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ORIGINAL ARTICLE12-13-2024
Nurses’ experience regarding patient safety in mobile pre-hospital care
- Eduardo Dias Filipe
, - Roberto Chrispim Modesto ,
- Hercules de Oliveira Carmo ,
- Haviley Oliveira Martins ,
- Maristela Santini Martins
Abstract
ORIGINAL ARTICLENurses’ experience regarding patient safety in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77(5):e20230529
DOI 10.1590/0034-7167-2023-0529
- Eduardo Dias Filipe ,
- Roberto Chrispim Modesto ,
- Hercules de Oliveira Carmo ,
- Haviley Oliveira Martins ,
- Maristela Santini Martins
Views0See moreABSTRACT
Objectives:
to understand nurses’ experience regarding patient safety in mobile pre-hospital care.
Method:
a qualitative, exploratory and descriptive study, conducted with nurses active in mobile pre-hospital care services. Semi-structured interviews were conducted, audio-graved and submitted to Bardin’s content analysis.
Results:
from four thematic categories established, nurses reported the care and management skills necessary to work in this service. They demonstrated a commitment to ensuring safe care for patients, staff and spectators. They highlighted the actions taken to prevent and mitigate incidents. However, they based their experiences on practice protocols and individual actions, expressing the need to improve knowledge about patient safety.
Final Considerations:
mobile pre-hospital care nurses’ experience in relation to patient safety was limited, suggesting the need for training on the subject, alignment of work processes and implementation of strategies, aiming to guarantee safe care.
- Eduardo Dias Filipe
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ORIGINAL ARTICLE12-13-2024
Stress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
Abstract
ORIGINAL ARTICLEStress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
DOI 10.1590/0034-7167-2023-0542
Views1See moreABSTRACT
Objectives:
to analyze stress from the perspective of nursing workers caring for people with COVID-19 in a public hospital in the Recôncavo region of Bahia.
Methods:
this is an exploratory qualitative study, conducted through semi-structured interviews. The data were analyzed using word clouds, similarity trees, and content analysis.
Results:
nursing workers were exposed to stress while attending to patients with COVID-19. The reported stressors in the workplace included: work overload, lack of planning, speed in performing tasks, fatigue, lack of participation in decision-making, lack of support from management, technological changes, excessive responsibility without preparation, interpersonal conflicts, and professional undervaluation.
Conclusions:
exposure to these stressors leads to emotional exhaustion and demotivation, which were intensified during the COVID-19 pandemic.
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ORIGINAL ARTICLE12-13-2024
Knowledge and attitudes of nursing students regarding the sexuality of older adults: a quasi-experimental study
- Ana Carolina Macri Gaspar Vendramini ,
- Rosemeiry Capriata de Souza Azevedo ,
- Priscila Aguiar Mendes ,
- Janderson Diego Pimenta da Silva ,
- Annelita Almeida Oliveira Reiners , [ … ],
- Amanda Cristina de Souza Andrade
Abstract
ORIGINAL ARTICLEKnowledge and attitudes of nursing students regarding the sexuality of older adults: a quasi-experimental study
Revista Brasileira de Enfermagem. 2024;77(5):e20240011
DOI 10.1590/0034-7167-2024-0011
- Ana Carolina Macri Gaspar Vendramini ,
- Rosemeiry Capriata de Souza Azevedo ,
- Priscila Aguiar Mendes ,
- Janderson Diego Pimenta da Silva ,
- Annelita Almeida Oliveira Reiners ,
- Amanda Cristina de Souza Andrade
Views0See moreABSTRACT
Objectives:
to compare the knowledge and attitudes of nursing students regarding sexual behavior and sexually transmitted infections (STIs) in older adults before and after an educational intervention.
Methods:
this quasi-experimental study involved a convenience sample of 45 nursing students from a public university, conducted in three stages: pre-intervention, intervention, and post-intervention. A questionnaire was used to assess sociodemographic characteristics, academic training, and knowledge and attitudes on the topic. The intervention was an educational web conference. Paired t-test and Wilcoxon test were used for data analysis.
Results:
there was a statistically significant difference in the knowledge and attitude scores of nursing students before and after the educational intervention (p < 0.001). A significant increase was observed in the knowledge score (from 9.3 to 12.2) and attitude score (from 108 to 117.2) in the post-intervention phase.
Conclusions:
the knowledge of nursing students regarding the sexuality of older adults increased after the educational intervention, and their attitudes on the subject became more positive.
- Ana Carolina Macri Gaspar Vendramini
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ORIGINAL ARTICLE12-13-2024
Educational booklet on labor and delivery: validity study
- Michelle Tatiane Carvalho Gonçalves ,
- Ana Roberta Vilarouca da Silva ,
- Mara Cristina Ribeiro Furlan ,
- Bruna Moretti Luchesi ,
- Tatiana Carvalho Reis Martins
Abstract
ORIGINAL ARTICLEEducational booklet on labor and delivery: validity study
Revista Brasileira de Enfermagem. 2024;77(5):e20240138
DOI 10.1590/0034-7167-2024-0138
- Michelle Tatiane Carvalho Gonçalves ,
- Ana Roberta Vilarouca da Silva ,
- Mara Cristina Ribeiro Furlan ,
- Bruna Moretti Luchesi ,
- Tatiana Carvalho Reis Martins
Views2See moreABSTRACT
Objectives:
to develop and validate an educational booklet on labor and delivery for pregnant women.
Methods:
this methodological study involved constructing and validating a booklet based on Echer’s framework. We used the Content Validity Index and Cronbach’s alpha for content and face validation, selecting judges according to Fering’s criteria. We then conducted a clinical validation with the target population.
Results:
the booklet, developed based on evidence from an integrative review and validated by judges and the target audience, achieved global Content Validity Index of 0.919 and 0.913, respectively. After clinical validation with 22 pregnant women, it included 28 topics and 48 pages, with illustrations by a graphic designer.
Conclusions:
expert judges and the target audience considered this educational technology valid, deeming it a relevant tool for promoting the health of pregnant women.
- Michelle Tatiane Carvalho Gonçalves
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12-08-2024
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
Abstract
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
DOI 10.1590/0034-7167.2024770101pt
Views0Na próxima semana, acontecerão dois grandes eventos científicos em Madri e Granada (Espanha). Serão atividades internacionais, específicas e de forma muito especial, embora não exclusivas do campo ibero-americano, organizadas e desenvolvidas por duas sociedades científicas de enfermagem muito importantes, como a Associação de Enfermagem Comunitária (AEC) e a Associação Latino-Americana de Escolas e Faculdades de […]See more -
ORIGINAL ARTICLE12-08-2024
Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
Abstract
ORIGINAL ARTICLEInitial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
DOI 10.1590/0034-7167-2022-0773
Views0See moreABSTRACT
Objective:
to analyze the initial nipple damage degree by breastfeeding practice and to associate findings with clinical manifestations of breastfeeding women.
Methods:
a retrospective, cross-sectional study with primary data and photographic images database from two randomized clinical trials. Photographic images were analyzed by two independent evaluators using the Nipple Trauma Score. For analysis, the chi-square, Mann-Whitney tests and Kappa coefficient were applied.
Results:
115 breastfeeding women and their respective 186 photographic images were analyzed. The degree of agreement of evaluators using the Nipple Trauma Score was 93.6%. The nipple pain score during breastfeeding was moderate and compromised more than 25% of the nipple surface area.
Conclusions:
assistance to breastfeeding women should prioritize nipple pain intensity instead of the nipple damage size.
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REVIEW12-08-2024
Interventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
- Lais Palotta Balderrama Gueroni ,
- Daniele Alcalá Pompeo ,
- Letícia Palota Eid ,
- Marcos Antonio Ferreira Júnior ,
- Carlos Alberto da Cruz Sequeira , [ … ],
- Luciano Garcia Lourenção
Abstract
REVIEWInterventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
Revista Brasileira de Enfermagem. 2024;77(1):e20230192
DOI 10.1590/0034-7167-2023-0192
- Lais Palotta Balderrama Gueroni ,
- Daniele Alcalá Pompeo ,
- Letícia Palota Eid ,
- Marcos Antonio Ferreira Júnior ,
- Carlos Alberto da Cruz Sequeira ,
- Luciano Garcia Lourenção
Views0See moreABSTRACT
Objective:
To assess the evidence regarding the effectiveness of interventions aimed at strengthening self-efficacy beliefs in college students.
Methods:
Integrative Review conducted on the Lilacs, PubMed, CinahL, Cochrane Collaboration Databases, Scopus, and PsycInfo databases. The methodological quality of the studies was assessed using tools proposed by the Joanna Briggs Institute, and the results were analyzed descriptively.
Results:
Out of the 10 selected studies, six demonstrated that interventions aimed at strengthening self-efficacy were effective (Levels of Evidence II and III), and four revealed contrary results (Levels of Evidence I and II). Programs aimed at enhancing self-efficacy should include content on positive mental health, psychoeducation strategies, cover a period of eight to twelve weeks, and consider the completion of homework assignments.
Conclusion:
The synthesis of evidence pointed to pathways for building an effective self-efficacy strengthening program to be implemented in universities.
- Lais Palotta Balderrama Gueroni
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REVIEW12-08-2024
Common mental disorders in hematopoietic stem cell transplant patients: a scoping review
- Ana Clara Paiva de Almeida ,
- Valéria Dantas de Azevedo ,
- Tássia Regine de Morais Alves ,
- Viviane Euzébia Pereira Santos ,
- Glauber Weder dos Santos Silva , [ … ],
- Isabelle Campos de Azevedo
Abstract
REVIEWCommon mental disorders in hematopoietic stem cell transplant patients: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20220581
DOI 10.1590/0034-7167-2022-0581
- Ana Clara Paiva de Almeida ,
- Valéria Dantas de Azevedo ,
- Tássia Regine de Morais Alves ,
- Viviane Euzébia Pereira Santos ,
- Glauber Weder dos Santos Silva ,
- Isabelle Campos de Azevedo
Views0See moreABSTRACT
Objective:
to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation.
Methods:
this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included.
Results:
the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia.
Conclusions:
the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients’ evolution.
- Ana Clara Paiva de Almeida
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ORIGINAL ARTICLE07-31-2020
Sexuality and associated risk factors in pregnant women
- Paula Renata Amorim Lessa Soares ,
- Cinthia Gondim Pereira Calou ,
- Samila Gomes Ribeiro ,
- Priscila de Souza Aquino ,
- Paulo Cesar de Almeida , [ … ],
- Ana Karina Bezerra Pinheiro
Abstract
ORIGINAL ARTICLESexuality and associated risk factors in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20180786
DOI 10.1590/0034-7167-2018-0786
- Paula Renata Amorim Lessa Soares ,
- Cinthia Gondim Pereira Calou ,
- Samila Gomes Ribeiro ,
- Priscila de Souza Aquino ,
- Paulo Cesar de Almeida ,
- Ana Karina Bezerra Pinheiro
Views0See moreABSTRACT
Objectives:
to assess the sexual function of pregnant women and the influence of sociodemographic, obstetric, and behavioral factors on sexual dysfunction.
Methods:
cross-sectional study conducted with 141 pregnant women attended by the Single Health System and 120 by one private service, totaling 261 participants. A questionnaire containing sociodemographic, obstetric, and behavioral variables was applied, as well as the Female Sexual Function Index instrument, which was used to assess sexual function. Associations between variables and sexual dysfunction were made using the chi-square test, considering a statistically significant result when p < 0.05.
Results:
among the participants, 32.1% had sexual dysfunction, and the variables “age”, “income” and “type of health service” had an influence on sexual dysfunction. The prevalence of pregnant women was between 21 and 30 years old (p < 0.001), with an income between 1 and 2 minimum wages (p = 0.048) and used the public health system network (p = 0.000).
Conclusions:
the factors associated with sexual dysfunction are “young pregnant women”, “low income” and “attended in the public health service”.
- Paula Renata Amorim Lessa Soares
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ORIGINAL ARTICLE06-01-2020
Relationship between functional capacity, performance and symptoms in hospitalized patients with heart failure
Revista Brasileira de Enfermagem. 2020;73(4):e20190123
Abstract
ORIGINAL ARTICLERelationship between functional capacity, performance and symptoms in hospitalized patients with heart failure
Revista Brasileira de Enfermagem. 2020;73(4):e20190123
DOI 10.1590/0034-7167-2019-0123
Views0See moreABSTRACT
Objectives:
to evaluate the prevalence of symptoms in heart failure patients and to investigate the relationship between symptoms, functional capacity and performance.
Methods:
cross-sectional study, developed at a hospital specializing in cardiology. The sample (n=170) consisted of patients with heart failure, assessed by means of a sociodemographic form, New York Heart Association Functional Class, Edmonton Symptom Rating Scale and Karnofsky Physical Performance Scale. Analyzes were performed using Spearman’s Correlation and Pearson’s Chi-Square test.
Results:
dyspnea, fatigue and edema were the main symptoms that led to the search for health services. During hospitalization, the main symptoms were anxiety, sleep disturbance and sadness. Weak negative correlations were observed between functionality, functional class, and symptom overload.
Conclusions:
the prevalence of symptoms was high and changed throughout the hospitalization period. Patients with poorer functional capacity and poorer performance had greater symptom overload.
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ORIGINAL ARTICLE10-01-2022
Continuity of care for children with special healthcare needs during the COVID-19 pandemic
- José Pinheiro Batista Medeiros ,
- Eliane Tatsch Neves ,
- Mardênia Gomes Vasconcelos Pitombeira ,
- Sarah Vieira Figueiredo ,
- Daniella Barbosa Campos , [ … ],
- Ilvana Lima Verde Gomes
Abstract
ORIGINAL ARTICLEContinuity of care for children with special healthcare needs during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75(2):e20210150
DOI 10.1590/0034-7167-2021-0150
- José Pinheiro Batista Medeiros ,
- Eliane Tatsch Neves ,
- Mardênia Gomes Vasconcelos Pitombeira ,
- Sarah Vieira Figueiredo ,
- Daniella Barbosa Campos ,
- Ilvana Lima Verde Gomes
Views0See moreABSTRACT
Objective:
To describe the continuity of care for children with special healthcare needs during the COVID-19 pandemic through the perception of their caregivers in the Northeast of Brazil.
Methods:
Qualitative descriptive-exploratory research carried out between June and September 2020, in a municipality in the Northeast of Brazil. Eleven caregivers participated through semi-structured interviews conducted at home. The data were submitted to thematic content analysis.
Results:
The social isolation period and the suspension of health services affected the continuity of care, configuring the category “Implications of the COVID-19 pandemic for the continuity of care”. Caregivers expressed fear of children contracting the coronavirus, characterizing the category “Fears and uncertainties of the COVID-19 pandemic in view of the vulnerability of children with special healthcare needs”.
Final considerations:
Caregivers’ reports revealed problems in the continuity of care for the studied cohort. Therefore, health care practices must be rethought in times of pandemic.
- José Pinheiro Batista Medeiros
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ORIGINAL ARTICLE06-16-2021
Social representations of the quality of life of the young people living with HIV
- Danielle Pinheiro Elias Silva ,
- Denize Cristina de Oliveira ,
- Sergio Corrêa Marques ,
- Rodrigo Leite Hipólito ,
- Tadeu Lessa da Costa , [ … ],
- Yndira Yta Machado
Abstract
ORIGINAL ARTICLESocial representations of the quality of life of the young people living with HIV
Revista Brasileira de Enfermagem. 2021;74(2):e20200149
DOI 10.1590/0034-7167-2020-0149
- Danielle Pinheiro Elias Silva ,
- Denize Cristina de Oliveira ,
- Sergio Corrêa Marques ,
- Rodrigo Leite Hipólito ,
- Tadeu Lessa da Costa ,
- Yndira Yta Machado
Views0See moreABSTRACT
Objectives:
to analyze the social representations of the quality of life of the young people living with HIV.
Methods:
qualitative survey, based on the Social Representations Theory, with 24 young people living with HIV, monitored in specialized services in Rio de Janeiro, through semi-structured interviews, and the analysis supported by the software IRAMUTEQ.
Results:
multidimensionality of the quality of life was observed unfolding the implications of living with HIV/aids concerning the familiar and social support network, time of diagnosis, healthcare services, antiretroviral therapy, and prejudice expressions.
Final Considerations:
a conceptual synthesis of quality of life is observed when it is associated with healthy lifestyle habits, interpersonal relationships, and health services and professional practices.
- Danielle Pinheiro Elias Silva
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ORIGINAL ARTICLE12-08-2023
Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
- Carine Teles Sangaleti ,
- Maicon Henrique Lentsck ,
- Dannyele Cristina da Silva ,
- Andrielli Machado ,
- Maria Regiane Trincaus , [ … ],
- Fernanda Marciano Consolim Colombo
Abstract
ORIGINAL ARTICLEPolypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
DOI 10.1590/0034-7167-2022-0785
- Carine Teles Sangaleti ,
- Maicon Henrique Lentsck ,
- Dannyele Cristina da Silva ,
- Andrielli Machado ,
- Maria Regiane Trincaus ,
- Maria Cristina Umpierrez Vieira ,
- Bruno Bordin Pelazza ,
- Fernanda Marciano Consolim Colombo
Views0See moreABSTRACT
Objective:
to identify the prevalence and associations of polypharmacy and potentially inappropriate medication use among older adults with hypertension treated in primary care.
Methods:
a cross-sectional study carried out with older adults with hypertension treated at a Family Health Strategy unit. Data collection included analysis of medical records, interviews and multidimensional assessment of older adults. Socio-demographic information and clinical variables were collected. Statistical analysis was performed by multiple logistic regression.
Results:
polypharmacy prevalence was 38.09%, and potentially inappropriate medication (PIM), 28.57%. There was a significant association between polypharmacy and PIM use, altered sleep and ethnicity. PIM use was associated with polypharmacy, worse family functioning, and absence of a caregiver. Cognitive decline reduces the prevalence of these medications.
Conclusions:
polypharmacy and PIM use among older adults with hypertension represent a problem in this population, especially among the most vulnerable.
- Carine Teles Sangaleti
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ORIGINAL ARTICLE02-10-2020
Healthcare professionals’ perception of mental health in primary care
- Georgia Dalla Valle Garcia ,
- Daniela Viganó Zanoti-Jeronymo ,
- Gustavo Zambenedetti ,
- Michele da Rocha Cervo ,
- Marília Daniella Machado Araújo Cavalcante
Abstract
ORIGINAL ARTICLEHealthcare professionals’ perception of mental health in primary care
Revista Brasileira de Enfermagem. 2020;73(1):e20180201
DOI 10.1590/0034-7167-2018-02011
- Georgia Dalla Valle Garcia ,
- Daniela Viganó Zanoti-Jeronymo ,
- Gustavo Zambenedetti ,
- Michele da Rocha Cervo ,
- Marília Daniella Machado Araújo Cavalcante
Views0See moreABSTRACT
Objective:
To characterize the mental health care provided in Primary Care from the perception of health professionals in the cities to the 5th Regional Health Center of the state of Paraná.
Method:
An exploratory qualitative research. Participants were 121 health professionals working in primary care in the 20 cities of 5th Regional Health Center of the state of Parana. Twenty-two focus groups were recorded, transcribed and analyzed by content analysis.
Results:
Five thematic categories emerged, of which two were analyzed in this study: actions that professionals consider to be mental health actions; mental health actions developed by Primary Care professionals.
Final Considerations:
Despite of the indications of inclusion of mental health actions in Primary Care, this relationship is still occasional and unplanned. Policies that foster this interaction from a psychosocial perspective are needed.
- Georgia Dalla Valle Garcia
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ORIGINAL ARTICLE08-30-2021
Historical aspects in pain management in palliative care in an oncological reference unit
- Carolina Fraga Paiva ,
- Tânia Cristina Franco Santos ,
- Pacita Geovana Gama de Sousa Aperibense ,
- Gizele da Conceição Soares Martins ,
- Lilian Dias Ennes , [ … ],
- Antonio José de Almeida Filho
Abstract
ORIGINAL ARTICLEHistorical aspects in pain management in palliative care in an oncological reference unit
Revista Brasileira de Enfermagem. 2021;74(5):e20200761
DOI 10.1590/0034-7167-2020-0761
- Carolina Fraga Paiva ,
- Tânia Cristina Franco Santos ,
- Pacita Geovana Gama de Sousa Aperibense ,
- Gizele da Conceição Soares Martins ,
- Lilian Dias Ennes ,
- Antonio José de Almeida Filho
Views0See moreABSTRACT
Objective:
Describe the actions implemented for pain management in palliative care oncology and analyze the contribution of Hospital do Câncer IV, as a reference unit at the National Cancer Institute.
Methods:
Study of the history of the present time, whose sources were written documents and interviews with five participants. The collection took place from February to June 2018. The analysis of the written sources took place through internal and external criticism of the documents, considering their chronology and theme.
Results:
Professionals contributed with actions for pain management in palliative oncology care: in discussions and final drafting of ordinances, as rapporteurs at national and international events, in the elaboration of humanization conducts and systematization of assistance in addressing pain.
Final considerations:
These actions favored assistance in palliative oncology care at various levels of health care for patients and families, with greater technical and scientific recognition for all.
- Carolina Fraga Paiva
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REVIEW12-21-2020
Contrast-Induced Nephropathy in patients submitted to percutaneous coronary intervention: an integrative review
- Matheus Santos Moitinho ,
- Eduesley Santana Santos ,
- Adriano Mendes Caixeta ,
- Angélica Gonçalves da Silva Belasco ,
- Dulce Aparecida Barbosa , [ … ],
- Cassiane Dezoti da Fonseca
Abstract
REVIEWContrast-Induced Nephropathy in patients submitted to percutaneous coronary intervention: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200190
DOI 10.1590/0034-7167-2020-0190
- Matheus Santos Moitinho ,
- Eduesley Santana Santos ,
- Adriano Mendes Caixeta ,
- Angélica Gonçalves da Silva Belasco ,
- Dulce Aparecida Barbosa ,
- Cassiane Dezoti da Fonseca
Views0See moreABSTRACT
Objective:
to demonstrate scientific evidence on incidence and factors associated with contrast-induced nephropathy in patients undergoing percutaneous coronary intervention.
Methods:
an integrative review carried out in the VHL, PubMed, VHL Regional Portal and SciELO databases, of articles published between 2014 and 2019.
Results:
the sample consisted of five original articles, two cohorts, two control cases and a clinical trial. The incidence of contrast-induced nephropathy ranged from 6% to 24%. It stands out among patients with advanced age, male gender, diabetes mellitus, systemic arterial hypertension, volume of contrast infused and osmolarity. Intravenous hydration, sodium bicarbonate, ascorbic acid and statin were important prophylactic agents.
Conclusion:
this study envisioned the main risk factors for contrast-induced nephropathy in patients undergoing percutaneous coronary intervention and elucidated preventive measures that guide multidisciplinary health care aiming at a quality and safe care.
- Matheus Santos Moitinho
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