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REVIEW07-29-2024
Utilization of local pressure devices in pain management during injections: scoping review
- Jefferson Wildes da Silva Moura
, - Aline de Souza Bitencourt ,
- Thiago Lopes Silva ,
- Andréia Cristina Feitosa do Carmo ,
- Luciano Marques dos Santos , [ … ],
- Patrícia Kuerten Rocha
Abstract
REVIEWUtilization of local pressure devices in pain management during injections: scoping review
Revista Brasileira de Enfermagem. 2024;77(3):e20230399
DOI 10.1590/0034-7167-2023-0399
- Jefferson Wildes da Silva Moura ,
- Aline de Souza Bitencourt ,
- Thiago Lopes Silva ,
- Andréia Cristina Feitosa do Carmo ,
- Luciano Marques dos Santos ,
- Patrícia Kuerten Rocha
Views0See moreABSTRACT
Objective:
to map scientific evidence regarding the use of local pressure devices in pain relief during injection procedures in patients.
Methods:
scoping review, following the recommendations of the JBI Manual for Evidence Synthesis and PRISMA-ScR, with searches conducted in the PubMed, EMBASE, CINAHL, LILACS, and PsycINFO databases, without temporal restrictions and with a cutoff date of March 2023.
Results:
a total of 1,514 studies were identified, with 20 articles included in the final sample. The ShotBlocker® device was utilized during subcutaneous and intramuscular injections in children and adults, proving beneficial in reducing pain, anxiety, and fear associated with the procedure.
Final considerations:
the ShotBlocker® is a low-cost, easy-to-use device that can enhance nursing clinical practice during painful procedures. However, studies involving the Brazilian Pikluc® device are scarce. Further research involving both local pressure devices is recommended.
- Jefferson Wildes da Silva Moura
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ORIGINAL ARTICLE07-29-2024
Sexual counseling for people with acute coronary syndrome: educational video development
- Laura Rizardi dos Santos Andrade ,
- Lanay Dourado dos Anjos ,
- Ana Paula Freitas Aguiar ,
- Edvone Alves de Lima ,
- Erika de Sá Vieira Abuchaim , [ … ],
- Vinicius Batista Santos
Abstract
ORIGINAL ARTICLESexual counseling for people with acute coronary syndrome: educational video development
Revista Brasileira de Enfermagem. 2024;77(3):e20230416
DOI 10.1590/0034-7167-2023-0416
- Laura Rizardi dos Santos Andrade ,
- Lanay Dourado dos Anjos ,
- Ana Paula Freitas Aguiar ,
- Edvone Alves de Lima ,
- Erika de Sá Vieira Abuchaim ,
- Juliana de Lima Lopes ,
- Camila Tákao Lopes ,
- Vinicius Batista Santos
Views0See moreABSTRACT
Objective:
to assess validity evidence of an educational video on safe sexual activity after acute coronary syndrome.
Method:
study in three phases: video development; content validity analysis by 11 experts; and analysis of validity based on response processes by seven people with coronary disease. The content validity ratio (CVR) was calculated with critical values for the second phase of 0.63 and for the third of 1.0.
Results:
the video addressed the importance of resuming sexual activity and positions that consume less energy, clinical warning signs, the importance of adhering to treatment and a welcoming environment for sexual practice. A CVR above the critical value was obtained with a total of 4 minutes and 41 seconds.
Conclusion:
the educational video brings together adequate content validity evidence and can be used as a tool for patients after acute coronary syndrome.
- Laura Rizardi dos Santos Andrade
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ORIGINAL ARTICLE07-19-2024
The use of spirituality/religiosity by oncology nurse residents in nursing care
- Ana Paula Kelly de Almeida Tomaz ,
- Rômulo Frutuoso Antunes ,
- Rachel Verdan Dib ,
- Raquel de Souza Ramos ,
- Flaviana Pereira Bastos Nascimento , [ … ],
- Regina Célia Gollner Zeitoune
Abstract
ORIGINAL ARTICLEThe use of spirituality/religiosity by oncology nurse residents in nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230383
DOI 10.1590/0034-7167-2023-0383
- Ana Paula Kelly de Almeida Tomaz ,
- Rômulo Frutuoso Antunes ,
- Rachel Verdan Dib ,
- Raquel de Souza Ramos ,
- Flaviana Pereira Bastos Nascimento ,
- Sérgio Abreu de Jesus ,
- Kayo Henrique Jardel Feitosa Sousa ,
- Regina Célia Gollner Zeitoune
Views1See moreABSTRACT
Objectives:
to analyze the use of spirituality/religiosity by oncology nurse residents in caring for patients with cancer.
Methods:
a census, descriptive, sectional study, with 46 nurse residents from three public hospitals in Rio de Janeiro. Data collection took place between August 2020 and January 2021, using a sociodemographic questionnaire, including a question about the use of spirituality/ religiosity to deal with work situations. Descriptive analysis was carried out using SPSS software version 22.0.
Results:
participants stated that they use religiosity/spirituality in work situations related to patients or themselves. In relation to patients, death was the most mentioned situation among professionals, and for themselves, everyday situations and emotional vulnerability were the most mentioned.
Final Considerations:
spirituality and religiosity are dimensions that guide oncology nurse residents’ attitudes.
- Ana Paula Kelly de Almeida Tomaz
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ORIGINAL ARTICLE07-19-2024
Translation and cross-cultural adaptation of the MISSCARE Survey-Ped into Brazilian Portuguese
Revista Brasileira de Enfermagem. 2024;77(2):e20230060
Abstract
ORIGINAL ARTICLETranslation and cross-cultural adaptation of the MISSCARE Survey-Ped into Brazilian Portuguese
Revista Brasileira de Enfermagem. 2024;77(2):e20230060
DOI 10.1590/0034-7167-2023-0060
Views0See moreABSTRACT
Objectives:
to translate and cross-culturally adapt the MISSCARE Survey-Ped for use in Brazil.
Methods:
a methodological study proposed by translation, synthesis of translations, back-translation, assessment by a committee of experts and pre-testing with the target population.
Results:
two direct translations of the instrument were carried out, followed by a consensual version between them. This synthetic version was back-translated and analyzed by a committee of five experts in pediatric nursing and patient safety, obtaining a Content Validity Index (CVI) of 0.95 and Cronbach’s alpha of 0.804. The final version was sent for pre-testing with 254 Brazilian pediatric nurses, with 44 (17.3%) analyzing the instrument for understanding (CVI 0.866; Content Validity Ratio (CVR) 0.773), relevance (CVI 0.931; CVR 0.864) and relevance (CVI 0.977; CVR 0.955).
Conclusions:
the MISSCARE Survey-Ped Brasil was considered suitable for application in pediatric nurses’ clinical practice in the country.
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REVIEW07-19-2024
Drug-resistant tuberculosis: integrative review of nursing care in primary health care
- Sibele Naiara Ferreira Germano ,
- Alacoque Lorenzini Erdmann ,
- Camila Freire Albuquerque ,
- Lúcia Nazareth Amante ,
- Darlisom Sousa Ferreira , [ … ],
- Marlucia da Silva Garrido
Abstract
REVIEWDrug-resistant tuberculosis: integrative review of nursing care in primary health care
Revista Brasileira de Enfermagem. 2024;77(2):e20230097
DOI 10.1590/0034-7167-2023-0097
- Sibele Naiara Ferreira Germano ,
- Alacoque Lorenzini Erdmann ,
- Camila Freire Albuquerque ,
- Lúcia Nazareth Amante ,
- Darlisom Sousa Ferreira ,
- Marlucia da Silva Garrido
Views0See moreABSTRACT
Objectives:
to identify, in the scientific literature, the care that should be provided to individuals with drug-resistant tuberculosis by nurses in primary health care.
Methods:
integrative review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses study selection flowchart. Data collection was conducted in November 2022, across ten databases.
Results:
six studies emphasized that nurses should perform directly observed treatment; two highlighted the importance of integrated care management between tuberculosis and human immunodeficiency virus; two demonstrated comprehensive nursing consultation using the nursing process; one emphasized person-centered care, with discharge planning and improved hospital communication with primary health care services.
Final Considerations:
the care that nurses should provide to individuals with drug-resistant tuberculosis in primary health care, for care resolution, is evidence-based.
- Sibele Naiara Ferreira Germano
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ORIGINAL ARTICLE07-19-2024
Understanding intimate self-care among riverine women: qualitative research through the lens of the Sunrise Model
- Camila Evelyn de Sousa Brito ,
- Bruna Larissa Fernandes Coelho ,
- Talita Lima dos Santos ,
- Thais Cristina Flexa Souza Marcelino ,
- Lucas Geovane dos Santos Rodrigues , [ … ],
- Adriana de Sá Pinheiro
Abstract
ORIGINAL ARTICLEUnderstanding intimate self-care among riverine women: qualitative research through the lens of the Sunrise Model
Revista Brasileira de Enfermagem. 2024;77(2):e20230364
DOI 10.1590/0034-7167-2023-0364
- Camila Evelyn de Sousa Brito ,
- Bruna Larissa Fernandes Coelho ,
- Talita Lima dos Santos ,
- Thais Cristina Flexa Souza Marcelino ,
- Lucas Geovane dos Santos Rodrigues ,
- Mary Elizabeth de Santana ,
- Antonio Jorge Silva Correa Júnior ,
- Adriana de Sá Pinheiro
Views0See moreABSTRACT
Objectives:
to contribute to the change in understandings and knowledge of the popular system among riverine women about female intimate self-care before and after the application of an educational dynamic.
Methods:
a qualitative-participative study based on the Sunrise Model. Twenty women registered at a Basic Health Unit on the Combu island, state of Pará, Brazil, participated in the second half of 2022. Semi-structured interviews were conducted before and after the educational dynamic; followed by reflective inductive analysis.
Results:
these are pointed out: a female mechanism of generational education; the cultural act of bathing as synonymous with intimate self care and disease prevention; intimate care with medicinal herbs; lack of professional system approach to the topic; fear of using “muddy water”; and lack of financial resources to purchase specific products for genitourinary care.
Final Considerations:
companionship and social factors drive intimate self-care; however, riverine women experience taboos, ignorance, and poverty.
- Camila Evelyn de Sousa Brito
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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for assessing leprosy care in children and adolescents
- Gutembergue Santos de Sousa ,
- Isael Marcos Silva Mendonça ,
- Lia Hanna Martins Morita ,
- Denise da Costa Boamorte Cortela ,
- Pãmela Rodrigues de Souza Silva , [ … ],
- Silvana Margarida Benevides Ferreira
Abstract
ORIGINAL ARTICLEValidation of an instrument for assessing leprosy care in children and adolescents
Revista Brasileira de Enfermagem. 2024;77(2):e20230344
DOI 10.1590/0034-7167-2023-0344
- Gutembergue Santos de Sousa ,
- Isael Marcos Silva Mendonça ,
- Lia Hanna Martins Morita ,
- Denise da Costa Boamorte Cortela ,
- Pãmela Rodrigues de Souza Silva ,
- Silvana Margarida Benevides Ferreira
Views1See moreABSTRACT
Objectives:
to validate the content of an instrument for assessing leprosy care in individuals under 15 years old in the context of Primary Health Care.
Methods:
methodological study of content validation, based on the evaluation of essential and derived attributes in primary care, in the professional version. For data analysis, the Content Validation Index (CVI ≥ 0.8) and Cronbach’s Alpha were calculated.
Results:
a higher percentage of judges among nurses (61.5%) was observed; with a doctorate (46.2%), and engaged in teaching and research (77%). The overall Content Validation Index of the instrument was 0.98. In the analysis of Cronbach’s Alpha of the instrument, the assigned value was 0.717.
Conclusions:
the instrument represents an advancement in the measurement of health evaluation policies and can significantly contribute to improving the quality of care provided to children and adolescents with leprosy.
- Gutembergue Santos de Sousa
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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for patient classification to support obstetric nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230401
Abstract
ORIGINAL ARTICLEValidation of an instrument for patient classification to support obstetric nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230401
DOI 10.1590/0034-7167-2023-0401
Views0See moreABSTRACT
Objectives:
to develop and validate an instrument for the classification of pregnant and postpartum women according to the demand for nursing care.
Methods:
a methodological study conducted in three stages: 1) construction of the instrument based on literature review; 2) content validation using the Delphi technique with 12 experts; and 3) Evaluation of the convergent construct validity through the correlation between the scores of the constructed instrument and the Fugulin instrument.
Results:
an instrument with ten indicators of specific care for pregnant and postpartum women was developed. A content validity index higher than 0.9 was obtained, requiring only one round of the Delphi technique. The Spearman coefficient was 0.64 between the instruments, indicating a strong correlation.
Conclusions:
the classification instrument specifically constructed for pregnant and postpartum women showed evidence of content validity and convergent construct validity with a widely used instrument in the national territory.
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EXPERIENCE REPORT07-31-2020
(In)visibility of children with special health needs and their families in primary care
- Sonia Silva Marcon ,
- Beatriz Caroline Dias ,
- Eliane Tatsch Neves ,
- Maria Angelica Marcheti ,
- Regina Aparecida Garcia de Lima
Abstract
EXPERIENCE REPORT(In)visibility of children with special health needs and their families in primary care
Revista Brasileira de Enfermagem. 2020;73:e20190071
DOI 10.1590/0034-7167-2019-0071
- Sonia Silva Marcon ,
- Beatriz Caroline Dias ,
- Eliane Tatsch Neves ,
- Maria Angelica Marcheti ,
- Regina Aparecida Garcia de Lima
Views0See moreABSTRACT
Objectives:
to discuss the (in)visibility of children with special healthcare needs and their families in the Primary Health Care scenario.
Methods:
experience report about the difficulties faced by researchers from different regions of Brazil to locate children with special healthcare needs in the scope of primary care.
Results:
the main reason for these children and their families to be “unknown” and, therefore, not assisted in PHC, is the fact that they are followed-up by institutions/outpatient clinics and specialized and/or public rehabilitation clinics, or even because they have private health insurance.
Final Considerations:
transferring care responsibility to the Primary Health Care teams to specialized and rehabilitation institutions may be related to the lack of knowledge of the care demands of this group, as well as to the relevance of care centered on rehabilitation and the specialty instead of the long-term care, one of the features of primary health care.
- Sonia Silva Marcon
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ORIGINAL ARTICLE03-30-2020
Professional skills for health promotion in caring for tuberculosis patients
- Amanda de Fátima Alves Costa ,
- Altamira Mendonça Félix Gomes ,
- Ana Fátima Carvalho Fernandes ,
- Lucilane Maria Sales da Silva ,
- Lorena Pinheiro Barbosa , [ … ],
- Priscila de Souza Aquino
Abstract
ORIGINAL ARTICLEProfessional skills for health promotion in caring for tuberculosis patients
Revista Brasileira de Enfermagem. 2020;73(2):e20180943
DOI 10.1590/0034-7167-2018-0943
- Amanda de Fátima Alves Costa ,
- Altamira Mendonça Félix Gomes ,
- Ana Fátima Carvalho Fernandes ,
- Lucilane Maria Sales da Silva ,
- Lorena Pinheiro Barbosa ,
- Priscila de Souza Aquino
Views0See moreABSTRACT
Objectives:
to understand the health promotion skills found in the speeches of health practitioners in care for TB patients.
Methods:
qualitative study, developed with seven practitioners involved in care for TB patients, identified from a sociocentric approach, whose speeches were submitted to analysis based on the health promotion skills model in the Galway Consensus.
Results:
there were four domains: Catalyzing change; Leadership; Planning; and Partnerships. These domains resulted from health education actions, contribution of management nursing practitioners, seeking to meet patients’ needs and articulation of professional sectors.
Final considerations:
there were some skill domains in the speeches of health practitioners, with the nurse being quoted in the development of essential skills for health promotion activities, such as catalyzing change and leading care for TB patients.
- Amanda de Fátima Alves Costa
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REVIEW09-19-2022
Authentic leadership in the educational system and in nursing education: an integrative review
- Cezar Augusto da Silva Flores ,
- Suellen Rodrigues de Oliveira Maier ,
- André Almeida de Moura ,
- Alexandre Pazetto Balsanelli ,
- Bruna Moreno Dias , [ … ],
- Andrea Bernardes
Abstract
REVIEWAuthentic leadership in the educational system and in nursing education: an integrative review
Revista Brasileira de Enfermagem. 2022;75(1):e20220122
DOI 10.1590/0034-7167-2022-0122
- Cezar Augusto da Silva Flores ,
- Suellen Rodrigues de Oliveira Maier ,
- André Almeida de Moura ,
- Alexandre Pazetto Balsanelli ,
- Bruna Moreno Dias ,
- Andrea Bernardes
Views0See moreABSTRACT
Objectives:
to identify and analyze the knowledge produced in literature about authentic leadership in the educational system, as well as in nursing education.
Methods:
an integrative review, carried out in the Scopus, Web of Science, CINAHL, MEDLINE/PubMed, ERIC, LILACS databases. Articles that addressed authentic leadership in the educational system from a general perspective and within the nursing scope, as well as teaching practices of this leadership model, were eligible.
Results:
twenty-three articles met the inclusion criteria, most published in 2019, highlighting studies in the context of teaching, with a predominance in the nursing course and which were synthesized into three thematic categories.
Final Considerations:
it was found that the higher the levels of authentic leadership in the educational system, the higher the rates of other positive factors related to it, such as trust, involvement, academic optimism, responsibility, creativity, among others.
- Cezar Augusto da Silva Flores
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ORIGINAL ARTICLE12-07-2020
Construction and validation of an educational gerontotechnology on frailty in elderly people
- Cynthia Roberta Dias Torres Silva ,
- Sarah Giulia Bandeira Felipe ,
- Khelyane Mesquita de Carvalho ,
- Marcia Teles de Oliveira Gouveia ,
- Fernando Lopes Silva Júnior , [ … ],
- Maria do Livramento Fortes Figueiredo
Abstract
ORIGINAL ARTICLEConstruction and validation of an educational gerontotechnology on frailty in elderly people
Revista Brasileira de Enfermagem. 2020;73:e20200800
DOI 10.1590/0034-7167-2020-0800
- Cynthia Roberta Dias Torres Silva ,
- Sarah Giulia Bandeira Felipe ,
- Khelyane Mesquita de Carvalho ,
- Marcia Teles de Oliveira Gouveia ,
- Fernando Lopes Silva Júnior ,
- Maria do Livramento Fortes Figueiredo
Views0See moreABSTRACT
Objective:
to construct and validate an educational gerontechnology on frailty in elderly people.
Method:
a methodological study developed in three stages: educational video construction, validation by expert judges and elderly people. Validation was carried out by 22 judges and 22 elderly people. Educational Content Validation Instrument was used for judges and questions adapted from the Suitability Assessment of Materials questionnaire for elderly people. For validation, agreement criterion greater than 80% was considered, verified using Content Validation Index and binomial test.
Results:
the video addresses recommendations for elderly people at risk of frailty and health-promoting habits, using cordel literature. An agreement greater than 80% was verified in all items assessed by judges and the target audience.
Conclusion:
the video proved to be valid in terms of content and appearance by judges and elderly people, with the potential to mediate health-promoting educational practices in healthy aging.
- Cynthia Roberta Dias Torres Silva
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ORIGINAL ARTICLE10-01-2022
Self-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
- Gerlania Rodrigues Salviano Ferreira ,
- Lia Raquel de Carvalho Viana ,
- Cláudia Jeane Lopes Pimenta ,
- Cleane Rosa Ribeiro da Silva ,
- Tatiana Ferreira da Costa , [ … ],
- Kátia Neyla de Freitas Macedo Costa
Abstract
ORIGINAL ARTICLESelf-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
DOI 10.1590/0034-7167-2020-1257
- Gerlania Rodrigues Salviano Ferreira ,
- Lia Raquel de Carvalho Viana ,
- Cláudia Jeane Lopes Pimenta ,
- Cleane Rosa Ribeiro da Silva ,
- Tatiana Ferreira da Costa ,
- Jacira dos Santos Oliveira ,
- Kátia Neyla de Freitas Macedo Costa
Views1INTRODUCTIONChronic non-communicable diseases are the main causes of death and health problems in the world, causing about 41 million deaths each year, which corresponds to approximately 71% of all deaths. Among these diseases, diabetes mellitus has stood out due to the increase in its incidence and prevalence().Estimates indicate that 463 million people live with diabetes […]See more - Gerlania Rodrigues Salviano Ferreira
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01-27-2020
Comparison of Interpretive Description and Qualitative Description in the Nursing Scope
Revista Brasileira de Enfermagem. 2020;73(1):e20190339
Abstract
Comparison of Interpretive Description and Qualitative Description in the Nursing Scope
Revista Brasileira de Enfermagem. 2020;73(1):e20190339
DOI 10.1590/0034-7167-2019-0339
Views0Interpretive Description BasisID is a small scale qualitative research about a phenomenon regarded in the field that aims to extract themes and patterns. This approach begins with the critical analysis of clinical and theoretical knowledge in the field. It develops the initial conceptual framework, however it does not enter procedures details. Instead, this approach explains […]See more -
REVIEW07-09-2021
Nursing care for patients in post-transplantation of hematopoietic stem cells: an integrative review
- Jéssica Alline Pereira Rodrigues ,
- Maria Ribeiro Lacerda ,
- Cristina Maria Galvão ,
- Ingrid Meireles Gomes ,
- Marineli Joaquim Meier , [ … ],
- Nayla Tamara de Godoi Caceres
Abstract
REVIEWNursing care for patients in post-transplantation of hematopoietic stem cells: an integrative review
Revista Brasileira de Enfermagem. 2021;74(3):e20200097
DOI 10.1590/0034-7167-2020-0097
- Jéssica Alline Pereira Rodrigues ,
- Maria Ribeiro Lacerda ,
- Cristina Maria Galvão ,
- Ingrid Meireles Gomes ,
- Marineli Joaquim Meier ,
- Nayla Tamara de Godoi Caceres
Views0See moreABSTRACT
Objectives:
to analyze the available evidence on the nursing care provided to patients after hematopoietic stem cell transplantation.
Methods:
integrative review with the search for primary studies in four databases and a virtual health library. A broad search strategy was used, including research published in English, Brazilian Portuguese, or Spanish, between 2008 and 2018, totaling a sample of 42 studies.
Results:
the studies were grouped into three categories: multiple nursing care (n=19), first-line care (n=18), and self-management of care (n=5).
Conclusions:
nursing care is critical, comprising patients’ physical, psychological and social aspects. It occurs in hospital and home contexts, mainly involving technical actions and health guidance. The evidence identified provide subsidies for decision-making; however, most studies are of the non-experimental type, indicating the need for conducting intervention research.
- Jéssica Alline Pereira Rodrigues
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ORIGINAL ARTICLE08-18-2021
Mapping of advanced practice nursing actions in the Family Health Strategy
- Emerson Willian Santos de Almeida ,
- Simone de Godoy ,
- Ítalo Rodolfo Silva ,
- Orlene Veloso Dias ,
- Leila Maria Marchi-Alves , [ … ],
- Isabel Amélia Costa Mendes
Abstract
ORIGINAL ARTICLEMapping of advanced practice nursing actions in the Family Health Strategy
Revista Brasileira de Enfermagem. 2021;74:e20210228
DOI 10.1590/0034-7167-2021-0228
- Emerson Willian Santos de Almeida ,
- Simone de Godoy ,
- Ítalo Rodolfo Silva ,
- Orlene Veloso Dias ,
- Leila Maria Marchi-Alves ,
- Isabel Amélia Costa Mendes
Views0See moreABSTRACT
Objectives:
to map advanced practice nursing actions implemented in the Family Health Strategy context.
Methods:
cross-sectional exploratory study carried out with Family Health Strategy nurses. Data obtained in the mapping were compared to the characteristics that define advanced practice nurses and are adopted internationally by using a checklist based on the International Council of Nurses Guidelines.
Results:
the mapping allowed to identify advanced practice nursing actions, such as advanced assessment, judgement, decision-making, and diagnostic reasoning skills and authority to diagnose and prescribe medications, diagnostic testing, and therapeutic treatments. However, evidence found in the educational preparation domain indicated evident fragility, expressed as the low percentage of nurses credentialed with a professional master’s degree.
Conclusions:
the present study showed that nurses in the Family Health Strategy carry out advanced practice nursing actions without the professional master’s degree recommended for credentialing, with pertinent legislation, which requires initiatives to be taken by nursing leaders to overcome this deficiency.
- Emerson Willian Santos de Almeida
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