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ORIGINAL ARTICLE10-06-2023
Perception of graduates about the education of Nursing Technicians
Revista Brasileira de Enfermagem. 2023;76(5):e20220325
Abstract
ORIGINAL ARTICLEPerception of graduates about the education of Nursing Technicians
Revista Brasileira de Enfermagem. 2023;76(5):e20220325
DOI 10.1590/0034-7167-2022-0325
Views0See moreABSTRACT
Objectives:
to interpret the perception of graduates from the nursing technician program on the learning process developed during their education.
Methods:
a qualitative study was conducted from March to September 2021, based on interviews with 20 graduates from a nursing technician program at a school in the Midwest of São Paulo, using thematic analysis and the NVivo tool.
Results:
the following themes were identified: traditional teaching methods, active learning strategies, valuing proactivity and experiences in professional practice.
Final Considerations:
according to the graduates, the teaching process is essentially based on traditional methods, although there are initiatives to implement active strategies and recognition of the importance of advancing student proactivity and practical experience.
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ORIGINAL ARTICLE10-06-2023
Nursing, history, and orthopedics in manuals (1875-1928)
- Bruna Moura Oliveira dos Santos
, - Claudia Labriola ,
- Sarah Goes Barreto da Silva Moreira ,
- Hugo Alberto Neves de Souza ,
- Fernando Porto
Abstract
ORIGINAL ARTICLENursing, history, and orthopedics in manuals (1875-1928)
Revista Brasileira de Enfermagem. 2023;76(5):e20220567
DOI 10.1590/0034-7167-2022-0567
- Bruna Moura Oliveira dos Santos ,
- Claudia Labriola ,
- Sarah Goes Barreto da Silva Moreira ,
- Hugo Alberto Neves de Souza ,
- Fernando Porto
Views0See moreABSTRACT
Objectives:
to discuss the content of manuals, with emphasis on orthopedics, in support of the development of nursing care culture.
Methods:
cultural-historical method articulated with document analysis technique. The sources were nursing manuals – Portuguese, French, English, and Spanish – from 1875 to 1928.
Results:
this study pointed to 12 works – 6 authored by physicians, 2 by nurses, 3 institutional, and 1 by a Sister of Charity – that presented, in a transversal way, the professionalization process initiated in Europe. The manuals addressed first aid care and immobilization methods, from the simplest, such as improvised splints, to the application of plaster casts.
Conclusions:
the nurses’ work, even in a limited capacity, showed that they were able to observe warning signs so that doctors could act, with some exceptions.
- Bruna Moura Oliveira dos Santos
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10-06-2023
Evidências do cuidado centrado no paciente no contexto da prática profissional de saúde brasileira
- Josiane Bernart da Silva Ferla ,
- Cristiano Miranda de Araujo ,
- Marcos Herrerias de Oliveira ,
- Luciana Branco Carnevale ,
- Ana Paula Berberian
Abstract
Evidências do cuidado centrado no paciente no contexto da prática profissional de saúde brasileira
Revista Brasileira de Enfermagem. 2023;76(5):e20220448
DOI 10.1590/0034-7167-2022-0448
- Josiane Bernart da Silva Ferla ,
- Cristiano Miranda de Araujo ,
- Marcos Herrerias de Oliveira ,
- Luciana Branco Carnevale ,
- Ana Paula Berberian
Views0See moreRESUMEN
Objetivos:
analizar las actitudes centradas en el paciente en el cuidado y compartir prácticas de profesionales de enfermería, logopedia, odontología y medicina.
Métodos:
se utilizó una investigación transversal con 411 profesionales, y como medida de resultado se aplicó el instrumento Patient-Practitioner Orientation Scale.
Resultados:
los médicos presentaron puntuaciones medias más altas, lo que refleja una orientación centrada en el paciente, control compartido y enfoque en la persona, con diferencia estadística para todos los dominios (p<0,02). Los odontólogos fueron los profesionales que presentaron puntajes más bajos, especialmente en el dominio compartir, con diferencia estadística en relación a los enfermeros, logopedas y médicos (p<0,05).
Conclusiones:
finalmente, las actitudes de los profesionales de las áreas de salud estudiadas indicaron preferencia autorreferida por la centralidad en los pacientes. En este contexto, el cuidado centrado en el paciente puede ser un recurso importante en el cuidado de la salud cuando se apuesta por la superación del objeto hombre.
- Josiane Bernart da Silva Ferla
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ORIGINAL ARTICLE10-06-2023
Learning strategies of undergraduate nursing students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(5):e20220764
Abstract
ORIGINAL ARTICLELearning strategies of undergraduate nursing students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(5):e20220764
DOI 10.1590/0034-7167-2022-0764
Views0See moreABSTRACT
Objectives:
to analyze the learning strategies used by nursing students from a public university, in remote teaching, during the COVID-19 pandemic.
Methods:
a cross-sectional study developed with nursing students who attended remote teaching classes. The sample was obtained by convenience and data were collected online, with 112 participants. Student and Mann-Whitney tests were performed for data analysis.
Results:
the most frequently used learning strategies were self-regulatory and cognitive. There was moderate use of interpersonal help-seeking and emotional control strategies. Male students, with a private study environment and good internet connection, used emotional control strategies more frequently.
Conclusions:
self-regulatory and cognitive learning strategies, appropriate for higher education, were frequently used by nursing students, which is an important tool for adapting these students to the university context.
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ORIGINAL ARTICLE10-06-2023
Patient-centered care – evidence in the context of professional health practice
- Josiane Bernart da Silva Ferla ,
- Cristiano Miranda de Araujo ,
- Marcos Herrerias de Oliveira ,
- Luciana Branco Carnevale ,
- Ana Paula Berberian
Abstract
ORIGINAL ARTICLEPatient-centered care – evidence in the context of professional health practice
Revista Brasileira de Enfermagem. 2023;76(5):e20220448
DOI 10.1590/0034-7167-2022-0448
- Josiane Bernart da Silva Ferla ,
- Cristiano Miranda de Araujo ,
- Marcos Herrerias de Oliveira ,
- Luciana Branco Carnevale ,
- Ana Paula Berberian
Views0ABSTRACT
Objectives:
to analyze patient-centered attitudes in care and sharing practices of nursing, speech therapy, dentistry and medicine professionals.
Methods:
cross-sectional research was used with 411 professionals, and the Patient-Practitioner Orientation Scale instrument was applied as a measure of outcome.
Results:
physicians presented higher mean scores, reflecting a patient-centered orientation, shared control, and focus on the person, with statistical difference for all domains (p<0.02). Dentists were the professionals who presented lower scores, especially in the sharing domain, with statistical difference in relation to nurses, speech therapists, and physicians (p<0.05).
Conclusions:
finally, the attitudes of professionals in the health areas studied indicated self-reported preference for centrality in patients. In this context, patient-centered care can be an important resource in health care when committed to overcoming the object man.
Keywords:Health Care ProfessionalHealth PersonnelPatient-Centered CarePerson Centered CareProfessional PracticeSee more
- Josiane Bernart da Silva Ferla
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10-06-2023
Advanced Practice Nursing: “Training” Pillar in Supporting the Proposal in Brazil
- Cristina Maria Garcia de Lima Parada ,
- Elisabete Pimenta Araujo Paz ,
- Lucia Yasuko Izumi Nichiata ,
- Dulce Aparecida Barbosa ,
- Luciane Kantorski
Abstract
Advanced Practice Nursing: “Training” Pillar in Supporting the Proposal in Brazil
Revista Brasileira de Enfermagem. 2023;76(5):e20230118
DOI 10.1590/0034-7167-2023-0118
- Cristina Maria Garcia de Lima Parada ,
- Elisabete Pimenta Araujo Paz ,
- Lucia Yasuko Izumi Nichiata ,
- Dulce Aparecida Barbosa ,
- Luciane Kantorski
Views0See moreABSTRACT
Objectives:
to present the pillars that support what has been called Advanced Practice Nursing and discuss the necessary training for its implementation.
Methods:
elements contained in assessment documents for graduate programs proposals, reports of presentations by international professors in countries and selected scientific publications were gathered to compose the argument.
Results:
practice/competency (adds broad and in-depth knowledge about health processes and scientific evidence, clinical reasoning and clinical skills for therapeutic indications); 3) professional regulation (corresponding legislation and monitoring); and 4) funding (broad training and professional practice policy).
Final Considerations:
the agenda for implementing Advanced Practice Nursing in Brazil involves joining efforts to identify stakeholders for a work to legitimize their importance in the country’s health and education overview.
- Cristina Maria Garcia de Lima Parada
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REVIEW10-06-2023
Nursing theories in the care of stroke patients: a scoping review
- Josefa Nayara de Lima ,
- Layane Ribeiro Lima ,
- Edilma Gomes Rocha Cavalcante ,
- Glauberto da Silva Quirino ,
- Woneska Rodrigues Pinheiro
Abstract
REVIEWNursing theories in the care of stroke patients: a scoping review
Revista Brasileira de Enfermagem. 2023;76(5):e20220791
DOI 10.1590/0034-7167-2022-0791
- Josefa Nayara de Lima ,
- Layane Ribeiro Lima ,
- Edilma Gomes Rocha Cavalcante ,
- Glauberto da Silva Quirino ,
- Woneska Rodrigues Pinheiro
Views0See moreABSTRACT
Objectives:
to map and synthesize nursing theories and conceptual frameworks that have been applied in the practice of nursing care for stroke patients in hospital settings.
Methods:
a scoping review was conducted in October 2022 using the MEDLINE (accessed via PubMed), CINAHL, Scielo, and Web of Science databases, following The Joanna Briggs Institute guidelines.
Results:
nine studies incorporated six nursing theories and three conceptual frameworks, which were employed to enhance stroke patient care. The objective of these theories and conceptual frameworks was to facilitate the identification of the patient’s psychobiological, psychosocial, and psychospiritual needs, elucidate the nurse’s role and expand their perspective on rehabilitation, and acknowledge the survivor’s process of transition.
Final Considerations:
this mapping exercise identified major nursing theories, middle-range theories, and conceptual frameworks applied to the care of stroke patients.
- Josefa Nayara de Lima
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ORIGINAL ARTICLE10-06-2023
Quality of health care in Primary Care: perspective of people with Diabetes Mellitus
- Rosilene Rocha Palasson ,
- Elisabete Pimenta Araújo Paz ,
- Gerson Luiz Marinho ,
- Luiz Felipe da Silva Pinto ,
- Elen Ferraz Teston , [ … ],
- Sonia Silva Marcon
Abstract
ORIGINAL ARTICLEQuality of health care in Primary Care: perspective of people with Diabetes Mellitus
Revista Brasileira de Enfermagem. 2023;76(5):e20230008
DOI 10.1590/0034-7167-2023-0008
- Rosilene Rocha Palasson ,
- Elisabete Pimenta Araújo Paz ,
- Gerson Luiz Marinho ,
- Luiz Felipe da Silva Pinto ,
- Elen Ferraz Teston ,
- Margareth de Almeida Gomes ,
- Maria Helena do Nascimento Souza ,
- Sonia Silva Marcon
Views0See moreABSTRACT
Objectives:
to identify how people with diabetes assess the care offered by Primary Care teams.
Methods:
a cross-sectional study based on structured interviews with the application of the Patient Assessment of Chronic Illness instrument to people with Type 2 Diabetes Mellitus. Data were submitted to statistical analysis.
Results:
451 individuals participated in the study, more than half aged 60 years or older (64.0%); 63.9% had been diagnosed for more than five years; and 23.9% used insulin. The average score obtained was 2.5, which indicated little involvement in self-care and low support for the care of the chronic condition by the Family Health Strategy team, and was higher among women and people with a partner.
Conclusions:
people with diabetes consider that they do not receive individualized treatment, with dialogue and discussion for setting goals, and that they are not prepared for self-managing their health condition.
- Rosilene Rocha Palasson
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ORIGINAL ARTICLE05-15-2020
Stress and quality of sleep in undergraduate nursing students
- Kézia Katiane Medeiros da Silva ,
- Milva Maria Figueiredo de Martino ,
- Clarissa Maria Bandeira Bezerra ,
- Ângela Monic Lima de Souza ,
- Danila Maria da Silva , [ … ],
- Jacqueline Targino Nunes
Abstract
ORIGINAL ARTICLEStress and quality of sleep in undergraduate nursing students
Revista Brasileira de Enfermagem. 2020;73:e20180227
DOI 10.1590/0034-7167-2018-0227
- Kézia Katiane Medeiros da Silva ,
- Milva Maria Figueiredo de Martino ,
- Clarissa Maria Bandeira Bezerra ,
- Ângela Monic Lima de Souza ,
- Danila Maria da Silva ,
- Jacqueline Targino Nunes
Views0See moreABSTRACT
Objective:
to analyze the level of stress and sleep quality in nursing students according to terms of the nursing program.
Method:
descriptive and cross-sectional research developed in a higher education institution in Northeastern Brazil on 167 students. We used data collection, sociodemographic information, and a scale for assessing stress and sleep quality in nursing students.
Results:
we identified a statistically significant difference between domains of the stress scale and the terms of the undergraduate program, and between the quality of sleep and such terms such as as in the fourth and sixth semesters.
Conclusion:
different stress scores show that the semester which concerns students the most is the fifth. Quality of sleep was deemed good for the first, third, fifth, seventh, and eighth semesters; and poor for the fourth and sixth terms.
- Kézia Katiane Medeiros da Silva
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ORIGINAL ARTICLE09-21-2020
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
Abstract
ORIGINAL ARTICLEClinical judgment and diagnostic reasoning of nursing students in clinical simulation
Revista Brasileira de Enfermagem. 2020;73(6):e20180878
DOI 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 ARTICLE12-05-2019
Quality of life of institutionalized aged with and without symptoms of depression
- Gerson Scherrer Júnior ,
- Meiry Fernanda Pinto Okuno ,
- Leticia Meazzini de Oliveira ,
- Dulce Aparecida Barbosa ,
- Angélica Castilho Alonso , [ … ],
- Angélica Gonçalves Silva Belasco
Abstract
ORIGINAL ARTICLEQuality of life of institutionalized aged with and without symptoms of depression
Revista Brasileira de Enfermagem. 2019;72:127-133
DOI 10.1590/0034-7167-2018-0316
- Gerson Scherrer Júnior ,
- Meiry Fernanda Pinto Okuno ,
- Leticia Meazzini de Oliveira ,
- Dulce Aparecida Barbosa ,
- Angélica Castilho Alonso ,
- Dayana Souza Fram ,
- Angélica Gonçalves Silva Belasco
Views0See moreABSTRACT
Objective:
compare the quality of life (QOL) of aged residents in homes for aged people with or without symptoms of depression, and identify social, physical activity; leisure; health and basic activities of daily living (ADL) variables that correlate with QOL scores.
Method:
cross-sectional study conducted with 101 institutionalized aged. Multiple linear regression was used for data analysis.
Results:
symptoms of depression changed negatively the QOL in the domains: autonomy; present, past and future activities; social participation; intimacy and total score. Dependent aged presented lower QOL for the performance of ADL in the domains: autonomy; social participation and total score; dancing without limitation of movement; liking the residential and not presenting symptoms of depression were the variables that positively influenced the QOL of the aged.
Conclusion:
social and psychological support, good living conditions and stimulating assistance can improve the QOL of institutionalized elderlies.
- Gerson Scherrer Júnior
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ORIGINAL ARTICLE07-08-2020
Spirituality and religiousity in the experience of suffering, guilt, and death of the elderly with cancer
- Raniele Araújo de Freitas ,
- Tânia Maria de Oliva Menezes ,
- Lucivalda Barbosa Santos ,
- Halanna Carneiro Guimarães Bastos Moura ,
- Marta Gabriele Santos Sales , [ … ],
- Fabiana Araújo Moreira
Abstract
ORIGINAL ARTICLESpirituality and religiousity in the experience of suffering, guilt, and death of the elderly with cancer
Revista Brasileira de Enfermagem. 2020;73:e20190034
DOI 10.1590/0034-7167-2019-0034
- Raniele Araújo de Freitas ,
- Tânia Maria de Oliva Menezes ,
- Lucivalda Barbosa Santos ,
- Halanna Carneiro Guimarães Bastos Moura ,
- Marta Gabriele Santos Sales ,
- Fabiana Araújo Moreira
Views0See moreABSTRACT
Objective:
to understand spirituality and religiosity in the experience of suffering, guilt, and death of the elderly with cancer.
Method:
qualitative research based on Viktor Frankl’s Existential Analysis. Twenty phenomenological interviews were conducted with people over 60 years old undergoing chemotherapy treatment at an oncology unit of a hospital in the city of Salvador, Bahia State, Brazil, between August and October 2018.
Results:
the following categories emerged: Experiences spirituality and religiosity in the face of the tragic triad and existential emptiness; Uses spirituality/religiosity as resilience strategies. After apprehension of ontic aspects, it was possible the ontological understanding of spirituality and religiosity in the face of suffering, guilt, and death experienced in the elderly with cancer’s daily life.
Final considerations:
spirituality and religiosity were understood as coping strategies used in the unstable experience of the elderly with cancer, providing comfort and resilience.
- Raniele Araújo de Freitas
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ORIGINAL ARTICLE02-10-2020
Mental health profile of the elderly community: a cross-sectional study
- Renata Cavalcanti Cordeiro ,
- Renata Clemente dos Santos ,
- Gleicy Karine Nascimento de Araújo ,
- Neyce de Matos Nascimento ,
- Rafaella Queiroga Souto , [ … ],
- Jeane da Silva Rocha Santos
Abstract
ORIGINAL ARTICLEMental health profile of the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73(1):e20180191
DOI 10.1590/0034-7167-2018-0191
- Renata Cavalcanti Cordeiro ,
- Renata Clemente dos Santos ,
- Gleicy Karine Nascimento de Araújo ,
- Neyce de Matos Nascimento ,
- Rafaella Queiroga Souto ,
- Albanita Gomes da Costa de Ceballos ,
- Fabia Alexandra Pottes Alves ,
- Jeane da Silva Rocha Santos
Views0See moreABSTRACT
Objective:
to describe the mental health profile of the elderly registered in a Family Health Unit in the city of Recife, Pernambuco State.
Method:
it was a descriptive quantitative study, conducted with 159 elderly through the scales Geriatric Depression, Resilience, Social Support, Life Satisfaction, and Positive and Negative Affects, Mini-Mental State Examination, Stressful Events Inventory and Brazil Old Age Shedule.
Results:
females, young and literate elderly predominated. Most were satisfied with life, 52.2% without depressive symptoms, 68.6% without cognitive impairment, 67.9% high resilience and 95.8% high social support, but 62% of elderly with depressive symptoms showed cognitive deficit. Negative correlation was identified between depression and cognitive impairment, resilience, social support and life satisfaction.
Conclusion:
assessment of these indicators identifies triggers of psychological distress, assisting the nursing staff in the development of preventive and care actions.
- Renata Cavalcanti Cordeiro
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EXPERIENCE REPORT10-26-2020
Collaborative practices from health care teams to face the covid-19 pandemic
- Adriano da Costa Belarmino ,
- Maria Eunice Nogueira Galeno Rodrigues ,
- Saiwori de Jesus Silva Bezerra dos Anjos ,
- Antonio Rodrigues Ferreira Júnior
Abstract
EXPERIENCE REPORTCollaborative practices from health care teams to face the covid-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200470
DOI 10.1590/0034-7167-2020-0470
- Adriano da Costa Belarmino ,
- Maria Eunice Nogueira Galeno Rodrigues ,
- Saiwori de Jesus Silva Bezerra dos Anjos ,
- Antonio Rodrigues Ferreira Júnior
Views0See moreABSTRACT
Objective:
To report the experience of collaborative practices facing the COVID-19 pandemic.
Methods:
This is a report about the experience of collaborative practices conducted by health care teams in emergency service in the Emergency Care Units facing of COVID-19 pandemic in the city of Fortaleza, State of Ceará, in the first semester of 2020.
Results:
Collaborative actions, cooperation and effective communication among nursing and medical team contribute to the management of mild and complex cases of COVID-19, as well as qualify them in suitable and necessary care and confrontation measures.
Final considerations:
The report shows the need for collaborative practices to minimize negative effects on the population in the face of the new coronavirus pandemic.
- Adriano da Costa Belarmino
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ORIGINAL ARTICLE11-25-2020
Family experiences in discovering Autism Spectrum Disorder: implications for family nursing
- Tassia de Arruda Bonfim ,
- Bianca Cristina Ciccone Giacon-Arruda ,
- Catchia Hermes-Uliana ,
- Sueli Aparecida Frari Galera ,
- Maria Angélica Marcheti
Abstract
ORIGINAL ARTICLEFamily experiences in discovering Autism Spectrum Disorder: implications for family nursing
Revista Brasileira de Enfermagem. 2020;73:e20190489
DOI 10.1590/0034-7167-2019-0489
- Tassia de Arruda Bonfim ,
- Bianca Cristina Ciccone Giacon-Arruda ,
- Catchia Hermes-Uliana ,
- Sueli Aparecida Frari Galera ,
- Maria Angélica Marcheti
Views0See moreabstract
Objectives:
to describe the family’s experience in the process of discovering the diagnosis and initiation of treatment of children with Autism Spectrum Disorder.
Methods:
this qualitative and descriptive study interviewed nine relatives of eight children on autism spectrum. They were inserted in health services, public education, and Association of Parents and Friends of The Exceptional of cities in the countryside of the Center-West. Data were collected through open interviews from July to September 2017. Data was submitted to thematic analysis.
Results:
at the beginning, the family was difficult to perceive the first atypical signs presented by the children. Families experience situations of vulnerability, since support networks are insufficient. The school played a significant role in recognizing unexpected behaviors.
Final Considerations:
support, offered by nurses, health professionals, school and social support devices, is important to family and children in this trajectory.
- Tassia de Arruda Bonfim
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ORIGINAL ARTICLE10-21-2019
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
Abstract
ORIGINAL ARTICLENurses defending the autonomy of the elderly at the end of life
Revista Brasileira de Enfermagem. 2019;72(6):1639-1645
DOI 10.1590/0034-7167-2018-0768
- Rafael Barroso Gaspar ,
- Marcelle Miranda da Silva ,
- Karen Gisela Moraes Zepeda ,
- Ítalo Rodolfo Silva
Views1See 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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