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REVIEW
Preditores de nanismo entre crianças de 0 a 24 meses no Sudeste Asiático: Uma revisão do escopo
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
05-13-2024
Abstract
REVIEWPreditores de nanismo entre crianças de 0 a 24 meses no Sudeste Asiático: Uma revisão do escopo
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
05-13-2024DOI 10.1590/0034-7167-2022-0625
Views0See moreRESUMEN
Objetivo:
Identificar indicadores de desnutrición crónica entre niños de 0 a 24 meses en el Sudeste Asiático.
Métodos:
Esta revisión de alcance se centró en artículos con diseño de estudio observacional publicados en inglés, entre los años 2012 y 2023 de cinco bases de datos internacionales. Las principales palabras clave utilizadas fueron: “stunting (Desnutrición crónica)” o “growth disorder (Desorden del crecimiento)”, y “newborn (Recién nacido)”, y “predict (Predecir)”, y “Southeast Asia (Sudeste Asiático)”.
Resultados:
De los 27 artículos seleccionados para el análisis final, se encontraron trece indicadores que influyen en la desnutrición crónica en siete países del Sudeste Asiático. Los trece indicadores incluyen el niño, la madre, el hogar, la alimentación inadequada complementaria, la lactancia materna inadecuada, la atención inadecuada, los alimentos de mala calidad, la seguridad de los alimentos y el agua, la infección, la economía política, la salud y la asistencia sanitaria, el agua, el saneamiento y el medio ambiente, y por último el factor sociocultural.
Conclusión:
Todos estos indicadores pueden provocar desnutrición crónica en niños del Sudeste Asiático. Para poder prevenirlo los prestadores de servicios de salud y otros sectores relacionados, necesitan realizar actividades de promoción y prevención de la salud de acuerdo con los indicadores encontrados en este artículo.
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REVIEW
Lean methodology: contributions to improving work processes in health and nursing
- Fernanda Novaes Moreno Brancalion
, - Lara Gonçalves de Souza ,
- Simone Berger ,
- Antônio Fernandes Costa Lima
05-13-2024
Abstract
REVIEWLean methodology: contributions to improving work processes in health and nursing
Revista Brasileira de Enfermagem. 2024;77(2):e20230322
05-13-2024DOI 10.1590/0034-7167-2023-0322
- Fernanda Novaes Moreno Brancalion ,
- Lara Gonçalves de Souza ,
- Simone Berger ,
- Antônio Fernandes Costa Lima
Views0ABSTRACT
Objective:
to investigate the contributions of applying the Lean methodology to improve work processes in health and nursing and its impact on associated financial aspects.
Method:
an integrative review, carried out in six databases, whose sample of ten (100.0%) studies was analyzed and summarized descriptively.
Results:
the outcomes obtained were stratified into: benefits/barriers to Lean Healthcare implementation; economic aspects involving Lean Healthcare implementation; and process improvements through Lean Healthcare implementation. The majority of studies (60.0%) were carried out in university hospitals, contexts that need to continually improve the quality of services provided, generally with scarce and limited resources, which support the viability of maintaining the teaching, research and extension tripod.
Conclusion:
three (30.0%) studies highlighted the financial aspects associated with Lean methodology application. The others only mentioned the possibility of financial gains through improving processes and reducing waste.
Keywords:Cost Efficiency AnalysisCost SavingsEfficiencyOrganizationalProcess OptimizationTotal Quality ManagementSee more
- Fernanda Novaes Moreno Brancalion
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ORIGINAL ARTICLE
A influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
05-13-2024
Abstract
ORIGINAL ARTICLEA influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
05-13-2024DOI 10.1590/0034-7167-2023-0321
Views0See moreRESUMEN
Objetivos:
describir el perfil de los ancianos que acceden a internet para buscar información de salud e identificar los factores que pueden influir en las decisiones de los ancianos sobre su salud a partir de la información recopilada en línea.
Métodos:
391 ancianos respondieron a un cuestionario online sobre hábitos y satisfacción con la información de salud recogida en internet. El procesamiento de datos implicó regresión logística.
Resultados:
la educación superior reduce en un 44% la probabilidad de que un anciano siga las recomendaciones de salud en los sitios web. Sin embargo, las actividades sociales y la salud autopercibida aumentan la posibilidad de seguir las recomendaciones en un 83% y un 71%, respectivamente. La creencia de que internet promueve hábitos saludables aumenta 29,2 veces la probabilidad de que un anciano siga un consejo.
Consideraciones Finales:
conocer el perfil de los ancianos que utilizan internet puede ayudar a los profesionales a formular políticas públicas y construir buenas plataformas de información sobre salud y bienestar.
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REVIEW
Technologies used in the treatment of burn victims in intensive care: a scope review
- Kyohana Matos de Freitas Clementino ,
- Gabriela Duarte Bezerra ,
- Gleice Adriana Araujo Gonçalves ,
- Maria Corina Amaral Viana ,
- Luis Rafael Leite Sampaio , [ … ],
- Woneska Rodrigues Pinheiro
05-13-2024
Abstract
REVIEWTechnologies used in the treatment of burn victims in intensive care: a scope review
Revista Brasileira de Enfermagem. 2024;77(1):e20220738
05-13-2024DOI 10.1590/0034-7167-2022-0738
- Kyohana Matos de Freitas Clementino ,
- Gabriela Duarte Bezerra ,
- Gleice Adriana Araujo Gonçalves ,
- Maria Corina Amaral Viana ,
- Luis Rafael Leite Sampaio ,
- Woneska Rodrigues Pinheiro
Views0See moreABSTRACT
Objectives:
to analyze the technologies used by the nursing team in the treatment of skin lesions caused by burns in patients under intensive care.
Methods:
this is a scope review conducted on the LILACS, Medline, PubMed, and CINAHL databases without temporal or language restrictions.
Results:
the highlighted technologies included the use of specialized dressings, biological agents such as probiotics and cyanobacteria, as well as negative pressure therapies and enzymes such as papain and collagenase. Some technologies, such as nanocrystalline silver, demonstrated efficacy in infection control.
Final Considerations:
the study identified essential technologies in burn care, emphasizing the need for further research on “soft” technologies. The findings support the promotion of evidence-based nursing care for burn patients in intensive care and enhance knowledge about effective treatments.
- Kyohana Matos de Freitas Clementino
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ORIGINAL ARTICLE
The influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
05-13-2024
Abstract
ORIGINAL ARTICLEThe influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
05-13-2024DOI 10.1590/0034-7167-2023-0321
Views0See moreABSTRACT
Objectives:
to describe the profile of older adults who access the internet to search for health information and identify the factors that can influence older adults’ decisions about their health based on information collected online.
Methods:
391 older adults answered an online questionnaire regarding habits and satisfaction with information about health collected on the internet. Data processing involved Logistic Regression.
Results:
higher education reduces by 44% the likelihood of an older adult following the health recommendations on internet sites. However, social activities and self-perceived health increase the possibility of following the recommendations by 83% and 71%, respectively. The belief that the internet promotes healthy habits increases by 29.2 times the probability of an older adult following the advice.
Final Considerations:
knowing the profile of older adults who use the Internet can help professionals formulate public policies and build good information platforms on health and well-being.
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REVIEW
Intervenções de Enfermagem para capacitar o cuidador familiar de uma pessoa com amputação de membro inferior: revisão de escopo
- Diana Fonseca Rodrigues ,
- Fabiana Sofia Ferreira Machado Castanheira ,
- António Luís Rodrigues Faria de Carvalho ,
- Cristina Maria Correia Barroso Pinto
05-03-2024
Abstract
REVIEWIntervenções de Enfermagem para capacitar o cuidador familiar de uma pessoa com amputação de membro inferior: revisão de escopo
Revista Brasileira de Enfermagem. 2024;77(1):e20230264
05-03-2024DOI 10.1590/0034-7167-2023-0264
- Diana Fonseca Rodrigues ,
- Fabiana Sofia Ferreira Machado Castanheira ,
- António Luís Rodrigues Faria de Carvalho ,
- Cristina Maria Correia Barroso Pinto
Views0See moreRESUMEN
Objetivos:
mapear intervenciones de enfermería que capaciten al cuidador familiar de la persona con amputación de miembro inferior para su rol.
Métodos:
es una revisión de alcance guiada por la metodología del Instituto Joanna Briggs, llevada a cabo en diferentes bases de datos (incluyendo literatura gris).
Resultados:
se tuvieron en cuenta seis estudios publicados entre 2009 y 2021, a saber: intervenciones de asesoramiento y apoyo para pacientes y familiares; intervenciones de apoyo entre iguales realizadas por un par de profesionales certificados; participación de cuidadores o familiares en grupos de apoyo e intervenciones clave para el equilibrio psicológico del paciente y del cuidador familiar. Dos estudios analizaron la importancia de la formación del cuidador y del amputado y del desarrollo de habilidades de afrontamiento. Otro estudio recomendó intervenciones de apoyo informativo para los cuidadores en relación con el cuidado del amputado y su adaptación a la vida hogareña.
Conclusiones:
los resultados de esta revisión permiten identificar recomendaciones/directrices para la práctica y recomendaciones/sugerencias de intervenciones según las necesidades identificadas de los cuidadores familiares de pacientes con amputación de miembros inferiores.
- Diana Fonseca Rodrigues
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ORIGINAL ARTICLE
Psychometric properties of the Chilean version of the quality of life questionnaire for multiple myeloma
- Luz Alejandra Lorca ,
- Cinara Sacomori ,
- Camila Peña ,
- Claudia Barrera ,
- Melissa Salazar , [ … ],
- Christine Rojas
05-03-2024
Abstract
ORIGINAL ARTICLEPsychometric properties of the Chilean version of the quality of life questionnaire for multiple myeloma
Revista Brasileira de Enfermagem. 2024;77(1):e20230100
05-03-2024DOI 10.1590/0034-7167-2023-0100
- Luz Alejandra Lorca ,
- Cinara Sacomori ,
- Camila Peña ,
- Claudia Barrera ,
- Melissa Salazar ,
- Ivana Leão ,
- Ximena Valladares ,
- Christine Rojas
Views0See moreABSTRACT
Objectives:
To evaluate the internal consistency and construct validity of the QLQ-MY20 for assessing the quality of life in multiple myeloma survivors in Chile.
Methods:
This was a cross-sectional study conducted between March 2020 and December 2022. It involved 118 individuals from two public hospitals. The QLQ-C30 and QLQ-MY20 questionnaires were used. Internal consistency was assessed using Cronbach’s alpha(α), and construct validity was evaluated through hypothesis testing (Mann-Whitney and Spearman correlation).
Results:
The average age of participants was 67.2 years (SD=9.2). Internal consistency for the complete scale was α=0.779, for the “disease symptoms” dimension α=0.671, for the “side effects of treatments” dimension α=0.538, and for the “future perspective” dimension α=0.670. Four of the five construct validity hypotheses were confirmed: women, individuals with worse performance status, those with pain, and those with worse fatigue showed more symptoms.
Conclusions:
The Chilean version of the QLQ-MY20 demonstrates adequate internal consistency and construct validity.
- Luz Alejandra Lorca
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ORIGINAL ARTICLE
Cancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25
Revista Brasileira de Enfermagem. 2024;77(1):e20230358
05-03-2024
Abstract
ORIGINAL ARTICLECancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25
Revista Brasileira de Enfermagem. 2024;77(1):e20230358
05-03-2024DOI 10.1590/0034-7167-2023-0358
Views0See moreABSTRACT
Objectives:
to psychometrically validate the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ-INFO25 instrument and identify the domains that influence patients’ perception of the information received.
Methods:
a cross-sectional methodology with cancer patients in a Brazilian philanthropic hospital institution. Sociodemographic and clinical instruments, EORTC QLQ-C30, EORTC QLQ-INFO25 and Supportive Care Needs Survey – Short Form 34 were used. Analysis occurred using Cronbach’s alpha coefficients, intraclass correlation, test-retest and exploratory factor analysis.
Results:
128 respondents participated. Cronbach’s alpha coefficient was 0.85. The test-retest obtained p-value=0.21. In the factor analysis, one item was excluded. Satisfaction with the information received was 74%, with three areas with averages below 70%. In open-ended questions, there was a greater desire for information.
Conclusions:
validity evidence was obtained with instrument reliability, consistency and stability. Respondents expressed satisfaction with the information received.
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ORIGINAL ARTICLE
Mental health of nursing in coping with COVID-19 at a regional university hospital
- Eduardo Bassani Dal’Bosco ,
- Lara Simone Messias Floriano ,
- Suellen Vienscoski Skupien ,
- Guilherme Arcaro ,
- Alessandra Rodrigues Martins , [ … ],
- Aline Cristina Correa Anselmo
07-13-2020
Abstract
ORIGINAL ARTICLEMental health of nursing in coping with COVID-19 at a regional university hospital
Revista Brasileira de Enfermagem. 2020;73:e20200434
07-13-2020DOI 10.1590/0034-7167-2020-0434
- Eduardo Bassani Dal’Bosco ,
- Lara Simone Messias Floriano ,
- Suellen Vienscoski Skupien ,
- Guilherme Arcaro ,
- Alessandra Rodrigues Martins ,
- Aline Cristina Correa Anselmo
Views0See moreABSTRACT
Objective:
to identify prevalence and factors associated with anxiety and depression in nursing professionals who work to cope with COVID-19 at a university hospital.
Methods:
a cross-sectional observational study using a sociodemographic questionnaire and Hospital Anxiety and Depression Scale, with 88 nursing professionals. Data were analyzed using absolute and relative frequency and Statistical Package for the Social Sciences.
Results:
there was prevalence of anxiety (48.9%) and depression (25%). The majority of the sample consisted of women over 40 years old, married or in a common-law marriage, white, with higher education or graduate degree, with an income above 3,000.00 reais, public servants, working 40 hours a week and working in the hospital from 1 to 5 years.
Conclusion:
we must consider the impact on mental health nursing caused by COVID-19 and intervene with coping strategies to minimize the suffering of professionals.
- Eduardo Bassani Dal’Bosco
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REFLECTION
Thematic content analysis using ATLAS.ti software: Potentialities for researchs in health
Revista Brasileira de Enfermagem. 2020;73(3):e20190250
04-22-2020
Abstract
REFLECTIONThematic content analysis using ATLAS.ti software: Potentialities for researchs in health
Revista Brasileira de Enfermagem. 2020;73(3):e20190250
04-22-2020DOI 10.1590/0034-7167-2019-0250
Views0See moreABSTRACT
Objective:
to describe the most important tools of ATLAS.ti Software and to associate them with the procedures of Thematic Content Analysis.
Method:
It is a theoretical reflection of the Content Analysis phases of Laurence Bardin, associating them with software tools Atlas.ti and showing its usefulness for data analysis in qualitative research.
Results:
historical contextualization and the available resources of Atlas.ti software with presentation of health research involving the phases of thematic content analysis.
Final considerations:
The Atlas.ti software assists in the accomplishment of the thematic content analysis being this promising association in health research.
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REFLECTION
Nursing education: challenges and perspectives in times of the COVID-19 pandemic
- Ana Luisa Brandão de Carvalho Lira ,
- Edlamar Kátia Adamy ,
- Elizabeth Teixeira ,
- Francisca Valda da Silva
10-26-2020
Abstract
REFLECTIONNursing education: challenges and perspectives in times of the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200683
10-26-2020DOI 10.1590/0034-7167-2020-0683
- Ana Luisa Brandão de Carvalho Lira ,
- Edlamar Kátia Adamy ,
- Elizabeth Teixeira ,
- Francisca Valda da Silva
Views0See moreABSTRACT
Objective:
To discuss the challenges and perspectives of nursing education in times of the COVID-19 pandemic.
Methods:
Reflection study, with theoretical approach based on national and international publications, allied to the experience of researchers in the area of nursing education.
Results:
Four sections are identified: Nursing education: current affairs and perspectives; Education and technologies in time of pandemic: acceleration, alteration and paralysis; Difference between emergency, intentional and remote teaching; the return to the “new normality”: new structuring axes and legal norms.
Final considerations:
The conclusion is that longstanding challenges have emerged with the pandemic, and the processes of acceleration, change and paralysis have marked education in these times. Moreover, epidemiological, technological and psychological aspects should be more valued in the return to activities.
- Ana Luisa Brandão de Carvalho Lira
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ORIGINAL ARTICLE
Social determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic
- Alexandre Medeiros de Figueiredo ,
- Daniela Cristina Moreira Marculino de Figueiredo ,
- Luciano Bezerra Gomes ,
- Adriano Massuda ,
- Eugenia Gil-García , [ … ],
- Antonio Daponte
11-13-2020
Abstract
ORIGINAL ARTICLESocial determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200673
11-13-2020DOI 10.1590/0034-7167-2020-0673
- Alexandre Medeiros de Figueiredo ,
- Daniela Cristina Moreira Marculino de Figueiredo ,
- Luciano Bezerra Gomes ,
- Adriano Massuda ,
- Eugenia Gil-García ,
- Rodrigo Pinheiro de Toledo Vianna ,
- Antonio Daponte
Views0See moreABSTRACT
Objective:
To analyze the influence of socioeconomic, demographic, epidemiological factors, and the health system structure in the evolution of the COVID-19 pandemic in Brazil.
Methods:
Ecological study with variables extracted from databases, having the incidence and mortality by COVID-19 until August 23, 2020, in Brazilian states, as response variables. The magnitude of the associations was estimated using Spearman’s correlation coefficient and multiple regression analysis.
Results:
In the Brazilian states, 59.8% of variation in the incidence of COVID-19 was justified by income inequality, significant home densification, and higher mortality. In the case of mortality, those same variables explained 57.9% of the country’s variations in federal units.
Conclusion:
Our results indicate that socioeconomic factors influenced the evolution and impact of COVID-19 in Brazil. Thus, we suggest comprehensive actions to ensure economic conditions and strengthening of health networks for populations with socioeconomic vulnerability.
- Alexandre Medeiros de Figueiredo
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ORIGINAL ARTICLE
Validation of a booklet on self-care with the diabetic foot
- Yara Lanne Santiago Galdino ,
- Thereza Maria Magalhães Moreira ,
- Antonio Dean Barbosa Marques ,
- Francisca Alexandra Araújo da Silva
06-27-2019
Abstract
ORIGINAL ARTICLEValidation of a booklet on self-care with the diabetic foot
Revista Brasileira de Enfermagem. 2019;72(3):780-787
06-27-2019DOI 10.1590/0034-7167-2017-0900
- Yara Lanne Santiago Galdino ,
- Thereza Maria Magalhães Moreira ,
- Antonio Dean Barbosa Marques ,
- Francisca Alexandra Araújo da Silva
Views0ABSTRACT
Objective:
to describe the validation of the booklet on self-care with the feet of people with diabetes.
Method:
methodological study, focusing on the validation of a printed booklet. The content and appearance of the booklet was validated by 23 judges divided into three groups: 11 content and appearance, seven technicians and five of the area of design and marketing. The appearance was validated by 30 people with type 2 Diabetes Mellitus.
Results:
the judges in the nursing area allowed the validation of material with a Content Validity Index (CVI) of 0.99, judges in the area of design and marketing with Suitability Assessment of Materials (SAM) of 99.2% and the target audience with concordance index of 99.4%.
Conclusion:
the educational booklet proved to be valid and reliable educational material to be used in order to promote compliance with self-care with the feet of people with Diabetes Mellitus.
Keywords:Diabetes Mellitus Type 2Diabetic FootEducational TechnologyTeaching MaterialsValidation StudiesSee more
- Yara Lanne Santiago Galdino
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ORIGINAL ARTICLE
Braden Scale in pressure ulcer risk assessment
Revista Brasileira de Enfermagem. 2020;73(6):e20190413
08-10-2020
Abstract
ORIGINAL ARTICLEBraden Scale in pressure ulcer risk assessment
Revista Brasileira de Enfermagem. 2020;73(6):e20190413
08-10-2020DOI 10.1590/0034-7167-2019-0413
Views0See moreABSTRACT
Objective:
To analyze the applicability of the Braden Scale to individuals admitted to an Intensive Care Unit (ICU) with the nursing diagnosis Impaired Physical Mobility, in its prediction potential to develop pressure ulcer (PU).
Methods:
A cross-sectional, quantitative study that evaluated all patients hospitalized in an ICU between November 2016 and February 2017, with the Braden Scale.
Results:
The prevalence of PU was 35.8% (24/67), in male individuals 58.3% (14/24), diagnosed with ischemic CVA 51.9% (12/27), and with hemorrhagic CVA 7.4% (2/27). Among patients classified at severe risk of developing pressure ulcer, 83.3% (20/53) developed it, and 76.7% (33/53) did not develop it.
Conclusion:
The performance of the Braden Scale showed a balance between sensitivity and specificity, confirming it as a better predictive risk assessment instrument in this group of patients.
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ORIGINAL ARTICLE
Prevalence of symptoms and quality of life of cancer patients
- Marina de Góes Salvetti ,
- Caroline Silva Pereira Machado ,
- Suzana Cristina Teixeira Donato ,
- Adriana Marques da Silva
02-27-2020
Abstract
ORIGINAL ARTICLEPrevalence of symptoms and quality of life of cancer patients
Revista Brasileira de Enfermagem. 2020;73(2):e20180287
02-27-2020DOI 10.1590/0034-7167-2018-0287
- Marina de Góes Salvetti ,
- Caroline Silva Pereira Machado ,
- Suzana Cristina Teixeira Donato ,
- Adriana Marques da Silva
Views0See moreABSTRACT
Objectives:
to analyze the prevalence of symptoms and their relationship with the quality of life of cancer patients.
Methods:
this is a cross-sectional study with 107 patients evaluated using a sociodemographic instrument, the hospital anxiety and depression scale (HADS) and the quality of life scale (EORTC-QLQ-C30). Pearson’s correlation test was used to evaluate the relationship between symptoms and quality of life.
Results:
prevalence of female patients (56.1%), 55 years as the mean age and 10 years of schooling. Fatigue (76.6%), insomnia (47.7%), pain (42.1%), loss of appetite (37.4%), anxiety (31.8%) and depression (21.5%) were identified. Anxiety and depression symptoms presented a negative correlation with quality of life and positive correlation with physical symptoms.
Conclusions:
fatigue, insomnia, pain and loss of appetite were the most common and most intense symptoms. Anxiety and depression symptoms presented a negative correlation with quality of life and positive correlation with physical symptoms.
- Marina de Góes Salvetti
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REVIEW
Strategies of active learning methodologies in nursing education: an integrative literature review
- Joyce Fernanda Soares Albino Ghezzi ,
- Elza de Fátima Ribeiro Higa ,
- Monike Alves Lemes ,
- Maria José Sanches Marin
03-24-2021
Abstract
REVIEWStrategies of active learning methodologies in nursing education: an integrative literature review
Revista Brasileira de Enfermagem. 2021;74(1):e20200130
03-24-2021DOI 10.1590/0034-7167-2020-0130
- Joyce Fernanda Soares Albino Ghezzi ,
- Elza de Fátima Ribeiro Higa ,
- Monike Alves Lemes ,
- Maria José Sanches Marin
Views0See moreABSTRACT
Objectives:
to analyze the scientific evidence on the strategies of active learning methodologies used in the training of nurses, as well as their contributions and obstacles in training.
Methods:
integrative literature review conducted with 33 selected articles in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Literature in Health Sciences, Nursing Database, Scopus, Web of Science and Education Resources Information Center databases.
Results:
among the strategies, simulation, problem-based learning and flipped classroom were highlighted. The active search, the integration of theory and practice and group work were examples of contributions to the training of nurses. However, the lack of preparation of the actors and the lack of structural support contribute to the dissatisfaction of the students.
Final Considerations:
the active learning methodology places the student at the heart of the learning process, favors critical thinking and the ability to make decisions.
- Joyce Fernanda Soares Albino Ghezzi
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