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RESEARCH01-01-2017
Nursing care by telehealth: what is the influence of distance on communication?
Revista Brasileira de Enfermagem. 2017;70(5):928-934
Abstract
RESEARCHNursing care by telehealth: what is the influence of distance on communication?
Revista Brasileira de Enfermagem. 2017;70(5):928-934
DOI 10.1590/0034-7167-2016-0142
Views0See moreABSTRACT
Objective:
Evaluate the perception of nurses regarding interpersonal communication while providing care via telehealth.
Method:
Qualitative research realized with seven nurses working in telehealth in Brazil, the sample was determined by data saturation. A questionnaire with open questions was applied and then content analysis of the dialogues was conducted, focusing on thematic analysis.
Results:
Four categories emerged from the dialogues: Understanding the importance of communication; the interpersonal relationship interfering with communication; Communicating via technology; and Learning the communication process.
Final considerations:
The perception of nurses working in telehealth in Brazil is that technology has facilitated their professional practice; however, in relation to the communication process, they believe it is harder to communicate by telehealth, mainly due to difficulty in perceiving nonverbal signals. To overcome these difficulties, they agreed that interpersonal communication is a skill that must be acquired during their professional training.
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RESEARCH01-01-2017
Experiences in the Family Health Strategy: demands and vulnerabilities in the territory
Revista Brasileira de Enfermagem. 2017;70(5):920-927
Abstract
RESEARCHExperiences in the Family Health Strategy: demands and vulnerabilities in the territory
Revista Brasileira de Enfermagem. 2017;70(5):920-927
DOI 10.1590/0034-7167-2015-0033
Views0See moreABSTRACT
Objective:
To understand the daily demands of Family Health Strategy in clinical practice of the team and social vulnerabilities of community territory.
Method:
Research with qualitative approach, in a critical-reflexive perspective, held with two teams of the Family Health Strategy, in the city of Fortaleza, State of Ceará, Brazil. The participants were 22 users and 19 health professionals from the basic health network. Data from the interviews and observation were analyzed under the assumptions of critical hermeneutics.
Results:
We highlight the unveiling of sufferings and daily clashes, the influence of social determinants on health and psychosocial demands, limits and possibilities of everyday clinical practice.
Conclusion:
The clinic attention must recognize the perceptions and living conditions by listening and promoting health in the community.
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RESEARCH01-01-2017
Neoliberalist influences on nursing hospital work process and organization
Revista Brasileira de Enfermagem. 2017;70(5):912-919
Abstract
RESEARCHNeoliberalist influences on nursing hospital work process and organization
Revista Brasileira de Enfermagem. 2017;70(5):912-919
DOI 10.1590/0034-7167-2016-0092
Views0See moreABSTRACT
Objectives:
To describe and analyze the influence of the neoliberal economic and political model on the nursing hospital work process and organization.
Method:
Qualitative descriptive research, having as its scenery a university hospital. The subjects were 34 nursing workers. The data collection took place from March to July 2013, through semi-structured interview. The data treatment technique used was content analysis, which brought up the following category: working conditions precariousness and its consequences to the hospital work process and organization in the neoliberal context.
Results:
The consequences of neoliberalism on hospital work process and organization were highlighted, being observed physical structure, human resources and material inadequacies that harms the assistance quality. In addition to wage decrease that cause the need of second jobs and work overload.
Final considerations:
There is a significant influence of the neoliberal model on hospital work, resulting on working conditions precariousness.
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RESEARCH01-01-2017
Nursing team’s conceptions about the families of hospitalized children
Revista Brasileira de Enfermagem. 2017;70(5):904-911
Abstract
RESEARCHNursing team’s conceptions about the families of hospitalized children
Revista Brasileira de Enfermagem. 2017;70(5):904-911
DOI 10.1590/0034-7167-2016-0233
Views0See moreABSTRACT
Objectives:
to describe nursing team care and discuss the nursing team’s conception of companion families of hospitalized children. The study was based on the theoretical framework of Collière’s theory of nursing care identity.
Method:
this was a qualitative study with 14 members of a nursing team, conducted through an unstructured group interview. Thematic data analysis was employed.
Results:
habitual and repair care was delegated to families, regardless of the child’s clinical condition.
Final considerations:
the team’s official discourse about the families of hospitalized children, as recommended by the literature, refers to the family’s alterity and participation in care provision, with sights on discharge and defending family participation as beneficial to children. In practice, however, the nursing staff makes concessions about the presence of chaperoning families and delegates care.
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RESEARCH01-01-2017
Innovation in nursing health care practice: expansion of access in primary health care
Revista Brasileira de Enfermagem. 2017;70(5):898-903
Abstract
RESEARCHInnovation in nursing health care practice: expansion of access in primary health care
Revista Brasileira de Enfermagem. 2017;70(5):898-903
DOI 10.1590/0034-7167-2016-0131
Views0See moreABSTRACT
Objective:
analyze the reorganization of the health care practice of nurses as an innovative strategy for expansion of access in primary care.
Method:
qualitative and quantitative study, which interviewed 32 management and care nurses and collected documentary data from public reports of production of nursing consultations from 2010 to 2014, in a municipality in southern Brazil. Data processing for textual analysis was performed by IRAMUTEQ software; for simple descriptive statistical analysis, the program Excel 2013 was used.
Results:
in the innovative care practice class, associated with awareness of change, related to implementation of the FHS, its challenges and advantages, the following subclasses were identified: reorganization of schedules, nursing consultation, physical restructuring of BHUs, and shared consultation.
Final considerations:
the need to expand access to and valorization of care practice encourages the development of innovative strategies. The protagonism of care needs to be discussed in the various spaces so that each professional carry out the respective role with competence and efficacy.
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01-01-2017
O trabalho em Enfermagem e a construção de uma sociedade democrática
Revista Brasileira de Enfermagem. 2017;70(5):896-897
Abstract
O trabalho em Enfermagem e a construção de uma sociedade democrática
Revista Brasileira de Enfermagem. 2017;70(5):896-897
DOI 10.1590/0034-7167.2017700501
Views0No Brasil, o trabalho em enfermagem é realizado por expressivo contingente de trabalhadores, que, de acordo com o último levantamento realizado pela Associação Brasileira de Enfermagem, somava 1.856.683 profissionais, em sua maioria mulheres, distribuído em três categorias profissionais: Enfermeiros, Técnicos e Auxiliares de Enfermagem que atuam na rede pública e privada de saúde. Com baixos […]See more -
01-01-2017
The Nursing work and the construction of a democratic society
Revista Brasileira de Enfermagem. 2017;70(5):896-897
Abstract
The Nursing work and the construction of a democratic society
Revista Brasileira de Enfermagem. 2017;70(5):896-897
DOI 10.1590/0034-7167.2017700501
Views0In Brazil, the Nursing work is performed by an expressive contingent of workers, which – according to the last survey by the Brazilian Nursing Association – comprised 1,856,683 professionals, mostly women, distributed into three professional categories: Nurses, Nursing Technicians and Nursing Assistants, who work in public and private health care networks. With salaries lower than […]See more -
01-01-2017
Trascendencia, historicidad y temporalidad del ser adulto mayor: reflexión enfermera en Heidegger
Revista Brasileira de Enfermagem. 2017;70(4):891-895
Abstract
Trascendencia, historicidad y temporalidad del ser adulto mayor: reflexión enfermera en Heidegger
Revista Brasileira de Enfermagem. 2017;70(4):891-895
DOI 10.1590/0034-7167-2016-0275
Views0See moreRESUMEN
El objetivo es reflexionar en la historicidad y temporalidad como caminos para la trascendencia del ser adulto mayor, basado en los conceptos fenomenológicos de Martín Heiddeger. Se llevó a cabo una revisión de los conceptos de trascendencia, historicidad y temporalidad en la obra de Martín Heidegger, realizando su integración en la perspectiva de enfermería al adulto mayor. La trascendencia del ser adulto mayor es factible accediendo a la temporalidad del mismo en el camino de su historicidad para llegar a la comprensión de sí a la que ha llegado: trascendiendo, que no es sino un proceso del mismo ser. El ser es el tiempo en sí mismo existiendo en el mundo, existencia dada por el encuentro del pasado (haber sido), presente y futuro (devenir), mismo encuentro que determina la historicidad del ser. El encuentro se ha consumado y el ser es trascendencia, como punto supremo la comprensión del ser mismo.
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01-01-2015
Quality of life and physical activity in intensive care professionals from middle São Francisco
Revista Brasileira de Enfermagem. 2015;68(1):26-31
Abstract
Quality of life and physical activity in intensive care professionals from middle São Francisco
Revista Brasileira de Enfermagem. 2015;68(1):26-31
DOI 10.1590/0034-7167.2015680104i
Views0See moreObjective:
the objective was to assess the level of physical activity (LPA) and the quality of life QL of the professionals who work in ICU.
Method:
this was a cross-sectional study carried out in Adult ICUs. LPA was assessed by the International Questionnarie of Physical Activity – short form (IQPA-SF) and the QL by the Medical Outcomes Study 36 (SF-36) questionnaire.
Results:
it was classified active 50.89% out of a total of 59 professionals. Nursing technicians were considered the most active with 60.6%. The QL of the professionals who were considered active were better when compared to inactives, with statistical differences to the category of physical aspects limitation, social aspects and mental health. The working hours were higher than recommend, the physicians were higher than the physical therapist, nurses and technicians nurses (p = 0.046).
Conclusion:
physically active professionals who work in ICU had higher quality of life probably why have lower hours of work and consequently more free time to engage in physical activity.
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01-01-2015
Learning needs of Nursing students in technical vocational education
Revista Brasileira de Enfermagem. 2015;68(1):20-25
Abstract
Learning needs of Nursing students in technical vocational education
Revista Brasileira de Enfermagem. 2015;68(1):20-25
DOI 10.1590/0034-7167.2015680103i
Views0See moreObjective:
identify learning needs of students of Technical Vocational Education (TVE) in Nursing. Qualitative study conducted in a city of São Paulo state.
Method:
the subjects were students, teachers and coordinators of TVE and students of the bachelor degree who have had contact with TVE. Data collection was performed by questionnaire socioeconomic and cultural circles about the learning needs. For data analysis we used the content analysis.
Results:
it was found that students have difficulties contents not related to nursing as portuguese and mathematics, as well as introductory courses in the course of TVE which possibly may interfere negatively in learning specific content of nursing and the quality of health care.
Conclusion:
it is necessary to rethink the content taught and ways to teach from basic education, as well as the training of teachers who now works in the TVE.
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01-01-2015
Serious game e-Baby: nursing students’ perception on learning about preterm newborn clinical assessment
Revista Brasileira de Enfermagem. 2015;68(1):13-19
Abstract
Serious game e-Baby: nursing students’ perception on learning about preterm newborn clinical assessment
Revista Brasileira de Enfermagem. 2015;68(1):13-19
DOI 10.1590/0034-7167.2015680102i
Views0See moreObjective:
to evaluate students opinion regarding e-Baby educational technology.
Methodology:
exploratory descriptive study in which participated a sample composed of 14 nursing Portuguese students that used e-Baby digital educational technology in an extracurricular course. To achieve the aim of the study, the data collection was realized through an opinion instrument in Likert scale including the possibility of commentaries by students. Is was also collected data of participants’ characterization.
Results:
students made very satisfactory evaluations regarding the game e-Baby, varying since usability acceptation through suggestions of expansion of the game to other nursing themes.
Conclusion:
serious game e-Baby can be considered a didactic innovation and motivator tool of learning. Besides, it demonstrates have adequate interface in design and educative function aspects, evocating intense interaction between user and computational tool.
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01-01-2015
Challenges beyond the scientific knowledge production
Revista Brasileira de Enfermagem. 2015;68(1):7-8
Abstract
Challenges beyond the scientific knowledge production
Revista Brasileira de Enfermagem. 2015;68(1):7-8
DOI 10.1590/0034-7167.2015680101p
Views0For several decades, innumerous appeals and reflections on how to build the nursing science and achieve visibility in the scientific world led researchers to make efforts to produce knowledge that contributed to the well-being of people, improving their quality of life, relieving their suffering and transforming the reality in which we live. In addition to […]See more
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12-04-2023
Maternal Concerns in Home Care for the Premature Newborn: An Integrative Review
- Thaís Emanuele da Conceição
, - Maria Helena do Nascimento Souza ,
- Rafael Braga Esteves ,
- Patrícia Lima Pereira Peres ,
- Donatella Valente , [ … ],
- Antonella Nespoli
Abstract
Maternal Concerns in Home Care for the Premature Newborn: An Integrative Review
Revista Brasileira de Enfermagem. 2023;76(6):e20220769
DOI 10.1590/0034-7167-2022-0769
- Thaís Emanuele da Conceição ,
- Maria Helena do Nascimento Souza ,
- Rafael Braga Esteves ,
- Patrícia Lima Pereira Peres ,
- Donatella Valente ,
- Antonella Nespoli
Views0See moreABSTRACT
Objective:
To identify and analyze the scientific literature, both national and international, concerning the primary maternal concerns about caring for premature newborns at home.
Methods:
This integrative review is based on the guiding question: “What scientific publications from 2012 to 2021 address maternal concerns about the care of premature newborns at home?”. Searches were conducted in the electronic databases: Embase, Medline, Web of Science, Lilacs, Scielo, and Cochrane Library.
Results:
A total of 21 articles were identified. The qualitative analysis showed that maternal concerns pertained to breastfeeding, hygiene, sunbathing practices, managing infant colic, identifying signs, symptoms, and clinical changes, temperature control, and the third phase of the kangaroo method.
Conclusions:
Maternal uncertainties underscore the importance of enhancing strategies focused on supporting families and ensuring continued care for neonates at home.
- Thaís Emanuele da Conceição
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12-04-2023
Web App for prediction of hospitalisation in Intensive Care Unit by covid-19
Revista Brasileira de Enfermagem. 2023;76(6):e20220740
Abstract
Web App for prediction of hospitalisation in Intensive Care Unit by covid-19
Revista Brasileira de Enfermagem. 2023;76(6):e20220740
DOI 10.1590/0034-7167-2022-0740
Views0See moreABSTRACT
Objective:
To develop a Web App from a predictive model to estimate the risk of Intensive Care Unit (ICU) admission for patients with covid-19.
Methods:
An applied technological production research was carried out with the development of Streamlit using Python, considering the decision tree model that presented the best performance (AUC 0.668).
Results:
Based on the variables associated with Precision Nursing, Streamlit stratifies patients admitted to clinical units who are most likely to be admitted to the Intensive Care Unit, serving as a decision-making support tool for healthcare professionals.
Final considerations:
The performance of the model may have been influenced by the start of vaccination during the data collection period, however, the Web App via Streamlit proved to be a feasible tool for presenting research results, due to the ease of understanding by nurses and its potential for supporting clinical decision-making.
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12-04-2023
Efeitos da auriculoterapia na ansiedade e biomarcadores na Atenção Primária à Saúde: um ensaio clínico
- Carina da Silva ,
- Letícia Siqueira ,
- Lívia Crespo Drago ,
- Elisa Mitkus Flores Lins ,
- Daniel Fernandes Martins , [ … ],
- Franciane Bobinski
Abstract
Efeitos da auriculoterapia na ansiedade e biomarcadores na Atenção Primária à Saúde: um ensaio clínico
Revista Brasileira de Enfermagem. 2023;76(6):e20220728
DOI 10.1590/0034-7167-2022-0728pt
- Carina da Silva ,
- Letícia Siqueira ,
- Lívia Crespo Drago ,
- Elisa Mitkus Flores Lins ,
- Daniel Fernandes Martins ,
- Franciane Bobinski
Views0See moreRESUMEN
Objetivo:
evaluar los efectos de la auriculoterapia sobre la ansiedad y los niveles séricos de factor neurotrófico derivado de cerebro (BDNF), enolasa-específica de neurona (NSE) y proteína fijadora de calcio S100B (S100B) en adultos atendidos en Atención Primaria de Salud.
Métodos:
ensayo clínico piloto preexperimental. Se obtuvo información de 19 pacientes mediante el Inventario de Ansiedad Estado-Rasgo (STAI) y análisis de niveles séricos de BDNF, NSE y S100B.
Resultados:
la puntuación de ansiedad preintervención en el IDATE-Rasgo fue de 52,11±6,691 (CV 12,84%) y la valoración tras la auriculoterapia fue significativamente menor (43,72±8,141; CV 18,62%; P=0,0007). Los niveles de S100B se redujeron significativamente después de la auriculoterapia (de 64,03±72,18 a 54,03±68,53 pg/mL; CV 126,8%; P=0,0023).
Conclusión:
la auriculoterapia redujo efectivamente los niveles de ansiedad. Demostró ser seguro y fácil de aplicar, lo que permitió a las enfermeras realizar esta técnica de forma autónoma. También se evidenció una reducción de S100B, lo que demuestra una posible prevención del daño neuronal.
- Carina da Silva
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ORIGINAL ARTICLE12-04-2023
Effects of auriculotherapy on anxiety and biomarkers in Primary Health Care: a clinical trial
- Carina da Silva ,
- Letícia Siqueira ,
- Lívia Crespo Drago ,
- Elisa Mitkus Flores Lins ,
- Daniel Fernandes Martins , [ … ],
- Franciane Bobinski
Abstract
ORIGINAL ARTICLEEffects of auriculotherapy on anxiety and biomarkers in Primary Health Care: a clinical trial
Revista Brasileira de Enfermagem. 2023;76(6):e20220728
DOI 10.1590/0034-7167-2022-0728pt
- Carina da Silva ,
- Letícia Siqueira ,
- Lívia Crespo Drago ,
- Elisa Mitkus Flores Lins ,
- Daniel Fernandes Martins ,
- Franciane Bobinski
Views0See moreABSTRACT
Objective:
to assess the effects of auriculotherapy on anxiety and brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE) and S100 calcium-binding protein B (S100B) serum levels in adults assisted in Primary Health Care.
Methods:
a pre-experimental pilot clinical trial. Information was obtained from 19 patients using the State-Trait Anxiety Inventory (STAI) and analysis of BDNF, NSE and S100B serum levels.
Results:
the pre-intervention anxiety score in the IDATE-Trait was 52.11±6.691 (CV 12.84%) and the assessment after auriculotherapy was significantly lower (43.72±8.141; CV 18.62%; P=0.0007). S100B levels were significantly reduced after auriculotherapy (from 64.03±72.18 to 54.03±68.53 pg/mL; CV 126.8%; P=0.0023).
Conclusion:
auriculotherapy effectively reduced anxiety levels. It proved to be safe and easy to apply, allowing nurses to perform this technique autonomously. A reduction of S100B was also evidenced, demonstrating possible prevention of neuronal damage.
- Carina da Silva
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ORIGINAL ARTICLE12-04-2023
Leadership Competencies of the Medical-Surgical Nursing Specialist Nurse
- Marina Filipa Silveira Pires ,
- Romana Silva Lopes ,
- Cláudia Sofia Fernandes Caetano ,
- Liliana Andreia Neves da Mota ,
- Fernanda Maria Príncipe Bastos Ferreira
Abstract
ORIGINAL ARTICLELeadership Competencies of the Medical-Surgical Nursing Specialist Nurse
Revista Brasileira de Enfermagem. 2023;76(6):e20220721
DOI 10.1590/0034-7167-2022-0721
- Marina Filipa Silveira Pires ,
- Romana Silva Lopes ,
- Cláudia Sofia Fernandes Caetano ,
- Liliana Andreia Neves da Mota ,
- Fernanda Maria Príncipe Bastos Ferreira
Views0See moreABSTRACT
Objective:
To identify the leadership competencies of Medical-Surgical Nursing Specialist Nurses.
Methods:
A quantitative, descriptive study using the Leadership Competencies Questionnaire. 311 Portuguese Medical-Surgical Nursing Specialist Nurses participated. Data analysis involved descriptive and inferential statistical analysis using the Statistical Package for Social Sciences (SPSS), version 22.0.
Results:
Study participants had an above-average self-perception on the scale (mean = 3.5) in all leadership roles, recognizing their leadership competencies. The leadership competencies of Medical-Surgical Nursing Specialist Nurses are balanced across all roles: Mentor (5.80 ± 1.02); Coordinator (5.53 ± 0.86); Facilitator (5.38 ± 1.04); Innovator (5.34 ± 0.88); Director (5.31 ± 1.10); Producer (5.30 ± 0.98); Monitor (5.15 ± 1.00); Corrector (4.79 ± 1.29)
Conclusions:
Specialized nursing practice enhances nurses’ self-perceived leadership competencies. Nurses see themselves as leaders focused on internal support and facilitation of collective effort and opportunities for skill development.
- Marina Filipa Silveira Pires
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ORIGINAL ARTICLE12-04-2023
Assessment of the components of sarcopenia and quality of life perceived of individuals on hemodialysis
Revista Brasileira de Enfermagem. 2023;76(6):e20220677
Abstract
ORIGINAL ARTICLEAssessment of the components of sarcopenia and quality of life perceived of individuals on hemodialysis
Revista Brasileira de Enfermagem. 2023;76(6):e20220677
DOI 10.1590/0034-7167-2022-0677
Views1See moreABSTRACT
Objectives:
to evaluate the prevalence of sarcopenia in individuals aged 50 years or older on hemodialysis; to verify the association between sarcopenia and sociodemographic, clinical, anthropometric factors, components of sarcopenia and quality of life (QoL); and to correlate the components of sarcopenia with QoL.
Methods:
Participated 83 individuals on hemodialysis. Sarcopenia was established according to the current European consensus. Dynamometry to determine strength, calf circumference (CC) and appendicular skeletal muscle mass index (ASMMI) to obtain muscle mass and gait speed (GS) for physical performance. For QoL used the WHOQOL-bref.
Results:
the prevalence of sarcopenia was 32.6% (CC) and 18.1% (ASMMI). There was no association between sarcopenia and QoL. Both handgrip strength (r=0.25) and GS (r=0.36) showed a correlation with physical domain.
Conclusions:
sarcopenia was expressive, and the aspects of functionality determine the physical impairment in this population.
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ORIGINAL ARTICLE12-04-2023
Construction and validation of an educational booklet for patients in the postoperative period of cardiac surgery: a methodological study
- Sônia Regina Barcellos ,
- Alexandre do Rosário Joras ,
- Angelita Paganin Constanzi ,
- Emiliane Nogueira de Souza
Abstract
ORIGINAL ARTICLEConstruction and validation of an educational booklet for patients in the postoperative period of cardiac surgery: a methodological study
Revista Brasileira de Enfermagem. 2023;76(6):e20220621
DOI 10.1590/0034-7167-2022-0621
- Sônia Regina Barcellos ,
- Alexandre do Rosário Joras ,
- Angelita Paganin Constanzi ,
- Emiliane Nogueira de Souza
Views0See moreABSTRACT
Objective:
to construct and validate an educational booklet for self-care of patients in the postoperative period of cardiac surgery
Methods:
methodological study, including bibliographic survey, construction of the booklet and validation with judges and the target audience. For validation with judges, the Health Educational Content Validation Instrument was used, and with the target audience, an instrument was used with questions related to organization, writing style, appearance and motivation. To analyze the judges’ answers, the content validation index was used
Results:
the booklet was prepared with 14 topics. The content validation index among the eight judges was 1 and the concordance index among the ten patients was above 80%. The final version of the material was made available in printed format
Conclusion:
the educational booklet was developed and validated by judges and the target audience, serving as an educational support tool for self-care of patients in the postoperative period of cardiac surgery.
- Sônia Regina Barcellos
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12-04-2023
Quality of care in peripheral venous catheterization: A scoping review
- Saulo Pereira da Costa ,
- Rodrigo Euripedes da Silveira ,
- Damiana Aparecida Trindade Monteiro ,
- Divanice Contim ,
- Silmara Elaine Malaguti Toffano
Abstract
Quality of care in peripheral venous catheterization: A scoping review
Revista Brasileira de Enfermagem. 2023;76(6):e20220578
DOI 10.1590/0034-7167-2022-0578
- Saulo Pereira da Costa ,
- Rodrigo Euripedes da Silveira ,
- Damiana Aparecida Trindade Monteiro ,
- Divanice Contim ,
- Silmara Elaine Malaguti Toffano
Views0See moreABSTRACT
Objective:
To map the current status of parameters and tools to assess quality of care related to peripheral venous catheter use in adults.
Methods:
Scoping review, conducted in 2022 in the MEDLINE, LILACS, CINAHL and SCOPUS databases and with a publication time limit from 2013 to 2022.
Results:
The sample consisted of 15 articles, summarized in the following categories: Indication, documentation and registration, coverage assessment, connection, stabilization and signs and symptoms inherent to the catheter. The use of a complete instrument, with the domains observed in this review, may have a positive impact on a more effective and safe clinical practice.
Conclusions:
The present review mapped the evidence about the insertion and maintenance of peripheral venous catheters that can be improved with training of good practices and the quality of the team, regarding the use of tools, materials and instruments for the evaluation of care.
- Saulo Pereira da Costa
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