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ORIGINAL ARTICLE12-16-2024
Childbirth care by health professionals: conflicting practices in obstetrics
- Greici Naiara Mattei
, - Gabriela Marcellino de Melo Lanzoni ,
- Giovana Dorneles Callegaro Higashi ,
- Taís Regina Schapko ,
- Maria Aparecida Baggio
Abstract
ORIGINAL ARTICLEChildbirth care by health professionals: conflicting practices in obstetrics
Revista Brasileira de Enfermagem. 2024;77(6):e20230129
DOI 10.1590/0034-7167-2023-0129
- Greici Naiara Mattei ,
- Gabriela Marcellino de Melo Lanzoni ,
- Giovana Dorneles Callegaro Higashi ,
- Taís Regina Schapko ,
- Maria Aparecida Baggio
Views0See moreABSTRACT
Objectives:
to understand the perceptions of women and health professionals regarding childbirth care at a teaching hospital in the western state of Paraná, Brazil.
Methods:
this qualitative study employed Grounded Theory, conducted in an obstetric care service with 38 participants (women and health professionals) through semi-structured interviews.
Results:
limitations in physical infrastructure and management of care, along with the women’s limited knowledge about the childbirth process and the decision-making and guidance of professionals, show conflicting obstetric practices-a discrepancy between good practices and obstetric violence. Training in obstetric nursing and active participation in care, alongside the presence of a companion, were identified as intervening conditions and strategies in the process.
Final Considerations:
childbirth care is characterized by dichotomous practices. While some professionals base their practices on scientific evidence, others rely on teachings and experiences from the time of their training.
- Greici Naiara Mattei
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12-16-2024
Religión y experiencia profesional: ¿Serán predictores de la inteligencia espiritual de los enfermeros? Estudio transversal
- Jhon Alex Zeladita-Huaman ,
- Juana Matilde Cuba-Sancho ,
- Martha Brigida Martina-Chávez ,
- Roberto Zegarra-Chapoñan ,
- Henry Castillo-Parra
Abstract
Religión y experiencia profesional: ¿Serán predictores de la inteligencia espiritual de los enfermeros? Estudio transversal
Revista Brasileira de Enfermagem. 2024;77(6):e20240217
DOI 10.1590/0034-7167-2024-0217es
- Jhon Alex Zeladita-Huaman ,
- Juana Matilde Cuba-Sancho ,
- Martha Brigida Martina-Chávez ,
- Roberto Zegarra-Chapoñan ,
- Henry Castillo-Parra
Views1See moreRESUMEN
Objetivos:
analizar la relación entre religión y experiencia profesional con la inteligencia espiritual en enfermeros.
Métodos:
estudio transversal y analítico realizado en 2021, participaron 544 profesionales de enfermería que laboraban en establecimiento de salud de Perú durante la pandemia por COVID-19. Para el análisis de los datos se emplearon el análisis de regresión múltiple y correlación de Pearson.
Resultados:
en los enfermeros predominó un nivel de inteligencia espiritual saludable (42,8%). Quienes no profesaban una religión tenían mayor probabilidad de tener menor puntaje de inteligencia espiritual (escala global y dimensiones); sin embargo, los enfermeros expertos tuvieron mayor probabilidad de tener mayor inteligencia espiritual (escala global y dimensiones) que los enfermeros novatos (p<0,05).
Conclusiones:
la inteligencia espiritual en los enfermeros fue predicha por la religión y la experiencia profesional. Este hallazgo sugiere que la inteligencia espiritual en enfermería se consolida mediante prácticas religiosas y durante el ejercicio profesional.
- Jhon Alex Zeladita-Huaman
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12-16-2024
A relação entre gênero, formação educacional e ambiente de aprendizagem com a ansiedade do estudante de enfermagem
- Amelia Margaretha Simbolon ,
- Jesika Sari Munthe ,
- Mikar Syah Idaman Daeli ,
- Ineke Patrisia ,
- Chriska Roully Adeline Sinaga
Abstract
A relação entre gênero, formação educacional e ambiente de aprendizagem com a ansiedade do estudante de enfermagem
Revista Brasileira de Enfermagem. 2024;77(6):e20220615
DOI 10.1590/0034-7167-2022-0615
- Amelia Margaretha Simbolon ,
- Jesika Sari Munthe ,
- Mikar Syah Idaman Daeli ,
- Ineke Patrisia ,
- Chriska Roully Adeline Sinaga
Views1See moreRESUMEN
Objetivos:
identificar las variables asociadas a la práctica clínica relacionadas con la ansiedad de los estudiantes de enfermería.
Métodos:
se utilizó un diseño descriptivo, cuantitativo, correlacional con las recomendaciones STROBE, EQUATOR. La población fue de 233 estudiantes de enfermería con una muestra de 135 personas. Los datos se recopilaron de marzo a abril de 2022 utilizando instrumentos validados.
Resultados:
la prueba de chi-cuadrado y razón de verosimilitud significativa para género, formación académica y entorno de aprendizaje son superiores a 0.05, por lo que no existe una relación significativa entre las variables y la ansiedad de los estudiantes.
Conclusiones:
los estudiantes necesitan prepararse nuevamente antes de ingresar al campo de la práctica. Investigaciones cualitativas también son necesarias.
- Amelia Margaretha Simbolon
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ORIGINAL ARTICLE12-16-2024
Bladder ultrasound: evidence of content validity of a checklist for training nurses
- Filipe Utuari de Andrade Coelho ,
- Sabrina Martins Reigota ,
- Flávia Manfredi Cavalcanti ,
- Dejanira Aparecida Regagnin ,
- Beatriz Murata Murakami , [ … ],
- Vinícius Batista Santos
Abstract
ORIGINAL ARTICLEBladder ultrasound: evidence of content validity of a checklist for training nurses
Revista Brasileira de Enfermagem. 2024;77(6):e20230183
DOI 10.1590/0034-7167-2023-0183
- Filipe Utuari de Andrade Coelho ,
- Sabrina Martins Reigota ,
- Flávia Manfredi Cavalcanti ,
- Dejanira Aparecida Regagnin ,
- Beatriz Murata Murakami ,
- Vinícius Batista Santos
Views0See moreABSTRACT
Objectives:
to develop and analyze evidence of content validity of a checklist for training nurses in measuring bladder volume through ultrasound.
Methods:
a methodological study, consisting of three stages: literature review; instrument item preparation; and analysis of evidence of content validity. The Content Validity Index (CVI) and Gwet’s AC2 were used for content validity analyses.
Results:
the checklist consisted of 23 items. The CVIs for clarity, relevance and dimensionality were 0.99, 0.99 and 0.98 respectively, and the CVIs for Gwet’s AC2 with coefficients for clarity, relevance and dimensionality were 0.89, 0.97 and 0.95, respectively, with p<0.001.
Conclusions:
the checklist developed for training nurses in measuring bladder volume through ultrasound achieved adequate evidence of content validity, and can be used to train nurses in clinical practice and future research.
- Filipe Utuari de Andrade Coelho
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ORIGINAL ARTICLE12-16-2024
Nursing team’s perceptions about care for pregnant women in a psychiatric unit
- Helena Moro Stochero ,
- Suzinara Beatriz Soares de Lima ,
- Juliana Silveira Colomé ,
- Dirce Stein Backes ,
- Mara Regina Caino Teixeira Marchiori
Abstract
ORIGINAL ARTICLENursing team’s perceptions about care for pregnant women in a psychiatric unit
Revista Brasileira de Enfermagem. 2024;77(6):e20230186
DOI 10.1590/0034-7167-2023-0186
- Helena Moro Stochero ,
- Suzinara Beatriz Soares de Lima ,
- Juliana Silveira Colomé ,
- Dirce Stein Backes ,
- Mara Regina Caino Teixeira Marchiori
Views0See moreABSTRACT
Objectives:
to understand the nursing team’s perception in relation to the care provided to pregnant women with mental disorders admitted to a psychiatric hospital unit.
Methods:
Convergent Care Research carried out between August and December 2021, through semi-structured interviews with 25 nursing professionals from a Psychiatric Unit from a reference Hospital in Southern Brazil.
Results:
the organized and analyzed data resulted in two thematic categories: Technical, generic and impersonal care; and From impersonality to the singularity of nursing care. Ensuring unique care for pregnant women with mental disorders means giving them a meaning of existence and providing care from a multidimensional and continuous perspective.
Final Considerations:
nursing care for pregnant women in psychiatric hospitalization requires continuous professional qualification, interactive technologies and support for the nursing process, in addition to promoting singular and multidimensional care.
- Helena Moro Stochero
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ORIGINAL ARTICLE12-16-2024
The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
- Caren de Oliveira Riboldi ,
- Renata Cristina Gasparino ,
- Wiliam Wegner ,
- Eder Henriqson ,
- Tarcísio Abreu Saurin , [ … ],
- Ana Maria Müller de Magalhães
Abstract
ORIGINAL ARTICLEThe nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
DOI 10.1590/0034-7167-2023-0315
- Caren de Oliveira Riboldi ,
- Renata Cristina Gasparino ,
- Wiliam Wegner ,
- Eder Henriqson ,
- Tarcísio Abreu Saurin ,
- Ana Maria Müller de Magalhães
Views1See moreABSTRACT
Objectives:
to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.
Methods:
a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach.
Results:
the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment.
Conclusions:
the study results indicate a relationship between these constructs, with implications for the quality and the safety of care.
- Caren de Oliveira Riboldi
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ORIGINAL ARTICLE12-16-2024
Factors associated with maternal well-being during childbirth among postpartum women in Minas Gerais
- Talyta Sâmara Batista Ferreira ,
- Cinara Botelho Moutinho ,
- Edmar Rocha Almeida ,
- Ana Júlia Soares Oliveira ,
- Carolina Amaral Oliveira Rodrigues , [ … ],
- Marise Fagundes Silveira
Abstract
ORIGINAL ARTICLEFactors associated with maternal well-being during childbirth among postpartum women in Minas Gerais
Revista Brasileira de Enfermagem. 2024;77(6):e20230304
DOI 10.1590/0034-7167-2023-0304
- Talyta Sâmara Batista Ferreira ,
- Cinara Botelho Moutinho ,
- Edmar Rocha Almeida ,
- Ana Júlia Soares Oliveira ,
- Carolina Amaral Oliveira Rodrigues ,
- Clara de Cássia Versiani ,
- Sibylle Emilie Vogt ,
- Marise Fagundes Silveira
Views0See moreABSTRACT
Objectives:
to analyze the factors associated with maternal well-being during childbirth among postpartum women in Minas Gerais.
Methods:
a cross-sectional study nested within a cohort was conducted with postpartum women in a municipality of Minas Gerais. The Maternal Well-being in Childbirth Scale 2 was used. The prevalence of maternal well-being during childbirth was estimated. The magnitude of the association between maternal distress and care practices was estimated using the Prevalence Ratio (PR), applying Poisson regression.
Results:
a total of 183 postpartum women aged between 15 and 46 years participated, with 26.2%, 27.9%, and 45.9% reporting excellent, adequate, and poor well-being during childbirth care, respectively. Maternal distress was more prevalent among women who underwent cesarean sections (PR = 1.60) and those who did not receive breastfeeding information (PR = 1.59).
Conclusions:
a high prevalence of maternal distress during childbirth was observed, associated with cesarean delivery and the lack of breastfeeding information.
- Talyta Sâmara Batista Ferreira
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ORIGINAL ARTICLE12-16-2024
Prevalence and factors associated with musculoskeletal pain among hospital cleaning staff
- Emanuelli Mancio Ferreira da Luz ,
- Oclaris Lopes Munhoz ,
- Patrícia Bitencourt Toscani Greco ,
- Bruna Xavier Morais ,
- Silviamar Camponogara , [ … ],
- Tânia Solange Bosi de Souza Magnago
Abstract
ORIGINAL ARTICLEPrevalence and factors associated with musculoskeletal pain among hospital cleaning staff
Revista Brasileira de Enfermagem. 2024;77(6):e20230237
DOI 10.1590/0034-7167-2023-0237
- Emanuelli Mancio Ferreira da Luz ,
- Oclaris Lopes Munhoz ,
- Patrícia Bitencourt Toscani Greco ,
- Bruna Xavier Morais ,
- Silviamar Camponogara ,
- Tânia Solange Bosi de Souza Magnago
Views0See moreRESUMO
Objetivos:
verificar a prevalência e os fatores associados à dor musculoesquelética em trabalhadores do serviço hospitalar de limpeza.
Métodos:
estudo transversal, realizado com trabalhadores de limpeza de um hospital de ensino do Sul do Brasil. Utilizaram-se questionário com variáveis sociodemográficas, laborais e de saúde, o Nordic Musculoskeletal Questionnaire e o Diagrama de Corlett e Manenica. Realizou-se análise bivariada.
Resultados:
participaram 149 trabalhadores. Prevaleceu dor musculoesquelética na coluna lombar no último ano (65,8%) e últimos sete dias (42,3%). Constataram-se associações entre automedicação e dor na parte inferior das costas (p=0,020) e ombros (p=0,026); sedentarismo, oito horas de sono diárias e dor nos tornozelos (p=0,041) e pés (p=0,039); ex-tabagismo, uso de medicamento e dor nos punhos (p=0,015) e mãos (p=0,004).
Conclusões:
prevaleceram lombalgias associadas a hábitos de saúde e vida. Um programa de educação em saúde e recomendações de melhorias nos processos de trabalho podem minimizar a exposição à dor musculoesquelética.
- Emanuelli Mancio Ferreira da Luz
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ORIGINAL ARTICLE10-28-2020
“Health does not discuss trans bodies”: Oral History of transsexuals and transvestites
Revista Brasileira de Enfermagem. 2020;73:e20190228
Abstract
ORIGINAL ARTICLE“Health does not discuss trans bodies”: Oral History of transsexuals and transvestites
Revista Brasileira de Enfermagem. 2020;73:e20190228
DOI 10.1590/0034-7167-2019-0228
Views0See moreABSTRACT
Objectives:
to understand the life stories and itineraries of transvestites and transsexuals in health services.
Methods:
study with a qualitative approach, anchored in the methodological framework of Oral History. Interviews were conducted and thematically analyzed.
Results:
two themes emerged: 1) gender and sexuality in life stories; and 2) the trajectories in health services. These revealed the challenges in the process of recognizing gender identity before the family and society. The reports show the dilemmas that transsexuals and transvestites face in health care, which ends up generating the removal of this population from services.
Final Considerations:
it has been demonstrated that Oral History can increase knowledge, especially about life histories and trajectories in the health services of transvestites and transsexuals; in addition, information was offered that can assist managers and health professionals in making decisions or caring for these people.
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ORIGINAL ARTICLE07-10-2020
Working conditions and depression in hospital emergency service nurses
Revista Brasileira de Enfermagem. 2020;73:e20180952
Abstract
ORIGINAL ARTICLEWorking conditions and depression in hospital emergency service nurses
Revista Brasileira de Enfermagem. 2020;73:e20180952
DOI 10.1590/0034-7167-2018-0952
Views0See moreABSTRACT
Objective:
to analyze the presence, intensity and factors related to working conditions for depressive symptoms in hospital emergency nurses in the east of São Paulo.
Methods:
a descriptive, exploratory, quantitative and qualitative study, which applied psychometric scales and interview script.
Results:
nurses (95.24%) had depressive symptoms by the assessment scales by the observer, most with mild and moderate intensity. Inadequate working conditions led to suffering. Factors that trigger depressive symptoms were: disorganized work; harmful relationship with immediate management; inappropriate physician behavior; aggressions; lack of inputs, infrastructure and human resources; professional devaluation. Identified professionals with depressive symptoms who, because they were unaware of being affected by the disorder, did not seek treatment, continued to perform activities that compromised their physical and mental health, promoting damage to the assistance provided.
Final considerations:
high frequency of depressive symptoms. The precarious work environment negatively influenced the care and development of depressive symptoms.
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ORIGINAL ARTICLE06-01-2020
Nursing students: medication use, psychoactive substances and health conditions
- Bárbara de Oliveira Prado Sousa ,
- André Luiz Thomaz de Souza ,
- Jacqueline de Souza ,
- Sivani Andreia dos Santos ,
- Manoel Antônio dos Santos , [ … ],
- Sandra Cristina Pillon
Abstract
ORIGINAL ARTICLENursing students: medication use, psychoactive substances and health conditions
Revista Brasileira de Enfermagem. 2020;73:e20190003
DOI 10.1590/0034-7167-2019-0003
- Bárbara de Oliveira Prado Sousa ,
- André Luiz Thomaz de Souza ,
- Jacqueline de Souza ,
- Sivani Andreia dos Santos ,
- Manoel Antônio dos Santos ,
- Sandra Cristina Pillon
Views0See moreABSTRACT
Objective:
to assess the use of nonprescription psychoactive medications and their associations with psychoactive substance use and health aspects among nursing students.
Method:
a cross-sectional study conducted with 182 students at a nursing school in the city of Vale do Ribeira, Brazil. Sociodemographic information, screening for alcohol, tobacco and other drug use, information on physical and mental health and physical activity practices were assessed.
Results:
more than half of the students (79.2%) used psychoactive drugs without prescription, with a predominance of monthly consumption. Consumption of these drugs was found to be associated with alcohol use, binge drinking, smoking and illicit drug use.
Conclusion:
the findings have implications for the implementation of health promotion strategies among nursing students, in view of lifestyle changes.
- Bárbara de Oliveira Prado Sousa
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08-07-2023
Chemsex and its repercussions on the health of men who have sex with men (MSM): a global health perspective
Revista Brasileira de Enfermagem. 2023;76(3):e20230004
Abstract
Chemsex and its repercussions on the health of men who have sex with men (MSM): a global health perspective
Revista Brasileira de Enfermagem. 2023;76(3):e20230004
DOI 10.1590/0034-7167-2023-0004
Views0See moreABSTRACT
Objectives:
to discuss the repercussions of chemsex on the health of men who have sex with men (MSM), contextualizing it in a global health scenario and pointing out the implications for nursing care.
Methods:
theoretical-reflexive study based on scientific literature and concepts related to global health.
Results:
we present the epidemiology of the chemsex phenomenon, the main demands of the field, the reasons why it has become a global public health problem, and the implications for nursing practice.
Final Considerations:
chemsex is growing in all age groups of MSM and is globally benefiting from location-based applications to gain magnitude, finding an important potential audience in the migrant population. Nursing structures can help accelerate the proposal and implementation of biomedical and behavioral measures to address chemsex in its entirety, qualifying care and inducing teamwork with interprofessional collaboration.
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ORIGINAL ARTICLE05-24-2021
Critical thinking in nursing training: evaluation in the area of competence Education in Health
Revista Brasileira de Enfermagem. 2021;74:e20200979
Abstract
ORIGINAL ARTICLECritical thinking in nursing training: evaluation in the area of competence Education in Health
Revista Brasileira de Enfermagem. 2021;74:e20200979
DOI 10.1590/0034-7167-2020-0979
Views0See moreABSTRACT
Objective:
To analyze the constitution of critical thinking in nursing training in the approach by competence and the integrated curriculum, considering the evaluation process by capturing its challenges, and proposing overcoming strategies.
Methods:
Qualitative. In the first phase of data collection, interviews were conducted with twenty-four professors, nine preceptors, and fifteen students to reconstruct the profile of competence, and in the second phase, a workshop to validate the profile identified challenges and proposals. The Collective Subject Discourse was used to analyze the interviews and the holistic competence reference in reconstructing the profile.
Results:
The critical thinking is built based on experiences in the world of work, and evaluation is the conductor of reflections towards emancipation.
Final considerations:
It signals the importance of professor training in the learning evaluation and working with the collective construction of subjects to overcome challenges that happen in the changes of training.
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REVIEW11-25-2020
Nurse’s interventions in preventing falls in hospitalized children: scoping review
- Alexandra Margarida Ribeiro Brás ,
- Margarida Maria de Sousa Lourenço Quitério ,
- Elisabete Maria Garcia Teles Nunes
Abstract
REVIEWNurse’s interventions in preventing falls in hospitalized children: scoping review
Revista Brasileira de Enfermagem. 2020;73:e20190409
DOI 10.1590/0034-7167-2019-0409
- Alexandra Margarida Ribeiro Brás ,
- Margarida Maria de Sousa Lourenço Quitério ,
- Elisabete Maria Garcia Teles Nunes
Views1See moreABSTRACT
Objectives:
map both nursing interventions for the prevention of falls in paediatric age during hospitalization and the instruments for assessing the risk of falls in paediatrics.
Methods:
scoping review according to the protocol of Joanna Briggs Institute, with acronym PCC (P – children, C – fall preventive nursing interventions and instruments for assessing the risk of falling, C – hospital admission), in three sources of information (EBSCO, PubMed and SciELO).
Results:
the sample consisted of seven articles. The education of the child/family is the basis of the interventions, and the instruments for assessing the risk of falling identified were: Humpty Dumpty Falls Scale, GRAF PIF, CUMMINGS, I’M SAFE and CHAMPS.
Conclusions:
the education of children/parents on preventive measures is important and should be reinforced during hospitalization, using different methodologies. The Humpty Dumpty Falls Scale was the most analyzed.
- Alexandra Margarida Ribeiro Brás
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ORIGINAL ARTICLE06-14-2021
Mothers’ knowledge of premature newborn care and application of Kangaroo Mother Care at home
- Marcilene Pimentel Gomes ,
- Salma Brito Saráty ,
- Alexandre Aguiar Pereira ,
- Andressa Tavares Parente ,
- Mary Elizabeth de Santana , [ … ],
- Andreza Duarte Martins Figueira
Abstract
ORIGINAL ARTICLEMothers’ knowledge of premature newborn care and application of Kangaroo Mother Care at home
Revista Brasileira de Enfermagem. 2021;74(6):e20200717
DOI 10.1590/0034-7167-2020-0717
- Marcilene Pimentel Gomes ,
- Salma Brito Saráty ,
- Alexandre Aguiar Pereira ,
- Andressa Tavares Parente ,
- Mary Elizabeth de Santana ,
- Maria de Nazaré da Silva Cruz ,
- Andreza Duarte Martins Figueira
Views0See moreABSTRACT
Objective:
to identify mothers’ knowledge about premature newborn care and application of Kangaroo Mother Care at home.
Methods:
a descriptive, qualitative study carried out with 15 mothers of premature newborns in a reference Maternal and Child Hospital in northern Brazil using two semi-structured interviews with open- and closed-ended questions. The testimonies were analyzed using thematic analysis technique, proposed by Bardin.
Results:
two thematic categories originated: “Caring for a premature newborn at home: strengths and weaknesses” and “Applying Kangaroo Mother Care at home: new knowledge acquired during hospitalization”.
Final considerations:
the speeches of the interviewed mothers pointed out their knowledge about home care of premature NBs and understanding the importance of Kangaroo Mother Care, mainly acquired and improved with the guidance of professionals during hospitalization and application of the method, in addition to fears, possible difficulties in home care and the need to be better informed at hospital discharge.
- Marcilene Pimentel Gomes
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ORIGINAL ARTICLE05-03-2021
Nursing care for patient in postoperatory heart surgery in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(2):e20200163
Abstract
ORIGINAL ARTICLENursing care for patient in postoperatory heart surgery in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(2):e20200163
DOI 10.1590/0034-7167-2020-0163
Views0See moreABSTRACT
Objective:
To investigate the critical nodes related to nursing care for patients in the postoperative period of cardiac surgery.
Methods:
Exploratory study with a qualitative approach. Data collected through semi-structured interviews with 27 members of the nursing team working in the Intensive Care Unit. Material submitted to thematic analysis.
Results:
Three categories emerged: Flaws in the professional qualification for patient care in the postoperative period of cardiac surgery; Team challenges concerning specific patient care in the postoperative period of cardiac surgery; and (dis) organization of work in the Intensive Care Unit and its impact on nursing care for patients in the postoperative period of cardiac surgery.
Final considerations:
Given the identification of the critical nodes, the professionals presented suggestions to overcome daily difficulties: investments in strategies for Permanent Education in Health; creation of tools to guide patient assistance in the postoperative of cardiac surgery; and provision of adequate human resources.
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