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ORIGINAL ARTICLE12-16-2024
Predisposing factors for symptoms of anxiety, depression, and insomnia in university students
Revista Brasileira de Enfermagem. 2024;77(6):e20230387
Abstract
ORIGINAL ARTICLEPredisposing factors for symptoms of anxiety, depression, and insomnia in university students
Revista Brasileira de Enfermagem. 2024;77(6):e20230387
DOI 10.1590/0034-7167-2023-0387
Views0See moreABSTRACT
Objectives:
to characterize the sociodemographic and psychological aspects of university students who sought psychiatric care at a Student Support Center of a Federal University and to analyze associations between mental health issues and predisposing factors.
Methods:
a retrospective analysis of 103 medical records was conducted. The statistical analysis consisted of two steps: a descriptive analysis and a predictive analysis using the Logistic Regression Model.
Results:
the majority of the students were female. Symptoms of anxiety, depression, and insomnia were the main reasons for seeking care. Students who reported having emotional difficulties that negatively impacted their studies and those who had undergone some form of health treatment showed a higher probability of experiencing anxiety symptoms. Notable correlations were found between anxiety and emotional difficulties, depression and diarrhea, and insomnia and a sedentary lifestyle.
Conclusions:
symptoms of anxiety, depression, and insomnia led students to seek psychiatric care at the university. Understanding the predisposing factors for mental health issues in university students can inform care strategies and promote academic success.
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ORIGINAL ARTICLE12-16-2024
Educational technology to empower patients as participants in their care
Revista Brasileira de Enfermagem. 2024;77(6):e20230359
Abstract
ORIGINAL ARTICLEEducational technology to empower patients as participants in their care
Revista Brasileira de Enfermagem. 2024;77(6):e20230359
DOI 10.1590/0034-7167-2023-0359
Views0See moreABSTRACT
Objectives:
to build and validate an educational technology to empower patients as participants in their own care.
Methods:
methodological study to develop an educational technology based on the elaboration, validation, and evaluation that were carried out in five stages at a teaching hospital in Amazonas. The study was carried out from 2019 to 2022, with the participation of 19 judges specialized in patient safety and 72 patients admitted to the hospital’s medical and surgical clinics, the study setting.
Results:
the agreement between the judges obtained an overall index of 0.85, being considered validated. The overall analysis of the booklet obtained an assessment of the level of agreement above 85%.
Final Considerations:
the educational technology presented here was validated and suitable for promoting patient/professional rapprochement and consolidating health care in a way that increases the patient’s ability to contribute to their treatment and prevent the occurrence of adverse events.
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ORIGINAL ARTICLE12-16-2024
The relationship between gender, educational background, and learning environment with nursing student’s anxiety
Revista Brasileira de Enfermagem. 2024;77(6):e20220615
Abstract
ORIGINAL ARTICLEThe relationship between gender, educational background, and learning environment with nursing student’s anxiety
Revista Brasileira de Enfermagem. 2024;77(6):e20220615
DOI 10.1590/0034-7167-2022-0615
Views0See moreABSTRACT
Objectives:
to identify variables associated with nursing students’ anxiety-related clinical practice.
Methods:
this study used a correlational quantitative descriptive design with the STROBE equator instrument. The population is 233 nursing students with a sample of 135. Data were collected from March to April 2022 using validated instruments.
Results:
the Chi-square test and the sig likelihood ratio on the gender, educational background, and learning environment is more than 0.05 so there is no significant relationship between the variables and student anxiety.
Conclusions:
students need to be prepared again before entering the practice field. Qualitative research is needed too.
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ORIGINAL ARTICLE12-16-2024
Training profile of intensive care nurses in Brazil: cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(6):e20230460
Abstract
ORIGINAL ARTICLETraining profile of intensive care nurses in Brazil: cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(6):e20230460
DOI 10.1590/0034-7167-2023-0460
Views0ABSTRACT
Objectives:
to describe the training profile of Brazilian intensive care nurses.
Methods:
a cross-sectional study carried out in two stages: a structured, self-administered questionnaire; mapping of the national supply of lato sensu postgraduate courses. Data was collected on the sociodemographic profile, training process and characterization of the courses.
Results:
in the first stage, 202 respondents were obtained. The majority were women (79.2%), aged between 26 and 45 (80.7%), graduated less than 5 years ago (44%), through lato sensu postgraduate courses (55.5%), which were marked by the absence of laboratory practice (57.5%) and guided tours (42.5%). In the second stage, 457 courses were identified, with face-to-face teaching (58.9%), a workload of 360 to 420 hours (51.2%), a duration of up to 6 months (41.8%) and variation in the sub-area of training.
Conclusions:
there was a predominance of professionals graduating from lato sensu post-graduate courses, with essentially theoretical teaching and heterogeneity in terms of modality, workload and sub-area of training.
Keywords:Critical Care NursingEducationIntensive Care UnitsNursing EducationNursing, GraduateProfessional PracticeSee more -
ORIGINAL ARTICLE12-16-2024
Construction and validation of an educational game on biosafety in the central sterile supply department
Revista Brasileira de Enfermagem. 2024;77(6):e20230478
Abstract
ORIGINAL ARTICLEConstruction and validation of an educational game on biosafety in the central sterile supply department
Revista Brasileira de Enfermagem. 2024;77(6):e20230478
DOI 10.1590/0034-7167-2023-0478
Views0See moreABSTRACT
Objectives:
to construct and validate an educational game on biosafety in the Central Sterile Supply Department of a hospital in Curitiba, PR.
Methods:
the study was conducted using a quantitative approach, employing applied and technological research with an exploratory design. The process was divided into six stages, from the definition of the theme to the validation and application of the game. The study was carried out from May to August 2022, involving 17 nursing professionals from a Central Sterile Supply Department during day and night shifts, as well as 9 judges.
Results:
the study resulted in the construction of a board game named by the authors as “My Health First.”
Conclusions:
the research achieved its objective of constructing and validating an educational game. By reflecting on professional practice and correlating the occupational risks present, the professionals were able to list safe actions, identify problems, and seek solutions.
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REVIEW12-16-2024
Strategies for expanding vaccination coverage in children in Brazil: systematic literature review
Revista Brasileira de Enfermagem. 2024;77(6):e20230343
Abstract
REVIEWStrategies for expanding vaccination coverage in children in Brazil: systematic literature review
Revista Brasileira de Enfermagem. 2024;77(6):e20230343
DOI 10.1590/0034-7167-2023-0343
Views0See moreABSTRACT
Objectives:
to identify the strategies found in the literature for increasing vaccination coverage among children in Brazil. It is justified mainly by the current scenario of falling vaccination coverage.
Methods:
systematic literature review. The search was carried out in the Pubmed (MEDLINE), Embase and Scopus databases, following the PRISMA guidelines.
Results:
initially, 4,824 results were returned. In the end, 6 studies were included for narrative synthesis using the SWiM methodology. Of these, 50% dealt with studies related to the Bolsa Família Program (PBF). The others explored strategies for approaching parents directly, Rapid Vaccination Monitoring (MRV) and the Community Health Agents Program (PACS). The PBF did not guarantee compliance with the conditionality of keeping vaccinations up to date. The MRV and PACS are effective strategies, especially because they allow active search for absentees.
Conclusions:
we conclude that more publications are needed on strategies to increase vaccination coverage among children in Brazil.
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ORIGINAL ARTICLE12-16-2024
Complexities of nursing in healthcare waste management in hospitals
Revista Brasileira de Enfermagem. 2024;77(6):e20230391
Abstract
ORIGINAL ARTICLEComplexities of nursing in healthcare waste management in hospitals
Revista Brasileira de Enfermagem. 2024;77(6):e20230391
DOI 10.1590/0034-7167-2023-0391
Views0See moreABSTRACT
Objectives:
to understand how healthcare waste management is developed by nursing professionals in hospitals.
Methods:
qualitative research, whose theoretical and methodological frameworks were Complexity Theory and Grounded Theory. Thirty-two nursing professionals from a public hospital in Rio de Janeiro participated in the study. Semi-structured interviews were used.
Results:
nursing affects healthcare waste management multidimensionally. Shortage of materials and work overload were identified as factors that influence professionals’ decision-making and increase the risk of improper waste disposal. The lack of knowledge on the subject also influences nursing practice. However, professionals value actions related to hazardous waste.
Final Considerations:
nursing professionals recognize themselves in healthcare waste management and understand the need to develop systemic awareness for sustainable practice.
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REVIEW09-21-2020
Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
Abstract
REVIEWMiddle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
DOI 10.1590/0034-7167-2019-0334
Views1See moreABSTRACT
Objective:
To stablish a middle range theory for the understanding of the causal mechanisms and clinical consequentes of the nursing diagnosis Excess Fluid Volume (00026) among pregnant women.
Method:
The Middle Range Theory was constructed in five stages: defining of construction approach, establishing main concepts, elaborating propositions, developing a pictorial diagram, and establishing the causal relationships and evidence for practice of the Middle Range Theory.
Results:
We identified 14 clinical indicators and 6 causal factors of Excess Fluid Volume. A pictorial diagram was developed and relationships between Excess Fluid Volume elements were established with 6 propositions for them.
Conclusion:
The Middle Range Theory included both physiological and pathological conditions to explain Excess Fluid Volume. This Middle Range Theory might help in the better understanding of interactions between causal factors and clinical indicators of Excess Fluid Volume.
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ORIGINAL ARTICLE06-27-2019
Assessment of the attribute “Community Orientation” from the perspective of primary care adult users
Revista Brasileira de Enfermagem. 2019;72(3):632-639
Abstract
ORIGINAL ARTICLEAssessment of the attribute “Community Orientation” from the perspective of primary care adult users
Revista Brasileira de Enfermagem. 2019;72(3):632-639
DOI 10.1590/0034-7167-2018-0601
Views1See moreABSTRACT
Objective:
To assess the presence and extension of the attribute “Community Orientation” of Primary Health Care from the perspective of health services adult users from the Municipality of Juazeiro do Norte-CE.
Methods:
Quantitative, cross-sectional and evaluative study, carried out in 14 Basic Health Units, from October 2016 to June 2017, using the Primary Care Assessment Tool.
Results:
The attribute assessment was negative, reaching expressive negative responses in the seven districts, with a mean score of 3.8 (±3.8). The Raw Score (RS) reached a mean of 6.6 and the Derived Score (DS) was assigned a score of 6.4, below the cut-off point ≥ 6.60.
Conclusion:
The low value of the DS represents that units are not providers of PHC, suggesting fragility in the integration of services with the community and the need to promote greater discussion among agents, when designing measures of intervention and improvement of scores.
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REVIEW12-21-2020
Communication between pre-hospital and intra-hospital emergency medical services: literature review
Revista Brasileira de Enfermagem. 2020;73:e20190817
Abstract
REVIEWCommunication between pre-hospital and intra-hospital emergency medical services: literature review
Revista Brasileira de Enfermagem. 2020;73:e20190817
DOI 10.1590/0034-7167-2019-0817
Views1ABSTRACT
Objectives:
to analyze, according to the scientific literature, communication strategies in the transfer of cases between pre-hospital and in-hospital services and their contributions to patient safety.
Methods:
this is a literature review study, that is, one that aims to gather and synthesize research results on the subject in a systematic and orderly manner.
Results:
ten articles were published, published between 2010 and 2018, and two points of discussion emerged: use of mnemonics; and barriers to transferring a case.
Conclusions:
studies point to the need to standardize the case transfer process, as well as integrative training of professionals, regular assessment of the teams involved in emergency medical services and the need for research on the subject.
Keywords:AmbulanceCommunicationEmergency Medical ServicesReviewTransfer of Responsibility by the PatientSee more -
ORIGINAL ARTICLE03-24-2021
Health promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
Abstract
ORIGINAL ARTICLEHealth promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
DOI 10.1590/0034-7167-2019-0769
Views1See moreABSTRACT
Objectives:
to compare health promotion actions carried out by Family Health teams in Ceará, linked to the School Health Program.
Methods:
a cross-sectional study involving the first and second cycles of an external assessment of 910 and 1,626 teams from 184 municipalities, which joined the Brazilian National Program for Improvement of Access and Quality of Primary Care. Eight clinical assessment and seven health promotion indicators were assessed, together with health professionals working in schools.
Results:
the interviewees were nurses (95.6% and 98.3%). Between the cycles, there was an increase in clinical assessment (78.7% and 91.3%), health promotion and disease prevention (82.5% and 89.3%) and survey of students for follow-up (41.4% and 66.4%) in schools.
Conclusions:
health actions at school advanced between cycles, with nurses as protagonists in school health, which can reduce vulnerabilities in children and adolescents and qualify Primary Care.
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ORIGINAL ARTICLE05-28-2021
Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
Abstract
ORIGINAL ARTICLEManaged clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
DOI 10.1590/0034-7167-2020-0282
Views1See moreABSTRACT
Objectives:
to assess the impact of the implementation of a managed sepsis protocol on quality indicators of treatment for septic patients in an emergency department of a university hospital.
Methods:
an observational epidemiological study involving septic patients. The study was divided into two phases, pre-intervention and intervention, resulting from the implementation of the managed sepsis protocol. The study variables included sepsis treatment quality indicators. The results were statistically analyzed using the program Epi InfoTM.
Results:
the study sample included 631 patients, 95 from pre-intervention phase and 536 from intervention phases. Implementing the protocol increased patients’ chances of receiving the recommended treatment by 14 times. Implementing the protocol reduced the hospitalization period by 6 days (p <0.001) and decreased mortality (p <0.001).
Conclusions:
this study showed that implementing the managed protocol had an impact on the improvement of sepsis treatment quality indicators.
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ORIGINAL ARTICLE05-28-2021
Prevalence and severity levels of post-radical prostatectomy incontinence: different assessment instruments
Revista Brasileira de Enfermagem. 2021;74(2):e20200692
Abstract
ORIGINAL ARTICLEPrevalence and severity levels of post-radical prostatectomy incontinence: different assessment instruments
Revista Brasileira de Enfermagem. 2021;74(2):e20200692
DOI 10.1590/0034-7167-2020-0692
Views1See moreABSTRACT
Objectives:
to analyze urinary incontinence prevalence and severity in prostatectomized men assessed by three different instruments.
Methods:
a cross-sectional study was conducted with 152 men. The pad test, pad used, and International Consultation on Incontinence Questionnaire – Short Form (self-report) were considered. Data were analyzed using Spearman’s correlation, Kappa index, considering a significance level of 0.05.
Results:
urinary incontinence prevalence was 41.4%, 46.7% and 80.3% according to pad used, pad test and self-report. Positive correlations and moderate to poor agreement were found between the instruments. As for severity, most participants had mild incontinence. The largest number of cases of mild and severe incontinence was identified by self-report.
Conclusions:
the self-report showed higher values for prevalence of mild and severe severity levels. Through the identified differences, we propose that the objective assessment (pad used and pad test) be associated with individuals’ perception (self-report) to better estimate prevalence and severity.
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ORIGINAL ARTICLE05-28-2021
Cultural adaptation and validation of an instrument about nursing critical thinking skills
Revista Brasileira de Enfermagem. 2021;74(2):e20200720
Abstract
ORIGINAL ARTICLECultural adaptation and validation of an instrument about nursing critical thinking skills
Revista Brasileira de Enfermagem. 2021;74(2):e20200720
DOI 10.1590/0034-7167-2020-0720
Views1See moreABSTRACT
Objectives:
to validate the Nursing Critical Thinking in Clinical Practice Questionnaire regarding cultural aspects and metric properties.
Methods:
a methodological research carried out through cross-cultural adaptation, face and content validity, dimensional construct and known groups validity, test-retest reliability and internal consistency. 511 nurses from four hospitals participated in the study, of which 54 participated in retest.
Results:
the instrument validation for Brazilian Portuguese maintained equivalences, according to the original version. The dimensional validity demonstrated adjustment to the tetrafactorial structure of the original version (GFI=0.69). There were statistically significant differences in critical thinking skills between nurses with graduate degrees and who undertook training, reading articles, developing research and working in an institution with a longer time implementation of the Nursing Process. The instrument showed temporal stability (ICC 073-0.84; p<0.001) and adequate internal consistency (α=0.97).
Conclusions:
the instrument proved to be valid and reliable for the studied population.
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REVIEW07-09-2021
Breast cancer screening in Primary Health Care in Brazil: a systematic review
Revista Brasileira de Enfermagem. 2021;74(3):e20200995
Abstract
REVIEWBreast cancer screening in Primary Health Care in Brazil: a systematic review
Revista Brasileira de Enfermagem. 2021;74(3):e20200995
DOI 10.1590/0034-7167-2020-0995
Views1See moreABSTRACT
Objectives:
to analyze care strategies for breast cancer screening in Primary Health Care in Brazil.
Methods:
this is a systematic review following the Cochrane Collaboration recommendations.
Results:
among 355 manuscripts, five were eligible. The patient navigation program by Community Health Agent stood out with the best result, among the strategies: flexibility of goals considering viability; community engagement; team training; active search of the target population by Community Health Agent; request for mammography by physicians; actions integrated to women’s health; monitoring of mammography results, absent users, and population coverage by physician and nurse; and assessment of criteria for requesting screening mammography by means of an information system. The population coverage rate in the program ranged from 23% to 88%.
Conclusions:
Primary Health Care in Brazil presents devices with potential to induce the production of care for breast cancer screening.
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ORIGINAL ARTICLE10-21-2019
Being an institutionalized elderly person: meaning of experiences based on Heidegger’s phenomenology
Revista Brasileira de Enfermagem. 2019;72(6):1632-1638
Abstract
ORIGINAL ARTICLEBeing an institutionalized elderly person: meaning of experiences based on Heidegger’s phenomenology
Revista Brasileira de Enfermagem. 2019;72(6):1632-1638
DOI 10.1590/0034-7167-2018-0763
Views0See moreABSTRACT
Objective:
Analyze the meaning of being an elderly person living in a long-term institution.
Method:
Qualitative study based on Martin Heidegger’s thought. Twelve phenomenological interviews were conducted with people aged over 60 years living in a long-term institution for the elderly in the city of Itabuna, Bahia, Brazil.
Results:
The units of meaning identified were: experience of progressive loss of autonomy and independence, perception of living in an institution as an inevitable circumstance; and being-with becoming being-alone/being-lonely. After the identification of ontic aspects and hermeneutical understanding, the unit of meaning was constructed: meaning of being an elderly person living in a long-term institution.
Final considerations:
The ontological needs referring to being an elderly person remain forgotten. As we are ontic and ontological, limited care to the ontic instance indicates deficiencies in institutionalization. Improvements are required to ensure the right to age with quality of life to this population.
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ORIGINAL ARTICLE09-21-2020
Adaptive problems arising out of the progenitor’s abandonment after Zika Congenital Syndrome
Revista Brasileira de Enfermagem. 2020;73:e20190602
Abstract
ORIGINAL ARTICLEAdaptive problems arising out of the progenitor’s abandonment after Zika Congenital Syndrome
Revista Brasileira de Enfermagem. 2020;73:e20190602
DOI 10.1590/0034-7167-2019-0602
Views0See moreABSTRACT
Objective:
to reveal the adaptive problems of the woman abandoned by the child’s parent after Congenital Zika Syndrome, in the light of Roy’s Adaptation Model.
Method:
a qualitative, descriptive study, based on Roy’s Adaptation Model, developed with six women abandoned by their child’s parent after Zika Congenital Syndrome diagnosis, through interview and Content Analysis technique.
Results:
adaptive problems appeared in nutrition, activity, rest, and protection patterns, due to limitations in self-care; self-concept, related to dissatisfaction with body image and personal being; in the role of transition role, through difficulties in taking over new roles and in interdependence, related to changes in affective needs.
Final considerations:
the overload of care for children with Congenital Zika Syndrome, added to the challenges of the abandoned woman by her child’s parent, led to adaptive problems, showing their main difficulties of coping.
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REVIEW04-16-2021
Nursing assistance in patient care with external ventricular drain: a scoping review
Revista Brasileira de Enfermagem. 2021;74(2):e20190796
Abstract
REVIEWNursing assistance in patient care with external ventricular drain: a scoping review
Revista Brasileira de Enfermagem. 2021;74(2):e20190796
DOI 10.1590/0034-7167-2019-0796
Views0See moreABSTRACT
Objectives:
to map the available evidence about nursing care aimed at adult patients using external ventricular drain.
Methods:
this is a review using the scoping review method.
Results:
Initially, 965 studies were identified and, after the eligibility criteria, a sample of 54 publications was obtained. Each of them was assessed according to GRADE, resulting in three studies with high quality; 14 with moderate quality; 32 with low quality; and five with very low quality. It was highlighted 20 nursing care subdivided into nine categories, namely: drainage system; bed positioning and mobilization; catheter care; monitoring of intracranial pressure; and medication administration.
Conclusions:
the scoping review made it possible to identify the main nursing care directed to adult patients undergoing placement of external ventricular drain from the evidence available to date.
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REFLECTION11-11-2020
Children with special needs in health: challenges of the single health system in the 21st century
Revista Brasileira de Enfermagem. 2020;73:e20190037
Abstract
REFLECTIONChildren with special needs in health: challenges of the single health system in the 21st century
Revista Brasileira de Enfermagem. 2020;73:e20190037
DOI 10.1590/0034-7167-2019-0037
Views0See moreABSTRACT
Objective:
Reflect on the gaps in the care of Children with Special Needs in Health that demand complex clinical care with dependence on technological support for the maintenance of life, in the Unified Health System.
Methods:
This is a reflection study based on recent policies and literature related to the theme.
Discussion:
Despite the advances achieved with the Unified Health System with regard to access to health services and the expansion of Primary Care, with the aim of reorienting health, it can be said that the health care model for CSHCN in Brazil is still centered on the hospital and medical knowledge.
Final considerations:
There are gaps in the policies for children aimed at the new paediatric profile, and little is discussed about its implications for the Unified Health System.
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Resilience in elderly people: factors associated with sociodemographic and health conditions
Revista Brasileira de Enfermagem. 2021;74:e20200171
Abstract
Resilience in elderly people: factors associated with sociodemographic and health conditions
Revista Brasileira de Enfermagem. 2021;74:e20200171
DOI 10.1590/0034-7167-2020-0171
Views0See moreABSTRACT
Objective:
to describe the sociodemographic and health characteristics of elderly people, measure the score of total resilience and by sex and verify the association of sociodemographic and health variables with total resilience and by sex.
Methods:
this is a household survey with 808 elderly people, assessed by validated instruments. Student’s t test and multiple linear regression (p<0.05).
Results:
most were female, 60|-|79 years old. The total resilience score was 78.06, for men 81.53 and for women, 76.32. Total resilience was associated with males; positive self-perceived health; greater participation in Advanced Activities of Daily Living; fewer morbidities; absence of depressive symptoms. Among men and women, resilience was associated with greater participation in Advanced Activities of Daily Living and absence of depressive symptoms and, specifically, among women, positive self-perceived health.
Conclusion:
these results contribute to nursing care, aiming to encourage resilience.
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ORIGINAL ARTICLE04-15-2022
Nursing diagnoses in elderly people with diabetes mellitus according to Orem’s Self-Care Theory
Revista Brasileira de Enfermagem. 2022;75:e20201171
Abstract
ORIGINAL ARTICLENursing diagnoses in elderly people with diabetes mellitus according to Orem’s Self-Care Theory
Revista Brasileira de Enfermagem. 2022;75:e20201171
DOI 10.1590/0034-7167-2020-1171
Views0See moreABSTRACT
Objective:
To identify nursing diagnoses and conditioning factors of self-care in older adults with diabetes mellitus, in the light of Orem’s Theory of Self-Care.
Methods:
Exploratory, descriptive study with a qualitative approach, conducted with the theoretical framework of Orem’s Theory of Self-Care. It was developed with 12 older people with diabetes, in a country’s southern municipality, between October and November 2019. For data collection, it was used individual interviews and focus groups. The data was submitted to thematic and content analysis directed to taxonomy II of NANDA International.
Results:
Twenty nursing diagnoses related to universal self-care requirements and health deviations were identified. All diagnoses were anchored in the supportive-education nursing system.
Final considerations:
The development of the disease and the consequences of chronic hyperglycemia were poorly recognized by the elderly, interfering with low adherence to self-care practices and disease control.
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