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RESEARCH01-01-2016
Leads for potentializing groups in Primary Health Care
Revista Brasileira de Enfermagem. 2016;69(5):964-971
Abstract
RESEARCHLeads for potentializing groups in Primary Health Care
Revista Brasileira de Enfermagem. 2016;69(5):964-971
DOI 10.1590/0034-7167-2015-0102
Views0ABSTRACT
Objective:
to analyze the aspects that potentialize groups in Primary Health Care according to their coordinators and participants.
Method:
This is a descriptive study with a qualitative approach, conducted with a health promotion group affiliated with a Family Health Unit. The data were collected by means of focus groups with participants and community workers who were submitted to thematic content analysis.
Results:
the analysis gave rise to three thematic categories: The group is our medicine; Healthy living and learning; and Priceless leadership.
Conclusion:
the leads identified during the study were as follows: group organization involves investment in motivation and leadership by the coordinators; production of grouping and cohesion is a result of participants and coordinators meeting together, interspersed with dialog, things said and left unsaid that the subjects expressed in the group dynamic; the sense of belonging guarantees their placement in the group based on the recognition of their knowledge and affective, social and health needs.
Keywords:Group ProcessesGroup StructureHealth PromotionNursing in Community HealthPrimary Health CareSee more -
RESEARCH01-01-2016
Intimate partner violence in adolescence: an analysis of gender and generation
Revista Brasileira de Enfermagem. 2016;69(5):946-955
Abstract
RESEARCHIntimate partner violence in adolescence: an analysis of gender and generation
Revista Brasileira de Enfermagem. 2016;69(5):946-955
DOI 10.1590/0034-7167-2016-0408
Views0ABSTRACT
Objective:
to analyze the intimate partner violence in adolescence from the perspective of gender and generation.
Method:
Quantitative, descriptive, and exploratory research. 111 adolescents participated in this study, with ages from 15 to 19 years old.
Results:
We found that 91% of participants have perpetrated and 90.1% have undergone at least one of the natures of violence. The intimate partner violence in adolescence constitutes a form of gender violence, and gender constructions have determined the suffered and perpetrated aggressions, possibly also determining the naturalization and legitimization of such aggressions. The inequality of power between generations may determine greater vulnerability of youngsters to the phenomenon.
Conclusion:
The historical and social construction of masculinity and femininity and the power inequalities set by these constructions converge with the power inequality between generations. Thus, gender and generation are determinants of intimate partner violence in adolescence, as well as of the vulnerability of adolescents to this phenomenon.
Keywords:AdolescentAdolescent HealthGender and HealthIntimate Partner ViolenceViolence Against WomenSee more -
RESEARCH01-01-2016
Hospitalization anxiety in children: conceptual analysis
Revista Brasileira de Enfermagem. 2016;69(5):940-945
Abstract
RESEARCHHospitalization anxiety in children: conceptual analysis
Revista Brasileira de Enfermagem. 2016;69(5):940-945
DOI 10.1590/0034-7167-2015-0116
Views0See moreABSTRACT
Objective:
to analyze the concept “hospitalization anxiety in children”, identifying its antecedents, attributes, and consequences, with the objective of clarifying its meaning.
Method:
we used a conceptual analysis model, whose objective is to clarify the meaning of terms.
Results:
we identified the concept antecedents and its attributes, classified as biological and psychological needs, which are essential characteristics of “hospitalization anxiety in children”. This process consequences have also been identified. We proceeded to the analysis of the characteristics with emphasis on the impacts of the hospitalization process on the child and on the family.
Conclusion:
based on the conceptual analysis of the phenomenon, it was possible to identify the antecedents, attributes, and consequences of Hospitalization Anxiety in children. We recommend the continuation of the study validating the essential characteristics presently identified as a way to join knowledge gathered and professional practice.
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RESEARCH01-01-2016
Stroke: patient characteristics and quality of life of caregivers
Revista Brasileira de Enfermagem. 2016;69(5):933-939
Abstract
RESEARCHStroke: patient characteristics and quality of life of caregivers
Revista Brasileira de Enfermagem. 2016;69(5):933-939
DOI 10.1590/0034-7167-2015-0064
Views0See moreABSTRACT
Objective:
to investigate the association between the domains of health-related quality of life of family caregivers and sociodemographic characteristics of individuals with stroke sequelae.
Method:
descriptive, cross-sectional, quantitative research, conducted with 136 family caregivers of individuals with stroke sequelae by means of home interviews from April to June 2013.
Results:
we found that caregivers of individuals aged under 65 years, married, with 10 to 12 years of formal education, presented higher scores, respectively, in the domains ‘Social aspects’, ‘Emotional aspects’, and ‘Mental health’. However, caregivers of patients with higher degree of disability obtained lower score in the ‘Mental Health’ domain.
Conclusion:
the results foster reflection on the need of including the family caregivers of individuals with stroke sequelae in the planning of care provided by health professionals.
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RESEARCH01-01-2016
A quasi-experimental nursing study on pain in comatose patients
Revista Brasileira de Enfermagem. 2016;69(5):927-932
Abstract
RESEARCHA quasi-experimental nursing study on pain in comatose patients
Revista Brasileira de Enfermagem. 2016;69(5):927-932
DOI 10.1590/0034-7167-2015-0121
Views0See moreABSTRACT
Objective:
to verify whether comatose patients feel pain during the bed bath nursing procedure.
Method:
nineteen patients aged 61 ± 17.39 years participated in the study. A quantitative analysis was conducted on the P substance (PS) in the saliva collected before and during a bed bath, using the ELISA method. Program Graph Pad Prisma 6 was used to analyze the data. The verification of normality was made through the Shapiro Wilk test, which determined the choice for the Wilcoxon nonparametric test.
Results:
the study showed a statistically significant increase (∆= 5.62%, p<0.001) in the PS level of the patients studied during the nursing procedure.
Conclusion:
when caring for comatose patients during a bed bath, professionals cause or add painful stimuli; therefore, they feel pain.
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RESEARCH01-01-2016
Quality of nursing care: instrument development and validation
Revista Brasileira de Enfermagem. 2016;69(5):920-926
Abstract
RESEARCHQuality of nursing care: instrument development and validation
Revista Brasileira de Enfermagem. 2016;69(5):920-926
DOI 10.1590/0034-7167-2015-0151
Views0See moreABSTRACT
Objectives:
to describe the development and validation process of a scale to measure the nurses’ perception of the activities that contribute to nursing care quality.
Method:
methodological study based on a literature review, the opinion of experts and the experience of study investigators. An instrument was designed containing six dimensions and 25 items, applied as a questionnaire to 775 nurses from a hospital in northern Portugal, from May to July 2014. The instrument validation used an exploratory factor analysis and an internal consistency assessment of each factor/dimension.
Results:
the factor analysis indicated the need to adjust the original composition of the scale, which then received one more dimension, totaling seven dimensions and the same 25 items, and presented a high internal consistency (Cronbach’s alpha of 0.940).
Conclusion:
the final version of the scale presents adequate psychometric properties, with potential use in future studies.
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ORIGINAL ARTICLE12-04-2023
30-Year High Cardiovascular Risk Incidence and its Determinants: CUME Study
Revista Brasileira de Enfermagem. 2023;76(6):e20220544
Abstract
ORIGINAL ARTICLE30-Year High Cardiovascular Risk Incidence and its Determinants: CUME Study
Revista Brasileira de Enfermagem. 2023;76(6):e20220544
DOI 10.1590/0034-7167-2022-0544
Views0See moreABSTRACT
Objective:
Estimate the incidence of the 30-year high cardiovascular risk and its determinants among graduates of federal universities in Minas Gerais.
Methods:
This is a prospective cohort of 2,854 adults aged 20 to 59. The incidence of the outcome was calculated using the Framingham equation and its determinants were determined through multivariate Cox regression.
Results:
After an average of 2.62 years, the incidence of high cardiovascular risk was 8.09 and 20.1 cases per 1,000 person-years, for females and males respectively. Being male (HR: 2.34; 95% CI: 1.58 – 3.46), employment (HR: 2.13; 95% CI: 1.13 – 3.99), high consumption of processed foods (HR: 2.44; 95% CI: 1.21 – 4.90), and being physically active (HR: 0.63; 95% CI: 0.41 – 0.98) were associated with high cardiovascular risk.
Conclusions:
Among highly educated adults, being male, employment, and high consumption of processed foods are predictors of high cardiovascular risk, while being physically active acts as a protective factor.
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ORIGINAL ARTICLE12-04-2023
“Fala-M@no-COVID-19”: technological development of a health navigation program for men during the pandemic
Revista Brasileira de Enfermagem. 2023;76(6):e20220534
Abstract
ORIGINAL ARTICLE“Fala-M@no-COVID-19”: technological development of a health navigation program for men during the pandemic
Revista Brasileira de Enfermagem. 2023;76(6):e20220534
DOI 10.1590/0034-7167-2022-0534
Views0See moreABSTRACT
Objective:
to develop a care-educational technology similar to a health navigation program for men during the COVID-19 pandemic.
Methods:
a methodological and qualitative study of a care-educational technology of health navigation program, structured by Program Development Cycle, with 16 patient navigators and 10 professional navigators. It used reflective thematic content analysis and an adaptation model for data processing.
Results:
the ; navigation program was developed by: I) Observation of reality, problem mapping, needs assessment: content selection, creation of domains and questions; II) Theoretical-conceptual and methodological definition, creation of product under the elaboration of care plans, based on theory, process and taxonomies by a flowchart of operationalization of actions; and III) Self-assessment: qualitative research with professional navigators.
Final considerations:
the technology developed, with theoretical and methodological support, allowed to derive a viable navigation program compatible with reality based on the audience’s needs.
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The Medical Healing of Souls: a strategy for welcoming post-pandemic mental health
Revista Brasileira de Enfermagem. 2023;76(6):e20220331
Abstract
The Medical Healing of Souls: a strategy for welcoming post-pandemic mental health
Revista Brasileira de Enfermagem. 2023;76(6):e20220331
DOI 10.1590/0034-7167-2022-0331
Views0See moreABSTRACT
Objective:
to reflect on the applicability of the Medical Healing of Souls (MHS) by health professionals as a welcoming strategy in post-pandemic mental health.
Methods:
a theoretical and reflective study, based on Viktor Frankl’s philosophy, based on the book “The Doctor and the Soul, From Psychotherapy to Logotherapy” and scientific literature.
Results:
the study was structured in two discursive approaches: MHS in the field of health; The applicability of MHS in post-pandemic mental health care.
Final considerations:
MHS can be used in mental health care, in health emergencies, promoting a more humane performance of health professionals, facilitating the integration of inevitable suffering into a meaningful life.
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ORIGINAL ARTICLE12-04-2023
Translation, cross-cultural adaptation and validity study of the “Play Nicely Program: The Healthy Discipline Handbook” for use in Brazil
Revista Brasileira de Enfermagem. 2023;76(6):e20220281
Abstract
ORIGINAL ARTICLETranslation, cross-cultural adaptation and validity study of the “Play Nicely Program: The Healthy Discipline Handbook” for use in Brazil
Revista Brasileira de Enfermagem. 2023;76(6):e20220281
DOI 10.1590/0034-7167-2022-0281
Views0See moreABSTRACT
Objective:
to describe the translation, cross-cultural adaptation and validity process of the “Play Nicely Program: The Healthy Discipline Handbook” for use in Brazil.
Methods:
a methodological study that followed the translation, back-translation, expert committee assessment, and pre-test steps. The Content Validity Index (CVI) was calculated for both the judge population and the pre-test population. Four translators, seven expert judges in the field of child health and thirty participants in the pre-test, including parents, teachers and healthcare professionals, participated in the study.
Results:
in experts’ analysis (98.4%), a value of 100% of adequate assessments was obtained, and in the target population’s analysis (89.5%), there were 100% of adequate assessments. In both analyses, suggested adaptations were made.
Conclusios:
cross-cultural adaptation and content validity into Brazilian Portuguese of the “Play Nicely Program: The Healthy Discipline Handbook” were considered adequate for application in the target population.
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ORIGINAL ARTICLE12-04-2023
Emergency units and COVID-19: Burnout, and empathy reported by nursing professionals and perceived by patients
Revista Brasileira de Enfermagem. 2023;76(6):e20210869
Abstract
ORIGINAL ARTICLEEmergency units and COVID-19: Burnout, and empathy reported by nursing professionals and perceived by patients
Revista Brasileira de Enfermagem. 2023;76(6):e20210869
DOI 10.1590/0034-7167-2021-0869
Views0See moreABSTRACT
Objective:
To investigate Burnout Syndrome and empathy self-reported by the nursing staff and empathy perceived by the patient.
Method:
Cross-sectional study in a public emergency unit in São Paulo (from October/2020 to March/2021). The nursing staff answered the Maslach Burnout Inventory and the Consultation and Relational Empathy Measure-Nurses (Brazilian version), whereas adult patients answered the Consultation and Relational Empathy Measure (Brazilian version). Descriptive and inferential analysis, with a 5% significance level.
Results:
A total of 92 professionals and 271 patients participated. Most professionals reported impact of COVID-19 (80; 86.96%) and, among them, increased Burnout Syndrome (93; 75%), but with low emotional exhaustion (71; 74%), low depersonalization (59; 78%) and high level of professional accomplishment (72; 83%). Most reported impact and increased empathy, and the results reported by professionals and patients (mean and standard deviation) were: 39.89 (6.44) and 38.25 (9.45), respectively.
Conclusion:
The professionals reported a low level of Burnout Syndrome and a high level of empathy in pandemic.
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ERRATUM11-27-2023
ERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e05
DOI 10.1590/0034-7167.20237605e05
Views0In the article “Performance of Family Health Strategy Nurses in LGBT+ Healthcare”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(4): e20220514, authored:Where it read:[…]See more -
ORIGINAL ARTICLE11-27-2023
Mental suffering in family daily life: a temporal journey according to Merleau-Ponty
Revista Brasileira de Enfermagem. 2023;76(5):e20230258
Abstract
ORIGINAL ARTICLEMental suffering in family daily life: a temporal journey according to Merleau-Ponty
Revista Brasileira de Enfermagem. 2023;76(5):e20230258
DOI 10.1590/0034-7167-2023-0258
Views0See moreABSTRACT
Objectives:
to describe the family’s experience in relation to daily life with a family member experiencing mental suffering.
Methods:
a qualitative, descriptive, phenomenological study grounded in Merleau-Ponty’s ontology of experience was conducted in ten households in a city in the state of Bahia, Brazil, where 24 participants of the Intersubjectivity Wheels reside. The descriptions produced were subjected to the Ambiguity Analytics technique.
Results:
the descriptions were categorized into: absence as a creative power of the sense of “being” and “not being a family”; and exclusion and acceptance as expressions of mental suffering in the family context.
Final Considerations:
the experience of mental suffering in the family’s daily life is marked by ambiguous feelings, such as joy and sadness, disappointment and satisfaction, lack of love and love. However, experiencing these feelings can mobilize the desire to “become” a family, increase the sense of autonomy and independence, and drive the formation of new family configurations.
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ORIGINAL ARTICLE11-22-2024
Temporal trends in neonatal mortality in Pernambuco
Revista Brasileira de Enfermagem. 2024;77(4):e20230451
Abstract
ORIGINAL ARTICLETemporal trends in neonatal mortality in Pernambuco
Revista Brasileira de Enfermagem. 2024;77(4):e20230451
DOI 10.1590/0034-7167-2023-0451
Views0See moreABSTRACT
Objective:
To verify the temporal trend of neonatal mortality in the health regions of Pernambuco between 2000 and 2020.
Method:
A time-series ecological study was conducted, analyzing the total neonatal mortality rate and its early and late components. For regression analysis, Joinpoint Regression was applied, trends were classified, and annual and average percentage changes were calculated for the period, with a significance level of 95%.
Results:
The average neonatal mortality rate in Pernambuco was 11.5 during the studied period. A decreasing trend in neonatal mortality rate was observed, especially in the early component. The region where the state capital is located showed the fastest decrease across all components.
Conclusion:
The temporal trend of neonatal mortality was decreasing; however, the rate of reduction was not uniform across the health regions of the state, and the implementation of the Mãe Coruja Pernambucana Program did not impact the trend in neonatal mortality.
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ORIGINAL ARTICLE11-22-2024
Evaluation of a video to promote HIV testing in sexual minorities
Revista Brasileira de Enfermagem. 2024;77(4):e20230320
Abstract
ORIGINAL ARTICLEEvaluation of a video to promote HIV testing in sexual minorities
Revista Brasileira de Enfermagem. 2024;77(4):e20230320
DOI 10.1590/0034-7167-2023-0320
Views0ABSTRACT
Objective:
To design and evaluate an educational video aimed at promoting HIV testing in gay men from the theoretical perspective of the Nola J. Pender Health Promotion Model.
Methods:
The design comprised five steps: 1.- Literature search; 2.- Formulation of the educational objective; 3.- Drafting of the script and location of the information in the theoretical components; 4.- Production; and 5.- Evaluation by experts and the target population.
Results:
The video “Living Without Fear” was produced, which presents the dilemma faced by gay men before taking a HIV test. The content validity index was 0.85, which indicated that the information was adequate and acceptable for promoting the rapid HIV test.
Final Considerations:
The results contribute to the scientific evidence aimed at promoting healthy behavior. In addition, the video was shown to be an acceptable educational tool.
Keywords:Audiovisual ResourcesHIV TestingInstructional Film and VideoSexual and Gender MinoritiesValidation StudySee more -
ORIGINAL ARTICLE11-22-2024
Development and validity of a mobile application prototype for hospital shift handover
Revista Brasileira de Enfermagem. 2024;77(4):e20230173
Abstract
ORIGINAL ARTICLEDevelopment and validity of a mobile application prototype for hospital shift handover
Revista Brasileira de Enfermagem. 2024;77(4):e20230173
DOI 10.1590/0034-7167-2023-0173
Views0ABSTRACT
Objective:
To develop and validate a mobile application prototype for nursing shift handover in a hospital inpatient unit.
Methods:
A methodological study of technological production, carried out from April 2020 to January 2022, for mobile application construction and validity through the Design Thinking methodology. The study involved the stages of prototype development and validity by experts.
Results:
The application for mobile nursing shift handover obtained a usability score of 79 points and a content validity coefficient of 0.7.
Conclusions:
The instrument obtained an excellent assessment according to usability and agreement among experts. However, future studies are needed to implement this technology in order to assess effectiveness, time optimization and failures during communication.
Keywords:Health Information ExchangeHealth TechnologyHospitalizationMobile ApplicationsSoftware ValidationSee more -
ORIGINAL ARTICLE10-25-2024
Analysis of the vaccination situation against Mpox in people living with HIV/AIDS: an ecological study
Revista Brasileira de Enfermagem. 2024;77(5):e20230234
Abstract
ORIGINAL ARTICLEAnalysis of the vaccination situation against Mpox in people living with HIV/AIDS: an ecological study
Revista Brasileira de Enfermagem. 2024;77(5):e20230234
DOI 10.1590/0034-7167-2023-0234
Views0See moreABSTRACT
Objectives:
to analyze the vaccination situation against Mpox in people living with HIV/AIDS in Brazil.
Methods:
an ecological study on the vaccination status against Mpox in people living with HIV/AIDS (PLWHA) in Brazil. The data were collected in April 2023 through information from the Ministry of Health, using the “Microsoft app Power BI,” which is publicly accessible.
Results:
the data analysis revealed that in Brazil, 2,978 doses of the MVA-BN Jynneos Mpox vaccine were administered in PLWHA, resulting in a vaccination coverage of 18.3%, with the southern and southeastern regions showing the lowest and highest vaccination coverage, respectively. Gender-based evaluation showed a higher proportion of vaccinated males.
Conclusions:
we identified low vaccination coverage in all regions of Brazil, highlighting the need for intensified vaccination activities, especially for PLWHA.
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ORIGINAL ARTICLE10-11-2024
Indigenous women’s experiences about the pregnancy-puerperal cycle
Revista Brasileira de Enfermagem. 2024;77:e20230410
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
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.
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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
Indicators of emotional distress and mindfulness in undergraduate students: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(5):e20230499
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
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.
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ORIGINAL ARTICLE10-07-2024
Development and validation of a mobile application prototype for postoperative cardiac surgery
Revista Brasileira de Enfermagem. 2024;77(5):e20230491
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
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.
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