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ORIGINAL ARTICLE06-14-2024
Translation and Cross-Cultural Adaptation of the LYMPH-ICF Instrument for Lymphedema into Portuguese/Brazil
- Ana Paula Oliveira Santos
, - Samantha Karlla Lopes de Almeida Rizzi ,
- Gil Facina ,
- Afonso Celso Pinto Nazário ,
- Simone Elias
Abstract
ORIGINAL ARTICLETranslation and Cross-Cultural Adaptation of the LYMPH-ICF Instrument for Lymphedema into Portuguese/Brazil
Revista Brasileira de Enfermagem. 2024;77(2):e20230137
DOI 10.1590/0034-7167-2023-0137
- Ana Paula Oliveira Santos ,
- Samantha Karlla Lopes de Almeida Rizzi ,
- Gil Facina ,
- Afonso Celso Pinto Nazário ,
- Simone Elias
Views0ABSTRACT
Objective:
The aim of this study is to cross-culturally adapt the Lymphoedema Functioning, Disability and Health Questionnaire Lymphoedema (LYMPH-ICF) instrument into Brazilian Portuguese and conduct a pilot application (n = 10), without psychometric pretensions.
Method:
Methodological research was conducted, following the steps of translation, synthesis, back-translation, and evaluation by the expert committee. Two translators, two back-translators, and twelve professionals participated in the expert committee. A pretest was carried out with 10 patients with secondary lymphedema due to breast cancer. The degree of agreement was determined by the content validity coefficient.
Results:
It was necessary to modify 8 out of the 29 questions comprising the questionnaire, which exhibited idiomatic disagreement. However, despite these changes, there were no indications of impairments, as content reliability was achieved through a validity coefficient of 0.90.
Final Considerations:
The instrument was successfully translated and cross-culturally adapted for Brazil with a high level of agreement.
Keywords:Breast NeoplasmsHealth CareInternational Classification of Functioning, Disabiliy and HealthLymphedemaPatient Health QuestionnaireSee more
- Ana Paula Oliveira Santos
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ORIGINAL ARTICLE06-14-2024
Teoria de médio alcance do diagnóstico de enfermagem sobrepeso
- Ana Carolina Costa Carino ,
- Renata Marinho Fernandes ,
- Anna Thays Dias Almeida ,
- Cecília Maria Farias de Queiroz Frazão ,
- Caroline Evelin Nascimento Kluczynik , [ … ],
- Ana Luisa Brandão de Carvalho Lira
Abstract
ORIGINAL ARTICLETeoria de médio alcance do diagnóstico de enfermagem sobrepeso
Revista Brasileira de Enfermagem. 2024;77(2):e20230372
DOI 10.1590/0034-7167-2023-0372
- Ana Carolina Costa Carino ,
- Renata Marinho Fernandes ,
- Anna Thays Dias Almeida ,
- Cecília Maria Farias de Queiroz Frazão ,
- Caroline Evelin Nascimento Kluczynik ,
- Ana Luisa Brandão de Carvalho Lira
Views0See moreRESUMEN
Objetivo:
Construir una teoría de rango medio para el diagnóstico de enfermería Sobrepeso en adolescentes y adultos jóvenes.
Métodos:
Estudio metodológico a la luz de los marcos teóricos de Roy y de Lopes, Silva y Herdman. Un total de 3.925 artículos fueron recuperados y evaluados utilizando el software State of the Art Through Systematic Review. La muestra final fue de 28 artículos.
Resultados:
Los resultados convergieron en 3 atributos esenciales, 13 antecedentes y 7 consecuencias. Se construyó una teoría de rango medio compuesta por un diagrama ilustrado, 11 proposiciones y 12 relaciones causales.
Consideraciones finales:
A partir de la creación de la teoría, fue posible comprender mejor el diagnóstico de enfermería Sobrepeso en el contexto de adolescentes y adultos jóvenes. La comprensión de los fenómenos de enfermería contribuye para el avance y fortalecimiento de la ciencia de enfermería.
- Ana Carolina Costa Carino
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ORIGINAL ARTICLE06-14-2024
Meanings attributed to health-related quality of life by caregivers of adolescents with diabetes
- Marina Saraiva de Araújo Pessoa ,
- Elisabeth Luisa Rodrigues Ramalho ,
- Maria Elizabete de Amorim Silva Marinho ,
- Elenice Maria Cecchetti Vaz ,
- Lucila Castanheira Nascimento , [ … ],
- Neusa Collet
Abstract
ORIGINAL ARTICLEMeanings attributed to health-related quality of life by caregivers of adolescents with diabetes
Revista Brasileira de Enfermagem. 2024;77(2):e20230314
DOI 10.1590/0034-7167-2023-0314
- Marina Saraiva de Araújo Pessoa ,
- Elisabeth Luisa Rodrigues Ramalho ,
- Maria Elizabete de Amorim Silva Marinho ,
- Elenice Maria Cecchetti Vaz ,
- Lucila Castanheira Nascimento ,
- Valéria de Cássia Sparapani ,
- Neusa Collet
Views0See moreABSTRACT
Objective:
to interpret the meanings attributed to the health-related quality of life by caregivers of adolescents with type 1 diabetes mellitus.
Methods:
qualitative, descriptive-exploratory study of 14 caregivers of adolescents with diabetes developed at the reference outpatient clinic for endocrine diseases in a city in the state of Paraíba. Interviews were performed between May and September 2021. Inductive thematic analysis of the empirical material, and its interpretation in light of the concepts of health-related quality of life and family functioning were performed.
Results:
the meanings attributed by caregivers to the health-related quality of life of adolescents converged on the feeling of being healthy, healthy eating, satisfactory family income, family involvement in care and effective access to the care network.
Final Considerations:
knowledge of these meanings enables health professionals to develop strategies that meet the unique demands of caregivers experiencing this diagnosis.
- Marina Saraiva de Araújo Pessoa
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ORIGINAL ARTICLE06-14-2024
Validity of the TBApp mobile application for self-care management for people with tuberculosis
- Lara Bezerra de Oliveira de Assis ,
- Denise Maria Guerreiro Vieira da Silva ,
- Jucimar Maia da Silva Junior ,
- Edinilza Ribeiro dos Santos ,
- Jair dos Santos Pinheiro , [ … ],
- Amélia Nunes Sicsú
Abstract
ORIGINAL ARTICLEValidity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
DOI 10.1590/0034-7167-2023-0195
- Lara Bezerra de Oliveira de Assis ,
- Denise Maria Guerreiro Vieira da Silva ,
- Jucimar Maia da Silva Junior ,
- Edinilza Ribeiro dos Santos ,
- Jair dos Santos Pinheiro ,
- Daniel Souza Sacramento ,
- Hermann Jacques Hernani de Oliveira ,
- Amélia Nunes Sicsú
Views1See moreABSTRACT
Objectives:
to describe the validity process of the TBApp mobile application for self-care management for people with tuberculosis linked to Primary Health Care.
Methods:
methodological research developed with ten expert judges, carried out virtually. The application was assessed in relation to content and technology quality in seven domains (objectivity; structure and appearance; relevance; functionality; reliability; usability; and efficiency), using an instrument with a Likert scale.
Results:
TBApp was considered valid, relevant, functional, reliable and effective by expert judges. The objectives, structure and presentation and relevance domains presented an overall Content Validity Index of 0.93, and the functionality, reliability, usability and efficiency domains presented characteristics and sub-characteristics values greater than 0.80.
Conclusions:
TBApp is a creative and innovative tool that can be used by people with TB and disseminated in the scientific community.
- Lara Bezerra de Oliveira de Assis
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ORIGINAL ARTICLE06-14-2024
Cardiovascular Risk and Lifestyle: comparison between teaching workers in Portugal and Brazil
- Noeli das Neves Toledo ,
- Gilsirene Scantelbury de Almeida ,
- Nair Chase da Silva ,
- Luana Coimbra ,
- Sara Alves Monteiro , [ … ],
- Irma Brito
Abstract
ORIGINAL ARTICLECardiovascular Risk and Lifestyle: comparison between teaching workers in Portugal and Brazil
Revista Brasileira de Enfermagem. 2024;77(2):e20230354
DOI 10.1590/0034-7167-2023-0354
- Noeli das Neves Toledo ,
- Gilsirene Scantelbury de Almeida ,
- Nair Chase da Silva ,
- Luana Coimbra ,
- Sara Alves Monteiro ,
- Anna Camily Oliveira Bitar ,
- Filipa de Brito Homem ,
- Irma Brito
Views0ABSTRACT
Objective:
Compare Cardiovascular Risk between workers in Brazil and Portugal who work in the teaching context and its relationship with Lifestyle and Common Mental Disorder.
Methods:
Cross-sectional study that compared the cardiovascular health conditions of teaching workers in Manaus (Brazil) and Coimbra (Portugal). The odds ratio between groups was estimated.
Results:
The differences were: Smoking and hypercholesterolemia in participants from Portugal. Hypertension, chronic disease, increased abdominal perimeter, common mental disorder, and absence from work in Brazil. The variables with the greatest effect for high cardiovascular risk were: Country-Portugal [17.273 (95%CI1.538-193.951)], sex-male [61.577 (95%CI5.398-702.469)] and smoking [593.398 (95%CI57.330-6.142.020)].
Conclusion:
The differences in risk between groups showed that participants from Portugal, men, with high blood pressure and/or smokers are the most vulnerable to having a cardiovascular event. There is a need for interventions to promote cardiovascular health in the workplace in both countries.
Keywords:Community-Based Participatory ResearchHeart Disease Risk FactorsLife StyleOccupational HealthUniversitiesSee more - Noeli das Neves Toledo
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REVIEW06-14-2024
Primary health care professionals’ practice in the face of leprosy: a scoping review
- Michelle Santos Macêdo ,
- Nanielle Silva Barbosa ,
- Priscilla Dantas Almeida ,
- Júlia Oliveira Melo ,
- Jonas Alves Cardoso , [ … ],
- Telma Maria Evangelista de Araújo
Abstract
REVIEWPrimary health care professionals’ practice in the face of leprosy: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230207
DOI 10.1590/0034-7167-2023-0207
- Michelle Santos Macêdo ,
- Nanielle Silva Barbosa ,
- Priscilla Dantas Almeida ,
- Júlia Oliveira Melo ,
- Jonas Alves Cardoso ,
- Telma Maria Evangelista de Araújo
Views0See moreABSTRACT
Objectives:
to identify Primary Health Care professionals’ practice in the face of leprosy.
Methods:
a scoping review, carried out between November 2022 and January 2023, conducted according to the methodological structure proposed by JBI and checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews in six databases and additional literature.
Results:
the sample consisted of 11 articles, published between 2008 and 2022. The findings were synthesized into three categories: Early diagnosis and timely treatment; Physical disability prevention; and Household and social contact surveillance.
Final Considerations:
there is a need to align the practices carried out with those recommended by the Brazilian National Program for Leprosy Control and Elimination, as some were not identified in studies, which implies losses to qualified assistance directed to patient demands, with a view to control and elimination of leprosy.
- Michelle Santos Macêdo
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ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e05
DOI 10.1590/0034-7167.20247702e05
Views0In the article “Educational technologies used to promote self-care for people with diabetes mellitus: integrative review”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 4):e20230049, in the title:Where it read:[…]See more -
ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
DOI 10.1590/0034-7167.20247702e06
Views0In the article “Is there scientific relevance to the plot of films and documentaries about eating disorders?”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(1):e20220547, page 7:Where it read:[…]See more
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ORIGINAL ARTICLE06-29-2020
Hand hygiene in high-complexity sectors as an integrating element in the combat of Sars-CoV-2
- Danielle Galdino de Paula ,
- Marianna Ramos Francisco ,
- Juliana Dias Freitas ,
- Renata Christine Quintella Levachof ,
- Bianca de Oliveira Fonseca , [ … ],
- Rafael de Lima Bilio
Abstract
ORIGINAL ARTICLEHand hygiene in high-complexity sectors as an integrating element in the combat of Sars-CoV-2
Revista Brasileira de Enfermagem. 2020;73:e20200316
DOI 10.1590/0034-7167-2020-0316
- Danielle Galdino de Paula ,
- Marianna Ramos Francisco ,
- Juliana Dias Freitas ,
- Renata Christine Quintella Levachof ,
- Bianca de Oliveira Fonseca ,
- Bruno Francisco Teixeira Simões ,
- Rafael de Lima Bilio
Views0See moreABSTRACT
Objective:
to perform a situational diagnosis of the behavior of health professionals concerning hand hygiene practices in highly-complex sectors.
Methods:
this quantitative and retrospective study was based on reports (2016 and 2017) of Adult and Pediatric ICUs of a Federal hospital in Rio de Janeiro.
Results:
one thousand two hundred fifty-eight opportunities for hand hygiene were analysed. The chance of professionals sanitizing hands in Pediatric ICUs is 41.61% higher than in Adult ICUs. Concerning proper hand hygiene, the medical team had a 39.44% lower chance than the nursing team. Others had a 30.62% lower chance when compared to the nursing team. The moment “after contact with the patient” presented 4.5275 times the chance in relation “before contact with the patient”.
Conclusion:
in front of hand hygiene recommendations to control COVID-19, diagnostic assessment and previous analysis of the behavior of professionals proved to be positive.
- Danielle Galdino de Paula
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ORIGINAL ARTICLE08-19-2019
Functional capacity and social support to people affected by cerebrovascular accident
- Raquel Janyne de Lima ,
- Cláudia Jeane Lopes Pimenta ,
- Maria Cristina Lins de Oliveira Frazão ,
- Gerlania Rodrigues Salviano Ferreira ,
- Tatiana Ferreira da Costa , [ … ],
- Kátia Neyla de Freitas Macedo Costa
Abstract
ORIGINAL ARTICLEFunctional capacity and social support to people affected by cerebrovascular accident
Revista Brasileira de Enfermagem. 2019;72(4):868-873
DOI 10.1590/0034-7167-2017-0854
- Raquel Janyne de Lima ,
- Cláudia Jeane Lopes Pimenta ,
- Maria Cristina Lins de Oliveira Frazão ,
- Gerlania Rodrigues Salviano Ferreira ,
- Tatiana Ferreira da Costa ,
- Lia Raquel de Carvalho Viana ,
- Kaisy Pereira Martins ,
- Kátia Neyla de Freitas Macedo Costa
Views0See moreABSTRACT
Objective:
To investigate the functional capacity and its relationship with the level of social support to people affected by cerebrovascular accident.
Methods:
Cross-sectional and quantitative research, conducted with 108 individuals with sequelae of cerebrovascular accident in João Pessoa/PB. Data were collected through interviews, using a sociodemographic instrument – the Barthel Index and the Social Support Scale.
Results:
We observed the prevalence of functional dependency in 93.5%, and the mild dependency stood out in 40.7%. Medium social support was the most found, with 48.2%. The predominant dimensions of social support were the material dimension, followed by the emotional. There was a significant association (p ≤ 0.05) between very serious dependency and high social support.
Conclusion:
The results found allow us to reflect on the need for involvement of health professionals in strengthening the social support of patients with disabling diseases, such as the cerebrovascular accident.
- Raquel Janyne de Lima
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ORIGINAL ARTICLE08-19-2019
Nursing practice in home care: the mediation of care by reflexivity
- Angélica Mônica Andrade ,
- Edna Aparecida Barbosa de Castro ,
- Maria José Menezes Brito ,
- Patrícia Pinto Braga ,
- Kênia Lara Silva
Abstract
ORIGINAL ARTICLENursing practice in home care: the mediation of care by reflexivity
Revista Brasileira de Enfermagem. 2019;72(4):956-963
DOI 10.1590/0034-7167-2018-0431
- Angélica Mônica Andrade ,
- Edna Aparecida Barbosa de Castro ,
- Maria José Menezes Brito ,
- Patrícia Pinto Braga ,
- Kênia Lara Silva
Views0See moreABSTRACT
Objective:
To analyze the practice of nurses in home care, considering the mediation of care by reflexivity.
Method:
Unique, qualitative case study, anchored in the dialectical framework. The participants were 13 nurses who work in home care in Minas Gerais. Data were obtained by participant observation and interview, and submitted to critical discourse analysis.
Results:
Nursing care at home involves the repetitions of everyday actions and a degree of unpredictability. Reflexivity, according to Schön’s theoretical framework, emerges as a component of professional practice that leads to the practice of care as a continuous assessment of work, and also to reflection on the challenges imposed by conflicting situations. Reflexivity also stems from professionals’ search for improvements in their practices.
Final considerations:
We identified the presence of actions and knowledge mobilized by the reflexivity of the nurse in the home care setting. The following were the elements of this reflexive practice: knowing-in-action, reflection-in-action and reflection reflection-in-action.
- Angélica Mônica Andrade
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ORIGINAL ARTICLE10-18-2022
Adherence to antiretroviral therapy by adults living with HIV/aids: a cross-sectional study
- Mariana de Morais Fortunato Miranda ,
- Dayanne Rakelly de Oliveira ,
- Glauberto da Silva Quirino ,
- Célida Juliana de Oliveira ,
- Maria Lúcia Duarte Pereira , [ … ],
- Edilma Gomes Rocha Cavalcante
Abstract
ORIGINAL ARTICLEAdherence to antiretroviral therapy by adults living with HIV/aids: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(2):e20210019
DOI 10.1590/0034-7167-2021-0019
- Mariana de Morais Fortunato Miranda ,
- Dayanne Rakelly de Oliveira ,
- Glauberto da Silva Quirino ,
- Célida Juliana de Oliveira ,
- Maria Lúcia Duarte Pereira ,
- Edilma Gomes Rocha Cavalcante
Views0ABSTRACT
Objective:
To verify the association between adherence to antiretroviral treatment by adults with HIV/AIDS and sociodemographic factors, social and clinical support.
Methods:
Cross-sectional study, with a quantitative approach. Participation of 230 patients. Questionnaires of sociodemographic characterization, social and clinical support, and assessment of adherence to antiretroviral treatment were used. Descriptive and inferential statistics were performed.
Results:
Adherence was classified as good/adequate. An association with sex, income, employment, and level of education was noted. In social support: having access to health services; communication with health professionals; health education; having support to allow venting/talking about issues; information on HIV/AIDS; and company for leisure. In the clinical profile: non-interruption of the drug treatment due to absence from the service or due to changes in the medical prescription.
Conclusion:
Adherence was classified as good/adequate and especially associated with social support factors, which should be enhanced in clinical practice.
Keywords:Acquired Immunodeficiency SyndromeAdherence to MedicationHighly Active Antiretroviral TherapyHIVSocial SupportSee more - Mariana de Morais Fortunato Miranda
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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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EDITORIAL01-27-2020
Comparison of Interpretive Description and Qualitative Description in the Nursing Scope
Revista Brasileira de Enfermagem. 2020;73(1):e20190339
Abstract
EDITORIALComparison 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 -
ORIGINAL ARTICLE06-04-2021
Information demands from families of children with Autism Spectrum Disorder
- Gisele Weissheimer ,
- Verônica de Azevedo Mazza ,
- Julia Mazul Santana ,
- Victoria Beatriz Trevisan Nobrega Martins Ruthes ,
- Cibelly Aliny Siqueira Lima Freitas
Abstract
ORIGINAL ARTICLEInformation demands from families of children with Autism Spectrum Disorder
Revista Brasileira de Enfermagem. 2021;74(5):e20200642
DOI 10.1590/0034-7167-2020-0642
- Gisele Weissheimer ,
- Verônica de Azevedo Mazza ,
- Julia Mazul Santana ,
- Victoria Beatriz Trevisan Nobrega Martins Ruthes ,
- Cibelly Aliny Siqueira Lima Freitas
Views0See moreABSTRACT
Objective:
to identify the information demands of families of children with Autism Spectrum Disorder.
Method:
this is a qualitative study conducted through semi-structured and audio-recorded interviews with 55 family members, in the states of Paraná, Ceará, and Macapá, between September 2018 and September 2019. Thematic category analysis and Qualitative Data Analysis Software resources were used for data organization.
Results:
it was identified that families need information regarding the characteristics of Autism Spectrum Disorder (definition, cause, possibility of cure, prognosis and the probability of having another child with Autism Spectrum Disorder); child’s routine and behavior; future rights and expectations.
Final considerations:
information demands are relevant to support professionals, health managers and other services in health care organization to support families of children with autism.
- Gisele Weissheimer
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ORIGINAL ARTICLE07-31-2020
Educational demands of family members of children with special health care needs in the transition from hospital to home
- Meirilane Lima Precce ,
- Juliana Rezende Montenegro Medeiros de Moraes ,
- Sandra Teixeira de Araújo Pacheco ,
- Liliane Faria da Silva ,
- Daniele Santos da Conceição , [ … ],
- Elisa da Conceição Rodrigues
Abstract
ORIGINAL ARTICLEEducational demands of family members of children with special health care needs in the transition from hospital to home
Revista Brasileira de Enfermagem. 2020;73:e20190156
DOI 10.1590/0034-7167-2019-0156
- Meirilane Lima Precce ,
- Juliana Rezende Montenegro Medeiros de Moraes ,
- Sandra Teixeira de Araújo Pacheco ,
- Liliane Faria da Silva ,
- Daniele Santos da Conceição ,
- Elisa da Conceição Rodrigues
Views0See moreABSTRACT
Objectives:
to analyze the educational demands of family members of children with special health care needs in the transition from hospital to home
Methods:
qualitative research conducted between February and June 2018, using the handbook on creativity and sensitivity dynamics, from the sensitive creative method; the participants were nine family caregivers of children admitted to a public hospital in Rio de Janeiro; the data were subjected to French discourse analysis
Results:
the educational demands were clinical, centered on the categories complex and continuous care, technological care, modified habits, medication, development and mixed care, and social, related to the supplies and rights of children
Final Considerations:
the social educational demand has emerged as a new demand to be incorporated in the care of these children. The transition from hospital to home should be progressive and have the nurse as its coordinator, with the objective of providing participatory, safe, quality care, articulated within a social network
- Meirilane Lima Precce
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