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02-26-2024
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
Abstract
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
DOI 10.1590/0034-7167.2024770201
Views0The professional practice of patient navigation is incipient in Brazil and, therefore, a broad discussion with various sectors of society is essential, which is the main purpose of this editorial. Shall we start with the story. Patient navigation was defined in 1989 as a community-based service delivery intervention aimed at appropriately promoting access to diagnosis […]See more -
REVIEW02-26-2024
Evidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230134
Abstract
REVIEWEvidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230134
DOI 10.1590/0034-7167-2023-0134
Views0See moreABSTRACT
Objectives:
to synthesize and analyze evidence on intrauterine device insertion by nurses in Primary Health Care.
Methods:
an integrative review, carried out in the BDENF, CINAHL, LILACS, SciELO, Scopus, PubMed and Web of Science databases in June 2022, delimiting the period from 1960 to 2022.
Results:
141 articles were identified in the initial search, and 10 studies made up the final sample. Four (40%) were developed in the United States and one (10%) in Brazil, with publications from 1979 to 2021. The findings were grouped into three categories: Nurse training to insert an intrauterine device; Nurses’ competency to insert an intrauterine device; and Women’s access to intrauterine devices.
Conclusions:
nurse theoretical and practical training is a prominent element, consolidated in the favorable outcomes of insertions performed by nurses and satisfaction among women, a practice that has expanded access to the contraceptive method in Primary Health Care.
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ORIGINAL ARTICLE02-26-2024
Artificial intelligence to predict bed bath time in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(1):e20230201
Abstract
ORIGINAL ARTICLEArtificial intelligence to predict bed bath time in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(1):e20230201
DOI 10.1590/0034-7167-2023-0201
Views0See moreABSTRACT
Objectives:
to assess the predictive performance of different artificial intelligence algorithms to estimate bed bath execution time in critically ill patients.
Methods:
a methodological study, which used artificial intelligence algorithms to predict bed bath time in critically ill patients. The results of multiple regression models, multilayer perceptron neural networks and radial basis function, decision tree and random forest were analyzed.
Results:
among the models assessed, the neural network model with a radial basis function, containing 13 neurons in the hidden layer, presented the best predictive performance to estimate the bed bath execution time. In data validation, the squared correlation between the predicted values and the original values was 62.3%.
Conclusions:
the neural network model with radial basis function showed better predictive performance to estimate bed bath execution time in critically ill patients.
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ORIGINAL ARTICLE02-26-2024
Technological prospecting of patents related to monitoring accidents due to falls in hospitals
Revista Brasileira de Enfermagem. 2024;77(1):e20230084
Abstract
ORIGINAL ARTICLETechnological prospecting of patents related to monitoring accidents due to falls in hospitals
Revista Brasileira de Enfermagem. 2024;77(1):e20230084
DOI 10.1590/0034-7167-2023-0084
Views0See moreABSTRACT
Objectives:
to map the production of technologies aimed at monitoring falls in a hospital environment protected by registered patents.
Methods:
a technological prospecting of international patents, with a quantitative approach, with search carried out between February and March 2022 in the Derwent Innovations Index database with descriptors fall, hospital, monitoring.
Results:
212 patents were found, with the majority filed and published since 2010, by Tran B (9) and Cerner Innovation Inc (9), focused on health technology. Universities were responsible for 13% of deposits. There was a predominance of records from the United States (43.4%), China (21.7%) and Japan (12.3%), in addition to technological strategies classified as devices for the environment (80.7%) and for preventing falls (66.5%) as well as trend towards resources with multiple functionalities in the same technology.
Conclusions:
the plurality of functions in the same device reflects the search for optimizing resources and the concern with comprehensive care.
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ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20230045
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20230045
DOI 10.1590/0034-7167.20247701e04
Views2In the article “Coping strategies for chronically ill children and adolescents facing the COVID-19 pandemic”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 2):e20230045, in the author:Where it read:[…]See more -
ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e02
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e02
DOI 10.1590/0034-7167.20247701e02
Views2In the article “Active teaching model to promote critical thinking”, with DOI number: , published in Revista Brasileira de Enfermagem, 2019;72(1):293-8, on page 297:Include before REFERENCES:[…]See more -
ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
DOI 10.1590/0034-7167.20247701e03
Views2In the article “Nurses in the labor market: professional insertion, competencies and skills”, with DOI number: , published in Revista Brasileira de Enfermagem, 2017;70(6):1220-6, on page 1225:Include before REFERENCES:[…]See more -
REVIEW02-26-2024
Practice of immersion in hot water to relieve pain in neonatology: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230260
Abstract
REVIEWPractice of immersion in hot water to relieve pain in neonatology: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230260
DOI 10.1590/0034-7167-2023-0260
Views1See moreABSTRACT
Objectives:
to identify immersion use in hot water to relieve pain in newborns.
Methods:
an integrative literature review, carried out in the PubMed, VHL, EMBASE, Scopus, CINAHL, Cochrane and SciELO databases, with investigations in English, Spanish, French or Portuguese, published between 2002 and 2022. The Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) were used to answer the following question: what are the uses of hot water immersion in relieving pain in newborns?
Results:
nine studies were included, mainly Brazilian, experimental, with a predominance of strong and moderate levels of evidence. Hydrotherapy and bath use (immersion and bandaging) was observed, promising interventions in reducing pain scores, assessed using scales, physiological and endocrine parameters.
Conclusions:
hot water proved to be a promising non-pharmacological intervention in relieving pain in infants in different contexts.
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ERRATUM04-22-2020
ERRATUM
Revista Brasileira de Enfermagem. 2020;73(3):202073n3e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2020;73(3):202073n3e05
DOI 10.1590/0034-7167.202073n3e05
Views0Article “Concept formation of ambience for labor and normal institutionalized delivery”, with number of DOI: , published in the journal Revista Brasileira de Enfermagem, 72(Suppl 3):348-59, on page 357:Include after Final Considerations the information:[…]See more -
ORIGINAL ARTICLE04-09-2020
Health promotion in schools: speeches, representations, and approaches
Revista Brasileira de Enfermagem. 2020;73(3):e20180774
Abstract
ORIGINAL ARTICLEHealth promotion in schools: speeches, representations, and approaches
Revista Brasileira de Enfermagem. 2020;73(3):e20180774
DOI 10.1590/0034-7167-2018-0774
Views0See moreABSTRACT
Objectives:
to analyze speeches, representations, and approaches on health and health promotion in schools, materialized in the speech of teachers.
Methods:
a qualitative study, of the case study type, carried out with 17 teachers from the municipal and state educational network. The data were obtained from interviews and analyzed by the Content-Oriented Discourse Analysis.
Results:
medical-sanitary and clinical-biological discourses predominated. Health is represented as the absence of disease, reflecting approaches that prioritize healthy habits and changes in behavior. Problematization of social determinants occurs in projects, in an intersectorial partnership.
Final Considerations:
carrying out projects of health promotion in schools ignores the solidification of partnerships and the construction of new speeches that represent it as quality of life conditioned by social, economic, and cultural factors as well as strategies for the ideological repositioning of those actors who act in this setting.
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ORIGINAL ARTICLE04-09-2020
Nursing work and competence in hemotherapy services: an ergological approach
Revista Brasileira de Enfermagem. 2020;73(3):e20180775
Abstract
ORIGINAL ARTICLENursing work and competence in hemotherapy services: an ergological approach
Revista Brasileira de Enfermagem. 2020;73(3):e20180775
DOI 10.1590/0034-7167-2018-0775
Views0See moreABSTRACT
Objetives:
to analyze the ingredients of the competence that the nurses use in the performance of their work in hemotherapy.
Methods:
qualitative study with 22 nurses, accomplished through documentary study, observation and semi-structured interview, with resources of Atlas.ti software based on the foundations of Historical Materialism Dialectic and Ergology. Performed Content Analysis.
Results:
the domain of specific knowledge of hemotherapy and the time of experience in the area, allied to the motivation of the worker and the ability to work in a team favor the competent action in the work activities. On the other hand, the lack of adequate work conditions, especially in relation to adequate materials, equipment and structure, impairs the work of the nurse in hemotherapy.
Final Considerations:
experience gained is critical to successful decision making. In addition, adequate working conditions, updating of knowledge and ability in teamwork favor a scenario of safe practices.
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ORIGINAL ARTICLE04-22-2020
Happiness as a strength in the promotion of adolescent and adult young health
Revista Brasileira de Enfermagem. 2020;73(3):e20190064
Abstract
ORIGINAL ARTICLEHappiness as a strength in the promotion of adolescent and adult young health
Revista Brasileira de Enfermagem. 2020;73(3):e20190064
DOI 10.1590/0034-7167-2019-0064
Views0See moreABSTRACT
Objectives:
to assess the relation between sociodemographic characteristics of young people associated with the subjectivity of being happy; to evaluate the relationship between the subjectivity of being happy and the perception of health status; to evaluate the relationship between the subjectivity of being happy and the school and family environments and peer groups at school.
Methods:
this is an observational study, with an intentional sample of 1,069 young Portuguese people, with ages varying from 14 to 24, most of them women, attending secondary education. The self-filling questionnaire was used.
Results:
there are statistically significant associations between the subjectivity of being happy and schooling, perception of health status, family APGAR, school and family involvement, absence of problems or teasing by peers at school.
Conclusions:
a positive and holistic care coupled with the potential of obtaining and consolidating healthy lifestyles for young people will enable health professionals to perceive them as agents of individual and social change.
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ORIGINAL ARTICLE04-22-2020
Preventing vertical HIV virus transmission: hospital care assessment
Revista Brasileira de Enfermagem. 2020;73(3):e20190491
Abstract
ORIGINAL ARTICLEPreventing vertical HIV virus transmission: hospital care assessment
Revista Brasileira de Enfermagem. 2020;73(3):e20190491
DOI 10.1590/0034-7167-2019-0491
Views0See moreABSTRACT
Objectives:
assess the implementation of actions to prevent vertical transmission of HIV.
Methods:
a retrospective cohort study conducted in two maternity hospitals in the city of Montes Claros, State of Minas Gerais. All women admitted for childbirth diagnosed with HIV and their respective newborns were included from 2014 to 2017. Data were collected from medical records and analyzed descriptively.
Results:
population consisted of 46 pairs of mothers and newborns. Management was considered inadequate in 30 cases of parturient/postpartum women (65.2%) and 14 cases of newborns (30.4%). The main reasons for inadequate maternal management were lack of pharmacological inhibition of lactation (53.3%) and counseling/consent for HIV testing (43.3%). For newborns, late onsetoffirst dose ofZidovudine (50.0%) and no prescriptionofNevirapine (28.6%).
Conclusions:
important prevention opportunities were missed, pointing to the need for improved care.
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ORIGINAL ARTICLE06-08-2020
Maternal-child nursing care for adolescent mothers: health education
Revista Brasileira de Enfermagem. 2020;73(4):e20180769
Abstract
ORIGINAL ARTICLEMaternal-child nursing care for adolescent mothers: health education
Revista Brasileira de Enfermagem. 2020;73(4):e20180769
DOI 10.1590/0034-7167-2018-0769
Views0See moreABSTRACT
Objectives:
to develop an educational intervention through a game that addresses aspects related to adolescent motherhood and child care.
Methods:
this is an action research based on diagnosis, intervention and apprehension stages.
Results:
the situational diagnosis was based on a literature review on adolescent motherhood and child care. In the intervention stage, the educational game’s first version was elaborated. In the third stage constituted by apprehension, the game was submitted to assessment of interdisciplinary experts. Suggestions of experts were adopted and the game had its second version.
Final Considerations:
the educational intervention in the present study appears a care technology that adds knowledge and practices to the work of nurses in Primary Health Care, focusing on adolescent women and children health care.
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REVIEW06-01-2020
Access of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
Abstract
REVIEWAccess of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
DOI 10.1590/0034-7167-2018-0834
Views1See moreABSTRACT
Objectives:
demonstrate and discuss how the black population’s access to health services occurs
Methods:
integrative literature review with the following question: How does the black population’s access to health services occur? The search was carried out in the Scholar, LILACS and SciELO databases and used the descriptor “access to health services” and the term “population,” resulting in a sample with twelve articles.
Results:
studies show that the difficulty of access is a fundamental factor for the quality of life of people, directly compromising preventive services, especially for women’s health and, in addition, it has significant impact on the illness process of the black population within its particularities.
Final Considerations:
several limiting factors compromise the black population’s access to health services, including institutional and structural factors
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ORIGINAL ARTICLE05-18-2020
Militancy of nurses in the institutionality field: printed media versions
Revista Brasileira de Enfermagem. 2020;73(4):e20180835
Abstract
ORIGINAL ARTICLEMilitancy of nurses in the institutionality field: printed media versions
Revista Brasileira de Enfermagem. 2020;73(4):e20180835
DOI 10.1590/0034-7167-2018-0835
Views0See moreABSTRACT
Objectives:
to analyze nurses’ professional militancy in the institutionality field, presented by the printed media from Bahia State in the 1970s and 1980s.
Methods:
a historical and qualitative research under Social History’s perspective, whose data source was the newspaper A Tarde. The temporal cut-off encompasses milestones such as professional body restructuring and creation.
Results:
the Associação Brasileira de Enfermagem democratization movement was reported in a superficial way, highlighting the struggle for power spaces. With respect to Conselhos Federal e Regional de Enfermagem daBahia, the newspaper notified creation and function of bodies, however, there was no visibility to the newspaper’s performance. Concerning the union, there was political fragility of nurses against the creation and union participation in the fight for labor rights.
Final Considerations:
organization of political action occurred from isolated groups mobilization of professionals who were already traveling in political spaces, not the large mass of professionals.
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REVIEW07-10-2020
Acute Kidney Injury by SARS-CoV-2 virus in patients with COVID-19: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200354
Abstract
REVIEWAcute Kidney Injury by SARS-CoV-2 virus in patients with COVID-19: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200354
DOI 10.1590/0034-7167-2020-0354
Views0See moreABSTRACT
Objective:
to assess scientific evidence on SARS-CoV-2 Acute Kidney Injury in patients with COVID-19.
Methods:
an integrative review, with adoption of PICO strategy and classification of the level of evidence, carried out on April 10, 2020 in the PubMed database, of articles available between December 2019 and April 2020.
Results:
the sample consisted of six original, five observational and one experimental articles. Observational studies addressed the clinical findings of patients with COVID-19 and association between kidney damage, infection, and morbidity-mortality.
Conclusion:
the studies addressed the mechanism of intracellular infection of SARS-CoV-2, its cytopathic effects on kidney cells and incidence of acute kidney injury in patients infected with SARS-CoV-2. Acute kidney injury is associated with increased mortality and morbidity in these patients. This review realizes the need for new research that can mention kidney care to patients with COVID-19.
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ORIGINAL ARTICLE03-24-2021
Development, validation and application of clinical simulation scenarios for assessment of stomatherapy specialists
Revista Brasileira de Enfermagem. 2021;74(1):e20200360
Abstract
ORIGINAL ARTICLEDevelopment, validation and application of clinical simulation scenarios for assessment of stomatherapy specialists
Revista Brasileira de Enfermagem. 2021;74(1):e20200360
DOI 10.1590/0034-7167-2020-0360
Views0See moreABSTRACT
Objectives:
to build and validate three clinical simulation scenarios and report the application with candidates for the specialist’s degree in stomatherapy.
Methods:
methodological study, building three scenarios and evaluation checklists; content validation with judges, using content validity index and Modified Kappa Coefficient; pre-test and application.
Results:
scenarios built based on nursing care for: 1. insufficiency and venous ulcer; 2. demarcation of intestinal stomia; and 3. Clean intermittent catheterization. In the content validation of the 24 items appreciated, 83%, 80%, and 92% were validated without change. In the pre-test, the objectives and checklists were adjusted. In the application, to standardize the evaluation, actors and evaluators were trained previously, and each candidate passed the three stations.
Conclusions:
scenarios built and with validated content, based on evidence and covering the three areas of stomatherapy. The pre-test allowed for adjustments in the scenarios, and the candidates achieved the expected objectives.
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ORIGINAL ARTICLE07-15-2020
Cultural adaptation of Infant Feeding Intentions Scale (IFI) for pregnant women in Brazil
Revista Brasileira de Enfermagem. 2020;73:e20190103
Abstract
ORIGINAL ARTICLECultural adaptation of Infant Feeding Intentions Scale (IFI) for pregnant women in Brazil
Revista Brasileira de Enfermagem. 2020;73:e20190103
DOI 10.1590/0034-7167-2019-0103
Views0See moreABSTRACT
Objectives:
to translate and culturally adapt the Infant Feeding Intentions Scale for pregnant women in Brazil.
Methods:
methodological study that included stages of translation, synthesis, face and content validation, back translation and semantic assessment. In the face and content and semantic validation stages, we used the Content Validity Index for individual items and for the overall scale for clarity and representativeness.
Results:
nine (100.0%) experts participated in face and content validation, and the average index obtained was 85.0% for representativeness. In the semantic assessment, performed with 31 (100.0%) pregnant women, the tool was considered clear, obtaining an average index of 91.0%.
Conclusions:
the Brazilian version of the scale was considered representative and clear. After assessing psychometric properties, the scale is expected to be valid and reliable to assess maternal intention to breastfeed exclusively until the infant’s six months of life in different Brazilian settings.
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ORIGINAL ARTICLE03-30-2020
Parental care for infants with feeding tube: psychosocial repercussions
Revista Brasileira de Enfermagem. 2020;73(2):e20180360
Abstract
ORIGINAL ARTICLEParental care for infants with feeding tube: psychosocial repercussions
Revista Brasileira de Enfermagem. 2020;73(2):e20180360
DOI 10.1590/0034-7167-2018-0360
Views0See moreABSTRACT
Objectives:
to understand the psychosocial repercussions experienced by caregiving parents, resulting from care for the child with dysphagic cleft lip and palate.
Methods:
qualitative study, developed in a tertiary hospital in September 2016. The sample defined by theoretical saturation consisted of seven mothers. Data collection was performed by unstructured interview, being audio-recorded and fully transcribed. Symbolic Interactionism was used as theoretical framework, and Thematic Content Analysis as methodological framework.
Results:
the following themes emerged: diagnosisimpact and coping; coping with overload and stress; interaction between caregivers as an acceptance and coping strategy; impact on family and social life of caregivers; and curiosity coping, and family and community prejudice.
Final considerations:
despite the physical and emotional overload, the mother figure plays the main and determining role in care, reflecting the complexity of care.
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ORIGINAL ARTICLE03-30-2020
Stomized children care practices: narratives of relatives
Revista Brasileira de Enfermagem. 2020;73(2):e20180370
Abstract
ORIGINAL ARTICLEStomized children care practices: narratives of relatives
Revista Brasileira de Enfermagem. 2020;73(2):e20180370
DOI 10.1590/0034-7167-2018-0370
Views0See moreABSTRACT
Objectives:
to understand the practices adopted by relatives regarding ostomized children care.
Methods:
qualitative approach, conducted with 11 relatives of ostomized children. Methodological framework was used as narrative technique; NVivo® software for data categorization and information analysis; content analysis technique.
Results:
participants revealed unpreparedness in dealing with children, lack of knowledge about handling materials and equipment inherent to ostomy and challenges faced in the daily life of children in school. They are unanimous in telling they feel encouraged and strengthened by receiving support from nurses in child care. They suggested the development of strategies to guide ostomized children care, such as educational material use.
Conclusions:
to understand family members’ experience made it possible to support training and qualification of nursing professionals, and to establish priorities in care. Evidence found may contribute to reflections that aid health promotion and prevention of complications in ostomized children care.
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ORIGINAL ARTICLE06-16-2021
Family interview for organ and tissue donation: good practice assumptions
Revista Brasileira de Enfermagem. 2021;74(2):e20190206
Abstract
ORIGINAL ARTICLEFamily interview for organ and tissue donation: good practice assumptions
Revista Brasileira de Enfermagem. 2021;74(2):e20190206
DOI 10.1590/0034-7167-2019-0206
Views0See moreABSTRACT
Objectives:
to identify information that can support creating good practice assumptions to develop family interview for organ and tissue donation.
Methods:
this scoping study, conducted in two Brazilian hospitals in the southern, between April and December 2017, included integrative review and consultation with 15 families who experienced interview for organ donation. For data analysis, thematic content analysis was used.
Results:
three categories emerged: communication of death, which shows the need to know the history of hospitalization of patients; emotional support, the team must have mastery of the stages of mourning; information about donation, professionals need to know the stages of the donation process and respect families’ time.
Final Considerations:
good practice assumptions point to the need for team training, respect for family time and the use of simple language.
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ORIGINAL ARTICLE12-13-2019
Perception of women with breast cancer undergoing chemotherapy: a comprehensive analysis
Revista Brasileira de Enfermagem. 2019;72:103-110
Abstract
ORIGINAL ARTICLEPerception of women with breast cancer undergoing chemotherapy: a comprehensive analysis
Revista Brasileira de Enfermagem. 2019;72:103-110
DOI 10.1590/0034-7167-2018-0165
Views0See moreABSTRACT
Objective:
To comprehensively analyze the perception of women with breast cancer on the experience of undergoing chemotherapy.
Method:
This was a qualitative, descriptive, phenomenological study, supported by the Merleau-Ponty philosophy. It was conducted in a chemotherapy outpatient clinic with 20 participants who completed a phenomenological interview.
Results:
The phenomenological data analysis demonstrated that the perception of women about the experience of chemotherapy is about change, not only of the physical body, but of their identity, and that it considers existential aspects. Three categories emerged from the experience of alopecia, fatigue, and spirituality, respectively: the body itself, the current and habitual body, and transcendence.
Final considerations:
Bodily changes, and the existential implications perceived by the women in this study, analyzed from the Merleau-Ponty perspective, makes it possible to consider body concept, and provides support for humanized care based on singularity and the socio-cultural context.
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REVIEW07-14-2021
Symptom management theory applied to nursing care: scoping review
Revista Brasileira de Enfermagem. 2021;74(3):e20201004
Abstract
REVIEWSymptom management theory applied to nursing care: scoping review
Revista Brasileira de Enfermagem. 2021;74(3):e20201004
DOI 10.1590/0034-7167-2020-1004
Views0See moreABSTRACT
Objectives:
to identify publications about the applicability of the Symptom Management Theory in nursing care to pediatric, adolescent, adult and elderly patients.
Methods:
scoping review following the steps: definition of the objective, research question and inclusion criteria; search, selection and analysis of publications; synthesis of results. The search occurred in the VHL, SciELO, CAPES and PubMed Journals Portal bases, contemplating publications between 1994 and July 2020.
Results:
out of 3,286 studies, ten were selected, published between 2008 and 2019. They described the relationships between the participants and the domains (person, environment, health and disease), components (symptom experience, management strategies, results) and presented strategies for symptom management.
Conclusions:
the Symptom Management Theory was considered applicable to the participants of the studies and to nursing care. It was concluded that understanding the interaction of these elements is essential to plan actions aimed at controlling symptoms effectively.
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