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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
Views0ABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
Keywords:COVID-19Health Care Evaluation MechanismsHealth PersonnelHealth Services ResearchPrimary Health CareSee more -
ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
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ORIGINAL ARTICLE07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
ORIGINAL ARTICLEMetodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0RESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
Keywords:Administração em SaúdeFluxo de TrabalhoGestão da QualidadeMelhoria de QualidadeUnidades de Terapia IntensivaSee more -
REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more -
ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
Views0ABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
Keywords:AgedCardiovascular DiseasesCosts and Cost AnalysisLearning Health SystemPrimary Health CareSee more -
ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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RESEARCH01-01-2015
Nursing actions in primary care and the control of diseases preventable through vaccines
Revista Brasileira de Enfermagem. 2015;68(5):803-809
Abstract
RESEARCHNursing actions in primary care and the control of diseases preventable through vaccines
Revista Brasileira de Enfermagem. 2015;68(5):803-809
DOI 10.1590/0034-7167.2015680506i
Views0See moreABSTRACT
Objective:
to discuss the actions performed by nurses in the control and eradication of diseases preventable with vaccines in healthcare setting, according to the National Primary Health Care Policy.
Method:
qualitative research supported by the social phenomenology of Schutz. It had as its setting a Family Health Clinic, located in the city of Rio de Janeiro (Brazil), with ten nurses. The data collection occurred through interviews.
Results:
nurses’ actions aimed at the control and eradication of preventable diseases mainly involve updating a vaccination card, administering the vaccine, and guiding the user of the Health Unit, with the purpose of preventing diseases. The National Primary Care Policy and all manuals from the Ministry of Health recognize the importance of focusing on the service user.
Conclusion:
the user’s lifestyle must be considered, and his access to services aiming at the expansion of the control of diseases preventable with vaccines should be promoted.
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RESEARCH01-01-2015
Children with neuropsychomotor development delay: music therapy promoting quality of life
Revista Brasileira de Enfermagem. 2015;68(5):797-802
Abstract
RESEARCHChildren with neuropsychomotor development delay: music therapy promoting quality of life
Revista Brasileira de Enfermagem. 2015;68(5):797-802
DOI 10.1590/0034-7167.2015680505i
Views0See moreABSTRACT
Objective:
to identify the influence of music therapy on the behavior and quality of life of children with neuropsychomotor development delay (NPMDD).
Method:
experimental research, with applications of music therapy (in a group of children) held in the specialized association in Cruz das Almas – Bahia, composed of 17 children with NPMDD aged 5 to 12 years. The behavior of children involving emotional, physical, social and school aspects was observed.
Results:
there was an evolution in all aspects, being this improvement significant to Emotional Capacity and School Capacity domains, showing the beneficial effects of music therapy.
Conclusion:
music therapy becomes a treatment option for children with NPMDD, improving their quality of life.
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RESEARCH01-01-2015
Spirituality, religion and personal beliefs of adolescents with cancer
Revista Brasileira de Enfermagem. 2015;68(5):791-796
Abstract
RESEARCHSpirituality, religion and personal beliefs of adolescents with cancer
Revista Brasileira de Enfermagem. 2015;68(5):791-796
DOI 10.1590/0034-7167.2015680504i
Views0See moreABSTRACT
Objective:
to examine adolescents’ perception about spirituality, religion and personal beliefs in their lives due to cancer and a possible strategy for coping with the disease.
Method:
qualitative research, both descriptive and exploratory. The data were collected by means of a personal semi-structured interview, and the categories were analyzed by content analyzes.
Results:
nine adolescents who were undergoing cancer treatment at one of the two institutions located Uberaba, Brazil, participated in the study. Based on the analysis and interpretation of results, it was possible to systematize them according to four categories: spiritual history of the individual; faith and belief; importance of spirituality in their lives, and the community acting as a spiritual supporter. Most adolescents referred to spirituality as being an important tool for dealing with the disease, especially concerning religious rituals and community support.
Conclusion:
spirituality creates hope for adolescents, which helps them to cope with cancer-related diffi culties and contribute to the search for the meaning of life.
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RESEARCH01-01-2015
Coping strategies of nursing students for dealing with university stress
Revista Brasileira de Enfermagem. 2015;68(5):783-790
Abstract
RESEARCHCoping strategies of nursing students for dealing with university stress
Revista Brasileira de Enfermagem. 2015;68(5):783-790
DOI 10.1590/0034-7167.2015680503i
Views0See moreABSTRACT
Objective:
to identify the coping strategies used by nursing students in a university in southern Brazil, establishing the relationship between the sociodemographic and academic variables examined.
Method:
an exploratory, descriptive, quantitative study, carried out with 146 nursing students, through application of the Coping Strategies Inventory. For the data analysis, descriptive statistics, analysis of variance and regression analysis were used.
Results:
it was found that the coping strategy most used by nursing students is escape. A connection was also detected between the academic dissatisfaction variable and the use of negative coping strategies.
Conclusion:
it was noted that students satisfi ed with the course used positive coping strategies targeting the problem, whereas dissatisfi ed students used negative strategies focusing on the emotion.
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RESEARCH01-01-2015
Unemployment and psychological distress in nurses
Revista Brasileira de Enfermagem. 2015;68(5):775-782
Abstract
RESEARCHUnemployment and psychological distress in nurses
Revista Brasileira de Enfermagem. 2015;68(5):775-782
DOI 10.1590/0034-7167.2015680502i
Views0See moreABSTRACT
Objective:
to assess psychological distress in nurses searching for their first job, especially symptoms of depression, and identify the factors that caused mental suffering, and how these nurses cope with the situation.
Method:
this was a qualitative study carried out with unemployed nurses who had graduated less than two years before the time of the study, and were residents of the town of Assis in the Brazilian state of São Paulo. Data were gathered by means of semi-structured interviews, content analysis, and application of the Beck Depression Inventory psychometric scale.
Results:
of the 14 nurses that participated, three had scores on the psychometric scale indicative of depression. Participants reported psychological distress related to unemployment, poor university education, and surplus labor due to the large number of graduates and lack of jobs, as well as a culture of employment centered on professionals’ social networks. The unemployed nurses did not have effective ways of coping.
Conclusion:
unemployment promoted psychological distress among the new nurses, especially symptoms of depression, without effective means of coping.
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EDITORIAL01-01-2015
Newborn blood spot screening: to expand or not to expand?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
Abstract
EDITORIALNewborn blood spot screening: to expand or not to expand?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
DOI 10.1590/0034-7167.2015680501i
Views0“The principal constraint on what we can detect in newborn screening is fast becoming what we choose to detect: rather than what is limited for us by technical feasibility or cost”().Technological advances are providing the medical world an opportunity to extend the number of conditions newborn babies are screened for. Tandem mass spectrometry (TMS, also […]See more -
EDITORIAL01-01-2015
Teste de triagem neonatal: expandir ou não expandir?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
Abstract
EDITORIALTeste de triagem neonatal: expandir ou não expandir?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
DOI 10.1590/0034-7167.2015680501i
Views0“A principal restrição sobre o que podemos detectar no teste de triagem neonatal está rapidamente se tornando o que escolhemos detectar em vez daquilo que nos é limitado por razão de viabilidade técnica ou custo”().Os avanços tecnológicos estão conferindo ao mundo médico uma oportunidade de aumentar o número de patologias para as quais os recém-nascidos […]See more -
REVIEW01-01-2015
International Classification for Nursing Practice – ICNP®: application to the Brazilian reality
Revista Brasileira de Enfermagem. 2015;68(4):730-731
Abstract
REVIEWInternational Classification for Nursing Practice – ICNP®: application to the Brazilian reality
Revista Brasileira de Enfermagem. 2015;68(4):730-731
DOI 10.1590/0034-7167.2015680422i
Views0The author and organizer, Telma Ribeiro Garcia, added her theoretical and practical knowledge to those of a dozen other authors for the creation of the book “International Classification for Nursing Practice – ICNP®: application to the Brazilian reality”. She is a retired professor of the Department of Public Health Nursing and Psychiatry at the Federal […]See more
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RESEARCH01-01-2015
Symbolic effects capitalized by nurses from the National Institute of Cancer in Brazil (1980 – 1990)
Revista Brasileira de Enfermagem. 2015;68(2):284-290
Abstract
RESEARCHSymbolic effects capitalized by nurses from the National Institute of Cancer in Brazil (1980 – 1990)
Revista Brasileira de Enfermagem. 2015;68(2):284-290
DOI 10.1590/0034-7167.2015680214i
Views0See moreABSTRACT
Objective:
to describe the strategies of nurses in the National Institute of Cancer to disseminate its scientifi c capital and discuss the symbolic effects capitalized in the fi eld of oncology in the 1980s.
Method:
historical social studies, with primary sources consisting of written documents and oral reports, and as secondary sources, articles and books on the subject, based on the French sociologist Pierre Bourdieu’s concepts of scientifi c capital and habitus.
Results:
it revealed the effective performance of nurses in this Institute on policies of cancer prevention and control and strategies used in the teaching of oncology nursing at the undergraduate level. In conclusion, nursing stands out in this context, through the dissemination of its scientifi c knowledge, as a participant in the construction of a scientifi c fi eld of oncology nursing in Brazil, highlighting the occupation of important social areas.
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RESEARCH01-01-2015
Perception of nursing undergraduate students on self-aging
Revista Brasileira de Enfermagem. 2015;68(2):278-283
Abstract
RESEARCHPerception of nursing undergraduate students on self-aging
Revista Brasileira de Enfermagem. 2015;68(2):278-283
DOI 10.1590/0034-7167.2015680213i
Views1See moreABSTRACT
Objective:
to analyze the perceptions of nursing undergraduate students on their self-aging process.
Method:
qualitative study carried out between August and September, 2011 with 18 nursing undergraduate students of a public university in Salvador, Bahia. The interviews were analyzed by means of the Content Analysis method.
Results:
the following thematic concept was apprehended: Perceptions of nursing undergraduates on their self-aging, which generated two subcategories: A) The “don’t think about it” process; B) The context infl uencing the process.
Conclusion:
undergraduates reveal that the aging process is an intrinsic factor to human development. Family ties, spirituality and physical activity would be key mechanisms toward active aging. However, students also reported that their accelerated and stressed social lifestyles led to inadequate habits, such as the consumption of fast food and alcohol, which become negative infl uences in their aging process.
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RESEARCH01-01-2015
Non-conventional technologies for data collection in Brazilian dissertations and theses
Revista Brasileira de Enfermagem. 2015;68(2):269-277
Abstract
RESEARCHNon-conventional technologies for data collection in Brazilian dissertations and theses
Revista Brasileira de Enfermagem. 2015;68(2):269-277
DOI 10.1590/0034-7167.2015680212i
Views0See moreABSTRACT
Objective:
to characterize non-conventional technologies used for data collection of dissertations and theses available in the Catalog of Theses and Dissertations (CEPEn) of the Brazilian Nursing Association (ABEn).
Method:
this is a documentary research, whose data were collected in the catalogs of theses and dissertations available at the ABEn website, from Volumes XIX to XXI. The indicators collected were: academic level; educational institution; year; qualification of the author; setting; non-conventional technology used; type of technology; association with conventional techniques; methodological design; benefi ts and methodological limitations.
Results:
from a total of 6346 studies, only 121 (1.91%) used non-conventional technologies for data collection, representing the fi nal sample of the study.
Conclusion:
it is concluded that Brazilian Nursing researches still need methodological innovations for data collection.
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RESEARCH01-01-2015
Content analysis of a technology to the nursing diagnostic reasoning
Revista Brasileira de Enfermagem. 2015;68(2):261-268
Abstract
RESEARCHContent analysis of a technology to the nursing diagnostic reasoning
Revista Brasileira de Enfermagem. 2015;68(2):261-268
DOI 10.1590/0034-7167.2015680211i
Views0See moreABSTRACT
Objective:
to undergo a content analysis of a metacognitive strategy of indirect assessment in the pre-encounter with the client.
Method:
methodological study. Agreement and inter-rater reliability index for the criteria: relevance, adequacy, clarity, conciseness and accuracy of a technology to the nursing diagnosis reasoning for novices through an electronic form. The sample consisted of 13 raters. Data were analyzed using descriptive statistics.
Results:
high agreement and inter-rater reliability for 85 items related to data collection stage and the strategy description. Only fi ve items did not reach the validation criteria and must be rewritten.
Conclusion:
indirect assessment of the pre-encounter is relevant to the diagnostic reasoning process, being possible to develop competencies and diagnostic skills in the novice through strategies, proposals on innovative technology in the form of a diagram.
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RESEARCH01-01-2015
Manual for monitoring the quality of nursing home care records
Revista Brasileira de Enfermagem. 2015;68(2):253-260
Abstract
RESEARCHManual for monitoring the quality of nursing home care records
Revista Brasileira de Enfermagem. 2015;68(2):253-260
DOI 10.1590/0034-7167.2015680210i
Views0See moreABSTRACT
Objective:
to build and validate an instrument aimed at monitoring the quality of nursing records in the Home Care Program (HCP) of a university hospital.
Method:
methodological study involving the elaboration of a manual, whose content was later submitted to six experts for validation, reaching a ≥ 80% consensus. The data collection process was carried out in 2012 by means of a questionnaire comprised of the following issues: nursing evolution, nursing diagnosis, and nursing prescription, and standards for the nursing team recommended by the Regional Nursing Council of São Paulo and by the assessed institution. Manual items were judged according to the following variables: relevance, pertinence, clarity and simplicity.
Results:
of the 39 propositions, 100% achieved ≥ 80% agreement in the relevance, pertinence and clarity variables; 92.3% in the simplicity variable. Sleep/rest, Mobility and Check-out variables did not reach a favorable minimum consensus in the prescribed activities and were improved following suggestions from the experts.
Conclusion:
we believe that the instrument will enable the improvement of the HCP’s work process.
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RESEARCH01-01-2015
Vulnerability of families of elderly citizens cared for by the Family Health Strategy
Revista Brasileira de Enfermagem. 2015;68(2):244-252
Abstract
RESEARCHVulnerability of families of elderly citizens cared for by the Family Health Strategy
Revista Brasileira de Enfermagem. 2015;68(2):244-252
DOI 10.1590/0034-7167.2015680209i
Views0See moreABSTRACT
Objective:
the present descriptive, exploratory, cross-sectional study aimed to identify the vulnerability of families of elderly citizens cared for by the Family Health Strategy (FHS).
Method:
the research employed home interviews and was developed with a sample of 500 families of aged people cared for by 32 FHS teams in the city of Dourados, MS, Brazil. The Family Development Index (FDI) was adapted in order to classify the families according to their degree of vulnerability.
Results:
the results revealed the presence of multigenerational families with low educational levels among individuals over the age of 20 and high illiteracy rates among elderly citizens. There were 403 families whose vulnerability was acceptable, 95 in severe vulnerability, and two families in a condition of very severe vulnerability. The most critical dimensions of the FDI were the access to knowledge and to work.
Conclusion:
the study identifi ed that there is still a need for further investments that can assist these aged people and their families in the Primary Health Care.
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RESEARCH01-01-2015
The work in prison: reflections on the health of prison officers
Revista Brasileira de Enfermagem. 2015;68(2):235-243
Abstract
RESEARCHThe work in prison: reflections on the health of prison officers
Revista Brasileira de Enfermagem. 2015;68(2):235-243
DOI 10.1590/0034-7167.2015680208i
Views0See moreABSTRACT
Objective:
to understand the working conditions of prison offi cers and the repercutions of labor activity on their health.
Method:
qualitative and descriptive research. Data were collected through open interviews with the prison offi cers of a regional prision and the speeches were submitted to content analysis.
Results:
the results showed unsatisfactory working conditions due to poor material resources and neglect of governmental regarding rehabilitation of convicts, resulting in workers’ exposure to psychosocial risks, dissatisfaction, and emotional distress.
Conclusion:
investments on the security of workers may contribute to their health promotion.
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RESEARCH01-01-2015
Mother recognition in the Neonatal Intensive Care Unit
Revista Brasileira de Enfermagem. 2015;68(2):228-234
Abstract
RESEARCHMother recognition in the Neonatal Intensive Care Unit
Revista Brasileira de Enfermagem. 2015;68(2):228-234
DOI 10.1590/0034-7167.2015680207i
Views0ABSTRACT
Objective:
analyze the maternal experience in a neonatal intensive care unit, focusing on relations of recognition.
Method:
a qualitative study, built on the perspective of Gadamer’s hermeneutics, based on Honneth’s concept of recognition. In-depth interviews were conducted with 10 mothers of children admitted to a neonatal intensive care unit.
Results:
failures were reported in the process of mother recognition in the unit, with consequent feelings of insecurity and obligation to child care, resulting in fragility of self-esteem.
Conclusion:
interactions with health professionals in the NICU and its standards and protocols cause vulnerabilities and affect maternal recognition and autonomy.
Keywords:Humanization of AssistanceIntegrality in HealthIntensive CareNeonatalProfessional-Family RelationsSee more
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