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ORIGINAL ARTICLE10-11-2024
Indigenous women’s experiences about the pregnancy-puerperal cycle
- Lubiane Boer
, - Francisca Georgina Macedo de Sousa ,
- Rizioléia Marina Pinheiro Pina ,
- Margarita Poblete ,
- Léris Salete Bonfanti Haeffner , [ … ],
- Dirce Stein Backes
Abstract
ORIGINAL ARTICLEIndigenous women’s experiences about the pregnancy-puerperal cycle
Revista Brasileira de Enfermagem. 2024;77:e20230410
DOI 10.1590/0034-7167-2023-0410
- Lubiane Boer ,
- Francisca Georgina Macedo de Sousa ,
- Rizioléia Marina Pinheiro Pina ,
- Margarita Poblete ,
- Léris Salete Bonfanti Haeffner ,
- Dirce Stein Backes
Views0See moreABSTRACT
Objectives:
to understand the experiences of indigenous women regarding the pregnancy-puerperal cycle.
Methods:
qualitative, exploratory and descriptive research, carried out between May and August 2023 with 27 pregnant women from Indigenous Villages in Mato Grosso, Brazil, through open individual interviews. The data was analyzed using Reflexive thematic analysis.
Results:
data analysis resulted in the following themes: Cultivation of labor and birth in its natural and sacred path; Unique practices and beliefs associated with breastfeeding; Evolved or reductive thinking? The participants suggest inviolable practices and beliefs, which must be welcomed, respected and enhanced by indigenous health teams.
Final Considerations:
the experiences of indigenous women regarding the pregnancy-puerperal cycle are unique and motivated by inviolable cultural and religious beliefs, which transcend scientific knowledge, certainties and the linearity of contemporary approaches, normally established as order.
- Lubiane Boer
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ORIGINAL ARTICLE10-07-2024
Indicators of emotional distress and mindfulness in undergraduate students: a cross-sectional study
- Vanessa Ferraz Leite ,
- Moisés Kogien ,
- Margani Cadore Weis Maia ,
- Marina Nolli Bittencourt ,
- Larissa de Almeida Rézio , [ … ],
- Samira Reschetti Marcon
Abstract
ORIGINAL ARTICLEIndicators of emotional distress and mindfulness in undergraduate students: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(5):e20230499
DOI 10.1590/0034-7167-2023-0499
- Vanessa Ferraz Leite ,
- Moisés Kogien ,
- Margani Cadore Weis Maia ,
- Marina Nolli Bittencourt ,
- Larissa de Almeida Rézio ,
- Samira Reschetti Marcon
Views0See moreABSTRACT
Objectives:
to assess the association between indicators of emotional distress and dispositional mindfulness in health students at a Brazilian federal public university.
Methods:
a cross-sectional study, developed with university students in the health area of a public institution from May to June 2022. In the analysis, multiple linear regression was used using SPSS software.
Results:
the sample was mostly female, ≤ 22 years old, non-white, studying the first semesters, with a higher prevalence for the medicine course. Students presented moderate dispositional mindfulness scores. It was observed that the variables of stress, depression and current suicide risk were associated with the capacity for mindfulness.
Conclusions:
knowing the indicators of emotional distress that are related to the potential of mindfulness can contribute as a situational diagnosis to better design strategies that promote the improvement of emotional indicators of health students.
- Vanessa Ferraz Leite
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ORIGINAL ARTICLE10-07-2024
Development and validation of a mobile application prototype for postoperative cardiac surgery
- Gabriele Cardoso Gonçalves Alves ,
- Fabiola Leticia Damascena Amador ,
- Vagner Rogério dos Santos ,
- Rita Simone Lopes Moreira
Abstract
ORIGINAL ARTICLEDevelopment and validation of a mobile application prototype for postoperative cardiac surgery
Revista Brasileira de Enfermagem. 2024;77(5):e20230491
DOI 10.1590/0034-7167-2023-0491
- Gabriele Cardoso Gonçalves Alves ,
- Fabiola Leticia Damascena Amador ,
- Vagner Rogério dos Santos ,
- Rita Simone Lopes Moreira
Views0See moreABSTRACT
Objectives:
to develop and validate the content, appearance, and semantics of a prototype application for monitoring patients in the postoperative period of cardiac surgery.
Methods:
this is a technological development study based on Contextualized Instructional Design. The content and appearance evaluation was conducted by a committee of specialists, and semantic validation was carried out by patients from a cardiac surgery outpatient clinic.
Results:
the application prototype consisted of 43 screens, validated by 17 health specialists, with content validity ratio and appearance validity index results of 0.86 and 0.99, respectively. For semantic validation, 10 patients participated in data collection, with a total content validity index of 0.978.
Conclusions:
the prototype of the “VivaCor PósOp” application demonstrated evidence of content, appearance, and semantic validity, with the potential to stimulate self-care in patients in the postoperative period of cardiac surgery.
- Gabriele Cardoso Gonçalves Alves
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REVIEW10-07-2024
Risk factors associated with the occurrence of the adverse event phlebitis in hospitalized adult patients
Revista Brasileira de Enfermagem. 2024;77(5):e20240162
Abstract
REVIEWRisk factors associated with the occurrence of the adverse event phlebitis in hospitalized adult patients
Revista Brasileira de Enfermagem. 2024;77(5):e20240162
DOI 10.1590/0034-7167-2024-0162
Views0See moreABSTRACT
Objectives:
to synthesize knowledge regarding risk factors associated with occurrence of adverse event phlebitis in hospitalized adult patients.
Methods:
an integrative literature review, carried out in the CINAHL, PubMed, Virtual Health Library, Embase, Web of Science and Scopus databases. The stages were carried out independently by two reviewers, and the data were analyzed descriptively.
Results:
from the analysis of 31 quantitative primary studies, the following risk factors were summarized: length of stay; use of antibiotics; peripheral intravenous catheter dwell time; receive less nursing care; catheter inserted multiple times; patients with infection and comorbidities; presence of pain at catheter insertion site; Teflon® catheter use; reduced patient mobility; quality of patient’s vein; skin elasticity; unsuccessful insertion.
Conclusions:
it is necessary to standardize the format for measuring occurrence of this adverse event and develop new studies with a higher level of evidence.
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ORIGINAL ARTICLE10-07-2024
Consequences of the legislation issued for nursing education in times of COVID-19 (2020-2022)
- Ailla Gabrielli Costa Silva ,
- Lenira Maria Wanderley Santos de Almeida ,
- Regina Maria dos Santos ,
- Danielly Santos dos Anjos Cardoso
Abstract
ORIGINAL ARTICLEConsequences of the legislation issued for nursing education in times of COVID-19 (2020-2022)
Revista Brasileira de Enfermagem. 2024;77(5):e20230375
DOI 10.1590/0034-7167-2023-0375
- Ailla Gabrielli Costa Silva ,
- Lenira Maria Wanderley Santos de Almeida ,
- Regina Maria dos Santos ,
- Danielly Santos dos Anjos Cardoso
Views0See moreABSTRACT
Objectives:
to analyze the legislation issued during the COVID-19 pandemic for nursing education and immediate consequences.
Methods:
documentary research, whose source was the legislation issued for nursing education during the COVID-19 pandemic. Thirty-two documents were analyzed and submitted to a collection instrument.
Results:
contradictions and consequences for nursing education following the guidelines and law of guidelines and bases were revealed. The consequences of the law affected the quality of teaching, equal access, exemption from minimum school days and course abbreviation. Regarding the guidelines, there was a lack of conditions for developing skills, in addition to the attempt to update them. Concerning internships, acting during the pandemic put students at risk, and their abbreviation prevented them from consolidating knowledge and skills.
Final Considerations:
remote teaching did not guarantee the quality and equality of teaching, weakened the development of skills, not taking into account nursing’s educational needs.
- Ailla Gabrielli Costa Silva
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ORIGINAL ARTICLE09-30-2024
Educational video for adherence to vaginal pessary in pelvic organ prolapse treatment
- Karine de Castro Bezerra ,
- Maria Luziene de Sousa Gomes ,
- Roger Rodrigues da Silva ,
- Dayana Maia Saboia ,
- José Ananias Vasconcelos Neto , [ … ],
- Mônica Oliveira Batista Oriá
Abstract
ORIGINAL ARTICLEEducational video for adherence to vaginal pessary in pelvic organ prolapse treatment
Revista Brasileira de Enfermagem. 2024;77:e20230515
DOI 10.1590/0034-7167-2023-0515
- Karine de Castro Bezerra ,
- Maria Luziene de Sousa Gomes ,
- Roger Rodrigues da Silva ,
- Dayana Maia Saboia ,
- José Ananias Vasconcelos Neto ,
- Camila Moreira Teixeira Vasconcelos ,
- Mônica Oliveira Batista Oriá
Views0ABSTRACT
Objectives:
to construct and assess an educational video to promote the adherence of women with pelvic organ prolapse to vaginal pessary use.
Methods:
this is a methodological study, with a longitudinal design and quantitative analysis. The pre-production (synopsis, argument, script, storyboard), production and post-production stages were covered. Content and technical assessments were carried out by judges from the health and communication areas, respectively, and appearance assessment by the target audience.
Results:
the video was the first to be developed on the topic on the national scene, considered assessed from the point of view of appearance and content, presenting an overall Content Validity Index of 0.99 and a level of agreement among judges of 91.1% to 100%. Assessment by the target audience reached a percentage of 96% to 100%.
Conclusions:
the educational video is an instrument capable of promoting adherence to pessary in women indicated for this therapeutic approach.
Keywords:Health CommunicationInstructional Film and VideoPelvic Organ ProlapsePessariesTreatment Adherence and ComplianceSee more
- Karine de Castro Bezerra
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EXPERIENCE REPORT09-30-2024
Health promotion of long-haul truck drivers and their families
Revista Brasileira de Enfermagem. 2024;77:e20230511
Abstract
EXPERIENCE REPORTHealth promotion of long-haul truck drivers and their families
Revista Brasileira de Enfermagem. 2024;77:e20230511
DOI 10.1590/0034-7167-2023-0511
Views0ABSTRACT
Objectives:
to describe the development of a Health Information and Communication Technology for the health care of long-haul truck drivers and their families.
Methods:
this is a description of the development of an Information and Communication Technology, developed from March to September 2023, following the systematization of the experience in five steps: 1) starting point, 2) initial questions, 3) recovery of the lived process, 4) background reflection, and 5) arrival points.
Results:
the technology called “Work-Family Balance,” electronically available, presents resources for the health care of long-haul truck drivers. It is anchored in studies on the health of long-haul truck drivers, notes from the International Labor Organization, the Strategic Action Plan for Confronting Chronic Diseases and Non-Communicable Diseases in Brazil, 2021-2030, and the Declaration by the International Association of Family Nursing.
Final Considerations:
the theoretical improvement of nursing can potentially improve the health care of long-haul truck drivers, prevent Chronic Non-Communicable Diseases, and promote work-life balance to achieve the goals of Agenda 2030.
Keywords:Family HealthInformation TechnologyNoncommunicable DiseasesSustainable DevelopmentWork-Life BalanceSee more
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ORIGINAL ARTICLE09-30-2024
Giving new meaning to the impact of touch in Shantala massage: mothers’ perceptions of maternal and child well-being
- Danton Matheus de Souza ,
- Letícia Sangali ,
- Fernanda Marçal Ferreira ,
- Samia Ahmad Ghandour ,
- Isabelle Cristina Nogueira da Silva , [ … ],
- Lisabelle Mariano Rossato
Abstract
ORIGINAL ARTICLEGiving new meaning to the impact of touch in Shantala massage: mothers’ perceptions of maternal and child well-being
Revista Brasileira de Enfermagem. 2024;77:e20240012
DOI 10.1590/0034-7167-2024-0012
- Danton Matheus de Souza ,
- Letícia Sangali ,
- Fernanda Marçal Ferreira ,
- Samia Ahmad Ghandour ,
- Isabelle Cristina Nogueira da Silva ,
- Lisabelle Mariano Rossato
Views0See moreABSTRACT
Objectives:
to understand maternal perceptions of maternal and child well-being based on Shantala massage and discuss its association with the third Sustainable Development Goal.
Methods:
a descriptive-exploratory study in the light of Symbolic Interactionism. Eight women, mothers of infants, participated in five online meetings to teach Shantala massage, collected in focus groups, between November and December 2021. The data was subjected to thematic content analysis and lexical analysis with IRAMUTEQ®.
Results:
two categories emerged, 1) Maternal perceptions of Shantala massage and its promotion of child well-being and 2) Maternal perceptions of Shantala massage and its impact on their well-being, interconnected with subcategories.
Final Considerations:
Shantala massage promoted mutual impacts on maternal and child well-being, working together to achieve the third Sustainable Development Goal.
- Danton Matheus de Souza
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ORIGINAL ARTICLE07-13-2020
Awareness raising workshop for nursing students on the elderly with Alzheimer’s disease: contributions to education
Revista Brasileira de Enfermagem. 2020;73:e20190021
Abstract
ORIGINAL ARTICLEAwareness raising workshop for nursing students on the elderly with Alzheimer’s disease: contributions to education
Revista Brasileira de Enfermagem. 2020;73:e20190021
DOI 10.1590/0034-7167-2019-0021
Views0See moreABSTRACT
Objective:
To describe the contribution of an awareness-raising workshop for nursing students on Alzheimer’s disease in the context of the elderly/family.
Methods:
Strategic action-research developed with 15 university students from the sixth to the eighth semester of Nursing at a university institution in the Rio Grande do Sul. The data collected through semi-structured interviews, before and after an awareness-raising workshop on Alzheimer’s disease in elderly/family, were subjected to thematic content analysis.
Results:
Six categories were identified that concern (Mis) perception of Alzheimer’s disease in the context of elderly/ family, from the characterization; risk factors; diagnosis; treatment of Alzheimer’s disease; from care to family members/caregivers; and care strategies for the elderly with Alzheimer’s disease.
Conclusion:
The awareness-raising workshop enabled the students to broaden and deepen the knowledge on the theme of Alzheimer’s disease in the elderly.
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ORIGINAL ARTICLE09-23-2022
Analysis of the concept of cardiovascular risk: contributions to nursing practice
- Nuno Damácio de Carvalho Félix ,
- Brenda Silva Cunha ,
- Maria Naiane Rolim Nascimento ,
- Douglas Vieira Braga ,
- Célida Juliana de Oliveira , [ … ],
- Maria Miriam Lima da Nóbrega
Abstract
ORIGINAL ARTICLEAnalysis of the concept of cardiovascular risk: contributions to nursing practice
Revista Brasileira de Enfermagem. 2022;75(4):e20210803
DOI 10.1590/0034-7167-2021-0803
- Nuno Damácio de Carvalho Félix ,
- Brenda Silva Cunha ,
- Maria Naiane Rolim Nascimento ,
- Douglas Vieira Braga ,
- Célida Juliana de Oliveira ,
- Marcos Antônio Gomes Brandão ,
- Alba Lucia Bottura Leite de Barros ,
- Maria Miriam Lima da Nóbrega
Views0See moreABSTRACT
Objectives:
to analyze the concept of cardiovascular risk to support nursing practice.
Methods:
this is an analysis to define the concept of cardiovascular risk, through the use of eight steps of Walker’s and Avant’s framework, using a literature review in indexed scientific journals.
Results:
cardiovascular risk is defined in a broad and original way as a context of health and nursing care that makes it possible to identify modifiable (cardiometabolic, behavioral, psychosocial, cultural and occupational) and non-modifiable (biological) risk factors for cardiovascular diseases that act as early and interrelated markers, of multiple and heterogeneous etiology, predisposing to cardiovascular vulnerability.
Conclusions:
with the analysis and definition of the concept of cardiovascular risk, we realized that it will be possible to base nursing practice, with implications in clinical practice for identifying and reducing risk factors for cardiovascular diseases, with nursing relevance in the care of these subjects.
- Nuno Damácio de Carvalho Félix
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REFLECTION11-11-2020
Children with special needs in health: challenges of the single health system in the 21st century
- Camilla Ferreira Catarino Barreiros ,
- Maria Auxiliadora de Souza Mendes Gomes ,
- Saint Clair do Santos Mendes Júnior
Abstract
REFLECTIONChildren with special needs in health: challenges of the single health system in the 21st century
Revista Brasileira de Enfermagem. 2020;73:e20190037
DOI 10.1590/0034-7167-2019-0037
- Camilla Ferreira Catarino Barreiros ,
- Maria Auxiliadora de Souza Mendes Gomes ,
- Saint Clair do Santos Mendes Júnior
Views0See moreABSTRACT
Objective:
Reflect on the gaps in the care of Children with Special Needs in Health that demand complex clinical care with dependence on technological support for the maintenance of life, in the Unified Health System.
Methods:
This is a reflection study based on recent policies and literature related to the theme.
Discussion:
Despite the advances achieved with the Unified Health System with regard to access to health services and the expansion of Primary Care, with the aim of reorienting health, it can be said that the health care model for CSHCN in Brazil is still centered on the hospital and medical knowledge.
Final considerations:
There are gaps in the policies for children aimed at the new paediatric profile, and little is discussed about its implications for the Unified Health System.
- Camilla Ferreira Catarino Barreiros
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ORIGINAL ARTICLE10-21-2019
Being an institutionalized elderly person: meaning of experiences based on Heidegger’s phenomenology
- Camila Calhau Andrade Reis ,
- Tânia Maria de Oliva Menezes ,
- Adriana Valéria da Silva Freitas ,
- Larissa Chaves Pedreira ,
- Raniele Araújo de Freitas , [ … ],
- Isabella Batista Pires
Abstract
ORIGINAL ARTICLEBeing an institutionalized elderly person: meaning of experiences based on Heidegger’s phenomenology
Revista Brasileira de Enfermagem. 2019;72(6):1632-1638
DOI 10.1590/0034-7167-2018-0763
- Camila Calhau Andrade Reis ,
- Tânia Maria de Oliva Menezes ,
- Adriana Valéria da Silva Freitas ,
- Larissa Chaves Pedreira ,
- Raniele Araújo de Freitas ,
- Isabella Batista Pires
Views0See moreABSTRACT
Objective:
Analyze the meaning of being an elderly person living in a long-term institution.
Method:
Qualitative study based on Martin Heidegger’s thought. Twelve phenomenological interviews were conducted with people aged over 60 years living in a long-term institution for the elderly in the city of Itabuna, Bahia, Brazil.
Results:
The units of meaning identified were: experience of progressive loss of autonomy and independence, perception of living in an institution as an inevitable circumstance; and being-with becoming being-alone/being-lonely. After the identification of ontic aspects and hermeneutical understanding, the unit of meaning was constructed: meaning of being an elderly person living in a long-term institution.
Final considerations:
The ontological needs referring to being an elderly person remain forgotten. As we are ontic and ontological, limited care to the ontic instance indicates deficiencies in institutionalization. Improvements are required to ensure the right to age with quality of life to this population.
- Camila Calhau Andrade Reis
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ORIGINAL ARTICLE09-21-2020
Adaptive problems arising out of the progenitor’s abandonment after Zika Congenital Syndrome
- Juliana Cristina Cruz Calazans ,
- Paula Daniella de Abreu ,
- Ednaldo Cavalcante de Araújo ,
- Francisca Márcia Pereira Linhares ,
- Cleide Maria Pontes , [ … ],
- Maria Gorete Lucena de Vasconcelos
Abstract
ORIGINAL ARTICLEAdaptive problems arising out of the progenitor’s abandonment after Zika Congenital Syndrome
Revista Brasileira de Enfermagem. 2020;73:e20190602
DOI 10.1590/0034-7167-2019-0602
- Juliana Cristina Cruz Calazans ,
- Paula Daniella de Abreu ,
- Ednaldo Cavalcante de Araújo ,
- Francisca Márcia Pereira Linhares ,
- Cleide Maria Pontes ,
- Ana Catarina Torres de Lacerda ,
- Maria Gorete Lucena de Vasconcelos
Views0See moreABSTRACT
Objective:
to reveal the adaptive problems of the woman abandoned by the child’s parent after Congenital Zika Syndrome, in the light of Roy’s Adaptation Model.
Method:
a qualitative, descriptive study, based on Roy’s Adaptation Model, developed with six women abandoned by their child’s parent after Zika Congenital Syndrome diagnosis, through interview and Content Analysis technique.
Results:
adaptive problems appeared in nutrition, activity, rest, and protection patterns, due to limitations in self-care; self-concept, related to dissatisfaction with body image and personal being; in the role of transition role, through difficulties in taking over new roles and in interdependence, related to changes in affective needs.
Final considerations:
the overload of care for children with Congenital Zika Syndrome, added to the challenges of the abandoned woman by her child’s parent, led to adaptive problems, showing their main difficulties of coping.
- Juliana Cristina Cruz Calazans
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REVIEW04-16-2021
Nursing assistance in patient care with external ventricular drain: a scoping review
- Victoria Tiyoko Moraes Sakamoto ,
- Tainara Wink Vieira ,
- Karin Viegas ,
- Carine Raquel Blatt ,
- Rita Catalina Aquino Caregnato
Abstract
REVIEWNursing assistance in patient care with external ventricular drain: a scoping review
Revista Brasileira de Enfermagem. 2021;74(2):e20190796
DOI 10.1590/0034-7167-2019-0796
- Victoria Tiyoko Moraes Sakamoto ,
- Tainara Wink Vieira ,
- Karin Viegas ,
- Carine Raquel Blatt ,
- Rita Catalina Aquino Caregnato
Views0See moreABSTRACT
Objectives:
to map the available evidence about nursing care aimed at adult patients using external ventricular drain.
Methods:
this is a review using the scoping review method.
Results:
Initially, 965 studies were identified and, after the eligibility criteria, a sample of 54 publications was obtained. Each of them was assessed according to GRADE, resulting in three studies with high quality; 14 with moderate quality; 32 with low quality; and five with very low quality. It was highlighted 20 nursing care subdivided into nine categories, namely: drainage system; bed positioning and mobilization; catheter care; monitoring of intracranial pressure; and medication administration.
Conclusions:
the scoping review made it possible to identify the main nursing care directed to adult patients undergoing placement of external ventricular drain from the evidence available to date.
- Victoria Tiyoko Moraes Sakamoto
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ORIGINAL ARTICLE10-21-2019
Multidisciplinary team actions of a Brazilian Psychosocial Care Center for Alcohol and Drugs
- Liana Longo Teixeira Lopes ,
- Mara Regina Santos da Silva ,
- Alessandro Marques dos Santos ,
- Jacqueline Flores de Oliveira
Abstract
ORIGINAL ARTICLEMultidisciplinary team actions of a Brazilian Psychosocial Care Center for Alcohol and Drugs
Revista Brasileira de Enfermagem. 2019;72(6):1624-1631
DOI 10.1590/0034-7167-2018-0760
- Liana Longo Teixeira Lopes ,
- Mara Regina Santos da Silva ,
- Alessandro Marques dos Santos ,
- Jacqueline Flores de Oliveira
Views0See moreABSTRACT
Objective:
to investigate the criteria used by health professionals to identify the phase of consumption of alcohol and drug users, and actions directed to their care.
Method:
a qualitative study developed with 14 professionals from a Brazilian Psychosocial Care Center for Alcohol and Drugs (Centro de Atenção Psicossocial Álcool e Drogas) based in the south of the country. Data were collected in June 2017 through semi-structured interviews and then submitted to thematic analysis.
Results:
the criteria used by the professionals were: periodicity of use; amount and type of drug used; repercussions of misuse; and place that the drug occupies in the person’s life. The actions developed were orientation and referral to support groups, therapeutic workshops and individual care.
Final considerations:
the chronic nature of alcohol/drug use/dependence requires specific care in each phase, and objective criteria to identify and intervene in early phases, aiming at the prevention of chemical dependence.
- Liana Longo Teixeira Lopes
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Resilience in elderly people: factors associated with sociodemographic and health conditions
Revista Brasileira de Enfermagem. 2021;74:e20200171
Abstract
Resilience in elderly people: factors associated with sociodemographic and health conditions
Revista Brasileira de Enfermagem. 2021;74:e20200171
DOI 10.1590/0034-7167-2020-0171
Views0See moreABSTRACT
Objective:
to describe the sociodemographic and health characteristics of elderly people, measure the score of total resilience and by sex and verify the association of sociodemographic and health variables with total resilience and by sex.
Methods:
this is a household survey with 808 elderly people, assessed by validated instruments. Student’s t test and multiple linear regression (p<0.05).
Results:
most were female, 60|-|79 years old. The total resilience score was 78.06, for men 81.53 and for women, 76.32. Total resilience was associated with males; positive self-perceived health; greater participation in Advanced Activities of Daily Living; fewer morbidities; absence of depressive symptoms. Among men and women, resilience was associated with greater participation in Advanced Activities of Daily Living and absence of depressive symptoms and, specifically, among women, positive self-perceived health.
Conclusion:
these results contribute to nursing care, aiming to encourage resilience.
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