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10-09-2023
Standard Operating Procedure validity on intramuscular vaccine administration in adults: a methodological study
- Elaine Aparecida da Cunha Lima
, - Renata Oliveira Caetano ,
- Marisa Dibbern Lopes Correia ,
- Luana Vieira Toledo ,
- Thais Bitencourt Faria , [ … ],
- Luciene Muniz Braga Daskaleas
Abstract
Standard Operating Procedure validity on intramuscular vaccine administration in adults: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220692
DOI 10.1590/0034-7167-2022-0692
- Elaine Aparecida da Cunha Lima ,
- Renata Oliveira Caetano ,
- Marisa Dibbern Lopes Correia ,
- Luana Vieira Toledo ,
- Thais Bitencourt Faria ,
- Daniela de Almeida Pereira ,
- Luciene Muniz Braga Daskaleas
Views0See moreABSTRACT
Objective:
to validate a Standard Operating Procedure on the intramuscular vaccine administration technique in adults using high frequency vibration associated with cryotherapy.
Methods:
a literature review on intramuscular vaccination practice using a vibration device associated with cryotherapy. Then, a form was created to validate the instrument, detailing the items that were assessed by judges following recommendations in the literature. Judges’ answers were assessed using the Content Validity Index, with items whose index was greater than or equal to 0.80 being validated.
Results:
twenty-five nurses participated in validity, identifying judges’ opinion regarding item relevance, clarity and accuracy. Judges validated the instrument, according to the values that remained between 0.88 and 1.0.
Conclusions:
the instrument developed and validated is a tool capable of guaranteeing safety and standardizing immunization practice in vaccine rooms.
- Elaine Aparecida da Cunha Lima
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ORIGINAL ARTICLE10-09-2023
Translation and validity of the Multidimensional Individual and Interpersonal Resilience Measure
- Jéssica Diniz Rodrigues Ferreira ,
- Mariana Figueiredo Miranda ,
- Millena Figueiredo Miranda ,
- Marco Aurélio Romano-Silva ,
- Maria Aparecida Camargos Bicalho , [ … ],
- Bernardo de Mattos Viana
Abstract
ORIGINAL ARTICLETranslation and validity of the Multidimensional Individual and Interpersonal Resilience Measure
Revista Brasileira de Enfermagem. 2023;76(4):e20220696
DOI 10.1590/0034-7167-2022-0696
- Jéssica Diniz Rodrigues Ferreira ,
- Mariana Figueiredo Miranda ,
- Millena Figueiredo Miranda ,
- Marco Aurélio Romano-Silva ,
- Maria Aparecida Camargos Bicalho ,
- Bernardo de Mattos Viana
Views0See moreABSTRACT
Objective:
to translate, culturally adapt and validate the Multidimensional Individual and Interpersonal Resilience Measure to Brazilian Portuguese.
Method:
after initial translation, the pre-final version underwent rigorous cultural adaptation procedures. As a result, the final adapted version was submitted to a validity study.
Results:
adaptation procedures provided equivalence between the pre-final and the original versions in semantic, idiomatic, experiential and conceptual terms. A total of 187 older adults were included in the validity study. Exploratory factorial analysis (EFA) generated a model of five factors ((RMSEA = 0.030; TLI = 0.959; X = 151.590 p> 0.05). Final version showed adequate consistency (Cronbach’s α = 0.705) and test-retest reliability (ICC=0.835). No statistically significant correlation was found between resilience and sociodemographic and epidemiological variables assessed in this study.
Conclusion:
EMRII-BR is a valid and reliable instrument for measuring resilience in Brazilian older adults.
- Jéssica Diniz Rodrigues Ferreira
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ORIGINAL ARTICLE10-09-2023
Health care for people with tuberculosis/HIV co-infection from the multidisciplinary team’s perspective
- Eduarda Aguiar da Silva ,
- Paula Hino ,
- Hugo Fernandes ,
- Maria Rita Bertolozi ,
- Aline Aparecida Monroe , [ … ],
- Lucimara Fabiana Fornari
Abstract
ORIGINAL ARTICLEHealth care for people with tuberculosis/HIV co-infection from the multidisciplinary team’s perspective
Revista Brasileira de Enfermagem. 2023;76(4):e20220733
DOI 10.1590/0034-7167-2022-0733
- Eduarda Aguiar da Silva ,
- Paula Hino ,
- Hugo Fernandes ,
- Maria Rita Bertolozi ,
- Aline Aparecida Monroe ,
- Lucimara Fabiana Fornari
Views0See moreABSTRACT
Objective:
to know the multidisciplinary team’s perspective about the health care of people with tuberculosis and human immunodeficiency virus co-infection in relation to treatment.
Methods:
this is a descriptive-exploratory study, with a qualitative approach, carried out in a health care service in São Paulo, from May to June 2019. Semi-structured interviews were conducted with nine professionals from the multidisciplinary team. Data were processed through discourse analysis with the support of webQDA.
Results:
Two empirical categories emerged: Health care interfaces for people with tuberculosis and human immunodeficiency virus co-infection; Barriers and facilitators for health care for people with co-infection.
Final considerations:
the health-disease process in co-infection is mediated by conditions that positively or negatively interfere with treatment compliance. People’s health care goes beyond exclusively clinical assistance and requires the recognition of needs in a broad perspective.
- Eduarda Aguiar da Silva
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ORIGINAL ARTICLE10-09-2023
Independent and combined effects of lifestyle behaviors on adolescent health-related quality of life
Revista Brasileira de Enfermagem. 2023;76(4):e20220780
Abstract
ORIGINAL ARTICLEIndependent and combined effects of lifestyle behaviors on adolescent health-related quality of life
Revista Brasileira de Enfermagem. 2023;76(4):e20220780
DOI 10.1590/0034-7167-2022-0780
Views0See moreABSTRACT
Objective:
To investigate the independent and combined effects of lifestyle behaviors, including physical activity, sedentary behavior, sleep duration and food intake, in the health-related quality of life (HRQoL) of Brazilian adolescents.
Methods:
Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect lifestyle behaviors data. Perception of the HRQoL was identified using the Kidscreen-27. The study used covariance analysis and linear regression models for statistical analysis.
Results:
Adolescents who reported ≤ 2 hours/day of screen-based sedentary behavior and sleep duration equivalent to 8-10 hours/night presented significantly higher HRQoL. Adolescents who reported joint adherence ≥ 3 healthy lifestyle behaviors demonstrated approximately two [OR=2.12] to three times [OR=3.04] more chance of presenting higher perceptions of HRQoL.
Conclusion:
Although healthy lifestyle behaviors had a positive independent effect on HRQoL, joint adherence to healthy behaviors enhances the cumulative effect.
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ORIGINAL ARTICLE10-09-2023
Spirituality in the uncertainty of illness: the perspective of oncology patients
- Roberto Firpo de Almeida Filho ,
- Maria Cristina Soares Figueiredo Trezza ,
- Isabel Comassetto ,
- Lucas Kayzan Barbosa da Silva ,
- Marcela Porangaba Lopes , [ … ],
- Francyane Adielle de Souza Praxedes
Abstract
ORIGINAL ARTICLESpirituality in the uncertainty of illness: the perspective of oncology patients
Revista Brasileira de Enfermagem. 2023;76(4):e20220712
DOI 10.1590/0034-7167-2022-0712
- Roberto Firpo de Almeida Filho ,
- Maria Cristina Soares Figueiredo Trezza ,
- Isabel Comassetto ,
- Lucas Kayzan Barbosa da Silva ,
- Marcela Porangaba Lopes ,
- Kleytonn Giann Silva de Santana ,
- Francyane Adielle de Souza Praxedes
Views0See moreABSTRACT
Objective:
To analyze spirituality in the process of illness uncertainty in cancer patients.
Methods:
This is a qualitative study, in which Merle Mishel’s Theory of Uncertainty of Disease was used as a theoretical framework; and as a methodological reference, the stages of Bardin’s Content Analysis. As a technique for obtaining information, a semi-structured interview was used.
Results:
Spirituality in the uncertainty of the disease varies from patient to patient and acts in a unique way. They presented readaptation attitudes in their reports. The presence of spirituality in their lives acted as the main force mechanism to deal with the uncertainty of the disease, and this moment was called by Mishel “probabilistic thinking”.
Conclusion:
Patients demonstrated readaptation attitudes in their reports, and spirituality acted as the main mechanism of strength to deal with uncertainty in the disease
- Roberto Firpo de Almeida Filho
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ORIGINAL ARTICLE10-09-2023
Glycemic variability and mortality in oncologic intensive care units
Revista Brasileira de Enfermagem. 2023;76(4):e20220812
Abstract
ORIGINAL ARTICLEGlycemic variability and mortality in oncologic intensive care units
Revista Brasileira de Enfermagem. 2023;76(4):e20220812
DOI 10.1590/0034-7167-2022-0812
Views0See moreABSTRACT
Objective:
This study aimed to investigate the association between glycemic variability and mortality in patients admitted to oncologic intensive care units.
Methods:
A retrospective cohort study was conducted using a convenience sample of 30 medical records of patients over 18 years of age of both sexes. Glycemic variability was measured using the standard deviation and general amplitude. Statistical analysis was performed using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). The significance level (α) was set at 5% with a confidence interval (CI) of 95%.
Results:
The study included 14 male patients (46.67%) with a mean age of 60±15 years. A total of 1503 blood glucose samples were collected. The AUC analysis for the standard deviation did not show a statistically significant result (p=.966; 95% CI=[0.283, 0.726]). In contrast, the general amplitude had a statistically significant association with mortality (p=.049; 95% CI=[0.514, 0.916]).
Conclusions:
This study found that glycemic variability measured by the general amplitude was significantly associated with patient mortality in oncologic intensive care units. These findings suggest that monitoring glycemic variability may be an important factor in the management of critically ill patients in oncologic intensive care units.
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ORIGINAL ARTICLE10-09-2023
Educational intervention in social skills for Primary Care nurses
- Aline Loiola Moura Bianconi ,
- Tatiana da Silva Melo Malaquias ,
- Adriana Valongo Zani ,
- Elen Ferraz Teston ,
- Maira Sayuri Sakai Bortoletto , [ … ],
- Maria do Carmo Fernandez Lourenço Haddad
Abstract
ORIGINAL ARTICLEEducational intervention in social skills for Primary Care nurses
Revista Brasileira de Enfermagem. 2023;76(4):e20220503
DOI 10.1590/0034-7167-2022-0503
- Aline Loiola Moura Bianconi ,
- Tatiana da Silva Melo Malaquias ,
- Adriana Valongo Zani ,
- Elen Ferraz Teston ,
- Maira Sayuri Sakai Bortoletto ,
- Maria do Carmo Fernandez Lourenço Haddad
Views0See moreABSTRACT
Objective:
to assess an educational intervention on social skills for nurses who work in Primary Health Care.
Method:
a qualitative research-intervention study, carried out in the municipalities covered by the 17th Health Regional of Paraná. It was developed in three interrelated stages: exploratory, where meetings were held with the managers to define the groups and logistics for running the course; intermediate, developed in meetings with different groups of nurses, addressing selected topics; assessment, in which the nurses developed a personal plan to improve their social skills.
Results:
participants were 57 nurses who acted as coordinators of Primary Care. They considered the educational intervention in social skills fundamental for positive changes in their professional performance.
Final considerations:
the educational intervention in social skills was assessed as an important strategy to strengthen the development of nurses’ managerial and care skills.
- Aline Loiola Moura Bianconi
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ORIGINAL ARTICLE10-09-2023
Intestinal parasitic infections: telephone health literacy with men in areas of poverty in the syndemic
- Julio Cesar Pegado Bordignon ,
- Antonia de Castro Ribeiro ,
- Érica Tex Paulino ,
- Maria de Fatima Leal Alencar ,
- Marcio Neves Boia , [ … ],
- Antonio Henrique Almeida de Moraes Neto
Abstract
ORIGINAL ARTICLEIntestinal parasitic infections: telephone health literacy with men in areas of poverty in the syndemic
Revista Brasileira de Enfermagem. 2023;76(4):e20220300
DOI 10.1590/0034-7167-2022-0300
- Julio Cesar Pegado Bordignon ,
- Antonia de Castro Ribeiro ,
- Érica Tex Paulino ,
- Maria de Fatima Leal Alencar ,
- Marcio Neves Boia ,
- Antonio Henrique Almeida de Moraes Neto
Views0See moreABSTRACT
Objectives:
to assess Popular Health Education practices on intestinal parasites, carried out by telephone contact with men living in urban communities in Rio de Janeiro, Brazil, during the COVID-19 syndemic.
Method:
a quasi-experimental, quantitative and descriptive study, carried out with men aged 20 to 59 years. Pre-test was applied, and participants were divided into two groups: control and experimental. Popular Education in Health practices were carried out with an experimental group, and post-test was applied for both.
Results:
health education practices were significant in the experimental group, with a reduction in incorrect answers. There was an increase in incorrect answers in the control group’s post-test.
Conclusions:
the Brazilian National Policy for Popular Education in Health contributed to qualify men’s health literacy on intestinal parasites. Practice by telephone contact proved to be a powerful strategy for nursing and public policies to access this group and promote health in Primary Health Care.
- Julio Cesar Pegado Bordignon
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ORIGINAL ARTICLE10-21-2019
Burnout assessment in nurses from a general emergency service
- Daniela Filipa Rocha Nobre ,
- Isabel Cristina Mascarenhas Rabiais ,
- Patrícia Cruz Pontífice Sousa Valente Ribeiro ,
- Paulo Rosário Carvalho Seabra
Abstract
ORIGINAL ARTICLEBurnout assessment in nurses from a general emergency service
Revista Brasileira de Enfermagem. 2019;72(6):1457-1463
DOI 10.1590/0034-7167-2017-0870
- Daniela Filipa Rocha Nobre ,
- Isabel Cristina Mascarenhas Rabiais ,
- Patrícia Cruz Pontífice Sousa Valente Ribeiro ,
- Paulo Rosário Carvalho Seabra
Views0See moreABSTRACT
Objective:
To assess the level of Burnout among nurses in a general emergency department.
Method:
Quantitative, descriptive, correlational and cross-sectional study. 32 nurses from a general adult emergency department answered a questionnaire to evaluate Burnout. (Copenhagen Burnout Inventory).
Result:
It was verified that 59.4% of the nurses presented total Burnout. Work-related burnout was the subscale with the highest average score. It was found that the lower the age and the longer the time working in the institution, the higher the level of Burnout. Longer professional experience was related to lower levels of Burnout. There were also higher scores of Burnout among participants who thought about changing their profession, their institution or their service.
Conclusion:
The prevalence of Burnout is high. Professional Burnout was the most critical subscale. Age and the current work are the subscales that most influence perceived Burnout
- Daniela Filipa Rocha Nobre
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REFLECTION03-05-2021
The nurse’s work in the context of COVID-19 pandemic
- Valéria Gomes Fernandes da Silva ,
- Bruno Neves da Silva ,
- Érika Simone Galvão Pinto ,
- Rejane Maria Paiva de Menezes
Abstract
REFLECTIONThe nurse’s work in the context of COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200594
DOI 10.1590/0034-7167-2020-0594
- Valéria Gomes Fernandes da Silva ,
- Bruno Neves da Silva ,
- Érika Simone Galvão Pinto ,
- Rejane Maria Paiva de Menezes
Views0See moreABSTRACT
Objective:
Reflect on the work experienced by the nurse in coping with the COVID-19 pandemic in a public hospital of the State of Rio Grande do Norte.
Methods:
Reflective essay based in the professional experience in a public reference hospital for the care of patients affected by COVID-19 in the State of Rio Grande do Norte. Results were organized in two empirical categories, which emphasize potentialities and barriers in the nurse’s work in the face of the COVID-19, presented by means of Ishikawa diagram.
Results:
Two categories emerged from the experiences: Nursing leadership in organizing health services to face COVID-19; and the performance of nursing care management in the COVID-19 pandemic.
Final considerations:
It is necessary to value the nurse’s work in all its attributes, as well as strengthen the interdisciplinary work processes, which collaborate to overcome the crisis caused by the pandemic.
- Valéria Gomes Fernandes da Silva
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ORIGINAL ARTICLE07-10-2020
Nursing appeals on social media in times of coronavirus
Revista Brasileira de Enfermagem. 2020;73:e20200225
Abstract
ORIGINAL ARTICLENursing appeals on social media in times of coronavirus
Revista Brasileira de Enfermagem. 2020;73:e20200225
DOI 10.1590/0034-7167-2020-0225
Views0See moreABSTRACT
Objective:
to know and analyze the nursing appeals on social media during the COVID-19 pandemic.
Method:
it is a documentary, qualitative, descriptive, and exploratory research with data collected in publications in two social media. Two hundred ninety-five publications of nursing professionals published on Twitter and Instagram between March 11 and 20, 2020 were submitted to content analysis using ATLAS.ti resources.
Results:
four thematic categories emerged: #stayathome, #whereismyPPE, #nowweareheroes, #nothingnewinthefrontline, according to frequency of communications. The appeals show a relationship with the social relevance of nursing professional work and with the conditions required for its exercise.
Final considerations:
old and new challenges of the profession were placed on the agenda in social media, especially related to the workforce and instruments of labor. These speeches can serve as a foundation for policies to improve working conditions and promote appreciation of the profession.
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ORIGINAL ARTICLE06-09-2020
Stress of nursing professionals working in pre-hospital care
- Ana Elizabeth Lopes de Carvalho ,
- Iracema da Silva Frazão ,
- Darine Marie Rodrigues da Silva ,
- Maria Sandra Andrade ,
- Selene Cordeiro Vasconcelos , [ … ],
- Jael Maria de Aquino
Abstract
ORIGINAL ARTICLEStress of nursing professionals working in pre-hospital care
Revista Brasileira de Enfermagem. 2020;73(2):e20180660
DOI 10.1590/0034-7167-2018-0660
- Ana Elizabeth Lopes de Carvalho ,
- Iracema da Silva Frazão ,
- Darine Marie Rodrigues da Silva ,
- Maria Sandra Andrade ,
- Selene Cordeiro Vasconcelos ,
- Jael Maria de Aquino
Views0See moreABSTRACT
Objectives:
To analyze the factors related to the occupational stress of a Mobile Emergency Care Service (Samu) nursing team.
Methods:
This is a descriptive study, with a quantitative approach, performed with nursing professionals from Samu service of a city of Pernambuco. A sociodemographic questionnaire and the Lipp’s Stress Symptom Inventory were used.
Results:
The participants presenting stress (24.6%) were classified in the phases: resistance (19.7%), exhaustion (4.4%) and near exhaustion (0.5%). It was also observed an association of stress level with the following factors: gender, sleep quality, professional autonomy restriction, emotional exhaustion with work performed and work in inadequate or unhealthy physical facilities.
Conclusions:
Although showing low occurrence of stress, this study pointed out the profile that presents the highest risk of developing occupational stress, through the factors significantly associated with stress in the studied population.
- Ana Elizabeth Lopes de Carvalho
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ORIGINAL ARTICLE08-19-2019
Mobile application for the teaching of the International Classification for Nursing Practice
- Nikaelly Pinheiro Mota ,
- Claudenisa Mara de Araújo Vieira ,
- Maria Naiane Rolim Nascimento ,
- Adriana Moraes Bezerra ,
- Glauberto da Silva Quirino , [ … ],
- Nuno Damácio de Carvalho Félix
Abstract
ORIGINAL ARTICLEMobile application for the teaching of the International Classification for Nursing Practice
Revista Brasileira de Enfermagem. 2019;72(4):1020-1027
DOI 10.1590/0034-7167-2018-0751
- Nikaelly Pinheiro Mota ,
- Claudenisa Mara de Araújo Vieira ,
- Maria Naiane Rolim Nascimento ,
- Adriana Moraes Bezerra ,
- Glauberto da Silva Quirino ,
- Nuno Damácio de Carvalho Félix
Views0See moreABSTRACT
Objective:
Developing a mobile application for the teaching of the International Classification for Nursing Practice.
Methods:
Methodological applied research for technological production, performed in three phases of the contextualized instructional design model: analysis, design and development.
Results:
The application has an initial screen, which provides information about the team and its purpose. Then, four moblets are listed, including presentation, user’s guide consisting of five modules, educational games and five clinical cases. The references on which the application was based are also presented.
Final considerations:
It was possible to develop an application with the potential to promote the knowledge of nursing students and professionals about this classification system.
- Nikaelly Pinheiro Mota
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REFLECTION06-29-2020
Children’s (in)visibility in social vulnerability and the impact of the novel coronavirus (COVID-19)
- Marialda Moreira Christoffel ,
- Ana Leticia Monteiro Gomes ,
- Tania Vignuda de Souza ,
- Lia Leão Ciuffo
Abstract
REFLECTIONChildren’s (in)visibility in social vulnerability and the impact of the novel coronavirus (COVID-19)
Revista Brasileira de Enfermagem. 2020;73:e20200302
DOI 10.1590/0034-7167-2020-0302
- Marialda Moreira Christoffel ,
- Ana Leticia Monteiro Gomes ,
- Tania Vignuda de Souza ,
- Lia Leão Ciuffo
Views0See moreABSTRACT
Objective:
To examine the impact of the infection by the novel coronavirus on Brazilian children in situation of social vulnerability based on the Millennium Sustainable Development Goals.
Method:
Reflective study based on discursive formulation in three aspects: principles of the objectives and goals for the millennium sustainable development; impact of the pandemic on the health of children and their families living in social vulnerability; and the role of pediatric nursing in the care provided – limits and challenges.
Results:
In January 2020, the news of COVID 19 is released as a pandemic. In Brazil, children and families are still without access to basic rights, thereby increasing their risks of social vulnerability because of the quarantine. The nursing field has an important role in monitoring children and their families, offering guidance in search for solutions and preventing contamination.
Conclusion:
There are still challenges to be overcome by the children and their families in situations of vulnerability against COVID-19.
- Marialda Moreira Christoffel
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ORIGINAL ARTICLE08-18-2021
Effects of floral therapy on labor and birth: a randomized clinical trial
- Sonia Regina Godinho de Lara ,
- Maria Cristina Gabrielloni ,
- Mônica Bimbatti Nogueira Cesar ,
- Márcia Barbieri
Abstract
ORIGINAL ARTICLEEffects of floral therapy on labor and birth: a randomized clinical trial
Revista Brasileira de Enfermagem. 2021;74:e20210079
DOI 10.1590/0034-7167-2021-0079
- Sonia Regina Godinho de Lara ,
- Maria Cristina Gabrielloni ,
- Mônica Bimbatti Nogueira Cesar ,
- Márcia Barbieri
Views0INTRODUCTIONThe Policy of Comprehensive Attention to Women’s Health focuses on improving obstetric care. One of the points observed in the Program of Comprehensive Attention to Women’s Health is the monitoring of pacts to reduce the rate of cesarean sections in hospitals of the Brazilian Unified Health System (SUS – Sistema Único de Saúde), rescuing the […]See more
- Sonia Regina Godinho de Lara
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ORIGINAL ARTICLE06-27-2019
Health literacy of adults with and without arterial hypertension
- Fernanda Moura Borges ,
- Ana Roberta Vilarouca da Silva ,
- Luisa Helena de Oliveira Lima ,
- Paulo César de Almeida ,
- Neiva Francenely Cunha Vieira , [ … ],
- Ana Larissa Gomes Machado
Abstract
ORIGINAL ARTICLEHealth literacy of adults with and without arterial hypertension
Revista Brasileira de Enfermagem. 2019;72(3):646-653
DOI 10.1590/0034-7167-2018-0366
- Fernanda Moura Borges ,
- Ana Roberta Vilarouca da Silva ,
- Luisa Helena de Oliveira Lima ,
- Paulo César de Almeida ,
- Neiva Francenely Cunha Vieira ,
- Ana Larissa Gomes Machado
Views1See moreABSTRACT
Objective:
Assess the level of health literacy of adults, with and without hypertension, treated in three basic health units (UBS) in Picos, Piauí.
Methods:
Cross-sectional study conducted with 357 adults. Data were collected using a questionnaire with sociodemographic variables, and literacy was assessed by the Test of Functional Literacy in Adults. Descriptive analysis was performed followed by the association between literacy and exposure variables with Pearson’s chi-squared (X2) test and Mann-Whitney U test.
Results:
Inadequate or marginal health literacy was found in three units investigated (71.5%; 77.8% and 85.2%);. Age and the years of schooling were factors associated with inadequate literacy in adults with hypertension (p<0.0001).
Conclusion:
Inadequate literacy was found in more than 70% of the hypertensive patients investigated. This finding reinforces the need to improve the self-care skills of hypertensive patients, especially the older ones and those with few years of schooling.
- Fernanda Moura Borges
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