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ORIGINAL ARTICLE09-20-2024
Predictor variables effect on the development of Burnout Syndrome in higher education professor
Revista Brasileira de Enfermagem. 2024;77(4):e20240132
Abstract
ORIGINAL ARTICLEPredictor variables effect on the development of Burnout Syndrome in higher education professor
Revista Brasileira de Enfermagem. 2024;77(4):e20240132
DOI 10.1590/0034-7167-2024-0132
Views0See moreABSTRACT
Objectives:
to correlate the development of Burnout Syndrome in higher education professors with the following variables: sociodemographic, economic, work, sleep pattern, level of anxiety and quality of life.
Methods:
observational, analytical, cross-sectional study with a quantitative approach. Data collection took place from August to November 2022, with 140 professors from a private higher education institution in the Western Brazilian Amazon.
Results:
professors who carried out activities outside institutional hours and who had sleep duration < 5 hours, presented lower scores in the personal fulfillment dimension of burnout, with (p=0.002) and (p=0.001), respectively. The higher the scores for the physical (p=0.001), psychological (p=0.000) and social relationships (p=0.002) domains of quality of life, the lower the personal fulfillment scores for the syndrome.
Conclusions:
through linear regression, it was evidenced that several variables explain the development of burnout. Institutional and governmental actions can minimize the negative influence of these variables.
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ORIGINAL ARTICLE09-20-2024
Construction and enhancement of a prototype for a medical-hospital equipment for hypodermoclysis: a qualitative study
Revista Brasileira de Enfermagem. 2024;77(4):e20240059
Abstract
ORIGINAL ARTICLEConstruction and enhancement of a prototype for a medical-hospital equipment for hypodermoclysis: a qualitative study
Revista Brasileira de Enfermagem. 2024;77(4):e20240059
DOI 10.1590/0034-7167-2024-0059
Views0See moreABSTRACT
Objectives:
to construct a Subcutaneous Hydration Device semi-functional prototype and gather initial information to improve this prototype design and realize its acceptance potential.
Methods:
a qualitative, descriptive and exploratory study, which used focus group, following the Technology Acceptance Model. The group was held at the Escola Superior de Enfermagem de Coimbra, Portugal, in December 2022, composed of nine participants from six different disciplinary areas, and followed thematic analysis.
Results:
four topics emerged associated with the device components: elastomeric infusion pump; needle/access device; clamp; administration set. From these topics, topics were triggered that highlighted: characteristics about the target population; ease of use and accessories; patient comfort and safety; and device application context.
Final Considerations:
the Subcutaneous Hydration Device semi-functional prototype is viable and interesting for the clinic. The results support its improvement and direct future investments for experimental studies.
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REVIEW09-20-2024
Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study
Revista Brasileira de Enfermagem. 2024;77(4):e20230520
Abstract
REVIEWBrazilian nursing specific situation, middle and micro-range theories: a bibliometric study
Revista Brasileira de Enfermagem. 2024;77(4):e20230520
DOI 10.1590/0034-7167-2023-0520
Views0See moreABSTRACT
Objectives:
to map the nursing theories developed in stricto sensu graduate programs in nursing in Brazil.
Methods:
a bibliometric study, carried out on the Coordination for the Improvement of Higher Education Personnel Theses and Dissertations Portal in October 2023. The controlled descriptors “Nursing Theory” and “Nursing Models” and the uncontrolled descriptors “Theories” and “Middle-Range Theory” were used. Selected studies were cataloged for analysis, which was conducted by the study authors, who have a doctoral degree and expertise in research on nursing theories.
Results:
thirty-nine nursing theories were mapped, with a predominance of middle-range theories (79.5%), focusing on nursing diagnostic concepts and use of the theoretical-methodology strategy of theoretical-causal validity.
Conclusions:
the study identified nursing theories developed in Brazil, recognizing trends, development strategies, theorized objects of disciplinary interest and investments necessary for practical application in Brazilian contexts.
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ORIGINAL ARTICLE09-20-2024
Cross-cultural adaptation and validation of the Healthy Work Environment Assessment Tool in Brazilian culture
Revista Brasileira de Enfermagem. 2024;77(4):e20230505
Abstract
ORIGINAL ARTICLECross-cultural adaptation and validation of the Healthy Work Environment Assessment Tool in Brazilian culture
Revista Brasileira de Enfermagem. 2024;77(4):e20230505
DOI 10.1590/0034-7167-2023-0505
Views0ABSTRACT
Objectives:
to adapt and validate the content of the Healthy Work Environment Assessment Tool for Brazilian culture, and evaluate the practical aspects of its application.
Methods:
methodological study that followed six stages: translation; synthesis; back translation; content validation by a group of experts, pre-testing and approval of the process by the author of the original instrument.
Results:
the first three stages were carried out by contracted companies. In the committee, two items and the title of a subscale were evaluated in a second round, when consensus was reached among experts. In the pre-test, more than 93% of professionals agreed that the tool was easy to understand. The average completion time was 8.53 minutes. The American Association of Critical-Care Nurses authorized publication of the results.
Conclusions:
the adaptation of the tool to Brazilian culture was completed following the adopted framework. In addition to the evidence of content validity, the tool appears promising for managerial use.
Keywords:Cross-Cultural ComparisonHealth Facility EnvironmentTranslatingValidation StudyWorking ConditionsSee more -
ORIGINAL ARTICLE09-20-2024
Construction and validation of a checklist for the management of totally implanted catheters in children
Revista Brasileira de Enfermagem. 2024;77(4):e20230447
Abstract
ORIGINAL ARTICLEConstruction and validation of a checklist for the management of totally implanted catheters in children
Revista Brasileira de Enfermagem. 2024;77(4):e20230447
DOI 10.1590/0034-7167-2023-0447
Views0See moreABSTRACT
Objectives:
to construct and validate the content of a checklist for the management of totally implanted catheters in hospitalized children and adolescents.
Methods:
methodological research conducted from October 2021 to December 2022 in two stages: development of the instrument with care guidelines and content validation of the checklist. The instrument, containing 23 items presented in Likert format, was evaluated online by specialists in two rounds. The Content Validity Index was applied, considering indices above 0.8 as valid.
Results:
the final checklist included four domains and 22 checklist items, validated with a Content Validity Index of 0.98. The overall evaluation of the instrument presented a global score of 9.9.
Conclusions:
the validation and application of instruments that standardize procedures, in addition to supporting professionals, promote autonomy and quality of care for children and adolescents using this device.
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ORIGINAL ARTICLE09-20-2024
Transgender people’s knowledge about the adverse effects of cross-hormonization: challenges for nursing
Revista Brasileira de Enfermagem. 2024;77(4):e20230346
Abstract
ORIGINAL ARTICLETransgender people’s knowledge about the adverse effects of cross-hormonization: challenges for nursing
Revista Brasileira de Enfermagem. 2024;77(4):e20230346
DOI 10.1590/0034-7167-2023-0346
Views0See moreABSTRACT
Objectives:
to identify trans women’s and men’s knowledge about the adverse effects of cross-hormonization and understand the repercussions of hormonization practices on trans women’s and men’s health.
Methods:
exploratory, descriptive, qualitative research, developed with 41 participants, from July 2019 to February 2020, in a trans health outpatient clinic. Thematic-categorical content analysis was used.
Results:
from the analysis, the categories emerged: Knowledge about the adverse effects of cross-hormonization; and Cross-hormonization practices and their meaning.
Final Considerations:
nursing practices, based on the identification of knowledge about adverse effects and the understanding of cross-hormonization practices in trans women’s and men’s health, can result in more inclusive care.
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ORIGINAL ARTICLE09-20-2024
Sociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77(4):e20230301
Abstract
ORIGINAL ARTICLESociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77(4):e20230301
DOI 10.1590/0034-7167-2023-0301
Views0See moreABSTRACT
Objectives:
to assess the socio-cognitive factors determining adherence to standard precautions by nursing professionals in care practice during the COVID-19 pandemic in Brazil.
Methods:
an analytical cross-sectional study, carried out with 9,039 nursing professionals in Brazil, using an electronic form containing participant sociodemographic, training and work variables, and the Brazilian version of the Standard Precautions Questionnaire. Descriptive and inferential statistics were used using the statistical software R.
Results:
participants recognize standard precautions as effective measures to reduce infections and report intention to perform them. Training regarding standard precautions was evidenced as a facilitator of adherence (4.72; SD: 0.73), and problems related to materials (3.78; SD: 1.45) were a hindrance.
Conclusions:
among the determining factors, facilitating organization presented the highest score, followed by intention to perform. Facilitating and hindering factor identification makes it possible to develop intervention strategies to strengthen patient safety and reduce occupational risks among professionals.
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ORIGINAL ARTICLE09-20-2024
Middle-range theory of the existential dimension of being-in-the-world of chronic kidney disease: Grounded Theory
Revista Brasileira de Enfermagem. 2024;77(4):e20230152
Abstract
ORIGINAL ARTICLEMiddle-range theory of the existential dimension of being-in-the-world of chronic kidney disease: Grounded Theory
Revista Brasileira de Enfermagem. 2024;77(4):e20230152
DOI 10.1590/0034-7167-2023-0152
Views0See moreABSTRACT
Objectives:
to develop a middle-range theory of the existential dimension of being-in-the-world of chronic kidney disease in the light of humanistic nursing theory.
Methods:
exploratory-descriptive, qualitative, Grounded Theory study, whose guiding question was: what theoretical relationships can be established between clinical practice carried out in the context of renal replacement therapies and the concepts of humanistic nursing theory? Data were collected through semi-structured interviews with nursing staff and chronic kidney disease patients.
Results:
a theory was developed that describes and explains the existential dimension of being-in-the-world of chronic kidney disease, identifying the qualitative evidence present in this context.
Final Considerations:
the theory contributes to clinical nursing practice qualification in nephrology, consolidating nursing as an art and science, because it arises from care practice and research, in addition to rescuing what differentiates it within the health disciplines, which is care par excellence.
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TECHNOLOGICAL INNOVATION11-13-2023
Digital technology for the prevention of healthcare-related infections in critical care
Revista Brasileira de Enfermagem. 2023;76:e20220528
Abstract
TECHNOLOGICAL INNOVATIONDigital technology for the prevention of healthcare-related infections in critical care
Revista Brasileira de Enfermagem. 2023;76:e20220528
DOI 10.1590/0034-7167-2022-0528
Views0See moreABSTRACT
Objective:
To develop digital technology for patient and family integration into the Intensive Care Unit care team, aiming to subsidize decision-making for the prevention of infections related to healthcare.
Method:
Methodological research of technological production in three phases: pre-production, production, and post-production in a teaching hospital in southern Brazil. Sixteen intensive care unit nurses participated.
Results:
The research produced six videos: general guidelines on the Intensive Care Unit, Preventing infections: hand hygiene; Pneumonia associated with mechanical ventilation; Catheter-associated primary bloodstream infection; Catheter-related urinary tract infection.
Final considerations:
The proposed technology was developed and aims to assist nurses in bringing patients and families closer to the routines of the intensive care environment to provide safety in the contact of the patient of intensive care units with family members and in the active participation for the prevention of infections related to healthcare.
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ORIGINAL ARTICLE11-13-2023
Development of educational videos about bathing in bed newborns admitted to a neonatal unit
Revista Brasileira de Enfermagem. 2023;76:e20220778
Abstract
ORIGINAL ARTICLEDevelopment of educational videos about bathing in bed newborns admitted to a neonatal unit
Revista Brasileira de Enfermagem. 2023;76:e20220778
DOI 10.1590/0034-7167-2022-0778
Views0See moreABSTRACT
Objective:
to develop and analyze evidence of content validity of educational videos about bathing newborns in bed in a neonatal unit.
Method:
applied and methodological research, carried out from December/2020 to February/2022, in three phases: pre-production, production, post-production. Validity was carried out by nurses specializing in social communication and nursing professionals, including the Brazilian Sign Language and assessment by nursing students. The Content Validity Index and Cronbach’s alpha above 0.8 were considered for analysis.
Results:
the videos were entitled “Best practices: bathing newborns in the heated crib” and “Best practices: bathing newborns in the incubator”, lasting seven minutes each, divided into six scenes that demonstrated the approach to parents, environment and material organization, preparing newborns, bathing and after-bath care.
Conclusion:
the videos will support permanent education processes, academic training and professional training in nursing.
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ORIGINAL ARTICLE11-13-2023
Vulnerability to physical inactivity: evidence of content validity and response processes
Revista Brasileira de Enfermagem. 2023;76:e20220563
Abstract
ORIGINAL ARTICLEVulnerability to physical inactivity: evidence of content validity and response processes
Revista Brasileira de Enfermagem. 2023;76:e20220563
DOI 10.1590/0034-7167-2022-0563
Views0See moreABSTRACT
Objective:
To analyze content validity evidence and response processes of a bank of items for measuring vulnerability to physical inactivity in adults.
Method:
Methodological study, with 13 specialists and 46 representatives of the target population. The Content Validity Index (CVI) and binomial test were calculated; data obtained through validity based on response processes were collected through interviews.
Results:
Of the 105 constructed items, 16 were excluded (CVI<0.78); 89 items showed agreement <80% in the psychometric criteria, being modified. Of the 101 items that remained (CVI>0.78), 34 were changed and 4 were deleted after evaluating the evidence of response processes. In the end, 97 items remained, with a global CVI of 0.92, organized into two dimensions: Subject (CVI=0.91) and Social (CVI=0.94).
Conclusion:
The items presented adequate parameters and evidence of validity; and can subsidize the construction of instruments that consider the subject’s and social vulnerability in understanding physical inactivity.
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ORIGINAL ARTICLE11-13-2023
Transphobia as a social disease: discourses of vulnerabilities in trans men and transmasculine people
Revista Brasileira de Enfermagem. 2023;76:e20220183
Abstract
ORIGINAL ARTICLETransphobia as a social disease: discourses of vulnerabilities in trans men and transmasculine people
Revista Brasileira de Enfermagem. 2023;76:e20220183
DOI 10.1590/0034-7167-2022-0183
Views0See moreABSTRACT
Objective:
to analyze the repercussions of transphobia on trans men’s and transmasculine people’s health.
Method:
a qualitative study carried out with 38 participants, 35 trans men and three trans men, who attended specialized transgender health services in Bahia, Brazil. In-depth interviews were carried out between June 2019 and February 2020. The Discourse of Collective Subject technique was used and interpretation based on the theoretical concept of transphobia.
Results:
transphobia has intra and interpersonal repercussions on the life and health of trans men and transmasculine people who attend health services. There were experiences of violence in the private space, fraying of family ties; discrimination in the school space; limitation in professional/work opportunities; barriers to self-care and access to health services; elaboration of trans identity protection strategies; consequences of transphobia on psycho-emotional health.
Conclusion:
transphobia is a social disease that affects different life and health dimensions. It causes damage to the socialization of trans men and transmasculine people, in addition to health service spaces as well as in family environments, schools, universities and at work, which result in non-adherence to self-care, distancing from health services and psycho-emotional distress.
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ORIGINAL ARTICLE11-10-2023
Validation of the Advanced Practice Nursing Competency Assessment Instrument in a hospital environment
Revista Brasileira de Enfermagem. 2023;76:e20220705
Abstract
ORIGINAL ARTICLEValidation of the Advanced Practice Nursing Competency Assessment Instrument in a hospital environment
Revista Brasileira de Enfermagem. 2023;76:e20220705
DOI 10.1590/0034-7167-2022-0705
Views0See moreABSTRACT
Objectives:
to evaluate the measurement properties of the Advanced Practice Nursing Competency Assessment Instrument – Brazilian version, in the hospital environment.
Methods:
a methodological study conducted in a hospital with 238 nurses. Three instruments collect the data: sample characterization form, Brazilian version of the Advanced Practice Nursing Competency Assessment Instrument, and the category “therapeutic interventions” of the nurse competence scale. Construct validity was verified by confirmatory factor analysis and Spearman’s correlation coefficient, and reliability by Cronbach’s Alpha and composite reliability.
Results:
in the factor analysis, the model converged to a satisfactory result. The study found acceptable evidence of reliability (Cronbach’s Alpha, 0.76-0.87; and composite reliability, 0.85-0.90).
Conclusions:
the instrument demonstrated evidence of construct validity and internal consistency and can be used in practice
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TECHNOLOGICAL INNOVATION11-10-2023
HeLP: Development of occupational protection mask against surgical smoke
Revista Brasileira de Enfermagem. 2023;76:e20220647
Abstract
TECHNOLOGICAL INNOVATIONHeLP: Development of occupational protection mask against surgical smoke
Revista Brasileira de Enfermagem. 2023;76:e20220647
DOI 10.1590/0034-7167-2022-0647
Views0ABSTRACT
Objectives:
to describe a technological innovation in the development of an individual, ergonomic, sustainable and effective occupational respiratory protection mask for workers exposed to surgical smoke.
Methods:
applied, exploratory, quantitative research, using design methods and tools: Sense Intent, Know Context, Know People, Frame Insights, Explore Concepts, Frame Solutions, Realize Offerings, in addition to the Product Development Process tools. It was developed from March 2019 to December 2021.
Results:
from the prototyping mold, it became possible to represent the abstract to the physical, where all the concepts created in the methodological steps were implemented and the necessary adjustments were made to create the model as a technological innovation, which will have the concept for product commercialization.
Conclusions:
a mask for protection against surgical smoke (HeLP) was developed, from the design step to the prototype development, being a technological innovation.
Keywords:Air Pollutants, OccupationalPersonal Protective EquipmentRespiratory Protective DevicesSmokeTechnological Development and Innovation ProjectsSee more -
TECHNOLOGICAL INNOVATION11-10-2023
Technology for the treatment promotion of adults living with HIV: Positive o Cuidado (Positive the Care)
Revista Brasileira de Enfermagem. 2023;76:e20220454
Abstract
TECHNOLOGICAL INNOVATIONTechnology for the treatment promotion of adults living with HIV: Positive o Cuidado (Positive the Care)
Revista Brasileira de Enfermagem. 2023;76:e20220454
DOI 10.1590/0034-7167-2022-0454
Views0See moreABSTRACT
Objectives:
to develop a responsive website focused on treatment adherence for adult users living with HIV.
Methods:
technological study conducted between August and October 2020, in the light of Pierre Lévy’s theoretical-philosophical framework, using the Double Diamond Process methodology associated with the five stages of The Elements of User Experience framework.
Results:
it was developed the responsive website Positive Care (Positive o Cuidado), composed of an initial presentation screen and 13 other screens named: Family Health and You; Undetectable = Untransmissible; Antiretroviral Drugs; Routine Tests; Vaccination; Antiretroviral Delivery; Drug Interactions; Combined Prevention; Support Services; Healthy Life; Family and Reproductive Planning; Covid 19; and Questions, Curiosities, and Myths.
Final Considerations:
the responsive website was developed based on the software design and programming process and has requirements/functionalities with the potential to strengthen the collective intelligence about HIV and, consequently, to promote treatment adherence by its users.
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EDITORIAL01-01-2016
Discoveries of Biological Sciences and their implications for nursing practice
Revista Brasileira de Enfermagem. 2016;69(4):619-620
Abstract
EDITORIALDiscoveries of Biological Sciences and their implications for nursing practice
Revista Brasileira de Enfermagem. 2016;69(4):619-620
DOI 10.1590/0034-7167.2016690401i
Views1For the longest time, the production of knowledge in the field of biological sciences was viewed as the exclusive responsibility and competence of medical professionals. This scenario has changed in light of the worldwide trend of improvements in other health professions, which includes the need to implement the use of evidence-based methodology in nursing practice. […]See more -
EDITORIAL01-01-2016
Descobertas das Ciências Biológicas e as implicações para a prática da Enfermagem
Revista Brasileira de Enfermagem. 2016;69(4):619-620
Abstract
EDITORIALDescobertas das Ciências Biológicas e as implicações para a prática da Enfermagem
Revista Brasileira de Enfermagem. 2016;69(4):619-620
DOI 10.1590/0034-7167.2016690401i
Views0A produção de conhecimento na área das ciências biológicas, durante muito tempo, foi vista como de responsabilidade e competência exclusivamente de profissionais médicos. Esse cenário alterou-se frente à tendência mundial de aperfeiçoamento dos demais profissionais de saúde, incluindo-se a necessidade de se concretizar a utilização da metodologia da prática baseada em evidência na atuação do […]See more -
REVIEW01-01-2016
Effects from acupuncture in treating anxiety: integrative review
Revista Brasileira de Enfermagem. 2016;69(3):602-609
Abstract
REVIEWEffects from acupuncture in treating anxiety: integrative review
Revista Brasileira de Enfermagem. 2016;69(3):602-609
DOI 10.1590/0034-7167.2016690325i
Views0See moreABSTRACT
Objective:
to evaluate the scientific evidence that is available in the literature on the effects of acupuncture for treating anxiety and on the quality of such studies.
Method:
the study is an integrative review of CINAHL, LILACS, PUBMED-PICO, SciELO, and The Cochrane Library between 2001 and 2014. Keywords anxiety, acupuncture therapy, acupuncture, and anxiety disorders were combined among themselves to ensure a wide search of primary studies.
Results:
among 514 articles, 67 were selected to be fully read and 19 were included. Among these, 11 were found to have strong evidence levels. Among the six articles about randomized clinical studies, five were found to be of reasonable quality. Two studies used acupuncturist nurses to perform their interventions. Its results showed positive and statistically significant effects from using acupuncture for treating subjects with anxiety.
Conclusion:
acupuncture seems to be a promising treatment for anxiety; however, there is a need for improving the methodological quality of the research on this field.
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REVIEW01-01-2016
Palliative care and spirituality: an integrative literature review
Revista Brasileira de Enfermagem. 2016;69(3):591-601
Abstract
REVIEWPalliative care and spirituality: an integrative literature review
Revista Brasileira de Enfermagem. 2016;69(3):591-601
DOI 10.1590/0034-7167.2016690324i
Views0See moreABSTRACT
Objective:
to analyze scientifi c articles published in international online journals about palliative care and spirituality.
Methods:
an integrative literature review with data collected in September 2014 from the LILACS, SCIELO, MEDLINE/PubMed, and IBECS databases.
Results:
thirty-nine publications were identifi ed and their textual analysis facilitated through four thematic approaches: the meaning of spirituality in the context of palliative care; palliative care and spiritual support; spirituality and relief of pain and other symptoms in patients under palliative care; and instruments to evaluate the spiritual dimension of the scope of palliative care.
Conclusion:
this study examined the relevance of the spiritual dimension in the care of patients with palliative care and the need for developing new studies to disseminate knowledge about this topic.
Descriptors:
Palliative Care; Palliative Care at End of Live; Spirituality; Religion; Health.
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REVIEW01-01-2016
Educational technologies to encourage (self) care in postpartum women
Revista Brasileira de Enfermagem. 2016;69(3):582-590
Abstract
REVIEWEducational technologies to encourage (self) care in postpartum women
Revista Brasileira de Enfermagem. 2016;69(3):582-590
DOI 10.1590/0034-7167.2016690323i
Views0See moreABSTRACT
Objective:
to evaluate national and international literature regarding the use of educational technologies to encourage self care in postpartum women.
Method:
an integrative review of the literature. The articles were collected from the CINAHL, SCOPUS, PubMed, SciELO, LILACS and Cochrane databases; the time period for the articles referred to January/2004 to July/2014; the languages used in the articles were Portuguese, English, Spanish and French; the articles were selected from the following descriptors: postpartum care period, educational technology, nursing and self care. Twenty-seven articles were selected for analysis
Results:
based on the information found, the scales, counseling and home visits were among the most recommended educational technologies.
Conclusion:
the technologies promote communication, but are sometimes dependent on computer and internet access, which hinder their use by low-income women.
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RESEARCH01-01-2016
Patients with HIV/Aids and ulcer risk: nursing care demands
Revista Brasileira de Enfermagem. 2016;69(3):574-581
Abstract
RESEARCHPatients with HIV/Aids and ulcer risk: nursing care demands
Revista Brasileira de Enfermagem. 2016;69(3):574-581
DOI 10.1590/0034-7167.2016690322i
Views0See moreABSTRACT
Objective:
to analyze the demand for nursing care and the risk of pressure ulcers (PU) of patients with HIV/Aids.
Method:
quantitative survey, carried out from December 2012 to March 2013 in a public hospital of Teresina, state of Piauí, Brazil.
Results:
the sample of 31 patients was predominantly male, mean age 36.6 years, average care demand 49.4%, most showing some risk of developing PU. The variables correlated with PU risk were care demand and clinical outcome (death). Those associated with care demand were age and clinical outcome (death).
Conclusion:
the results showed that patients require moderate nursing care needs and most of them present risk of developing PU.
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