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01-01-2017
Alta prevalencia de enteroparasitosis en niños de Ribeirão Preto, São Paulo, Brasil
Revista Brasileira de Enfermagem. 2017;70(3):566-571
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01-01-2017
High prevalence of enteroparasites in children from Ribeirão Preto, São Paulo, Brazil
Revista Brasileira de Enfermagem. 2017;70(3):566-571
Abstract
High prevalence of enteroparasites in children from Ribeirão Preto, São Paulo, Brazil
Revista Brasileira de Enfermagem. 2017;70(3):566-571
DOI 10.1590/0034-7167-2016-0059
Views0See moreABSTRACT
Objective:
To determine the prevalence of intestinal parasites and possible associated factors.
Method:
Cross-sectional epidemiological study of 962 children (3-12-years) from an area within the scope of a basic health unit in Ribeirão Preto, São Paulo, Brazil. Data were collected by home interviews and three-sample stool analysis and evaluated with the chi-square and Fisher’s exact tests (p<0.05).
Results:
The prevalence of intestinal parasites was significantly high (57.5%). Giardia lamblia was the most prevalent (50.8%), followed by Ascaris lumbricoides (17.8%), Entamoeba histolytica, Hymenolepis nana, Entamoeba coli and Enterobius vermiculares (5.6-7.3%) and other parasites of lower prevalence, such as Schistosoma japonicum (1%) and Schistosoma mansoni (0.5%). No statistically significant associations were detected between prevalence and the risk factors analyzed.
Conclusion:
Since the area presents good conditions of environmental sanitation, health education programs should be implemented that emphasize hygiene procedures for the hands and for food and water to be consumed by the population.
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RESEARCH01-01-2017
Validation of the adherence questionnaire for Brazilian chronic kidney disease patients under hemodialysis
Revista Brasileira de Enfermagem. 2017;70(3):558-565
Abstract
RESEARCHValidation of the adherence questionnaire for Brazilian chronic kidney disease patients under hemodialysis
Revista Brasileira de Enfermagem. 2017;70(3):558-565
DOI 10.1590/0034-7167-2016-0437
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Objective:
To validate the evaluation questionnaire on adherence of chronic kidney disease (CKD) patients under hemodialysis.
Method:
We verified the following psychometric properties of the instrument: reliability (stability and internal consistency) and validity (face, content, and construct).
Results:
The intraclass correlation coefficient reached a value of 0.98 for the adherence questions and 0.91 for the perception questions. Regarding the kappa of the 14 questions examined, 12 had a value > 0.8, whereas the Cronbach’s alpha had a value of 0.57. Experts ensured the face and content validity of the instrument, giving it an overall content validity index of 0.96. Construct validity, analyzed by Mann-Whitney test, was achieved as all domains showed a significant association with p<0.01.
Conclusion:
We verified, by the presented results, that the instrument has been validated for use in Brazil.
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RESEARCH01-01-2017
The experience of rural families in the face of cancer
Revista Brasileira de Enfermagem. 2017;70(3):550-557
Abstract
RESEARCHThe experience of rural families in the face of cancer
Revista Brasileira de Enfermagem. 2017;70(3):550-557
DOI 10.1590/0034-7167-2016-0367
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Objective:
To understand the meanings of cancer within the experience of rural families and how such meanings influence family dynamics.
Method:
Qualitative study guided by Symbolic Interactionism as a theoretical framework and Grounded Theory as a methodological framework. Six rural families (18 participants) undergoing the experience of having a relative with cancer participated in the interview.
Results:
Constant comparative analysis of data allowed the elaboration of an explanatory substantive theory, defined by the main category Caregiving to support the family world, which represents the family’s symbolic actions and strategies to reconcile care for the patient and care for family life.
Final considerations:
Throughout the experience, rural families seek to preserve the interconnected symbolic elements that provide support for the family world: family unit, land, work and care.
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RESEARCH01-01-2017
Contributions of Public Health to nursing practice
Revista Brasileira de Enfermagem. 2017;70(3):543-549
Abstract
RESEARCHContributions of Public Health to nursing practice
Revista Brasileira de Enfermagem. 2017;70(3):543-549
DOI 10.1590/0034-7167-2016-0401
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Objective:
Analyze the perceptions of undergraduate nursing students about the contributions of public health to nursing practice in the Unified Health System.
Method:
Qualitative Descriptive Study. Data collection was carried out through semi-directed interviews with 15 students. The language material was analyzed according to content and thematic analysis.
Results:
Thematic categories were established, namely: “Perceptions about Public Health” and “Contribution of Public Health to nursing practice in the Unified Health System”.
Final considerations:
Perceptions about Public Health are diversified, but converge to the recognition of this field as the basis for training nurses qualified to work in the SUS with technical competence, autonomy and focusing on the integrality in health care.
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RESEARCH01-01-2017
Cancellation of elective surgeries in a Brazilian public hospital: reasons and estimated reduction
Revista Brasileira de Enfermagem. 2017;70(3):535-542
Abstract
RESEARCHCancellation of elective surgeries in a Brazilian public hospital: reasons and estimated reduction
Revista Brasileira de Enfermagem. 2017;70(3):535-542
DOI 10.1590/0034-7167-2016-0084
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Objective:
To characterize cancellations of elective surgeries according to clinical and non-clinical reasons, as well as to verify seasonal influence and determine the estimated reduction of the index.
Method:
Quantitative, descriptive and retrospective study with secondary data extracted from the Public Hospital of the State of São Paulo database.
Results:
Out of the 8,443 (100%) elective surgeries scheduled, 7,870 (93.21%) were performed and 573 (6.79%) were canceled. Out of these 573 (100%) people, 48.33% were canceled for clinical reasons and 46.40% were for non-clinical reasons. Among the non-clinical reasons for surgery cancellations, those related to medical reasons stood out: at the request of the surgeon/change of approach (17.93%), followed by non-hospitalized patient (8.96%). There was no indication of seasonality regarding the reasons for cancellation in the assessed period.
Conclusion:
Although the rate of elective surgeries cancellations is lower than that of other hospitals with similar characteristics, it is still possible to reduce it from 6.79% to 1.36%, considering that 80% of the reasons for cancellation are avoidable.
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RESEARCH01-01-2017
Guide of attributes of the nurse’s political competence: a methodological study
Revista Brasileira de Enfermagem. 2017;70(3):526-534
Abstract
RESEARCHGuide of attributes of the nurse’s political competence: a methodological study
Revista Brasileira de Enfermagem. 2017;70(3):526-534
DOI 10.1590/0034-7167-2016-0483
Views0See moreABSTRACT
Objective:
To build and validate a guide of attributes of the nurse’s political competence.
Method:
Methodological research. This study comprised the construction of the instrument through literature review; experts validation of pre-established attributes for composing the guide; and clinical validation in the nurses work environment/reality. The data collection took place in the months from August to October 2014, and the analysis was based on the content analysis of Bardin and use of Epi info 3.5. All ethical precepts have been complied with.
Results:
From 29 attributes found in the literature, 25 have been validated by experts. Clinical/practical validation involved the participation of 43 nurses, who observed that the attributes are not articulated with the professional practices developed by them.
Conclusion:
The attributes of the nurse’s political competence were identified with support of literature. It is concluded that the professionals still have limited and fragmented perception of political competence, expressing difficulty/limitation.
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RESEARCH01-01-2017
Promoting oral care in the preschool child: effects of a playful learning intervention
Revista Brasileira de Enfermagem. 2017;70(3):519-525
Abstract
RESEARCHPromoting oral care in the preschool child: effects of a playful learning intervention
Revista Brasileira de Enfermagem. 2017;70(3):519-525
DOI 10.1590/0034-7167-2016-0237
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Objective:
To compare the number of appropriate behaviors for tooth brushing before and after a playful learning intervention with preschool children.
Method:
A quasi-experimental, quantitative, before and after study design was conducted in an early childhood educational institution, with children between three and five years of age. The intervention consisted of three meetings with educational activities about tooth brushing, whose outcome was evaluated by means of observation of ten behaviors suitable for tooth brushing.
Results:
Forty-four children participated in the study. The mean of adequate behaviors was 4.4 before the intervention, and 8.5 after the intervention. A significant increase in the adoption of appropriate behaviors for tooth brushing (p <0.01) was identified.
Conclusion:
Nurses can enhance oral health promotion actions with preschoolers in preschool institution using playful learning interventions
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01-01-2015
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
Symbolic 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
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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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01-01-2015
Perception of nursing undergraduate students on self-aging
Revista Brasileira de Enfermagem. 2015;68(2):278-283
Abstract
Perception 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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01-01-2015
Non-conventional technologies for data collection in Brazilian dissertations and theses
Revista Brasileira de Enfermagem. 2015;68(2):269-277
Abstract
Non-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
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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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01-01-2015
Content analysis of a technology to the nursing diagnostic reasoning
Revista Brasileira de Enfermagem. 2015;68(2):261-268
Abstract
Content analysis of a technology to the nursing diagnostic reasoning
Revista Brasileira de Enfermagem. 2015;68(2):261-268
DOI 10.1590/0034-7167.2015680211i
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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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01-01-2015
Manual for monitoring the quality of nursing home care records
Revista Brasileira de Enfermagem. 2015;68(2):253-260
Abstract
Manual for monitoring the quality of nursing home care records
Revista Brasileira de Enfermagem. 2015;68(2):253-260
DOI 10.1590/0034-7167.2015680210i
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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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01-01-2015
Vulnerability of families of elderly citizens cared for by the Family Health Strategy
Revista Brasileira de Enfermagem. 2015;68(2):244-252
Abstract
Vulnerability 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
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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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01-01-2015
The work in prison: reflections on the health of prison officers
Revista Brasileira de Enfermagem. 2015;68(2):235-243
Abstract
The 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
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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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01-01-2015
Mother recognition in the Neonatal Intensive Care Unit
Revista Brasileira de Enfermagem. 2015;68(2):228-234
Abstract
Mother recognition in the Neonatal Intensive Care Unit
Revista Brasileira de Enfermagem. 2015;68(2):228-234
DOI 10.1590/0034-7167.2015680207i
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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.
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01-01-2016
Leads for potentializing groups in Primary Health Care
Revista Brasileira de Enfermagem. 2016;69(5):964-971
Abstract
Leads for potentializing groups in Primary Health Care
Revista Brasileira de Enfermagem. 2016;69(5):964-971
DOI 10.1590/0034-7167-2015-0102
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Objective:
to analyze the aspects that potentialize groups in Primary Health Care according to their coordinators and participants.
Method:
This is a descriptive study with a qualitative approach, conducted with a health promotion group affiliated with a Family Health Unit. The data were collected by means of focus groups with participants and community workers who were submitted to thematic content analysis.
Results:
the analysis gave rise to three thematic categories: The group is our medicine; Healthy living and learning; and Priceless leadership.
Conclusion:
the leads identified during the study were as follows: group organization involves investment in motivation and leadership by the coordinators; production of grouping and cohesion is a result of participants and coordinators meeting together, interspersed with dialog, things said and left unsaid that the subjects expressed in the group dynamic; the sense of belonging guarantees their placement in the group based on the recognition of their knowledge and affective, social and health needs.
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01-01-2016
The path to crack addiction: perceptions of people under treatment
Revista Brasileira de Enfermagem. 2016;69(5):956-963
Abstract
The path to crack addiction: perceptions of people under treatment
Revista Brasileira de Enfermagem. 2016;69(5):956-963
DOI 10.1590/0034-7167-2016-0045
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Objective:
the objective of this study was to understand the meaning of the harmful use of crack by people undergoing addiction treatment.
Method:
qualitative approach of social research on strategic modality was used. Field observation, preparation of field diary and focus groups, and data analysis through the method of interpreting meaning were carried out.
Results:
the results contributed to the construction of three thematic categories: “The discovery of crack and other drugs” that describes the experimentation with crack and other drugs; “The pain of the pleasure”, key category that describes the moments after crack experimentation and that, many times, turns into addiction, which leads the person into a cycle of short periods of attempts at abstinence, relapse, and relentless consumption; and “Return to normal life”.
Conclusion:
treating people with crack addiction must be carried out in ways that narrow the distance between these people and their families, society and health care.
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01-01-2016
Intimate partner violence in adolescence: an analysis of gender and generation
Revista Brasileira de Enfermagem. 2016;69(5):946-955
Abstract
Intimate partner violence in adolescence: an analysis of gender and generation
Revista Brasileira de Enfermagem. 2016;69(5):946-955
DOI 10.1590/0034-7167-2016-0408
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Objective:
to analyze the intimate partner violence in adolescence from the perspective of gender and generation.
Method:
Quantitative, descriptive, and exploratory research. 111 adolescents participated in this study, with ages from 15 to 19 years old.
Results:
We found that 91% of participants have perpetrated and 90.1% have undergone at least one of the natures of violence. The intimate partner violence in adolescence constitutes a form of gender violence, and gender constructions have determined the suffered and perpetrated aggressions, possibly also determining the naturalization and legitimization of such aggressions. The inequality of power between generations may determine greater vulnerability of youngsters to the phenomenon.
Conclusion:
The historical and social construction of masculinity and femininity and the power inequalities set by these constructions converge with the power inequality between generations. Thus, gender and generation are determinants of intimate partner violence in adolescence, as well as of the vulnerability of adolescents to this phenomenon.
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01-01-2016
Hospitalization anxiety in children: conceptual analysis
Revista Brasileira de Enfermagem. 2016;69(5):940-945
Abstract
Hospitalization anxiety in children: conceptual analysis
Revista Brasileira de Enfermagem. 2016;69(5):940-945
DOI 10.1590/0034-7167-2015-0116
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Objective:
to analyze the concept “hospitalization anxiety in children”, identifying its antecedents, attributes, and consequences, with the objective of clarifying its meaning.
Method:
we used a conceptual analysis model, whose objective is to clarify the meaning of terms.
Results:
we identified the concept antecedents and its attributes, classified as biological and psychological needs, which are essential characteristics of “hospitalization anxiety in children”. This process consequences have also been identified. We proceeded to the analysis of the characteristics with emphasis on the impacts of the hospitalization process on the child and on the family.
Conclusion:
based on the conceptual analysis of the phenomenon, it was possible to identify the antecedents, attributes, and consequences of Hospitalization Anxiety in children. We recommend the continuation of the study validating the essential characteristics presently identified as a way to join knowledge gathered and professional practice.
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01-01-2016
Stroke: patient characteristics and quality of life of caregivers
Revista Brasileira de Enfermagem. 2016;69(5):933-939
Abstract
Stroke: patient characteristics and quality of life of caregivers
Revista Brasileira de Enfermagem. 2016;69(5):933-939
DOI 10.1590/0034-7167-2015-0064
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Objective:
to investigate the association between the domains of health-related quality of life of family caregivers and sociodemographic characteristics of individuals with stroke sequelae.
Method:
descriptive, cross-sectional, quantitative research, conducted with 136 family caregivers of individuals with stroke sequelae by means of home interviews from April to June 2013.
Results:
we found that caregivers of individuals aged under 65 years, married, with 10 to 12 years of formal education, presented higher scores, respectively, in the domains ‘Social aspects’, ‘Emotional aspects’, and ‘Mental health’. However, caregivers of patients with higher degree of disability obtained lower score in the ‘Mental Health’ domain.
Conclusion:
the results foster reflection on the need of including the family caregivers of individuals with stroke sequelae in the planning of care provided by health professionals.
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01-01-2016
A quasi-experimental nursing study on pain in comatose patients
Revista Brasileira de Enfermagem. 2016;69(5):927-932
Abstract
A quasi-experimental nursing study on pain in comatose patients
Revista Brasileira de Enfermagem. 2016;69(5):927-932
DOI 10.1590/0034-7167-2015-0121
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Objective:
to verify whether comatose patients feel pain during the bed bath nursing procedure.
Method:
nineteen patients aged 61 ± 17.39 years participated in the study. A quantitative analysis was conducted on the P substance (PS) in the saliva collected before and during a bed bath, using the ELISA method. Program Graph Pad Prisma 6 was used to analyze the data. The verification of normality was made through the Shapiro Wilk test, which determined the choice for the Wilcoxon nonparametric test.
Results:
the study showed a statistically significant increase (∆= 5.62%, p<0.001) in the PS level of the patients studied during the nursing procedure.
Conclusion:
when caring for comatose patients during a bed bath, professionals cause or add painful stimuli; therefore, they feel pain.
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01-01-2016
Quality of nursing care: instrument development and validation
Revista Brasileira de Enfermagem. 2016;69(5):920-926
Abstract
Quality of nursing care: instrument development and validation
Revista Brasileira de Enfermagem. 2016;69(5):920-926
DOI 10.1590/0034-7167-2015-0151
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Objectives:
to describe the development and validation process of a scale to measure the nurses’ perception of the activities that contribute to nursing care quality.
Method:
methodological study based on a literature review, the opinion of experts and the experience of study investigators. An instrument was designed containing six dimensions and 25 items, applied as a questionnaire to 775 nurses from a hospital in northern Portugal, from May to July 2014. The instrument validation used an exploratory factor analysis and an internal consistency assessment of each factor/dimension.
Results:
the factor analysis indicated the need to adjust the original composition of the scale, which then received one more dimension, totaling seven dimensions and the same 25 items, and presented a high internal consistency (Cronbach’s alpha of 0.940).
Conclusion:
the final version of the scale presents adequate psychometric properties, with potential use in future studies.
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01-01-2016
Network and social support in family care of children with diabetes
Revista Brasileira de Enfermagem. 2016;69(5):912-919
Abstract
Network and social support in family care of children with diabetes
Revista Brasileira de Enfermagem. 2016;69(5):912-919
DOI 10.1590/0034-7167-2015-0085
Views0See moreABSTRACT
Objective:
to understand the influence of network and social support in the care of a child with type 1 diabetes.
Method:
qualitative study, with assumptions of ethnonursing, conducted in a reference service specialized in the treatment of diabetes, in 2014, in the city of Fortaleza, state of Ceará, Brazil. Twenty-six members of the family and their respective school children participated in the study. The process of collection and analysis followed the observation-participation-reflection model.
Results:
the analytical categories showed that the social network in the care of children with diabetes helped sharing of information and experiences, moments of relaxation and aid in the acquisition of supplies for treatment, with positive repercussions in the family context, generating well-being and confidence in the care of children with diabetes.
Conclusion:
the cultural care provided by nurses strengthens the network and social support because it encourages autonomy in the promotion of the quality of life of children with type 1 diabetes and their families.
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