studies included had an abstract available for analysis, referring to pregnant women over 18 years old, written in Portuguese, French, Spanish and English, with publication date between 2010 and 2014. Studies that reporting pregnant women with an associated pathology were excluded.
Results:
sexual dysfunction in pregnant women is consistent in the literature. Nine defining characteristics were identified and 16 related factors, some not classified in NANDA International.
Conclusion:
clinical indicators can be added to the nursing diagnosis to favor an accurate diagnosis and effective interventions in the surveillance of pregnancy as a period of healthy sexual experience.
Keywords:Physiological Sexual Dysfunction, Psychogenic Sexual DysfunctionPregnant WomenReviewSexual BehaviorSee more -
RESEARCH01-01-2016
Conditions of functional health literacy of an elderly diabetics group
Revista Brasileira de Enfermagem. 2016;69(1):156-164
Abstract
RESEARCHConditions of functional health literacy of an elderly diabetics group
Revista Brasileira de Enfermagem. 2016;69(1):156-164
DOI 10.1590/0034-7167.2016690121i
Views0See moreABSTRACT
Objective:
to evaluate the conditions of functional health literacy of an elderly diabetics group.
Method:
cross-sectional and descriptive study, with diabetic’s elderly assisted in the SUS (N = 114). The social and health conditions were evaluated as well as functional health literacy by S-TOFHLA test (short version); the simple proportions, average, standard deviation and Pearson’s Chi-square were described by SPSS software (20.0) with α = 5% value.
Results:
the mean age was 67.4 years, 74.0% of the elderly were women, had up to four years of schooling; 29.8% had a long-standing illness, 64.0% reported having high blood pressure, 47.4% smoke or were smokers, 73.7% had low functional health literacy, which was associated with schooling p = 0.001.
Conclusions:
the low functional health literacy could be a self-care conditioning and can be influenced by low schooling because it implies to have skills to understand and make decisions aimed at self-management of health.
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