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ORIGINAL ARTICLE
Root cause analysis of safety incidents in antineoplastic use in children
- Elizangela Domiciano Garcia Barreto
, - Valcieny Souza Sandes ,
- Gustavo Cattelan Nobre ,
- Monica Martins ,
- Sima Esther Ferman , [ … ],
- Elisangela Costa Lima
07-15-2024
Abstract
ORIGINAL ARTICLERoot cause analysis of safety incidents in antineoplastic use in children
Revista Brasileira de Enfermagem. 2024;77:e20230139
07-15-2024DOI 10.1590/0034-7167-2021-0139
- Elizangela Domiciano Garcia Barreto ,
- Valcieny Souza Sandes ,
- Gustavo Cattelan Nobre ,
- Monica Martins ,
- Sima Esther Ferman ,
- Elisangela Costa Lima
Views0See moreABSTRACT
Objectives:
to identify and analyze the factors that contribute to safety incident occurrence in the processes of prescribing, preparing and dispensing antineoplastic medications in pediatric oncology patients.
Methods:
a quality improvement study focused on oncopediatric pharmaceutical care processes that identified and analyzed incidents between 2019-2020. A multidisciplinary group performed root cause analysis (RCA), identifying main contributing factors.
Results:
in 2019, seven incidents were recorded, 57% of which were prescription-related. In 2020, through active search, 34 incidents were identified, 65% relating to prescription, 29% to preparation and 6% to dispensing. The main contributing factors were interruptions, lack of electronic alert, work overload, training and staff shortages.
Conclusions:
the results showed that adequate recording and application of RCA to identified incidents can provide improvements in the quality of pediatric oncology care, mapping contributing factors and enabling managers to develop an effective action plan to mitigate risks associated with the process.
- Elizangela Domiciano Garcia Barreto
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EDITORIAL
Can nursing contribute to reducing mortality from land transport accidents?
Revista Brasileira de Enfermagem. 2024;77(4):e770401
07-08-2024
Abstract
EDITORIALCan nursing contribute to reducing mortality from land transport accidents?
Revista Brasileira de Enfermagem. 2024;77(4):e770401
07-08-2024DOI 10.1590/0034-7167.2024770401
Views0Morbidity and mortality from external causes, especially those resulting from land transport accidents (LTA), persist as a global challenge, given that they account for around 2 million lives lost annually, impacting various segments of society, especially in health services and systems().Evidence indicates that LTA are preventable, although historically they have been considered inevitable. However, isolated […]See more -
EDITORIAL
¿Puede la enfermería contribuir a reducir la mortalidad por accidentes de transporte terrestre?
Revista Brasileira de Enfermagem. 2024;77(4):e770401
07-08-2024
Abstract
EDITORIAL¿Puede la enfermería contribuir a reducir la mortalidad por accidentes de transporte terrestre?
Revista Brasileira de Enfermagem. 2024;77(4):e770401
07-08-2024DOI 10.1590/0034-7167.2024770401es
Views0La morbilidad y la mortalidad por causas externas, especialmente las resultantes de accidentes de transporte terrestre (ATT), persisten como un desafío global, dado que es responsable de alrededor de 2 millones de vidas perdidas anualmente, impactando a diversos segmentos de la sociedad, especialmente en los servicios y sistemas de salud().La evidencia indica que los ATT […]See more -
ORIGINAL ARTICLE
Quality of Care Transition for COVID-19 Patients in a University Hospital in Southern Brazil
- Ana Cecilia Boeng ,
- Caroline Cechinel-Peiter ,
- Maria Fernanda Baeta Neves Alonso da Costa ,
- Laísa Fisher Wachholz ,
- José Luís Guedes dos Santos , [ … ],
- Gabriela Marcellino de Melo Lanzoni
06-28-2024
Abstract
ORIGINAL ARTICLEQuality of Care Transition for COVID-19 Patients in a University Hospital in Southern Brazil
Revista Brasileira de Enfermagem. 2024;77:e20230402
06-28-2024DOI 10.1590/0034-7167-2023-0402
- Ana Cecilia Boeng ,
- Caroline Cechinel-Peiter ,
- Maria Fernanda Baeta Neves Alonso da Costa ,
- Laísa Fisher Wachholz ,
- José Luís Guedes dos Santos ,
- Gabriela Marcellino de Melo Lanzoni
Views0See moreABSTRACT
Objective:
To assess the quality of care transition from hospital to home for COVID-19 patients.
Method:
A cross-sectional study conducted at a University Hospital in Southern Brazil, involving 78 patients discharged after COVID-19 hospitalization. Data collection was performed via telephone using the Brazilian version of the Care Transitions Measure (CTM-15). Data were analyzed using descriptive and analytical statistics.
Results:
The mean quality of care transition was 70.8 on a scale ranging from zero to 100, indicating moderate quality of care transition. The highest score was attributed to factor 1, “Preparation for self-management,” and the lowest to factor 4, “Care Plan.”
Conclusions:
It is important to enhance communication and support provided to patients during the transition process, especially regarding understanding prescribed medications and the development of clear care plans.
- Ana Cecilia Boeng
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ORIGINAL ARTICLE
Quality of life at work for health professionals during the COVID-19 pandemic
- Monalisa Maria Leandro da Silva Oliveira ,
- Gabriela Ferreira de Oliveira Butrico ,
- Vanessa da Silva Carvalho Vila ,
- Katarinne Lima Moraes ,
- Marina Aleixo Diniz Rezende , [ … ],
- Sergiane Bisinoto Alves
06-28-2024
Abstract
ORIGINAL ARTICLEQuality of life at work for health professionals during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230461
06-28-2024DOI 10.1590/0034-7167-2023-0461
- Monalisa Maria Leandro da Silva Oliveira ,
- Gabriela Ferreira de Oliveira Butrico ,
- Vanessa da Silva Carvalho Vila ,
- Katarinne Lima Moraes ,
- Marina Aleixo Diniz Rezende ,
- Laidilce Teles Zatta Santos ,
- Larissa Silva Magalhães ,
- Sergiane Bisinoto Alves
Views0ABSTRACT
Objective:
to evaluate the quality of life at work of health professionals in direct and indirect care of COVID-19 cases.
Methods:
this was a cross-sectional study with 156 health professionals from a referral hospital. The relationship between sociodemographic and work-related variables and perceived stress and domains of the Quality of Life at Work Scale was investigated using inferential statistics and regression.
Results:
Satisfaction with Compassion was moderate (mean: 38.2), with low perception of stress, Burnout and Secondary Traumatic Stress (means: 18.8, 21.6 and 19.1). There were associations between: education, salary, multiple jobs and direct care with Compassion Satisfaction; low income, being a nurse and working overtime with Burnout; and working more than 12 hours, underlying disease and hospitalization for COVID-19 with Secondary Traumatic Stress.
Conclusion:
quality of life at work was satisfactory, despite the presence of Burnout and Secondary Traumatic Stress.
Keywords:Occupational HealthOccupational StressPsychological BurnoutQuality of LifeWorking ConditionsSee more - Monalisa Maria Leandro da Silva Oliveira
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REVIEW
Clinical outcomes in newborns of pregnant women with COVID-19: integrative review
- Iara Bezerra da Silva Ximenes ,
- Cassiano Richel Ferreira Leal ,
- Odinéia Maria Amorim Batista ,
- Maria Eliete Batista Moura ,
- Maria Zélia de Araújo Madeira , [ … ],
- Denise de Andrade
06-28-2024
Abstract
REVIEWClinical outcomes in newborns of pregnant women with COVID-19: integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230400
06-28-2024DOI 10.1590/0034-7167-2023-0400
- Iara Bezerra da Silva Ximenes ,
- Cassiano Richel Ferreira Leal ,
- Odinéia Maria Amorim Batista ,
- Maria Eliete Batista Moura ,
- Maria Zélia de Araújo Madeira ,
- Andreia Rodrigues Moura da Costa Valle ,
- Pedro Emílio Gomes Prates ,
- Álvaro Francisco Lopes de Sousa ,
- Denise de Andrade
Views0See moreABSTRACT
Objectives:
to analyze clinical outcomes in newborns of pregnant women with COVID-19.
Methods:
integrative review conducted in PubMed, Web of Knowledge, SCOPUS, CINHAL; 2,111 studies were obtained, and 8 articles comprised the final sample.
Results:
clinical outcomes in neonates of pregnant women positive for COVID-19 were classified according to the following categories: a) contamination by COVID-19, reported in 62.5% of the studies; b) hospital discharge due to improvement, mentioned in 37.5% of the articles; c) death, representing rare cases in 25% of the sample. The most prevalent gestational complication was prematurity, mentioned in 75% of the studies. This complication has been observed due to cases of premature rupture of membranes and placental abruption.
Conclusions:
despite the knowledge of asymptomatic and mildly symptomatic behavior in neonates, it is important to continue the search for new clinical data, as this public has uncertain reactions to SARS-CoV-2 infection.
- Iara Bezerra da Silva Ximenes
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ORIGINAL ARTICLE
Nursing leadership strategies in addressing COVID-19 in light of John Kotter’s framework
- Patrícia Alves Galhardo Varanda ,
- Gilberto Tadeu Reis da Silva ,
- Simone Coelho Amestoy ,
- Vânia Marli Schubert Backes ,
- Gabriela Marcellino de Melo Lanzoni , [ … ],
- Augusto Ferreira Umpiérrez
06-28-2024
Abstract
ORIGINAL ARTICLENursing leadership strategies in addressing COVID-19 in light of John Kotter’s framework
Revista Brasileira de Enfermagem. 2024;77:e20230289
06-28-2024DOI 10.1590/0034-7167-2023-0289
- Patrícia Alves Galhardo Varanda ,
- Gilberto Tadeu Reis da Silva ,
- Simone Coelho Amestoy ,
- Vânia Marli Schubert Backes ,
- Gabriela Marcellino de Melo Lanzoni ,
- Augusto Ferreira Umpiérrez
Views0See moreABSTRACT
Objective:
To analyze the leadership strategies of nurses in university hospitals in response to care management changes during the COVID-19 pandemic, informed by John Kotter’s insights.
Methods:
This multicentric study utilized qualitative and analytical methods. It was conducted through semi-structured interviews with 139 lead nurses from 10 university hospitals in Brazil. Data analysis included Bardin’s content analysis and the webQDA software.
Results:
The primary category identified was “Nursing Leadership Strategies in the Battle Against COVID-19,” encompassing five subcategories. This category underscored the importance of strategic vision in nursing leadership for combating COVID-19 within hospital settings, as well as the necessity of working collaboratively with their teams and other healthcare professionals.
Final Considerations:
The results highlight the strategies used by lead nurses in confronting COVID-19, which can be associated with John Kotter’s theoretical framework and his model of change.
- Patrícia Alves Galhardo Varanda
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ORIGINAL ARTICLE
Uncertainties experienced by nursing professionals who contracted Covid-19: a priori, everyone is human
- Cinthia Rafaela Amaro Gonçalves Andrade ,
- Laís de Miranda Crispim Costa ,
- Ingrid Martins Leite Lúcio ,
- Janaina Ferro Pereira ,
- Herika do Nascimento Lima , [ … ],
- Renata Lira do Nascimento
06-28-2024
Abstract
ORIGINAL ARTICLEUncertainties experienced by nursing professionals who contracted Covid-19: a priori, everyone is human
Revista Brasileira de Enfermagem. 2024;77:e20230142
06-28-2024DOI 10.1590/0034-7167-2023-0142
- Cinthia Rafaela Amaro Gonçalves Andrade ,
- Laís de Miranda Crispim Costa ,
- Ingrid Martins Leite Lúcio ,
- Janaina Ferro Pereira ,
- Herika do Nascimento Lima ,
- Renata Lira do Nascimento
Views0See moreABSTRACT
Objective:
To analyze the uncertainties experienced by nursing professionals who contracted COVID-19.
Methods:
This qualitative research was conducted with 20 nursing professionals who fell ill from COVID-19. Data collection was carried out through semi-structured interviews; the data were then organized using thematic analysis and discussed in the context of Merle Mishel’s Reconceptualized of Uncertainty in Illness Theory.
Results:
The antecedents of the disease had a strong influence on how nursing professionals who contracted COVID-19 perceived uncertainty. The media coverage of the increasing number of cases, the collapse of the healthcare system, and the high mortality rate contributed to associating the disease with fear and panic.
Final Considerations:
Viewing it from the perspective of the disease’s antecedents, the illness of a nursing professional from COVID-19 underscores that before being professionals, they are human beings just like anyone else, undergoing adversities and facing the possibilities associated with being ill.
- Cinthia Rafaela Amaro Gonçalves Andrade
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ORIGINAL ARTICLE
Serious Game e-Baby Família: an educational technology for premature infant care
- Marcela Mobiglia D’Agostini ,
- Natália Del Angelo Aredes ,
- Suzanne Hetzel Campbell ,
- Luciana Mara Monti Fonseca
06-24-2020
Abstract
ORIGINAL ARTICLESerious Game e-Baby Família: an educational technology for premature infant care
Revista Brasileira de Enfermagem. 2020;73(4):e20190116
06-24-2020DOI 10.1590/0034-7167-2019-0116
- Marcela Mobiglia D’Agostini ,
- Natália Del Angelo Aredes ,
- Suzanne Hetzel Campbell ,
- Luciana Mara Monti Fonseca
Views0See moreABSTRACT
Objectives:
to develop and assess the serious game e-Baby Família with parents of premature infants.
Methods:
a methodological study regarding the development of the serious game, with participatory design in scope definition, starting from parents’ learning needs about premature infant care. A qualitative approach was performed in the assessment stage with parents, with content analysis of the speech of the eight participants.
Results:
the following categories emerged: Realistic appearance of the virtual setting and game content and Gameplay implications for the use of e-Baby Família. The game was satisfactorily assessed regarding content, appearance and dynamics use, motivating participants to learn.
Final Considerations:
in the context of prematurity as a public health problem in Brazil and the need to strengthen family health education for care, the serious game was assessed as motivating and appropriate for health learning.
- Marcela Mobiglia D’Agostini
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ORIGINAL ARTICLE
Aging, sexuality and nursing care: the elderly woman’s look
- Cinoélia Leal de Souza ,
- Vanda Santana Gomes ,
- Roberta Lopes da Silva ,
- Elaine Santos da Silva ,
- Jaqueline Pereira Alves , [ … ],
- Simone Aline Ferreira
12-05-2019
Abstract
ORIGINAL ARTICLEAging, sexuality and nursing care: the elderly woman’s look
Revista Brasileira de Enfermagem. 2019;72:71-78
12-05-2019DOI 10.1590/0034-7167-2018-0015
- Cinoélia Leal de Souza ,
- Vanda Santana Gomes ,
- Roberta Lopes da Silva ,
- Elaine Santos da Silva ,
- Jaqueline Pereira Alves ,
- Núbia Rêgo Santos ,
- Victor Neves Reis ,
- Simone Aline Ferreira
Views0See moreABSTRACT
Objective:
to analyze the perception of elderly women about sexuality and practice of nursing care in this context.
Method:
a descriptive qualitative study. Fifty elderly women from Guanambi City – Bahia State were interviewed in 2016. Data collection technique was direct interview by using an unstructured script. Analysis of the semantic content described was carried out, and two empirical categories: the elderly woman’s view of nursing care in the promotion of sexual health and experience of sexuality in the elderly; and nursing care in the context of women’s aging.
Results:
it has been noted that the elderly women are afraid to talk about sexuality, especially with health professionals. By influences of society, they often exclude this issue of health care for elderly women.
Final considerations:
changes must be thought about assistance provided in relation to sexuality.
- Cinoélia Leal de Souza
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HIV infection in pregnant women and its challenges for the prenatal care
- Lidiane de Nazaré Mota Trindade ,
- Laura Maria Vidal Nogueira ,
- Ivaneide Leal Ataide Rodrigues ,
- Angela Maria Rodrigues Ferreira ,
- Gracileide Maia Corrêa , [ … ],
- Natasha Cristina Oliveira Andrade
01-22-2021
Abstract
HIV infection in pregnant women and its challenges for the prenatal care
Revista Brasileira de Enfermagem. 2021;74:e20190784
01-22-2021DOI 10.1590/0034-7167-2019-0784
- Lidiane de Nazaré Mota Trindade ,
- Laura Maria Vidal Nogueira ,
- Ivaneide Leal Ataide Rodrigues ,
- Angela Maria Rodrigues Ferreira ,
- Gracileide Maia Corrêa ,
- Natasha Cristina Oliveira Andrade
Views0ABSTRACT
Objective:
To analyze the epidemiological profile of HIV infections in pregnant women.
Methods:
Analytical study with a quantitative approach.
Results:
The HIV rate in pregnant women increased from 1.5/1000 babies born alive, in 2010, to 3.3/1000 in 2017. There was a significant association between the prenatal and the variables educational level (p<0.0001), occupation (p=0.0105), gestational age (p < 0.0001), and type of delivery (p < 0.0001). The mean rate of adherence to the antiretroviral treatment in the prenatal was 68.8% (DP = ± 3.7).
Conclusion:
The high rates of HIV detection in pregnant women suggest the need to intensify the health care to women during the prenatal, guaranteeing an integral care, early diagnoses, and enhancing the strategies to improve the adherence to the antiretroviral treatment, aiming to achieve the viral suppression of the mother by the time of childbirth, thus diminishing the risk of a vertical transmission.
Keywords:HIV InfectionsInfectious Disease Transmission, VerticalPregnant WomenPrenatal CarePublic HealthSee more
- Lidiane de Nazaré Mota Trindade
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EDITORIAL
Investigação qualitativa em tempos de pandemia
Revista Brasileira de Enfermagem. 2021;74:e74Suppl101
06-11-2021
Abstract
EDITORIALInvestigação qualitativa em tempos de pandemia
Revista Brasileira de Enfermagem. 2021;74:e74Suppl101
06-11-2021DOI 10.1590/0034-7167.202174Suppl101
Views0INTRODUÇÃOA investigação qualitativa permite a compreensão de realidades singulares que, dificilmente, são apreendidas a partir de um único prisma, assumindo-se cada vez mais como um campo inter e transdisciplinar–, com métodos e técnicas especificas que implicam a relação entre o investigador e os participantes para a colheita, análise e validação das transcrições e análise efetuada […]See more -
ORIGINAL ARTICLE
Clinical judgment and diagnostic reasoning of nursing students in clinical simulation
- Janaina Gomes Perbone Nunes ,
- José Joaquim Penedos Amendoeira ,
- Diná de Almeida Lopes Monteiro da Cruz ,
- Kathie Lasater ,
- Sheila Coelho Ramalho Vasconcelos Morais , [ … ],
- Emilia Campos de Carvalho
09-21-2020
Abstract
ORIGINAL ARTICLEClinical judgment and diagnostic reasoning of nursing students in clinical simulation
Revista Brasileira de Enfermagem. 2020;73(6):e20180878
09-21-2020DOI 10.1590/0034-7167-2018-0878
- Janaina Gomes Perbone Nunes ,
- José Joaquim Penedos Amendoeira ,
- Diná de Almeida Lopes Monteiro da Cruz ,
- Kathie Lasater ,
- Sheila Coelho Ramalho Vasconcelos Morais ,
- Emilia Campos de Carvalho
Views0See moreABSTRACT
Objectives:
to determine the degree of association between clinical judgment and diagnostic reasoning of nursing students in clinical simulation.
Methods:
this is a correlational research design using a quantitative approach. The sample consisted of 41 nursing students who assisted a patient with vaso-occlusive crisis in a high-fidelity clinical simulation setting. The instruments used included the Lasater Clinical Judgment Rubric – Brazilian Version and the Diagnostic Thinking Inventory.
Results:
clinical judgment was associated with diagnostic reasoning (r=0.313; p=0.046), as well as the “noticing” aspect of clinical judgment with diagnostic reasoning (r=0.312; p=0.047).
Conclusions:
the results show that skills to interpret patient data are associated with diagnostic reasoning skills. Teaching clinical judgment skills is necessary to develop the diagnostic reasoning of nursing students.
- Janaina Gomes Perbone Nunes
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ORIGINAL ARTICLE
Quality of life of nurse practitioners during the COVID-19 pandemic
- Juliano de Souza Caliari ,
- Mariana Alvina dos Santos ,
- Carla Renata Silva Andrechuk ,
- Kétrya Raiany Costa Campos ,
- Maria Filomena Ceolim , [ … ],
- Flávia Helena Pereira
10-18-2022
Abstract
ORIGINAL ARTICLEQuality of life of nurse practitioners during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75:e20201382
10-18-2022DOI 10.1590/0034-7167-2020-1382
- Juliano de Souza Caliari ,
- Mariana Alvina dos Santos ,
- Carla Renata Silva Andrechuk ,
- Kétrya Raiany Costa Campos ,
- Maria Filomena Ceolim ,
- Flávia Helena Pereira
Views0See moreABSTRACT
Objective:
to assess the quality of life of nurse practitioners during the COVID-19 pandemic and analyze related factors.
Methods:
cross-sectional and analytical study carried out with nurse practitioners. A questionnaire on sociodemographic characterization, work activities and changes perceived with the pandemic and WHOQOL-bref were used. To compare the groups of interest, analysis of covariance was used.
Results:
572 professionals participated, who had a mean total quality of life score of 56.79 (SD=13.56). In the relationship of variables with WHOQOL-bref, having two or more jobs and being a nurse were associated with better quality of life, but being a woman and working more than 50 hours a week was associated with a worse perception of the construct.
Conclusions:
the factors analyzed indicate a lower perception of quality of life associated with the social domain, requiring interventions that reduce the damage to professionals’ health and contribute to quality of care provided.
- Juliano de Souza Caliari
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ORIGINAL ARTICLE
Nurses defending the autonomy of the elderly at the end of life
- Rafael Barroso Gaspar ,
- Marcelle Miranda da Silva ,
- Karen Gisela Moraes Zepeda ,
- Ítalo Rodolfo Silva
10-21-2019
Abstract
ORIGINAL ARTICLENurses defending the autonomy of the elderly at the end of life
Revista Brasileira de Enfermagem. 2019;72(6):1639-1645
10-21-2019DOI 10.1590/0034-7167-2018-0768
- Rafael Barroso Gaspar ,
- Marcelle Miranda da Silva ,
- Karen Gisela Moraes Zepeda ,
- Ítalo Rodolfo Silva
Views0See moreABSTRACT
Objective:
to understand how nurses deal with the elderly’s autonomy at the end of life.
Method:
qualitative, exploratory study, guided by the Grounded Theory. Ten nurses, eight doctors and 15 nursing technicians were interviewed between November 2016 and May 2017 at a university hospital in Rio de Janeiro/Brazil.
Results:
nurses deal with the elderly’s autonomy in compliance with the code of ethics and exercise leadership in actions and interactions to defend this right, evaluating, guiding and listening to the preferences of the elderly; interacting with the family; and sharing information with the health team.
Final considerations:
the elderly’s autonomy must be ensured in care planning, based on patient-centered communication and developed in the interaction among agents involved in care. The discussion on “Living Wills” Health Care Directives and principles of palliative care must be encouraged.
- Rafael Barroso Gaspar
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ORIGINAL ARTICLE
Factors associated with depressive symptoms in elderly caregivers with chronic pain
- Marielli Terassi ,
- Estefani Serafim Rossetti ,
- Bruna Moretti Luchesi ,
- Karina Gramani-Say ,
- Priscilla Hortense , [ … ],
- Sofia Cristina Iost Pavarini
01-27-2020
Abstract
ORIGINAL ARTICLEFactors associated with depressive symptoms in elderly caregivers with chronic pain
Revista Brasileira de Enfermagem. 2020;73(1):e20170782
01-27-2020DOI 10.1590/0034-7167-2017-0782
- Marielli Terassi ,
- Estefani Serafim Rossetti ,
- Bruna Moretti Luchesi ,
- Karina Gramani-Say ,
- Priscilla Hortense ,
- Sofia Cristina Iost Pavarini
Views0See moreABSTRACT
Objective:
to identify factors associated with depressive symptoms in elderly caregivers with chronic pain.
Method:
the study included people 60 years of age or older who reported chronic pain and cared for another elderly person living in the same household (n=186). Statistical analyzes were performed using the Mann-Whitney test, univariate and multiple logistic regression.
Results:
most participants had no depressive symptoms (70.4%), 24.2% had mild depressive symptoms and 5.4% had severe symptoms. Univariate analysis showed that the variables family income, number of diseases, number of medications in use, pain intensity, overload and perceived stress were associated with depressive symptoms. Multivariate analysis found an association with perceived stress (95% CI 1.101-1207) and number of medications (95% CI 1.139-1.540) in use.
Conclusion:
factors associated with depressive symptoms in elderly caregivers with chronic pain were stress and the number of medications in use.
- Marielli Terassi
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