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ORIGINAL ARTICLE10-09-2023
Construction and validation of a scenario for recognizing sepsis by nursing students: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220537
Abstract
ORIGINAL ARTICLEConstruction and validation of a scenario for recognizing sepsis by nursing students: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220537
DOI 10.1590/0034-7167-2022-0537
Views0See moreABSTRACT
Objective:
To build and validate a clinical simulation scenario for teaching Nursing students about early recognition of signs and symptoms of sepsis in the context of the emergency unit.
Methods:
Methodological study developed in two phases: construction of a simulated scenario and content validation by expert judges. For data analysis, the Content Validity Index (CVI) was calculated considering agreement equal to or greater than 80%. The minimum acceptable CVI value for scenario validation was 1.0.
Results:
The simulation scenario proved to be appropriate, with a global Content Validity Index equal to 1. Some adjustments related to the clarity of the wording were necessary, as suggested by the judges. Conclusions: A medium-complexity, high-fidelity scenario was successfully constructed and validated for teaching early recognition of sepsis signs and symptoms.
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EXPERIENCE REPORT10-09-2023
Service organization protocol for coping with undergraduate students’ psychological distress: a collective construction
Revista Brasileira de Enfermagem. 2023;76(4):e20220535
Abstract
EXPERIENCE REPORTService organization protocol for coping with undergraduate students’ psychological distress: a collective construction
Revista Brasileira de Enfermagem. 2023;76(4):e20220535
DOI 10.1590/0034-7167-2022-0535
Views0See moreABSTRACT
Objective:
to report on the experience of the elaboration process of a service organization protocol for coping with public undergraduate students’ psychological distress in the countryside of São Paulo.
Method:
experience report on protocol production, an action research product, carried out according to the health care and service organization protocol model, made possible by remote meetings with 33 professionals linked to the management and services of the university’s health and social assistance departments.
Results:
collective protocol production provided an opportunity for an institutional agreement on educational, therapeutic and support actions, to be developed in groups or individually with students, with provision for permanent education with civil servants.
Final considerations:
this experience made it possible to list specific actions to face undergraduate students’ psychological distress, bringing health professionals closer to those in management, promoting the exchange of concepts and practices to re-signify and transform the work developed.
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ORIGINAL ARTICLE10-09-2023
Performance of Family Health Strategy Nurses in LGBT+ Healthcare
Revista Brasileira de Enfermagem. 2023;76(4):e20220514
Abstract
ORIGINAL ARTICLEPerformance of Family Health Strategy Nurses in LGBT+ Healthcare
Revista Brasileira de Enfermagem. 2023;76(4):e20220514
DOI 10.1590/0034-7167-2022-0514
Views0See moreABSTRACT
Objective:
To analyze the role of Family Health Strategy (FHS) nurses in the health care of LGBT+ individuals.
Methods:
This qualitative study is based on Institutional Analysis. Data was collected in August 2021 through semi-structured interviews with 14 Family Health Strategy nurses from municipalities in the state of São Paulo. The data was processed using the IRaMuTeQ® software and analyzed lexically.
Results:
The textual corpus gave rise to three themes, which addressed the nurses’ practice, the difficulties and challenges they face in providing care to LGBT+ individuals, and the direct association of LGBT+ individuals with sexually transmitted infections.
Conclusion:
Lack of preparedness, access to information, and the need for expanded listening skills are still gaps in the performance of FHS nurses in caring for LGBT+ individuals. However, fostering acceptance and building strong relationships have been effective strategies in bridging the gap in nursing care for the LGBT+ community.
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ORIGINAL ARTICLE10-09-2023
Perceived stress by mototaxi drivers and its relationship with sociodemographic and occupational characteristics
Revista Brasileira de Enfermagem. 2023;76(4):e20220505
Abstract
ORIGINAL ARTICLEPerceived stress by mototaxi drivers and its relationship with sociodemographic and occupational characteristics
Revista Brasileira de Enfermagem. 2023;76(4):e20220505
DOI 10.1590/0034-7167-2022-0505
Views0See moreABSTRACT
Objective:
To investigate the association of sociodemographic and occupational characteristics with a high level of perceived stress in motorcycle taxi drivers.
Method:
Cross-sectional study carried out with motorcycle taxi drivers who answered instruments on sociodemographic and occupational variables – Perceived Stress Scale, Job Content Questionnaire and Effort-Reward Imbalance. Descriptive statistics, Pearson’s chi-square test and Poisson regression with robust variance were used. Statistical significance was 5%.
Results:
Of the 800 motorcycle taxi drivers, 46.8% had a high level of perceived stress. In the multivariate analysis, a high level of stress was associated with low control over work (PR=7.76; 95%CI=5.19-11.61), low social support at work (PR=3.87; 95%CI =2.95 5.08), working hours longer than eight hours a day (RP=1.47; 95%CI=1.21-1.78) and monthly income less than or equal to two minimum wages (PR=1.34;95%CI=1.13-2.58).
Conclusion:
Long working hours, occupational stressors and low income were associated with a high level of perceived stress. Public policies and interventions to minimize occupational stressors are essential.
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ORIGINAL ARTICLE10-09-2023
Spatial and temporal analysis of tuberculosis incidence in Guinea-Bissau, 2018 to 2020
Revista Brasileira de Enfermagem. 2023;76(4):e20220481
Abstract
ORIGINAL ARTICLESpatial and temporal analysis of tuberculosis incidence in Guinea-Bissau, 2018 to 2020
Revista Brasileira de Enfermagem. 2023;76(4):e20220481
DOI 10.1590/0034-7167-2022-0481
Views0See moreABSTRACT
Objective:
to analyze the epidemiological profile, spatial and temporal distribution of tuberculosis in Guinea-Bissau from 2018 to 2020.
Methods:
an ecological study, carried out in Guinea-Bissau, considering new cases of tuberculosis. Spatial analysis of areas was used to verify tuberculosis distribution in the country, and time series were used to identify incidence evolution over the years of study.
Results:
a total of 6,840 new cases of tuberculosis were reported. Tuberculosis incidence rate in the country ranged from 36.8 to 267.7 cases/100,000 inhabitants, with emphasis on the regions of Bissau and Biombo (over 90 cases/100,000). By using time series, it was possible to observe an increase in case incidence over the years of study.
Conclusions:
the study made it possible to identify the epidemiological profile of tuberculosis in Guinea-Bissau, spatial distribution heterogeneity, in addition to identifying the disease evolution over the years of investigation.
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ORIGINAL ARTICLE10-09-2023
Eating habits: what foods do children between 12 and 36 months consume?
Revista Brasileira de Enfermagem. 2023;76(4):e20220393
Abstract
ORIGINAL ARTICLEEating habits: what foods do children between 12 and 36 months consume?
Revista Brasileira de Enfermagem. 2023;76(4):e20220393
DOI 10.1590/0034-7167-2022-0393
Views0See moreABSTRACT
Objective:
to identify toddlers’ eating habits.
Method:
a cross-sectional study of quantitative analysis, with a sample of 808 toddlers who attended day care centers in the district of Viseu, Portugal, between November 2018 and September 2019. Data were collected using a questionnaire directed at parents.
Results:
the prevalence of children who ate six meals a day was 42.8%, and 42.5%, those who ate five meals. It was found that 2.0% of children consumed chocolates, 1.0%, desserts, and 0.4%, carbonated beverages, daily. On average, dairy product (M=5.61; SD=2.62) and meat/fish/egg (M=4.80; SD=3.57) consumption was higher than recommended, while fat (M=0.48; SD=0.40), legume (M=0.49; SD=0.45), vegetable (M=1.18; SD=0.87) and water (M=0 .51; SD=0.29) consumption was lower.
Conclusions:
there was a higher or lower consumption than recommended for some foods, highlighting the need to implement nursing intervention programs aimed at promoting healthy eating habits in toddlers and families.
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REVIEW10-09-2023
Self-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review
Revista Brasileira de Enfermagem. 2023;76(4):e20220383
Abstract
REVIEWSelf-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review
Revista Brasileira de Enfermagem. 2023;76(4):e20220383
DOI 10.1590/0034-7167-2022-0383
Views0ABSTRACT
Objective:
To map the evidence on self-care guidelines for patients in the post-hematopoietic stem cell transplantation (HSCT) period.
Method:
Scoping review supported by Joanna Briggs Institute recommendations, with searches conducted between March and April 2022 in national and international databases and repositories of theses and dissertations.
Results:
Of the 11 studies that composed the final sample, the guidelines had a social and personal aspect, as post-transplant patients need to follow numerous essential recommendations for the prevention of infections and complications for successful treatment and improved quality of life.
Conclusion:
Knowing the self-care guidelines that must be performed by post-HSCT patients is fundamental for the nursing team to provide the necessary information for care outside the controlled environment of the hospital, in addition to minimizing episodes of infection, death, and increasing the survival and quality of life of transplant recipients.
Keywords:Health EducationHematopoietic Stem Cell TransplantationNursing CarePatient Discharge SummariesSelf-CareSee more
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Social representations about religion and spirituality
Revista Brasileira de Enfermagem. 2015;68(4):609-616
Abstract
Social representations about religion and spirituality
Revista Brasileira de Enfermagem. 2015;68(4):609-616
DOI 10.1590/0034-7167.2015680406i
Views0See moreABSTRACT
Objective:
to identify the social representations about the concepts of spirituality and religion of of health teachers.
Method:
exploratory and descriptive study, based on a qualitative approach. 25 subjects participated in it. The following instruments were used to collect data: questionnaire to identify the profile; questionnaire of free association, whose inducing words were religion and spirituality, and an interview based on the scale FICA (Puchalski, 2006).
Results:
the representations about religion and spirituality, for professors, are forged around the faith in God and it gives them meaning and purpose to deal with the challenges of personal and professional living.
Conclusion:
there are still barriers that need to be overcome with a view to a comprehensive care. For this, it is essential to incorporate spirituality in the process in the curricula of health courses.
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Prevalence and factors associated with smoking among tobacco growers in southern Brazil
Revista Brasileira de Enfermagem. 2015;68(4):603-608
Abstract
Prevalence and factors associated with smoking among tobacco growers in southern Brazil
Revista Brasileira de Enfermagem. 2015;68(4):603-608
DOI 10.1590/0034-7167.2015680405i
Views0See moreABSTRACT
Objective:
identify the prevalence and factors associated with smoking in tobacco growers.
Method:
descriptive, cross-sectional research. Data collection occurred in 2012 through household survey and interviews, including application of a structured instrument and scale Fargeström.
Results:
there were 100 growers included, average age of 46,9 ± 10,8 years; 90(90%) married; 72(72%) white, average family composition 3,7±1,1 people; median number of children 3(1-3), and the average study time 6±2,5. The prevalence of smoking among tobacco growers was 17%, which had less education (p=0.010) and fewer people in the household (p=0.049).
Conclusion:
the prevalence of smoking among tobacco growers was higher than the national average, but the nicotine dependence was low, which can facilitate the smoking cessation process. Highlights the need to implement a program to control smoking among tobacco growers.
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The family living the child recovery process after hospital discharge
Revista Brasileira de Enfermagem. 2015;68(4):594-602
Abstract
The family living the child recovery process after hospital discharge
Revista Brasileira de Enfermagem. 2015;68(4):594-602
DOI 10.1590/0034-7167.2015680404i
Views1See moreABSTRACT
Objective:
to understand the meaning attributed by the family to its experience in the recovery process of a child affected by an acute disease after discharge, and to develop a theoretical model of this experience. Symbolic interactionism was adopted as a theoretical reference, and grounded theory was adopted as a methodological reference.
Method:
data were collected through interviews and participant observation with 11 families, totaling 15 interviews. A theoretical model consisting of two interactive phenomena was formulated from the analysis: Mobilizing to restore functional balance and Suffering from the possibility of a child’s readmission.
Results:
the family remains alert to identify early changes in the child’s health, in an attempt to avoid rehospitalization.
Conclusion:
the effects of the disease and hospitalization continue to manifest in family functioning, causing suffering even after the child’s discharge and recovery.
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Multiprofessional residency in health: a document analysis of political pedagogical projects
Revista Brasileira de Enfermagem. 2015;68(4):586-593
Abstract
Multiprofessional residency in health: a document analysis of political pedagogical projects
Revista Brasileira de Enfermagem. 2015;68(4):586-593
DOI 10.1590/0034-7167.2015680403i
Views0See moreABSTRACT
Objective:
To analyze MPRH political pedagogical projects (PPP) developed in the state of São Paulo and identify scenarios that are highly favorable to IPE.
Method:
This was a descriptive exploratory study conducted through document analysis.
Results:
The analysis revealed a heterogeneous scenario regarding the curricula, didactic and pedagogical organization, educational objectives, pedagogical matrices and evaluation systems employed. One of the programs was identified as providing a highly favorable setting for IPE.
Conclusion:
The analysis adequately evaluated IPE in educational settings and found a highly favorable scenario for it, identifying didactic, pedagogical, political and organizational MPRH elements.
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Beliefs of older adults about their vulnerability to HIV/Aids, for the construction of nursing diagnoses
Revista Brasileira de Enfermagem. 2015;68(4):579-585
Abstract
Beliefs of older adults about their vulnerability to HIV/Aids, for the construction of nursing diagnoses
Revista Brasileira de Enfermagem. 2015;68(4):579-585
DOI 10.1590/0034-7167.2015680402i
Views0See moreABSTRACT
Objective:
to know the beliefs of older adults about their vulnerability to HIV/Aids, and to identify nursing diagnoses.
Method:
a field research implemented in Family Health Units, in João Pessoa, Brazil. The sample included 250 older adults of both genders with data collected from April to July of 2011. A Test of Free Word Association was applied using the term HIV/Aids. A content analysis and cross-mapping of the most frequent terms with the International Classification for Nursing Practice, 2011 were performed.
Results:
202 terms were identified in terms, with an overall frequency of 1156. Of the 202 terms, 16 were more frequent and were used to construct the nursing diagnoses. The diagnoses identified were knowledge about appropriate sexual behavior, ability for partial protection, fear of death and hopelessness.
Conclusion:
understanding these beliefs drew from knowledge about factors related to, vulnerability to HIV/Aids aimed at planning health care actions for this population segment.
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LETTER TO THE EDITOR01-01-2015
Considerations about the manuscript published
Revista Brasileira de Enfermagem. 2015;68(4):577-577
Abstract
LETTER TO THE EDITORConsiderations about the manuscript published
Revista Brasileira de Enfermagem. 2015;68(4):577-577
DOI 10.1590/0034-7167.20156804c
Views0Re: Chinese auriculotherapy to improve quality of life of nursing team To the Editor,[…]See more -
Research in nursing and new pathways based on SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
Abstract
Research in nursing and new pathways based on SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
DOI 10.1590/0034-7167.2015680401i
Views1Almost half a century after the beginning of nursing research in Brazil, there is still a need for investment before it can be considered consolidated. The truth of this statement can be seen in the national seminars that discuss research in the field through 17 events that present results and participation of nursing researchers and […]See more
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ORIGINAL ARTICLE09-20-2024
Risk assessment for postoperative complications in patients undergoing cardiac surgical procedures
Revista Brasileira de Enfermagem. 2024;77(4):e20230127
Abstract
ORIGINAL ARTICLERisk assessment for postoperative complications in patients undergoing cardiac surgical procedures
Revista Brasileira de Enfermagem. 2024;77(4):e20230127
DOI 10.1590/0034-7167-2023-0127
Views0ABSTRACT
Objectives:
to evaluate the risk of postoperative complications in cardiac patients.
Methods:
an evaluative study using the Tuman Score on medical records of 70 adult patients who underwent cardiac surgery at a University Hospital. The R for Windows software was used for the analyses. Descriptive statistics and bivariate analysis were employed to verify the association between the risk score and complications. The relative risk between the Tuman Score and postoperative complications was obtained through Quasi-Poisson regression, with a 95% confidence interval.
Results:
the majority of the patients were male (58.57%), aged between 41-64 years (50%), who underwent myocardial revascularization (50%). These patients were associated with a lower risk of postoperative complications (p=0.003), (p=0.008), and (p=0.000), respectively. High-risk patients had pulmonary complications (RR=1.32, p=0.002) and neurological complications (RR=1.20, p=0.047).
Conclusions:
preoperative risk assessment promotes qualified care to reduce postoperative complications.
Keywords:Cardiac Surgical ProceduresCardiovascular DiseasesCardiovascular NursingPostoperative ComplicationsRisk AssessmentSee more -
EXPERIENCE REPORT09-20-2024
Researchers’ experience in data collection with families of femicide victims
Revista Brasileira de Enfermagem. 2024;77(4):e20230119
Abstract
EXPERIENCE REPORTResearchers’ experience in data collection with families of femicide victims
Revista Brasileira de Enfermagem. 2024;77(4):e20230119
DOI 10.1590/0034-7167-2023-0119
Views0See moreABSTRACT
Objectives:
to describe researchers’ experience in collecting data from families of femicide victims.
Methods:
this descriptive, qualitative study took the form of an experience report and was conducted in Manaus, Amazonas, Brazil. It involved documentary consultation, training researchers, scheduling and conducting interviews, and using a field diary to record the researchers’ perceptions and experiences.
Results:
the descriptions and photographs of the crime scene were both distressing and impactful for the researchers. The mementos of the victims (including clothing, objects, and childhood photos) shown by their families were deeply moving. Identifying with these experiences facilitated listening to the stories told by the relatives. It was essential to maintain a non-judgmental attitude, acknowledge the loss, provide support for the suffering, and demonstrate a willingness to help.
Final Considerations:
the experience encompassed both theoretical and methodological aspects that were planned and executed in data collection, fostering the development of skills and sensitivity towards the cases. Beyond knowledge and preparation, researchers are expected to exhibit ethical conduct and empathetic capacity.
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ORIGINAL ARTICLE09-20-2024
Factors associated with preventable infant mortality in 2020: a Brazilian population-based study
Revista Brasileira de Enfermagem. 2024;77(4):e20230072
Abstract
ORIGINAL ARTICLEFactors associated with preventable infant mortality in 2020: a Brazilian population-based study
Revista Brasileira de Enfermagem. 2024;77(4):e20230072
DOI 10.1590/0034-7167-2023-0072
Views0ABSTRACT
Objectives:
to identify factors associated with preventable infant deaths, classified as neonatal and post-neonatal.
Methods:
this is an epidemiological and population-based study relating to 2020. Data from the Mortality Information System (MIS) and the preventability classification proposed in the Brazilian Health System List of Causes of Deaths Preventable by Interventions were used.
Results:
prematurity, living in the North and Northeast regions and the occurrence of the event at home were associated with preventable neonatal deaths. To the avoidable post-neonatal component, death outside the hospital, low maternal education and children of brown or yellow color/race were associated.
Conclusions:
the main risk factor associated with preventable deaths was prematurity, in the case of neonatal death. Low maternal education and occurrence outside the hospital were associated with post-neonatal deaths.
Keywords:Epidemiological StudiesHealth Care QualityHealth Information SystemsInfant MortalityVital StatisticsSee more -
Potential of Artificial Intelligence in Evidence-Based Practice in Nursing
Revista Brasileira de Enfermagem. 2024;77(5):e770501
Abstract
Potential of Artificial Intelligence in Evidence-Based Practice in Nursing
Revista Brasileira de Enfermagem. 2024;77(5):e770501
DOI 10.1590/0034-7167.2024770501
Views0Evidence-based practice (EBP) has established itself as a fundamental pillar in nursing, driving effective clinical decision-making based on high-quality scientific research. The primary goal of EBP is to ensure that patients receive the most appropriate and safe care, based on the best available evidence. In this context, knowledge synthesis methods are essential tools for EBP, […]See more -
REVIEW09-06-2024
Parents’ or legal guardians’ beliefs and attitudes about childhood vaccination: a scoping review
Revista Brasileira de Enfermagem. 2024;77(4):e20240126
Abstract
REVIEWParents’ or legal guardians’ beliefs and attitudes about childhood vaccination: a scoping review
Revista Brasileira de Enfermagem. 2024;77(4):e20240126
DOI 10.1590/0034-7167-2024-0126
Views0See moreABSTRACT
Objective:
to map scientific evidence about perceptions, beliefs, knowledge and attitudes of parents or legal guardians of children under 5 years of age regarding routine childhood vaccination.
Methods:
a scoping review, conducted in accordance with the JBI framework. The searches were carried out in the PubMed/MEDLINE, Web of Science, Scopus and LILACS databases. A total of 5,535 studies were returned and 77 were selected, which met the inclusion criteria.
Results:
perceptions related to interaction with healthcare professionals and services, with family organization and structure, with social interaction and public policies, cultural, religious and personal beliefs, knowledge about vaccination schedule, vaccination and immunization process and sources of information are the main factors mapped and which can positively or negatively influence parents’ or legal guardians’ attitudes towards vaccinating children.
Conclusions:
the findings allow us to identify factors related to parents’ perception and beliefs about childhood vaccination.
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ORIGINAL ARTICLE09-06-2024
Construction and validation of an instrument for event-related sterility of processed healthcare products
Revista Brasileira de Enfermagem. 2024;77(4):e20240021
Abstract
ORIGINAL ARTICLEConstruction and validation of an instrument for event-related sterility of processed healthcare products
Revista Brasileira de Enfermagem. 2024;77(4):e20240021
DOI 10.1590/0034-7167-2024-0021
Views0See moreABSTRACT
Objective:
To construct and validate an instrument to assess events related to maintaining the sterility of processed healthcare products.
Methods:
This methodological study developed the instrument through analysis by a panel of experts, focusing on the integrity of commonly used packaging: spunbond-meltblown-spunbond and medical-grade paper. The instrument was analyzed using the Content Validity Index and Content Validity Ratio (≥ 0.80) and modified Kappa (≥ 0.74). The instrument underwent pre-testing.
Results:
Six experienced professionals participated in the expert panel. After two rounds, the final version of the instrument contained five dimensions. In the pre-test, 30 nursing professionals participated, of whom 86.67% considered the instrument good, and 90% found it understandable.
Conclusion:
The construction and validation followed literature recommendations. The instrument is available, aiding in the safe use of processed healthcare products.
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ORIGINAL ARTICLE09-06-2024
Reflective practice of nurse residents in the teaching-learning process in teaching hospitals
Revista Brasileira de Enfermagem. 2024;77(4):e20230540
Abstract
ORIGINAL ARTICLEReflective practice of nurse residents in the teaching-learning process in teaching hospitals
Revista Brasileira de Enfermagem. 2024;77(4):e20230540
DOI 10.1590/0034-7167-2023-0540
Views0See moreABSTRACT
Objective:
To analyze reflective practice in the teaching-learning process of nurses in residency programs in teaching hospitals in Minas Gerais, Brazil.
Methods:
Case study, based on the reflective practice framework, conducted in two teaching hospitals. Observation and interviews were conducted with first and second-year residents, and five participants were included for in-depth analysis, with their data subjected to frequency distribution analysis and Critical Discourse Analysis.
Results:
In 519 observed activities, elements of reflection were identified in 22.2%, especially active listening and expression of doubts. Discourses indicated practice as the best moment for teaching-learning due to its potential to generate reflections. Learning by doing and case discussion were considered potential strategies for reflective learning.
Conclusion:
Know-in-action reflection was evidenced as the predominant formative aspect for residents, with few opportunities for reflection on reflection-in-action.
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ORIGINAL ARTICLE09-06-2024
Middle-Range theory of the nursing diagnosis of sedentary lifestyle in young adults
Revista Brasileira de Enfermagem. 2024;77(4):e20230516
Abstract
ORIGINAL ARTICLEMiddle-Range theory of the nursing diagnosis of sedentary lifestyle in young adults
Revista Brasileira de Enfermagem. 2024;77(4):e20230516
DOI 10.1590/0034-7167-2023-0516
Views0See moreABSTRACT
Objective:
To construct a middle-range theory for the nursing diagnosis of Sedentary Lifestyle in young adults.
Methods:
A methodological study for the validation of a nursing diagnosis based on a Middle-Range Theory, carried out in six stages: definition of the approach; definition of theoretical-conceptual models; definition of main concepts; development of a pictorial scheme; construction of propositions; establishment of causal relationships and evidence for practice. The theory construction was operationalized through an integrative review and supported by Roy’s adaptation model.
Results:
Three essential attributes were identified; 10 antecedents; 7 clinical consequences; a pictogram, 9 propositions, and 11 causal relationships and evidence for practice.
Conclusion:
The middle-range theory for the nursing diagnosis of Sedentary Lifestyle in young adults was constructed, expanding the understanding of this phenomenon, to be applied in clinical practice by nurses.
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