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ERRATUM01-13-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
DOI 10.1590/0034-7167.20247706e08
Views0In the article “Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(4):e20230520, Chart 1: Where it read: […]See more -
ERRATUM01-13-2024
ERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
Abstract
ERRATUMERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
DOI 10.1590/0034-7167.20247706e06pt
Views0No artigo “Crenças e atitudes de pais ou responsáveis legais sobre a vacinação infantil: revisão de escopo”, com número DOI: , publicado no periódico Revista Brasileira de Enfermagem, 2024;77(4):e20240126, página 5:Onde se lia:[…]See more -
ORIGINAL ARTICLE01-13-2024
Indicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
Abstract
ORIGINAL ARTICLEIndicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
DOI 10.1590/0034-7167-2024-0204
Views0See moreABSTRACT
Objectives:
to compare the sociodemographic and clinical severity indicators of hospitalized people with HIV in relation to clinical outcomes and urgent hospital admission.
Methods:
a retrospective cohort study was conducted with 102 medical records of HIV-infected individuals hospitalized in a hospital in southern Brazil. In addition to descriptive analysis, Fisher’s exact test, Pearson’s Chi-square, and logistic regression were used.
Results:
the data showed a significant direct effect on severity indicators in the following variables: male sex (p=0.013), skin color (p=0.023), level of education (p=0.000), urgent admissions (p=0.000), late diagnosis (p=0.001), diabetes mellitus (p=0.001), hypertension (p=0.004), kidney disease (p=0.002), high viral load (p=0.006), CD4+ count below 200 (p=0.005), fever (p=0.016), weight loss (p=0.013), co-infection with hepatitis C (p=0.004), and mortality (p=0.007).
Conclusions:
three sociodemographic and thirteen clinical markers were identified as being associated with the risk of clinical deterioration in hospitalized people with HIV.
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ORIGINAL ARTICLE01-13-2024
Nurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
Abstract
ORIGINAL ARTICLENurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
DOI 10.1590/0034-7167-2023-0481
Views1See moreABSTRACT
Objectives:
to understand the perspective of nurses on the use of telemonitoring in the management of people with type 2 diabetes mellitus and arterial hypertension in primary care.
Methods:
this qualitative research involved sixteen nurses from eight municipalities in Paraná. Data were collected between November 2022 and January 2023 through inperson or remote interviews, which were audio-recorded and subjected to content analysis.
Results:
according to the nurses, telemonitoring enhances users’ knowledge about these conditions, communication and connection with the team, and productivity. However, the lack of electronic resources and equipment, high staff turnover, low user adherence, and the limited availability of professional time present significant challenges.
Final Considerations:
the effective implementation and operation of telemonitoring in the management of people with diabetes and hypertension involve both potential benefits and barriers. It is essential to have the availability of human and technological resources, managerial support, and the commitment of professionals and users.
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ORIGINAL ARTICLE01-13-2024
Knowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
Abstract
ORIGINAL ARTICLEKnowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
DOI 10.1590/0034-7167-2023-0424
Views0ABSTRACT
Objectives:
to investigate the knowledge, attitudes, and practices of nurses regarding blood culture collection.
Methods:
a cross-sectional study was conducted in five Brazilian public hospitals with 112 nurses. Data were collected using an adapted questionnaire and analyzed through descriptive and inferential statistics.
Results:
nurses who did not consider themselves capable of collecting blood cultures had a 72% lower chance of performing the collection at the recommended site and an 83% lower chance of using the same needle for blood inoculation into the vials. Nurses working in the emergency department had a 75% lower chance of knowing the international benchmark for blood culture contamination rates, and those with less than 5 years in the position decreased their chance of accuracy in this matter by 79%.
Conclusions:
there are gaps in the knowledge, attitudes, and practices of nurses regarding blood culture collection. Standardization of the technique, periodic education, supervision and guidance of the collection team, and process auditing are recommended coping strategies.
Keywords:Blood CultureBlood Specimen CollectionHealth Knowledge, Attitudes, PracticeNursing CareQuality of Health CareSee more -
ORIGINAL ARTICLE01-13-2024
Evaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
Abstract
ORIGINAL ARTICLEEvaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
DOI 10.1590/0034-7167-2023-0190
Views0ABSTRACT
Objectives:
to verify the construct validation of an instrument for evaluating care for people living with HIV in Primary Health Care.
Methods:
methodological study carried out in 2021 with 260 health professionals in Recife, PE. Validation based on the internal structure was carried out at this stage using exploratory and confirmatory factor analysis, and validity based on item response theory.
Results:
the validation determined the retention of five factors and 63 items. The instrument’s internal consistency and quality of fit was 0.90, the Tukey-Lewis index was 0.915 and the comparative fit index was 0.918 in the confirmatory factor analysis. The indication for the absolute majority of items is adequate fit.
Conclusions:
the instrument has construct validity, making it possible to use it to evaluate the decentralization process and care for People Living with HIV in Primary Health Care.
Keywords:Acquired Immunodeficiency SyndromeComprehensive Health CareHIVPrimary Health CareProgram EvaluationSee more -
ORIGINAL ARTICLE01-10-2024
Inventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
Abstract
ORIGINAL ARTICLEInventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
DOI 10.1590/0034-7167-2023-0539
Views0See moreABSTRACT
Objective:
to construct and validate the content of an inventory of ethical problems experienced by nurses in mobile pre-hospital care.
Method:
a psychometric approach study, developed with the following stages: (1) instrument construction through a theoretical matrix based on deliberative bioethics, scoping review and online qualitative research; (2) content validity by judges; (3) pre-testing with Mobile Emergency Care Service nurses in various Brazilian states. For content validity analysis, the Content Validity Ratio was calculated (CVR>0.45 for judges and CVR>0.35 for the target population).
Results:
the instrument had 44 items, distributed across four dimensions.
Final considerations:
the constructed instrument presented sources of evidence of content validity, providing good psychometric measurements and constituting a useful tool for nurses’ practice in the pre-hospital setting.
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ORIGINAL ARTICLE10-06-2023
Evidências do cuidado centrado no paciente no contexto da prática profissional de saúde brasileira
Revista Brasileira de Enfermagem. 2023;76(5):e20220448
Abstract
ORIGINAL ARTICLEEvidências do cuidado centrado no paciente no contexto da prática profissional de saúde brasileira
Revista Brasileira de Enfermagem. 2023;76(5):e20220448
DOI 10.1590/0034-7167-2022-0448
Views0RESUMEN
Objetivos:
analizar las actitudes centradas en el paciente en el cuidado y compartir prácticas de profesionales de enfermería, logopedia, odontología y medicina.
Métodos:
se utilizó una investigación transversal con 411 profesionales, y como medida de resultado se aplicó el instrumento Patient-Practitioner Orientation Scale.
Resultados:
los médicos presentaron puntuaciones medias más altas, lo que refleja una orientación centrada en el paciente, control compartido y enfoque en la persona, con diferencia estadística para todos los dominios (p<0,02). Los odontólogos fueron los profesionales que presentaron puntajes más bajos, especialmente en el dominio compartir, con diferencia estadística en relación a los enfermeros, logopedas y médicos (p<0,05).
Conclusiones:
finalmente, las actitudes de los profesionales de las áreas de salud estudiadas indicaron preferencia autorreferida por la centralidad en los pacientes. En este contexto, el cuidado centrado en el paciente puede ser un recurso importante en el cuidado de la salud cuando se apuesta por la superación del objeto hombre.
Keywords:Assistência Centrada no PacienteCuidado Centrado no PacientePessoal de SaúdePrática ProfissionalProfissional de SaúdeSee more -
ORIGINAL ARTICLE10-06-2023
Patient-centered care – evidence in the context of professional health practice
Revista Brasileira de Enfermagem. 2023;76(5):e20220448
Abstract
ORIGINAL ARTICLEPatient-centered care – evidence in the context of professional health practice
Revista Brasileira de Enfermagem. 2023;76(5):e20220448
DOI 10.1590/0034-7167-2022-0448
Views0ABSTRACT
Objectives:
to analyze patient-centered attitudes in care and sharing practices of nursing, speech therapy, dentistry and medicine professionals.
Methods:
cross-sectional research was used with 411 professionals, and the Patient-Practitioner Orientation Scale instrument was applied as a measure of outcome.
Results:
physicians presented higher mean scores, reflecting a patient-centered orientation, shared control, and focus on the person, with statistical difference for all domains (p<0.02). Dentists were the professionals who presented lower scores, especially in the sharing domain, with statistical difference in relation to nurses, speech therapists, and physicians (p<0.05).
Conclusions:
finally, the attitudes of professionals in the health areas studied indicated self-reported preference for centrality in patients. In this context, patient-centered care can be an important resource in health care when committed to overcoming the object man.
Keywords:Health Care ProfessionalHealth PersonnelPatient-Centered CarePerson Centered CareProfessional PracticeSee more -
ORIGINAL ARTICLE10-06-2023
Perception of graduates about the education of Nursing Technicians
Revista Brasileira de Enfermagem. 2023;76(5):e20220325
Abstract
ORIGINAL ARTICLEPerception of graduates about the education of Nursing Technicians
Revista Brasileira de Enfermagem. 2023;76(5):e20220325
DOI 10.1590/0034-7167-2022-0325
Views0ABSTRACT
Objectives:
to interpret the perception of graduates from the nursing technician program on the learning process developed during their education.
Methods:
a qualitative study was conducted from March to September 2021, based on interviews with 20 graduates from a nursing technician program at a school in the Midwest of São Paulo, using thematic analysis and the NVivo tool.
Results:
the following themes were identified: traditional teaching methods, active learning strategies, valuing proactivity and experiences in professional practice.
Final Considerations:
according to the graduates, the teaching process is essentially based on traditional methods, although there are initiatives to implement active strategies and recognition of the importance of advancing student proactivity and practical experience.
Keywords:AssociateEducationEducation, NursingHealth Human Resource TrainingLearningProfessional TrainingSee more -
ORIGINAL ARTICLE10-06-2023
Effect of guided imagery relaxation on anxiety in cervical cancer: randomized clinical trial
Revista Brasileira de Enfermagem. 2023;76(5):e20210874
Abstract
ORIGINAL ARTICLEEffect of guided imagery relaxation on anxiety in cervical cancer: randomized clinical trial
Revista Brasileira de Enfermagem. 2023;76(5):e20210874
DOI 10.1590/0034-7167-2021-0874
Views0See moreABSTRACT
Objectives:
to evaluate the effect of guided imagery relaxation through virtual reality on anxiety in women with cervical cancer undergoing radiochemotherapy.
Methods:
randomized, non-blinded, single-center clinical trial conducted at a cancer reference hospital. 52 women participated, with randomized allocation of 24 in the control group and 28 in the experimental group (12 sessions of guided imagery relaxation through virtual reality, applied three times a week). The outcome was evaluated using the State-Trait Anxiety Inventory and statistical analysis was performed using the Generalized Linear Mixed Model.
Results:
n the experimental group, women presented significant anxiety traits (p=0.010) before the intervention. Between the 4th and 12th week of follow-up, there was a reduction in anxiety levels, without statistical significance.
Conclusions:
guided imagery relaxation through virtual reality provided evidence of anxiety reduction in women with cervical cancer undergoing radiochemotherapy and may contribute to clinical practice. Brazilian Clinical Trial Registry: RBR-7ssvytb.
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EDITORIAL09-25-2023
A inteligência artificial como aliada na enfermagem brasileira: desafios, oportunidades e responsabilidade profissional
Revista Brasileira de Enfermagem. 2023;76(3):e760301
Abstract
EDITORIALA inteligência artificial como aliada na enfermagem brasileira: desafios, oportunidades e responsabilidade profissional
Revista Brasileira de Enfermagem. 2023;76(3):e760301
DOI 10.1590/0034-7167.2023760301pt
Views0O estado atual da enfermagem no Brasil apresenta desafios e oportunidades complexas que requerem soluções inovadoras. Nesse contexto, a inteligência artificial (IA) surge como uma ferramenta promissora para enfrentar esses desafios e aproveitar as oportunidades. Em particular, os modelos de processamento de linguagem natural, como o ChatGPT da OpenAI, demonstram potencial para serem recursos valiosos […]See more -
EDITORIAL09-25-2023
Artificial intelligence as an ally in Brazilian nursing: challenges, opportunities and professional responsibility
Revista Brasileira de Enfermagem. 2023;76(3):e760301
Abstract
EDITORIALArtificial intelligence as an ally in Brazilian nursing: challenges, opportunities and professional responsibility
Revista Brasileira de Enfermagem. 2023;76(3):e760301
DOI 10.1590/0034-7167.2023760301
Views0The current state of nursing in Brazil presents complex challenges and opportunities that require innovative solutions. In this context, artificial intelligence (AI) emerges as a promising tool to address these challenges and seize opportunities. In particular, natural language processing models, such as OpenAI’s ChatGPT, demonstrate the potential to be valuable resources for nurses at all […]See more -
ORIGINAL ARTICLE09-18-2023
Vaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity
Revista Brasileira de Enfermagem. 2023;76(4):e20220734
Abstract
ORIGINAL ARTICLEVaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity
Revista Brasileira de Enfermagem. 2023;76(4):e20220734
DOI 10.1590/0034-7167-2022-0734
Views0See moreABSTRACT
Objective:
to analyze vaccination coverage spatial distribution in children under one year old and the socioeconomic factors associated with meeting the recommended goals in Minas Gerais.
Methods:
an ecological study, carried out in 853 municipalities in the state. Pentavalent, poliomyelitis, meningococcal conjugate, yellow fever, rotavirus, and 10-valent pneumococcal conjugate vaccination coverage were analyzed. Scan statistics and multiple logistic regression were performed to identify spatial clusters and factors associated with meeting coverage goals.
Results:
spatial analysis revealed clusters with risk of low coverage for all vaccines. Number of families with per capita income of up to 1/2 wage, Minas Gerais Social Responsibility Index and percentage of the poor or extremely poor population were associated with meeting the established goals.
Conclusions:
the results are useful for designing interventions regarding the structuring of vaccination services and the implementation of actions to increase vaccination coverage in clusters with less propensity to vaccinate.
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EDITORIAL09-04-2023
La cronicidad en el siglo XXI: frente a los desafíos de una sociedad cambiante
Revista Brasileira de Enfermagem. 2023;76(4):e760401
Abstract
EDITORIALLa cronicidad en el siglo XXI: frente a los desafíos de una sociedad cambiante
Revista Brasileira de Enfermagem. 2023;76(4):e760401
DOI 10.1590/0034-7167.2023760401es
Views0Actualmente, existe un aumento de las enfermedades no transmisibles (ENT), el envejecimiento de la población y los cambios en el estilo de vida, lo que corrobora el aumento de la cronicidad, uno de los mayores desafíos que enfrenta la sociedad contemporánea. En este editorial examinaremos la cronicidad en el siglo XXI y la necesidad de […]See more
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RESEARCH01-01-2016
Pressure ulcer healing with Plenusdermax® Calendula officinalis L. extract
Revista Brasileira de Enfermagem. 2016;69(2):250-257
Abstract
RESEARCHPressure ulcer healing with Plenusdermax® Calendula officinalis L. extract
Revista Brasileira de Enfermagem. 2016;69(2):250-257
DOI 10.1590/0034-7167.2016690207i
Views0See moreABSTRACT
Objective:
to evaluate the therapeutic benefits of the bioactive extracts of Plenusdermax®Calendula officinalis for pressure ulcer healing.
Method:
an observational cohort study, including 41 patients with a diagnosis of pressure ulcer that was stable in size for more than three months. Patients were evaluated every two weeks, over 30 weeks, for: reduction of the wound area, infection control, types of tissue and exudate, and ulcer microbiology.
Results:
the proportions of patients who were completely healed after 15 and 30 weeks of treatment were 63% and 88%, respectively, and the mean healing time was 12.5±7.8 weeks. No adverse events were observed during treatment.
Conclusion:
the results of the study indicate that bioactive C. officinalis Plenusdermax® is a safe treatment that promotes healing of pressure ulcers.
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RESEARCH01-01-2016
Quality of life assessment for health promotion groups
Revista Brasileira de Enfermagem. 2016;69(2):242-249
Abstract
RESEARCHQuality of life assessment for health promotion groups
Revista Brasileira de Enfermagem. 2016;69(2):242-249
DOI 10.1590/0034-7167.2016690206i
Views0See moreABSTRACT
Objective:
to analyze the use of quality of life assessment (QOL) as a strategy to evaluate the work with health promotion groups in the community.
Method:
cross-sectional, descriptive and analytical study. Participants of two elderly groups (n=46) were individually interviewed to fill the sociodemographic instruments, WHOQOL-BREF and WHOQOL-OLD.
Results:
the participants were women with up to 79 years, who did not live with a partner, with up to four years of study, retired, with individual income of up to a minimum salary. The mean scores on the WHOQOL-BREF were higher on “Social Relations” and lower in the “Environment”. For the WHOQOL-OLD, the highest scores were achieved in facets “Social Participation” (G1) and “Past, Present and Future Activities” (G2), while “Death and Dying” facet obtained lower scores in both groups.
Conclusion:
the assessment of QOL appears to be useful in helping to identify the coordination aspects of life of elderly people that need to be better developed in groups.
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RESEARCH01-01-2016
Transcultural adaptation and validation of the Brazilian version of Treatment Spirituality/Religiosity Scale
Revista Brasileira de Enfermagem. 2016;69(2):235-241
Abstract
RESEARCHTranscultural adaptation and validation of the Brazilian version of Treatment Spirituality/Religiosity Scale
Revista Brasileira de Enfermagem. 2016;69(2):235-241
DOI 10.1590/0034-7167.2016690205i
Views0See moreABSTRACT
Objective:
to perform the translation and transcultural adaptation to Brazilian Portuguese, and analyze the psychometric properties of the instrument Treatment Spirituality/Religiosity Scale (TSRS).
Method:
the sample consisted of 188 nursing students of technical and higher education. The reliability analysis by test-retest was performed one month after the first application of the instrument. To measure the construct validation, a factorial analysis was carried out.
Results:
the Brazilian version of the TSRS consisted of 10 items, with two factors. The reliability by test-retest showed a Kappa coefficient ranging from 0.22 to 0.47, and a global internal consistency Cronbach’s alpha of 0.85.
Conclusion:
the Brazilian version of the TSRS showed satisfactory values of validity and internal consistency, being suitable for use in the national context.
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RESEARCH01-01-2016
Epidemiological characteristics and causes of deaths in hospitalized patients under intensive care
Revista Brasileira de Enfermagem. 2016;69(2):229-234
Abstract
RESEARCHEpidemiological characteristics and causes of deaths in hospitalized patients under intensive care
Revista Brasileira de Enfermagem. 2016;69(2):229-234
DOI 10.1590/0034-7167.2016690204i
Views0ABSTRACT
Objective:
to describe the epidemiological and sociodemographic characteristics of patients hospitalized in an ICU.
Method:
an epidemiological, descriptive and retrospective study. Population: 695 patients admitted from January to December 2011. The data collected were statistically analyzed with both absolute and relative frequency distribution.
Results:
61.6% of the patients are male, aged 40 to 69 years, and most of them came from the surgery rooms. The most frequent reason for admission was diseases of the circulatory system (23.3%). At discharge from the ICU, 72.4% of the patients were sent to other units of the same institution, 31.1% to the intermediate care unit, and 20.4% died, of which 24.6% from diseases of the circulatory system. The afternoon shift had 45.8% of the admissions and 53.3% of the discharges.
Conclusion:
the description of the sociodemographic and epidemiological features guides the planning of nursing actions, providing a better quality service.
Keywords:Critical CareDescriptive EpidemiologyIntensive Care UnitMorbidityMortality IndicatorsNursingSee more -
RESEARCH01-01-2016
Hospital discharge of premature newborns: the father’s experience
Revista Brasileira de Enfermagem. 2016;69(2):221-228
Abstract
RESEARCHHospital discharge of premature newborns: the father’s experience
Revista Brasileira de Enfermagem. 2016;69(2):221-228
DOI 10.1590/0034-7167.2016690203i
Views0See moreABSTRACT
Objective:
To describe the father’s experience with his premature child discharge of the Neonatal Intensive-Care Unit and to point out interventions to promote this experience.
Method:
Qualitative research with eight fathers, adopting the Symbolic Interactionism as theoretical reference and thematic narrative research as methodological frame.
Results:
The analysis of data has allowed us to describe the experience of the father from three thematic units: “fatherhood boundaries”, “high responsibility for the child” and “social network and support”.
Conclusion:
The father feels insecure with the idea of taking care of his child at home because of the lack of professional support and the initial contact with the child in the Neonatal Intensive-Care Unit.
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RESEARCH01-01-2016
Nurses from the Mobile Emergency Service: profile and developed activities
Revista Brasileira de Enfermagem. 2016;69(2):213-220
Abstract
RESEARCHNurses from the Mobile Emergency Service: profile and developed activities
Revista Brasileira de Enfermagem. 2016;69(2):213-220
DOI 10.1590/0034-7167.2016690202i
Views0See moreABSTRACT
Objective:
to characterize the profile and identify the activities developed by nurses from the Mobile Emergency Care Service of a state of southern Brazil.
Method:
an exploratory, descriptive study. Data were collected through a questionnaire with 63 nurses.
Results:
the profile showed a workforce predominantly female, young and having specialized training. The activities were organized in the dimensions of caring, managing and educating, verifying the predominance of the first one. Care actions involved multiple procedures, but the use of the Systematization of Nursing Care (SNC) was not mentioned in the development of care activities. Then, the managerial dimension with a predominance of bureaucratic activities was emphasized. Educational activities were less prominent.
Conclusion:
care actions are the focus of the activities of nurses, predominantly the prescribed institutional care without the use of instruments such as SNC that could contribute to the greater visibility of their professional work.
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EDITORIAL01-01-2016
Challenges and leadership imperatives in cooperation with the World Health Organization
Revista Brasileira de Enfermagem. 2016;69(2):207-208
Abstract
EDITORIALChallenges and leadership imperatives in cooperation with the World Health Organization
Revista Brasileira de Enfermagem. 2016;69(2):207-208
DOI 10.1590/0034-7167.2016690201i
Views0When an institution promotes strategic innovations, it starts the rupture with tradition, causing changes and, consequently, altering the expectations and prospects of both their internal clients, as their external clients.The engines of the adopted innovations are driven by a broader view of the organization’s purposes, expanding its borders in terms of breadth and depth, which […]See more -
EDITORIAL01-01-2016
Desafios e imperativos de liderança na cooperação com a Organização Mundial da Saúde
Revista Brasileira de Enfermagem. 2016;69(2):207-208
Abstract
EDITORIALDesafios e imperativos de liderança na cooperação com a Organização Mundial da Saúde
Revista Brasileira de Enfermagem. 2016;69(2):207-208
DOI 10.1590/0034-7167.2016690201i
Views0Quando uma instituição promove inovações estratégicas, é colocado em curso o rompimento com a tradição, provocando mudanças e, por consequência, alterando as expectativas e as perspectivas tanto dos seus clientes internos, quanto dos seus clientes externos.Os motores das inovações adotadas são acionados por uma visão ampliada dos fins da organização, alargando suas fronteiras em termos […]See more
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