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01-01-2016
Discoveries of Biological Sciences and their implications for nursing practice
Revista Brasileira de Enfermagem. 2016;69(4):619-620
Abstract
Discoveries of Biological Sciences and their implications for nursing practice
Revista Brasileira de Enfermagem. 2016;69(4):619-620
DOI 10.1590/0034-7167.2016690401i
Views1For the longest time, the production of knowledge in the field of biological sciences was viewed as the exclusive responsibility and competence of medical professionals. This scenario has changed in light of the worldwide trend of improvements in other health professions, which includes the need to implement the use of evidence-based methodology in nursing practice. […]See more -
01-01-2016
Descobertas das Ciências Biológicas e as implicações para a prática da Enfermagem
Revista Brasileira de Enfermagem. 2016;69(4):619-620
Abstract
Descobertas das Ciências Biológicas e as implicações para a prática da Enfermagem
Revista Brasileira de Enfermagem. 2016;69(4):619-620
DOI 10.1590/0034-7167.2016690401i
Views1A produção de conhecimento na área das ciências biológicas, durante muito tempo, foi vista como de responsabilidade e competência exclusivamente de profissionais médicos. Esse cenário alterou-se frente à tendência mundial de aperfeiçoamento dos demais profissionais de saúde, incluindo-se a necessidade de se concretizar a utilização da metodologia da prática baseada em evidência na atuação do […]See more -
01-01-2016
The importance of civilian nursing organizations: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(3):610-618
Abstract
The importance of civilian nursing organizations: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(3):610-618
DOI 10.1590/0034-7167.2016690326i
Views0See moreABSTRACT
Objective:
to identify and analyze evidence from studies about the importance of civilian nursing organizations.
Method:
an integrative literature review, for which searches were conducted in the databases LILACS, PubMed/MEDLINE, SciELO, BDENF, and Scopus.
Results:
sixteen articles published between the years 2004-2013 were selected, 68.75% of which were sourced from Brazilian journals and 31.25% from American journals.
Conclusion:
civilian nursing organizations are important and necessary, because they have collaborated decisively in nursing struggles in favor of the working class and society in general, and these contributions influence different axes of professional performance.
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01-01-2016
Effects from acupuncture in treating anxiety: integrative review
Revista Brasileira de Enfermagem. 2016;69(3):602-609
Abstract
Effects from acupuncture in treating anxiety: integrative review
Revista Brasileira de Enfermagem. 2016;69(3):602-609
DOI 10.1590/0034-7167.2016690325i
Views0See moreABSTRACT
Objective:
to evaluate the scientific evidence that is available in the literature on the effects of acupuncture for treating anxiety and on the quality of such studies.
Method:
the study is an integrative review of CINAHL, LILACS, PUBMED-PICO, SciELO, and The Cochrane Library between 2001 and 2014. Keywords anxiety, acupuncture therapy, acupuncture, and anxiety disorders were combined among themselves to ensure a wide search of primary studies.
Results:
among 514 articles, 67 were selected to be fully read and 19 were included. Among these, 11 were found to have strong evidence levels. Among the six articles about randomized clinical studies, five were found to be of reasonable quality. Two studies used acupuncturist nurses to perform their interventions. Its results showed positive and statistically significant effects from using acupuncture for treating subjects with anxiety.
Conclusion:
acupuncture seems to be a promising treatment for anxiety; however, there is a need for improving the methodological quality of the research on this field.
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01-01-2016
Palliative care and spirituality: an integrative literature review
Revista Brasileira de Enfermagem. 2016;69(3):591-601
Abstract
Palliative care and spirituality: an integrative literature review
Revista Brasileira de Enfermagem. 2016;69(3):591-601
DOI 10.1590/0034-7167.2016690324i
Views0See moreABSTRACT
Objective:
to analyze scientifi c articles published in international online journals about palliative care and spirituality.
Methods:
an integrative literature review with data collected in September 2014 from the LILACS, SCIELO, MEDLINE/PubMed, and IBECS databases.
Results:
thirty-nine publications were identifi ed and their textual analysis facilitated through four thematic approaches: the meaning of spirituality in the context of palliative care; palliative care and spiritual support; spirituality and relief of pain and other symptoms in patients under palliative care; and instruments to evaluate the spiritual dimension of the scope of palliative care.
Conclusion:
this study examined the relevance of the spiritual dimension in the care of patients with palliative care and the need for developing new studies to disseminate knowledge about this topic.
Descriptors:
Palliative Care; Palliative Care at End of Live; Spirituality; Religion; Health.
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01-01-2016
Educational technologies to encourage (self) care in postpartum women
Revista Brasileira de Enfermagem. 2016;69(3):582-590
Abstract
Educational technologies to encourage (self) care in postpartum women
Revista Brasileira de Enfermagem. 2016;69(3):582-590
DOI 10.1590/0034-7167.2016690323i
Views0See moreABSTRACT
Objective:
to evaluate national and international literature regarding the use of educational technologies to encourage self care in postpartum women.
Method:
an integrative review of the literature. The articles were collected from the CINAHL, SCOPUS, PubMed, SciELO, LILACS and Cochrane databases; the time period for the articles referred to January/2004 to July/2014; the languages used in the articles were Portuguese, English, Spanish and French; the articles were selected from the following descriptors: postpartum care period, educational technology, nursing and self care. Twenty-seven articles were selected for analysis
Results:
based on the information found, the scales, counseling and home visits were among the most recommended educational technologies.
Conclusion:
the technologies promote communication, but are sometimes dependent on computer and internet access, which hinder their use by low-income women.
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01-01-2016
Patients with HIV/Aids and ulcer risk: nursing care demands
Revista Brasileira de Enfermagem. 2016;69(3):574-581
Abstract
Patients with HIV/Aids and ulcer risk: nursing care demands
Revista Brasileira de Enfermagem. 2016;69(3):574-581
DOI 10.1590/0034-7167.2016690322i
Views0See moreABSTRACT
Objective:
to analyze the demand for nursing care and the risk of pressure ulcers (PU) of patients with HIV/Aids.
Method:
quantitative survey, carried out from December 2012 to March 2013 in a public hospital of Teresina, state of Piauí, Brazil.
Results:
the sample of 31 patients was predominantly male, mean age 36.6 years, average care demand 49.4%, most showing some risk of developing PU. The variables correlated with PU risk were care demand and clinical outcome (death). Those associated with care demand were age and clinical outcome (death).
Conclusion:
the results showed that patients require moderate nursing care needs and most of them present risk of developing PU.
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01-01-2016
Lack of anticipated support for care for community-dwelling older adults
Revista Brasileira de Enfermagem. 2016;69(3):566-573
Abstract
Lack of anticipated support for care for community-dwelling older adults
Revista Brasileira de Enfermagem. 2016;69(3):566-573
DOI 10.1590/0034-7167.2016690321
Views0See moreABSTRACT
Objective:
to identify the factors associated with lack of anticipated support for care for community-dwelling older adults.
Method:
this study presents comparison and logistic regression analyses of data from 671 individuals who took part of the multicentric study entitled “Frailty in older Brazilians” – a quantitative, epidemiologic and transversal investigation carried out between 2008 and 2009.
Results:
the subjective evaluation of anticipated support for care for community-dwelling older adults was a good indicator of risk for lack of anticipated support for care in women, older adults who live alone and those with poor self-rated health.
Conclusion:
it is necessary to reflect upon the formal support system currently available for older people in Brazil, considering that those who most frequently presented lack of anticipated support for care are an increasing population. The study also highlights the importance of using subjective methods for the evaluation of the adequacy of older adults’ support network.
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01-01-2015
Research lines in nursing: phylosophical and epistemological highlights
Revista Brasileira de Enfermagem. 2015;68(4):723-729
Abstract
Research lines in nursing: phylosophical and epistemological highlights
Revista Brasileira de Enfermagem. 2015;68(4):723-729
DOI 10.1590/0034-7167.2015680421p
Views0See moreRESUMEN
Objetivo:
elucidar destaques filosóficos y epistemológicos mediante consideraciones en favor de la casualidad de cuestiones en el interés de la Enfermería.
Método:
es fundamentado en las proposiciones teóricas de Johannes Hessen y de otros autores consagrados.
Resultados:
clareamiento de aspectos sustantivo e implicaciones adjetivas no sólo el interés de la investigación, resaltando los significados esenciales del asunto coincidido con las elaboraciones de disertaciones y tesis (Maestría y Doctorado de Enfermería).
Conclusión:
texto representa una contribución valiosa para esclarecer mejor detalles de la construcción del conocimiento en la temática y problemática del asunto puesto en causa.
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01-01-2015
Linhas de pesquisa em enfermagem: destaques filosóficos e epistemológicos
Revista Brasileira de Enfermagem. 2015;68(4):723-729
Abstract
Linhas de pesquisa em enfermagem: destaques filosóficos e epistemológicos
Revista Brasileira de Enfermagem. 2015;68(4):723-729
DOI 10.1590/0034-7167.2015680421p
Views0See moreRESUMO
Objetivo:
elucidar destaques filosóficos e epistemológicos mediante considerações significativas, essenciais, em favor da causalidade de questões no interesse da Enfermagem.
Método:
abordagem fundamentada nas proposições teóricas de Johannes Hessen, com referência a outros autores expertos no tema.
Resultados:
esclarecimento de aspectos substantivos e implicações adjetivas não só no interesse da investigação, ressaltando os significados essenciais do assunto, condizente com as elaborações de dissertações de mestrado e teses de doutorado de Enfermagem.
Conclusão:
trata-se de uma contribuição valiosa para esclarecer melhor detalhes da construção do conhecimento na temática e problemática do assunto posto em causa, as linhas de pesquisa em enfermagem.
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01-01-2015
Using the theory of meaningful learning in nursing education
Revista Brasileira de Enfermagem. 2015;68(4):713-722
Abstract
Using the theory of meaningful learning in nursing education
Revista Brasileira de Enfermagem. 2015;68(4):713-722
DOI 10.1590/0034-7167.2015680420i
Views0See moreABSTRACT
Objective:
to synthesize the scientific literature about the Theory of Meaningful Learning in the process of teaching and learning in nursing.
Method:
this is an integrative review conducted in the databases MEDLINE, LILACS, SciELO, BDENF and CINAHL with studies addressing the subject or aspects of the theory of meaningful learning of David Ausubel. Ten studies were included, from which six were written in Portuguese and four in English, published from 1998 to 2013.
Results:
five studies used the theory of meaningful learning, four studies cited Ausubel as the author of this theory and only two studies followed the framework for the application of the theory completely. There are only a few studies on this subject and those which explore it are not correlated with Ausubel’s theory.
Conclusion:
it is necessary to break with the dichotomy between theory and practice and promote the articulation of content with action, introducing the student as the author of their own knowledge.
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01-01-2015
Nursing scientific production on health promotion, chronic condition, and aging
Revista Brasileira de Enfermagem. 2015;68(4):705-712
Abstract
Nursing scientific production on health promotion, chronic condition, and aging
Revista Brasileira de Enfermagem. 2015;68(4):705-712
DOI 10.1590/0034-7167.2015680419i
Views1See moreABSTRACT
Objective:
to characterize the scientific production of Postgraduate Programs Nursing in Brazil on health promotion with a focus on elderly people with chronic conditions in the period from 2006 to 2010.
Method:
integrative research developed by searching for dissertations and theses in the database of the Center for Nursing Studies and Research of the Brazilian Nursing Association published in the period from 2006 to 2010 and which focused on health promotion for elderly people with chronic conditions.
Results:
five themes emerged: “Living with the disease”; “Technologies of care”, “Potential for self-care” “Psycho-spiritual dimension”, and “Family caregiver”.
Conclusion:
it was possible to identify nursing care as a key element to promote the health of elderly people and make them more independent in their care so as to live with their limitations or disabilities, even when affected by chronic diseases.
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01-01-2015
Longevity according to life histories of the oldest-old
Revista Brasileira de Enfermagem. 2015;68(4):697-704
Abstract
Longevity according to life histories of the oldest-old
Revista Brasileira de Enfermagem. 2015;68(4):697-704
DOI 10.1590/0034-7167.2015680418i
Views0See moreABSTRACT
Objective:
to interpret life histories of the oldest-old in a community, grounded on the perspective of the Active Aging and Life Course.
Method:
this is a qualitative research. Participants included twenty seniors 80 years and older, users of a Basic Health Unit. Life histories were collected and analyzed according to the proposition of the Autobiographical Narrative Interview.
Results:
during the analytic process, elements found in the elders’ present and past arose, contributing to the development of a theoretical model: “Building longevity along the life course.”
Conclusion:
longevity is rooted in the past, strongly infl uenced by the family culture and life course; assumptions of the Active Aging are more meaningful in the informants’ present trajectory. The content of the narratives pointed to new possibilities of Gerontology Nursing intervention in Primary Care, aiming at health promotion and intervention, specially grounded on the respect to the oldest-elders’ culture.
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01-01-2015
Accuracy in inference of nursing diagnoses in heart failure patients
Revista Brasileira de Enfermagem. 2015;68(4):690-696
Abstract
Accuracy in inference of nursing diagnoses in heart failure patients
Revista Brasileira de Enfermagem. 2015;68(4):690-696
DOI 10.1590/0034-7167.2015680417i
Views0See moreABSTRACT
Objective:
to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients.
Method:
descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating effi cacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected.
Results:
the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identifi ed by the nursing evaluators.
Discussion:
the search for improving diagnostic accuracy reaffi rms the need for continuous and specifi c training to improve the diagnosis capability of nurses.
Conclusion:
the training allowed the exercise of clinical judgment and better accuracy of nurses.
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01-01-2015
Direct cost of development and documentation of the nursing process
Revista Brasileira de Enfermagem. 2015;68(4):683-689
Abstract
Direct cost of development and documentation of the nursing process
Revista Brasileira de Enfermagem. 2015;68(4):683-689
DOI 10.1590/0034-7167.2015680416i
Views0See moreABSTRACT
Objective:
identify the average direct cost (ADC) of the activities performed by nursing professionals in the nursing process development and documentation at the medical clinic of a teaching hospital.
Method:
1040 activities were observed and the ADC was calculated by multiplying the time spent by professionals by the unit cost of direct labor.
Results:
the ADC of patient admission was R$ 55.57 (SD=19.44); among the activities of patient follow-up, the assessment phase documentation had the most significant ADC (R$ 17.70 – SD=14.60); the ADC of descriptive records corresponded to R$ 1.21 (SD=1.21) and the ADC of the nursing team for shift change was R$ 54.23 (SD=28.95).
Conclusion:
the study promotes visibility of the work performed by nursing professionals in the development of the nursing process, providing financial data to ensure consistent arguments for proper resources to its feasibility.
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01-01-2015
Health status and mental health in patients after percutaneous coronary intervention
Revista Brasileira de Enfermagem. 2015;68(4):676-682
Abstract
Health status and mental health in patients after percutaneous coronary intervention
Revista Brasileira de Enfermagem. 2015;68(4):676-682
DOI 10.1590/0034-7167.2015680415i
Views0See moreABSTRACT
Objective:
to assess the association between perceived health status and the mental health of patients submitted to percutaneous coronary intervention after hospital discharge.
Method:
a quantitative and cross-sectional study involving 101 participants. The following instruments were used: a sociodemographic and clinical characterization instrument, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). Participants were divided into three groups: no anxiety and no depression (G1); anxiety or depression (G2); and both (G3). The ANOVA test was used for the intergroup comparison of means on the SF-36 domains.
Results:
There was an association between perceived health status and mental health. The participants in G1 presented higher scores in all SF-36 domains in comparison with participants in G2 and G3.
Conclusion:
Participants with no anxiety and depression presented better-perceived health status in comparison with those with anxiety or depression, or both.
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06-01-2015
Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
Abstract
Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
DOI 10.1590/0034-7167.2015680320i
Views0See moreABSTRACT
Objective:
To analyze the perceptions of adolescent public school students about drugs.
Method:
Qualitative approach of focus groups with 16 adolescent students. The data collected were analyzed by means of content analysis, leading to the following categories: meaning of drugs; living with drug use; opinions, beliefs and attitudes toward drug use; and preventing drug abuse in adolescence.
Results:
The adolescent students know about some drugs, and associate their use with delinquent and criminal behavior. The students identifi ed factors that lead to drug abuse, such as easy access, use by family and friends, idleness, dropping out of school and the characteristic vulnerability of adolescence.
Conclusion:
the results point to the need for educational activities in the context of where the adolescents live, including school, community and family environments, to support and to minimize their vulnerability.
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06-01-2015
Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
Abstract
Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
DOI 10.1590/0034-7167.2015680319i
Views0See moreABSTRACT
Objective:
to learn the infl uence of cognitive therapy at home, conducted by the caregivers of older people with Alzheimer’s Disease.
Method:
a case study was developed with fi ve older people with Alzheimer’s Disease and their caregivers. The stages of research development were: orientation with the caregivers; selection of older people and caregivers; approach of the study subjects at home; weekly meetings and reapplication of tests to follow up the cognitive function of the participants.
Results:
in three months it was possible to identify improved cognition, verifi ed by the result of the Mini-Mental State Examination (MMSE). The scores of the other tests (KATZ, LAWTON, CLOCK TEST and VFT) remained the same.
Conclusion:
this strategy can be considered a light technology of nursing care for older people with dementia. When providing this care with the support of a nurse, caregivers re feel less anxious and understand the disease better.
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06-01-2015
Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
Abstract
Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
DOI 10.1590/0034-7167.2015680318i
Views0See moreABSTRACT
Objective:
to study anxiety and spirituality and the relationship between them in university students.
Method:
the State-Trait-Anxiety Inventory (STAI) and Pinto and Pais-Ribeiro Spirituality Scales were used for data collection.
Results:
six hundred and sixty-nine students participated in the study, of whom 91.5% had moderate and high levels of trait anxiety and 92.9% of state anxiety; 93.8% had high spirituality scores. The multiple linear regression test showed a signifi cant relationship between anxiety and the presence of physical discomfort, unusual body movements, and the need for treatment. Furthermore, higher levels of anxiety were associated with the female gender, the lack of leisure activities, and low levels of optimism in the spirituality scale.
Conclusion:
it is important to develop strategies for coping with anxiety, which in turn can be oriented toward protective factors such as spirituality.
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06-01-2015
Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
Abstract
Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
DOI 10.1590/0034-7167.2015680317i
Views0See moreABSTRACT
Objective:
to evaluate the effectiveness of a nursing guidance protocol to reduce the anxiety of patients with acute coronary syndrome undergoing bed bath, and the correlation of vital signs with state-anxiety.
Method:
randomized clinical trial study. The sample consisted of 120 patients. The intervention group received a nursing guidance protocol about bed bath and the control group received the unit’s routine information. The STAI-State scale was used to assess anxiety, and data were collected at three times: immediately after informing the patients about the bed bath; immediately after interventions; and immediately after the bath.
Results:
the intervention group presented signifi cantly lower state-anxiety compared to the control group (p<0.001) after the intervention.
Conclusion:
the nursing orientation was effective to reduce anxiety in patients with acute coronary syndrome undergoing bed bath.
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06-01-2015
Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
Abstract
Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
DOI 10.1590/0034-7167.2015680316i
Views0See moreABSTRACT
Objective:
to classify body language used in nursing care, and propose “Body language in nursing care” as an analytical category for nursing communication.
Method:
quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions.
Results:
sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches.
Conclusion:
nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classifi ed body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.
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06-01-2015
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
Abstract
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
DOI 10.1590/0034-7167.2015680315i
Views0See moreABSTRACT
Objective:
to analyze health promotion programs in the supplementary health care.
Methods:
This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis.
Results:
Home care has been described as the main action in the fi eld of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the benefi ciaries.
Conclusions:
Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.
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06-01-2015
Drug addicts treatment motivations: perception of family members
Revista Brasileira de Enfermagem. 2015;68(3):474-481
Abstract
Drug addicts treatment motivations: perception of family members
Revista Brasileira de Enfermagem. 2015;68(3):474-481
DOI 10.1590/0034-7167.2015680314i
Views1See moreABSTRACT
Objective:
to identify the reasons and motivations why family members search treatment for the drug addicted.
Method:
descriptive qualitative research, developed in 2012 and 2013, in a Drug Addicts Rehabilitation Unit of Parana State, Brazil. A total of 19 semi-structured interviews were conducted with the drug addicts’ family members in treatment. The results were analyzed based on the Transtheoretical Model of Behavior Change and organized in thematic categories according with qualitative data analysis.
Results:
the search for treatment for drug addicts occurred: in the pre-contemplation stage infl uenced by external factors; in the contemplation stage both for ambivalence and behavioral changes needs; in the action stage by awareness of drug addiction and also professional help needs; and in the maintenance stage because of the non-conservation of behavioral changes.
Conclusion:
an evaluation of motivational stages in the beginning of treatment is required for expansion of success possibilities in the rehabilitation process.
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06-01-2015
Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
Abstract
Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
DOI 10.1590/0034-7167.2015680313i
Views0See moreABSTRACT
Objective:
to analyze the factors associated with the gateway of the health systems of Brazilian municipalities for the diagnosis of tuberculosis in older people.
Method:
survey study type, with a sample of 91 elders, in a population with 706 cases of tuberculosis. Data were collected by means of an instrument based on the Primary Care Assessment Tool (PCAT) adapted for tuberculosis care, emphasizing the gateway variable. Variables were categorized and compared between primary health care (PHC) and specialized care (SC) services. Bivariate analysis and the Chi-square association test were used.
Results:
a statistically signifi cant association (p = 0.0001) was found between the fi rst health service sought and the unit that diagnosed tuberculosis, showing better performance of specialized care services in the diagnosis.
Conclusion:
it is necessary to improve primary health care services to tackle delayed diagnosis of tuberculosis in older people.
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