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RESEARCH01-01-2017
Chronic hepatitis B and D: prognosis according to Child-Pugh score
Revista Brasileira de Enfermagem. 2017;70(5):1048-1053
Abstract
RESEARCHChronic hepatitis B and D: prognosis according to Child-Pugh score
Revista Brasileira de Enfermagem. 2017;70(5):1048-1053
DOI 10.1590/0034-7167-2016-0205
Views1See moreABSTRACT
Objective:
compare chronic hepatitis B patients to those superinfected with hepatitis D virus, according to Child-Pugh score regarding disease severity.
Method:
retrospective descriptive study, performed with 59 patients followed in the ambulatory, of which 22 (37.3%) were chronically infected with hepatitis B virus (Group HBV) and 37 (62.7%) superinfected with Delta virus (Group HBV+HDV); variables of sex, age and items of Child-Pugh score were collected by consulting medical records.
Results:
out of the patients, 57.6% were male, with a mean age of 30.5 years. Score A, which indicates lesser severity, was found in 100% of group HBV and 78.4% of group HBV+HDV. Score B, which indicates greater severity, was found only in group HBV+HDV in 21.6% of the patients.
Conclusion:
by means of the Child-Pugh score, it was observed that patients with superinfection by HDV tended to present a worse prognosis.
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RESEARCH01-01-2017
Humanization in the Intensive Care: perception of family and healthcare professionals
Revista Brasileira de Enfermagem. 2017;70(5):1040-1047
Abstract
RESEARCHHumanization in the Intensive Care: perception of family and healthcare professionals
Revista Brasileira de Enfermagem. 2017;70(5):1040-1047
DOI 10.1590/0034-7167-2016-0281
Views0See moreABSTRACT
Objective:
Understanding perceptions of family members and healthcare professionals about humanization at the Intensive Care Unit (ICU) to direct it to an educational action.
Method:
Exploratory descriptive and qualitative study conducted in an ICU level 3 of a public hospital in Porto Alegre, RS, Brazil, with fourteen subjects, eight family members and six healthcare professionals. Data collection carried out through semi-structured interviews and focus group. Content Analysis was used.
Results:
Emerged categories were: welcoming; communication; ethical and sensible professionalism; unfavorable aspects; perception on humanization; and religiosity/spirituality.
Final considerations:
Although the subjects have expressed their perceptions about humanization in different ways, both groups pointed out the same needs and priorities to improve humanization in Intensive Care. From the results, we created a reflective manual of humanizing assistance practices for professionals, a board to facilitate communication of these professionals with patients and a guideline book for family members.
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RESEARCH01-01-2017
Knowledge of adolescents regarding sexually transmitted infections and pregnancy
Revista Brasileira de Enfermagem. 2017;70(5):1033-1039
Abstract
RESEARCHKnowledge of adolescents regarding sexually transmitted infections and pregnancy
Revista Brasileira de Enfermagem. 2017;70(5):1033-1039
DOI 10.1590/0034-7167-2016-0531
Views0See moreABSTRACT
Objective:
To investigate the knowledge of adolescents related to sexually transmitted infections (STIs), AIDS, and pregnancy, and understand the role of school in sex education.
Method:
A qualitative descriptive study, developed through a semi-structured interview and a form for participant characterization, with 22 high school students from a public school aged 16 to 19 years. Data were submitted to content analysis.
Results:
After analysis, four thematic categories were developed: sexuality and sex education; understanding of risk behaviors; knowledge of STI/AIDS; and knowledge of and practices for prevention.
Final considerations:
This study showed the need for preventive educational actions for adolescents, because the lack of information contributes to their vulnerability. The adolescents recognize the importance of sex education; therefore it is important to implement strategies to promote and protect health in the school environment to encourage and strengthen self-care in health.
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RESEARCH01-01-2017
Care necessities: the view of the patient and nursing team
Revista Brasileira de Enfermagem. 2017;70(5):1026-1032
Abstract
RESEARCHCare necessities: the view of the patient and nursing team
Revista Brasileira de Enfermagem. 2017;70(5):1026-1032
DOI 10.1590/0034-7167-2016-0197
Views0See moreABSTRACT
Objectives:
To compare care necessities as perceived by the patient and nursing team and to investigate the sociodemographic factors associated with these perceptions.
Method:
A comparative study was conducted in units and hospitalized patients of a hospital institution in the state of São Paulo. The participants comprised 100 health professionals (50 nurses and 50 nursing technicians and auxiliaries) and 50 patients. A questionnaire was constructed and validated regarding care needs and was completed by the participants.
Results:
Considering cut-off value kappa ≥ 0.61, or that is, good and very good intervals, the greatest agreement between the perception of the patients and the nursing team was in the areas of: Care and Communication, both with 92.6% agreement; followed by Basic Care with 74.1%. The lowest value was found in the field of Care Planning and Organization, 64.3%.
Conclusion:
In a general manner, there was an agreement between the care needs from the view of the patients themselves and the nursing team.
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RESEARCH01-01-2017
Critical incidents connected to nurses’ leadership in Intensive Care Units
Revista Brasileira de Enfermagem. 2017;70(5):1018-1025
Abstract
RESEARCHCritical incidents connected to nurses’ leadership in Intensive Care Units
Revista Brasileira de Enfermagem. 2017;70(5):1018-1025
DOI 10.1590/0034-7167-2016-0137
Views0See moreABSTRACT
Objective:
The goal of this study is to analyze nurses’ leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents.
Method:
Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark.
Results:
Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses’ behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses’ activities; people management; and the setting of high quality care targets.
Final considerations:
Researchers identified a mixed leadership model, leading them to the conclusion that nurses’ knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization’s results.
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RESEARCH01-01-2017
Cross-cultural adaptation and validation of the Moral Distress Scale-Revised for nurses
Revista Brasileira de Enfermagem. 2017;70(5):1011-1017
Abstract
RESEARCHCross-cultural adaptation and validation of the Moral Distress Scale-Revised for nurses
Revista Brasileira de Enfermagem. 2017;70(5):1011-1017
DOI 10.1590/0034-7167-2016-0518
Views0See moreABSTRACT
Objective:
Cross-culturally adapt and validate the Moral Distress Scale-Revised for nurses.
Method:
Quantitative, analytical cross-sectional study conducted with 157 nurses of two hospital institutions of Southern Brazil, one public and one philanthropic. Procedures conducted: cultural adaptation of the instrument according to international recommendations; validation for the Brazilian context.
Results:
Face and content validation was considered satisfactory as assessed by a specialist committee and a pretest. The instrument demonstrated satisfactory internal consistency through frequency and intensity analysis per question in the 157 items and per subgroups of the various hospital units. Cronbach’s alpha was 0.88 for the instrument and between 0.76 and 0.94 for hospital units. Pearson’s correlation found a moderate association for moral distress among nurses.
Conclusion:
The Moral Distress Scale-Revised – Brazilian version is a valid instrument for the assessment of moral distress in nurses.
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RESEARCH01-01-2017
Sexual orientation and quality of life of people living with HIV/Aids
Revista Brasileira de Enfermagem. 2017;70(5):1004-1010
Abstract
RESEARCHSexual orientation and quality of life of people living with HIV/Aids
Revista Brasileira de Enfermagem. 2017;70(5):1004-1010
DOI 10.1590/0034-7167-2016-0420
Views0See moreABSTRACT
Objective:
To analyze whether sexual orientation affects the quality of life of people living with HIV/Aids (PLWHA).
Method:
A cross-sectional analytical study was carried out with 146 PLWHA in Teresina, capital city of the state of Piauí, in 2013, by means of the WHOQOL-HIV-bref. Descriptive analysis and multiple linear regression were used for data analysis.
Results:
There was a prevalence of men (63.7%), non-heterosexual (57.0%), aged between 19 and 39 years (89%). Of the total, 75.5% mentioned presence of negative feelings, such as fear and anxiety, and 38% reported have suffered stigma. With regard to the dimensions investigated, the most affected were “environment” and “level of independence”. Non-heterosexual orientation was negatively associated with quality of life in almost all dimensions.
Conclusion:
Living with HIV/Aids and having a non-heterosexual orientation have a negative impact on quality of life.
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RESEARCH01-01-2017
Prevention of chronic complications of diabetes mellitus according to complexity
Revista Brasileira de Enfermagem. 2017;70(5):996-1003
Abstract
RESEARCHPrevention of chronic complications of diabetes mellitus according to complexity
Revista Brasileira de Enfermagem. 2017;70(5):996-1003
DOI 10.1590/0034-7167-2016-0080
Views0See moreABSTRACT
Objective:
To assess the prevention by primary health care providers of chronic complications of diabetes mellitus according to the complex thinking theoretical approach.
Method:
Evaluative research based on the complex thinking theoretical approach. The following techniques for data collection were used: interviews with 38 participants; observation in collective and individual appointments; and analysis of medical records of people with diabetes. The triangulation applied for data analysis was the ATLAS.ti software.
Results:
The prevention and management of chronic complications of diabetes did not meet the requirements set forth by ministerial public policies aimed at this population. Systematic monitoring to prevention of chronic complications showed significant gaps.
Final considerations:
Primary health care did not consider preventive actions for diabetes mellitus complications. This context was marked by disjunctive, fragmented, and dissociated practices types of care targeted to the totality of the assisted people.
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01-01-2015
Critical incidents in nursing academics: discovering a new identity
Revista Brasileira de Enfermagem. 2015;68(2):219-227
Abstract
Critical incidents in nursing academics: discovering a new identity
Revista Brasileira de Enfermagem. 2015;68(2):219-227
DOI 10.1590/0034-7167.2015680206i
Views0See moreABSTRACT
Objective:
a qualitative study that followed the principles of the grounded theory in order to analyze the professional identity of nursing academics through the analysis of the most disturbing critical incidents.
Method:
semi-structured interviews were conducted with seven nurses who worked as professors and researchers in a private university in Barcelona.
Results:
the resulting empirical material was organized into two categories: characterization of critical incidents and responsiveness to the incident.
Conclusion:
the professional identity of nurses regarding the academic area is still under construction and inexperience is the major obstacle in the management of critical incidents in the teaching career.
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01-01-2015
Body mass index, waist circumference, and arterial hypertension in students
Revista Brasileira de Enfermagem. 2015;68(2):214-218
Abstract
Body mass index, waist circumference, and arterial hypertension in students
Revista Brasileira de Enfermagem. 2015;68(2):214-218
DOI 10.1590/0034-7167.2015680205i
Views0See moreABSTRACT
Objective:
to investigate what is the best anthropometric predictor of arterial hypertension among private school students.
Method:
this was a cross-sectional study with 286 students between the ages of 10 and 14 from two private schools in the city of Paranavaí, Paraná, Brazil. The following variables were analyzed: body mass index, waist circumference and blood pressure. Statistical analysis was conducted with Pearson’s partial correlation test and multivariate logistic regression, with p<0.05.
Results:
both anthropometric indicators displayed weak correlation with systolic and diastolic levels, with coeffi cients (r) ranging from 0.27 to 0.36 (p < 0.001). Multivariate analysis showed that the only anthropometric indicator associated with arterial hypertension was waist circumference (OR= 2.3; 95% CI: 1.1-4.5), regardless of age or gender.
Conclusion:
this age group, waist circumference appeared to be a better predictor for arterial hypertension than body mass index.
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01-01-2015
Perception of primary healthcare management nurses on the nursing process
Revista Brasileira de Enfermagem. 2015;68(2):206-213
Abstract
Perception of primary healthcare management nurses on the nursing process
Revista Brasileira de Enfermagem. 2015;68(2):206-213
DOI 10.1590/0034-7167.2015680204i
Views0See moreABSTRACT
Objective:
this qualitative study aimed to analyze the perceptions of primary health care management nurses on the nursing process.
Method:
data were collected through interviews and analyzed by the Content Analysis proposed by Bardin’s theoretical framework.
Results:
managers recognize the importance of the nursing process, although its implementation was not a priority at the time of the interviews. A conceptual diffi culty and a lack of understanding that the implementation of the care methodology should be a cross-departmental action in the local healthcare management were clearly observed.
Conclusion:
managers should have their perspectives broadened concerning the relevance of the nursing process and the professional training. The active participation of legislative nursing bodies, local healthcare management and the federal government may open the way for the effective implementation of the nursing process.
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01-01-2015
Cross-cultural cultural adaptation of the “Nursing Students’ Attitudes Toward Mental Health Nursing and Consumers” in Brazil
Revista Brasileira de Enfermagem. 2015;68(2):198-205
Abstract
Cross-cultural cultural adaptation of the “Nursing Students’ Attitudes Toward Mental Health Nursing and Consumers” in Brazil
Revista Brasileira de Enfermagem. 2015;68(2):198-205
DOI 10.1590/0034-7167.2015680203i
Views0See moreABSTRACT
Objective:
to make across-cultural adaptation of the “Nursing Students’ Attitudes Toward Mental Health Nursing and Consumers” scale in Brazil.
Method:
the scale was tested regarding conceptual, item, semantic, and operational equivalence.
Results:
content validation was conducted by an expert committee with a minimum consensus level of 80%. This process resulted in a 35-item scale divided into 6 factors. The experts reached 100% consensus on the scale’s clarity of language, practical pertinence and theoretical relevance, as well as on the need for excluding one factor. Data were collected in 2013 in the city of Londrina, Paraná, Brazil.
Conclusion:
the instrument was cross-culturally adapted to Brazilian Portuguese and presented satisfactory content validity. We propose further studies on the scale’s psychometric properties, such as construct validity, internal consistency and reliability.
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01-01-2015
Relational skills and preserving patient privacy in the caring process
Revista Brasileira de Enfermagem. 2015;68(2):191-197
Abstract
Relational skills and preserving patient privacy in the caring process
Revista Brasileira de Enfermagem. 2015;68(2):191-197
DOI 10.1590/0034-7167.2015680202i
Views0See moreABSTRACT
Objective:
to analyze the development and mobilization of relational skills central to the caring process among nursing students throughout their professional training.
Method:
this was a quantitative study, descriptive and cross-sectional in design. The sample consisted of nursing undergraduate students from the Higher School of Health Sciences, in the city of Évora, Portugal. Data were collected using the previously validated Helping Relational Skills Inventory.
Results:
the students gradually acquired “generic skills”, “communication skills” and “contact skills”, presenting the highest mean score in the last year of the program. However, the highest mean score for the “empathetic skills” subscale was presented by second-year students.
Conclusion:
age and year in program were found to be decisive variables regarding the acquisition of specifi c skills (empathetic and communication) by nursing students.
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01-01-2015
The Brazilian Association of Nursing in the uncompromising defense of the Brazilian Unified Health System
Revista Brasileira de Enfermagem. 2015;68(2):185-186
Abstract
The Brazilian Association of Nursing in the uncompromising defense of the Brazilian Unified Health System
Revista Brasileira de Enfermagem. 2015;68(2):185-186
DOI 10.1590/0034-7167.2015680201i
Views0The title of the 2015 Editor’s Comments could very well be from a journal published in decades past, a time when, in Brazil, all professional entities and civil society fought for the right to health, as was later established in the Brazilian Constitution of 1988. Twenty-five years later, despite its financial limitations and restricted operational […]See more -
01-01-2015
A ABEn na defesa intransigente do SUS
Revista Brasileira de Enfermagem. 2015;68(2):185-186
Abstract
A ABEn na defesa intransigente do SUS
Revista Brasileira de Enfermagem. 2015;68(2):185-186
DOI 10.1590/0034-7167.2015680201i
Views0Este título do Editorial de 2015 bem poderia ser de uma revista publicada em décadas passadas, período em que todas as entidades profissionais e a sociedade civil lutaram pela saúde como direito, como conquistado na Constituição de 1988. Vinte e cinco anos depois, com o Sistema Único de Saúde capilarizado por todo o país, mesmo […]See more -
EXPERIENCE REPORT01-01-2015
Nursing diagnoses and interventions for a child after cardiac surgery in an intensive care unit
Revista Brasileira de Enfermagem. 2015;68(1):155-160
Abstract
EXPERIENCE REPORTNursing diagnoses and interventions for a child after cardiac surgery in an intensive care unit
Revista Brasileira de Enfermagem. 2015;68(1):155-160
DOI 10.1590/0034-7167.2015680121i
Views0See moreObjetivo:
descrever o julgamento clínico de enfermagem para identificar diagnósticos NANDA e desenvolver um plano de tratamento NIC para uma criança em pós-operatório de cirurgia cardíaca em terapia intensiva.
Método:
estudo de caso com coleta de dados retrospectiva no prontuário.
Resultados:
três enfermeiras identificaram diagnósticos NANDA e intervenções NIC. Criança de 6 meses, submetida a cirurgia cardíaca, necessitou oxigenação extracorpórea por membrana no pós-operatório. Foram identificados quatro principais diagnósticos, aos quais foram direcionadas dez intervenções. A proposta de intervenções para responder às necessidades humanas prioritárias da criança foi otimizada pelo uso das terminologias padronizadas. Todos os diagnósticos foram sustentados por indicadores diagnósticos; todas as intervenções foram cientificamente sustentadas.
Conclusão:
espera-se que os enfermeiros abordem não somente as respostas fisiológicas, mas também aquelas dos domínios psicossociais.
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01-01-2016
Pressure ulcer healing with Plenusdermax® Calendula officinalis L. extract
Revista Brasileira de Enfermagem. 2016;69(2):250-257
Abstract
Pressure ulcer healing with Plenusdermax® Calendula officinalis L. extract
Revista Brasileira de Enfermagem. 2016;69(2):250-257
DOI 10.1590/0034-7167.2016690207i
Views0See moreABSTRACT
Objective:
to evaluate the therapeutic benefits of the bioactive extracts of Plenusdermax®Calendula officinalis for pressure ulcer healing.
Method:
an observational cohort study, including 41 patients with a diagnosis of pressure ulcer that was stable in size for more than three months. Patients were evaluated every two weeks, over 30 weeks, for: reduction of the wound area, infection control, types of tissue and exudate, and ulcer microbiology.
Results:
the proportions of patients who were completely healed after 15 and 30 weeks of treatment were 63% and 88%, respectively, and the mean healing time was 12.5±7.8 weeks. No adverse events were observed during treatment.
Conclusion:
the results of the study indicate that bioactive C. officinalis Plenusdermax® is a safe treatment that promotes healing of pressure ulcers.
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01-01-2016
Quality of life assessment for health promotion groups
Revista Brasileira de Enfermagem. 2016;69(2):242-249
Abstract
Quality of life assessment for health promotion groups
Revista Brasileira de Enfermagem. 2016;69(2):242-249
DOI 10.1590/0034-7167.2016690206i
Views0See moreABSTRACT
Objective:
to analyze the use of quality of life assessment (QOL) as a strategy to evaluate the work with health promotion groups in the community.
Method:
cross-sectional, descriptive and analytical study. Participants of two elderly groups (n=46) were individually interviewed to fill the sociodemographic instruments, WHOQOL-BREF and WHOQOL-OLD.
Results:
the participants were women with up to 79 years, who did not live with a partner, with up to four years of study, retired, with individual income of up to a minimum salary. The mean scores on the WHOQOL-BREF were higher on “Social Relations” and lower in the “Environment”. For the WHOQOL-OLD, the highest scores were achieved in facets “Social Participation” (G1) and “Past, Present and Future Activities” (G2), while “Death and Dying” facet obtained lower scores in both groups.
Conclusion:
the assessment of QOL appears to be useful in helping to identify the coordination aspects of life of elderly people that need to be better developed in groups.
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01-01-2016
Transcultural adaptation and validation of the Brazilian version of Treatment Spirituality/Religiosity Scale
Revista Brasileira de Enfermagem. 2016;69(2):235-241
Abstract
Transcultural adaptation and validation of the Brazilian version of Treatment Spirituality/Religiosity Scale
Revista Brasileira de Enfermagem. 2016;69(2):235-241
DOI 10.1590/0034-7167.2016690205i
Views0See moreABSTRACT
Objective:
to perform the translation and transcultural adaptation to Brazilian Portuguese, and analyze the psychometric properties of the instrument Treatment Spirituality/Religiosity Scale (TSRS).
Method:
the sample consisted of 188 nursing students of technical and higher education. The reliability analysis by test-retest was performed one month after the first application of the instrument. To measure the construct validation, a factorial analysis was carried out.
Results:
the Brazilian version of the TSRS consisted of 10 items, with two factors. The reliability by test-retest showed a Kappa coefficient ranging from 0.22 to 0.47, and a global internal consistency Cronbach’s alpha of 0.85.
Conclusion:
the Brazilian version of the TSRS showed satisfactory values of validity and internal consistency, being suitable for use in the national context.
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01-01-2016
Epidemiological characteristics and causes of deaths in hospitalized patients under intensive care
Revista Brasileira de Enfermagem. 2016;69(2):229-234
Abstract
Epidemiological characteristics and causes of deaths in hospitalized patients under intensive care
Revista Brasileira de Enfermagem. 2016;69(2):229-234
DOI 10.1590/0034-7167.2016690204i
Views0See moreABSTRACT
Objective:
to describe the epidemiological and sociodemographic characteristics of patients hospitalized in an ICU.
Method:
an epidemiological, descriptive and retrospective study. Population: 695 patients admitted from January to December 2011. The data collected were statistically analyzed with both absolute and relative frequency distribution.
Results:
61.6% of the patients are male, aged 40 to 69 years, and most of them came from the surgery rooms. The most frequent reason for admission was diseases of the circulatory system (23.3%). At discharge from the ICU, 72.4% of the patients were sent to other units of the same institution, 31.1% to the intermediate care unit, and 20.4% died, of which 24.6% from diseases of the circulatory system. The afternoon shift had 45.8% of the admissions and 53.3% of the discharges.
Conclusion:
the description of the sociodemographic and epidemiological features guides the planning of nursing actions, providing a better quality service.
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01-01-2016
Hospital discharge of premature newborns: the father’s experience
Revista Brasileira de Enfermagem. 2016;69(2):221-228
Abstract
Hospital discharge of premature newborns: the father’s experience
Revista Brasileira de Enfermagem. 2016;69(2):221-228
DOI 10.1590/0034-7167.2016690203i
Views0See moreABSTRACT
Objective:
To describe the father’s experience with his premature child discharge of the Neonatal Intensive-Care Unit and to point out interventions to promote this experience.
Method:
Qualitative research with eight fathers, adopting the Symbolic Interactionism as theoretical reference and thematic narrative research as methodological frame.
Results:
The analysis of data has allowed us to describe the experience of the father from three thematic units: “fatherhood boundaries”, “high responsibility for the child” and “social network and support”.
Conclusion:
The father feels insecure with the idea of taking care of his child at home because of the lack of professional support and the initial contact with the child in the Neonatal Intensive-Care Unit.
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01-01-2016
Nurses from the Mobile Emergency Service: profile and developed activities
Revista Brasileira de Enfermagem. 2016;69(2):213-220
Abstract
Nurses from the Mobile Emergency Service: profile and developed activities
Revista Brasileira de Enfermagem. 2016;69(2):213-220
DOI 10.1590/0034-7167.2016690202i
Views0See moreABSTRACT
Objective:
to characterize the profile and identify the activities developed by nurses from the Mobile Emergency Care Service of a state of southern Brazil.
Method:
an exploratory, descriptive study. Data were collected through a questionnaire with 63 nurses.
Results:
the profile showed a workforce predominantly female, young and having specialized training. The activities were organized in the dimensions of caring, managing and educating, verifying the predominance of the first one. Care actions involved multiple procedures, but the use of the Systematization of Nursing Care (SNC) was not mentioned in the development of care activities. Then, the managerial dimension with a predominance of bureaucratic activities was emphasized. Educational activities were less prominent.
Conclusion:
care actions are the focus of the activities of nurses, predominantly the prescribed institutional care without the use of instruments such as SNC that could contribute to the greater visibility of their professional work.
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01-01-2016
Challenges and leadership imperatives in cooperation with the World Health Organization
Revista Brasileira de Enfermagem. 2016;69(2):207-208
Abstract
Challenges and leadership imperatives in cooperation with the World Health Organization
Revista Brasileira de Enfermagem. 2016;69(2):207-208
DOI 10.1590/0034-7167.2016690201i
Views0When an institution promotes strategic innovations, it starts the rupture with tradition, causing changes and, consequently, altering the expectations and prospects of both their internal clients, as their external clients.The engines of the adopted innovations are driven by a broader view of the organization’s purposes, expanding its borders in terms of breadth and depth, which […]See more -
01-01-2016
Desafios e imperativos de liderança na cooperação com a Organização Mundial da Saúde
Revista Brasileira de Enfermagem. 2016;69(2):207-208
Abstract
Desafios e imperativos de liderança na cooperação com a Organização Mundial da Saúde
Revista Brasileira de Enfermagem. 2016;69(2):207-208
DOI 10.1590/0034-7167.2016690201i
Views0Quando uma instituição promove inovações estratégicas, é colocado em curso o rompimento com a tradição, provocando mudanças e, por consequência, alterando as expectativas e as perspectivas tanto dos seus clientes internos, quanto dos seus clientes externos.Os motores das inovações adotadas são acionados por uma visão ampliada dos fins da organização, alargando suas fronteiras em termos […]See more
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