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ORIGINAL ARTICLE11-26-2022
Transitional care of nurses to older adults with artificial pacemaker
- Emanuela Santos Oliveira
, - Tânia Maria de Oliva Menezes ,
- Nildete Pereira Gomes ,
- Lélia Mendes Sobrinho de Oliveira ,
- Verônica Matos Batista , [ … ],
- Alinne Nogueira Chaves
Abstract
ORIGINAL ARTICLETransitional care of nurses to older adults with artificial pacemaker
Revista Brasileira de Enfermagem. 2022;75:e20210192
DOI 10.1590/0034-7167-2021-0192
- Emanuela Santos Oliveira ,
- Tânia Maria de Oliva Menezes ,
- Nildete Pereira Gomes ,
- Lélia Mendes Sobrinho de Oliveira ,
- Verônica Matos Batista ,
- Monique Carolinne Macêdo Oliveira ,
- Alinne Nogueira Chaves
Views0See moreABSTRACT
Objective:
to understand how the transitional care of nurses to olde adults with artificial pacemaker occurs.
Method:
a qualitative research, carried out in a philanthropic hospital in the city of Salvador, Bahia, Brazil. Fourteen nurses working in surgical and cardiac inpatient units participated. Data were collected between August and November 2020, through semi-structured interviews, and analyzed using the methodological framework Discourse of the Collective Subject and discussed in the light of Afaf Meleis’ theory of transitions.
Results:
nurses’ incipient knowledge about transitional care was identified. It was observed that the nursing discharge report is a facilitating instrument for transitional care.
Final considerations:
the study pointed out that the transitional care of nurses to older adults with artificial pacemakers does not have a theoretical foundation, reporting as a priority the care with the pacemaker identification card and with the surgical wound.
- Emanuela Santos Oliveira
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ORIGINAL ARTICLE11-26-2022
Mental health assistance in Primary Care: the perspective of professionals from the Family Health Strategy
- Luana Cristina Bellini Cardoso ,
- Sonia Silva Marcon ,
- Thamires Fernandes Cardoso da Silva Rodrigues ,
- Marcelle Paiano ,
- Hellen Emília Peruzzo , [ … ],
- Leandro Barbosa de Pinho
Abstract
ORIGINAL ARTICLEMental health assistance in Primary Care: the perspective of professionals from the Family Health Strategy
Revista Brasileira de Enfermagem. 2022;75:e20190326
DOI 10.1590/0034-7167-2019-0326
- Luana Cristina Bellini Cardoso ,
- Sonia Silva Marcon ,
- Thamires Fernandes Cardoso da Silva Rodrigues ,
- Marcelle Paiano ,
- Hellen Emília Peruzzo ,
- Bianca Cristina Ciccone Giacon-Arruda ,
- Leandro Barbosa de Pinho
Views0See moreABSTRACT
Objective:
To learn about the perceptions of the professionals who work in Primary Health Care about mental health care.
Methods:
Descriptive and qualitative study, carried out with 29 health workers through open and individual interviews. The IRaMuTeQ® software was used to organize the data which, then, was submitted to a content analysis process in the thematic modality.
Results:
Three classes emerged from the content analysis: “Perceptions about the mental health care provided in the city”, “The biomedical paradigm in mental healthcare”, and “Elements for the construction of a new way for professionals to act in mental health”.
Final considerations:
It was found that, despite the good infrastructure of the services and the elements pointed at by the professionals to create a new way to act, they do not do so, and the responsibility falls, mostly, on the psychologist to carry out these activities.
- Luana Cristina Bellini Cardoso
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REVIEW11-26-2022
Parental burnout: a scoping review
- Ana Júlia de Paula ,
- Paulo César Condeles ,
- André Luiz Moreno ,
- Maria Beatriz Guimarães Ferreira ,
- Luciana Mara Monti Fonseca , [ … ],
- Mariana Torreglosa Ruiz
Abstract
REVIEWParental burnout: a scoping review
Revista Brasileira de Enfermagem. 2022;75:e20210203
DOI 10.1590/0034-7167-2021-0203
- Ana Júlia de Paula ,
- Paulo César Condeles ,
- André Luiz Moreno ,
- Maria Beatriz Guimarães Ferreira ,
- Luciana Mara Monti Fonseca ,
- Mariana Torreglosa Ruiz
Views0See moreABSTRACT
Objective:
to map available evidence on parental burnout theme.
Method:
scoping review as according to the Joanna Briggs Institute. Search in January 2021, in six databases of publications in English, Portuguese or Spanish, without time limits. Data extracted and descriptively analyzed by three independent researchers.
Results:
374 articles were identified and 20 were included in the final sample, all published in English, from 2017 onwards. Parental burnout is a complex, multifactorial problem, distinct from burnout cases, depressive symptoms and other mental health alterations. It affects 0.2 to 20% of parents, has validated and suitable instruments for measurement; if not treated, can have consequences on marital life, work relationships, child neglect and violence.
Conclusions:
this is a recent theme that needs to be explored, due to the possible impact on children’s and families’ health and on parents’ work processes. Protocol registered in the Open Science Framework ().
- Ana Júlia de Paula
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ORIGINAL ARTICLE11-26-2022
Religiosity and spirituality in mental health: nurses’ training, knowledge and practices
- José Adelmo da Silva Filho ,
- Helvis Eduardo Oliveira da Silva ,
- Jéssica Lima de Oliveira ,
- Caik Ferreira Silva ,
- Geanne Maria Costa Torres , [ … ],
- Antonio Germane Alves Pinto
Abstract
ORIGINAL ARTICLEReligiosity and spirituality in mental health: nurses’ training, knowledge and practices
Revista Brasileira de Enfermagem. 2022;75:e20200345
DOI 10.1590/0034-7167-2020-0345
- José Adelmo da Silva Filho ,
- Helvis Eduardo Oliveira da Silva ,
- Jéssica Lima de Oliveira ,
- Caik Ferreira Silva ,
- Geanne Maria Costa Torres ,
- Antonio Germane Alves Pinto
Views0See moreABSTRACT
Objective:
to analyze nurses’ training, knowledge and practices in the religiosity/spirituality interface in the context of Psychosocial Care Centers.
Methods:
a descriptive, exploratory, qualitative study, carried out in a metropolitan region of Ceará. Four nurses were interviewed, and the data were examined using the content analysis technique.
Results:
four categories emerged from analysis: Deficit in teaching religious and spiritual practices in higher education in nursing; View of the concept of religiosity and spirituality; Religiousness and spirituality as an integral part of the person; Reception of religious and spiritual practices as an aid to treatment.
Final considerations:
a deficit in nursing undergraduate teaching was identified concerning religiosity and spirituality. However, the interviewed professionals understand the importance of religious and spiritual dimensions in the therapeutic process, even though they do not accurately differentiate the concepts.
- José Adelmo da Silva Filho
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ORIGINAL ARTICLE11-26-2022
Health beliefs and adherence of the elderly to fall prevention measures: a quasi-experimental study
- Joana Darc Chaves Cardoso ,
- Rosemeiry Capriata de Souza Azevedo ,
- Annelita Almeida Oliveira Reiners ,
- Amanda Cristina de Souza Andrade
Abstract
ORIGINAL ARTICLEHealth beliefs and adherence of the elderly to fall prevention measures: a quasi-experimental study
Revista Brasileira de Enfermagem. 2022;75:e20201190
DOI 10.1590/0034-7167-2020-1190
- Joana Darc Chaves Cardoso ,
- Rosemeiry Capriata de Souza Azevedo ,
- Annelita Almeida Oliveira Reiners ,
- Amanda Cristina de Souza Andrade
Views0See moreABSTRACT
Objective:
To evaluate the effect of an educational intervention on health beliefs and adherence of elderly people to fall prevention measures.
Methods:
This is a quasi-experimental study, carried out at the Senior Citizens’ Center. Sixty-eight elderly completed the intervention. The intervention consisted of four meetings focused on beliefs about falls and prevention, and the evaluation occurred at baseline and 30 days after completion.
Results:
The elderly were predominantly women (83.82%), with one to four years of schooling (36.76%), with health problems (95.59%), and 48.53% had fallen. There was a significant increase in perceived susceptibility, severity, benefits, barriers, and total health belief score post educational intervention. By adding total to partial adherence, there was a significant increase in the adherence of the elderly to fall prevention measures after the educational intervention.
Conclusion:
Educational intervention was able to improve the beliefs and adherence of the elderly to fall prevention measures.
- Joana Darc Chaves Cardoso
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ORIGINAL ARTICLE11-26-2022
Vulnerability and quality of life of older persons in the community in different situations of family care
Revista Brasileira de Enfermagem. 2022;75:e20210034
Abstract
ORIGINAL ARTICLEVulnerability and quality of life of older persons in the community in different situations of family care
Revista Brasileira de Enfermagem. 2022;75:e20210034
DOI 10.1590/0034-7167-2021-0034
Views0See moreABSTRACT
Objective:
to correlate socio-contextual aspects, physical vulnerability and quality of life of older persons in the community in different situations of family care.
Methods:
epidemiological, a cross-sectional and analytical study, with elderly people in the community (n=769), with application of the instruments: Vulnerable Elders Survey-13 (VES-13), World Health Organization Quality of Life for Older Persons (WHOQOL-OLD) and the World Health Organization Quality of Life (WHOQOL-BREF); and socio-contextual data questionnaire.
Results:
the population assessed presented an average of regular quality of life in both the WHOQOL-BREF and the WHOQOL-OLD. Older non-vulnerable persons (62.2%) and those with close family contact (82.6%) have a better quality of life than the vulnerable (p<0.0001).
Conclusion:
lower quality of life scores and more distant families are related to vulnerable elderly people; thus, the assessment of family proximity and physical vulnerability of older persons is shown to be an important factor in improving quality of life.
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11-25-2022
Populações vulnerabilizadas no contexto da pandemia e crises sanitárias
Revista Brasileira de Enfermagem. 2022;75:e75Suppl201
Abstract
Populações vulnerabilizadas no contexto da pandemia e crises sanitárias
Revista Brasileira de Enfermagem. 2022;75:e75Suppl201
DOI 10.1590/0034-7167.202275Suppl201pt
Views0As condições e os modos de vida da população determinam o processo de saúde e adoecimento de forma diferenciada entre os diversos grupos populacionais. As desigualdades na saúde vêm adquirindo relevância ainda maior na produção de diferentes perfis de doença, em função de recentes e surpreendentes acontecimentos mundiais, como divergências étnico-raciais, religiosas, territoriais, identidade de […]See more -
11-25-2022
Reflections on science in gerontological nursing: possibilities for its path
Revista Brasileira de Enfermagem. 2022;75:e75Suppl401
Abstract
Reflections on science in gerontological nursing: possibilities for its path
Revista Brasileira de Enfermagem. 2022;75:e75Suppl401
DOI 10.1590/0034-7167.202275Suppl401
Views0Scientific knowledge in Brazilian gerontological nursing has its beginnings more than 50 years ago, specifically in the mid-1970s, in line with the worldwide movement to recognize the complexity of population aging and its challenges in the social, cultural, political and public health spheres. Since then, scientific production in this field has been related to the […]See more
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ORIGINAL ARTICLE07-15-2020
Spatial analysis of inequalities in fetal and infant mortality due to avoidable causes
- Cristine Vieira do Bonfim ,
- Amanda Priscila de Santana Cabral Silva ,
- Conceição Maria de Oliveira ,
- Mirella Bezerra Rodrigues Vilela ,
- Neison Cabral Ferreira Freire
Abstract
ORIGINAL ARTICLESpatial analysis of inequalities in fetal and infant mortality due to avoidable causes
Revista Brasileira de Enfermagem. 2020;73:e20190088
DOI 10.1590/0034-7167-2019-0088
- Cristine Vieira do Bonfim ,
- Amanda Priscila de Santana Cabral Silva ,
- Conceição Maria de Oliveira ,
- Mirella Bezerra Rodrigues Vilela ,
- Neison Cabral Ferreira Freire
Views0See moreABSTRACT
Objectives:
to analyze social inequalities in spatial distribution of fetal and infant mortality by avoidable causes and identify the areas of greater risk of occurrence.
Methods:
avoidable deaths of fetal and infant residents of Recife/Brazil were studied. The rates of avoidable fetal and infant mortality were calculated for two five-year periods, 2006-2010 and 2011-2015. The scan statistics was used for spatial analysis and related to the social deprivation index.
Results:
out of the total 2,210 fetal deaths, 80% were preventable. Avoidable fetal mortality rates increased by 8.1% in the five-year periods. Of the 2,846 infant deaths, 74% were avoidable, and the infant mortality rate reduced by 0.13%.
Conclusions:
in the spatial analysis, were identified clusters with higher risk for deaths. The social deprivation index showed sensibility with areas of worse living conditions.
- Cristine Vieira do Bonfim
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05-21-2021
Men’s mental health in the COVID-19 pandemic: is there a mobilization of masculinities?
- Anderson Reis de Sousa ,
- Gilson Vieira Alves ,
- Aline Macêdo Queiroz ,
- Raíssa Millena Silva Florêncio ,
- Wanderson Carneiro Moreira , [ … ],
- Murilo Fernandes Rezende
Abstract
Men’s mental health in the COVID-19 pandemic: is there a mobilization of masculinities?
Revista Brasileira de Enfermagem. 2021;74:e20200915
DOI 10.1590/0034-7167-2020-0915
- Anderson Reis de Sousa ,
- Gilson Vieira Alves ,
- Aline Macêdo Queiroz ,
- Raíssa Millena Silva Florêncio ,
- Wanderson Carneiro Moreira ,
- Maria do Perpétuo Socorro de Sousa Nóbrega ,
- Elizabeth Teixeira ,
- Murilo Fernandes Rezende
Views0See moreABSTRACT
Objective:
to understand how the COVID-19 pandemic mobilizes masculinities in relation to mental health.
Methods:
qualitative study conducted with 400 men, in a virtual environment, in all regions of Brazil. The data were analyzed by the Discourse of the Collective Subject and based on Symbolic Interactionism.
Results:
the mobilization of masculinities emerged from men towards the recognition of weaknesses and psycho-emotional vulnerabilities, with narratives that reveal the expression of feelings, pain, discomfort and psychological suffering, and showed themselves to be sensitive and engaged in performing practices, including autonomous ones, of health care mental.
Final considerations:
the pandemic mobilizes masculinities as men print meanings and senses, in their interaction and interpretation of mental health, and is a marker for the nursing clinic conduct.
- Anderson Reis de Sousa
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ORIGINAL ARTICLE03-24-2021
Health promotion actions in the School Health Program in Ceará: nursing contributions
- Adna de Araújo Silva ,
- Fabiane do Amaral Gubert ,
- Valter Cordeiro Barbosa Filho ,
- Roberto Wagner Júnior Freire de Freitas ,
- Anya Pimentel Gomes Fernandes Vieira-Meyer , [ … ],
- Lidiane Nogueira Rebouças
Abstract
ORIGINAL ARTICLEHealth promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
DOI 10.1590/0034-7167-2019-0769
- Adna de Araújo Silva ,
- Fabiane do Amaral Gubert ,
- Valter Cordeiro Barbosa Filho ,
- Roberto Wagner Júnior Freire de Freitas ,
- Anya Pimentel Gomes Fernandes Vieira-Meyer ,
- Maria Talyta Mota Pinheiro ,
- Lidiane Nogueira Rebouças
Views1See moreABSTRACT
Objectives:
to compare health promotion actions carried out by Family Health teams in Ceará, linked to the School Health Program.
Methods:
a cross-sectional study involving the first and second cycles of an external assessment of 910 and 1,626 teams from 184 municipalities, which joined the Brazilian National Program for Improvement of Access and Quality of Primary Care. Eight clinical assessment and seven health promotion indicators were assessed, together with health professionals working in schools.
Results:
the interviewees were nurses (95.6% and 98.3%). Between the cycles, there was an increase in clinical assessment (78.7% and 91.3%), health promotion and disease prevention (82.5% and 89.3%) and survey of students for follow-up (41.4% and 66.4%) in schools.
Conclusions:
health actions at school advanced between cycles, with nurses as protagonists in school health, which can reduce vulnerabilities in children and adolescents and qualify Primary Care.
- Adna de Araújo Silva
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REVIEW03-19-2021
Influence of burnout syndrome on the quality of life of nursing professionals: quantitative study
- Emelly Kerolayne do Amaral Ribeiro ,
- Renata Clemente dos Santos ,
- Gleicy Karine Nascimento de Araújo-Monteiro ,
- Bárbara Maria Lopes da Silva Brandão ,
- Jéssyka Chaves da Silva , [ … ],
- Rafaella Queiroga Souto
Abstract
REVIEWInfluence of burnout syndrome on the quality of life of nursing professionals: quantitative study
Revista Brasileira de Enfermagem. 2021;74:e20200298
DOI 10.1590/0034-7167-2020-0298
- Emelly Kerolayne do Amaral Ribeiro ,
- Renata Clemente dos Santos ,
- Gleicy Karine Nascimento de Araújo-Monteiro ,
- Bárbara Maria Lopes da Silva Brandão ,
- Jéssyka Chaves da Silva ,
- Rafaella Queiroga Souto
Views1See moreABSTRACT
Objective:
To estimate the prevalence and factors associated with the burnout syndrome and quality of life among nursing professionals.
Methods:
Cross-sectional, analytical study, developed with 83 professionals in emergency care units in the city of Campina Grande-PB. A questionnaire was used to characterize the sample, the Maslach Burnout Inventory scale and the SF-36. Data was analyzed using descriptive and inferential statistics.
Results:
Most professionals showed low professional effectiveness (78.3; n=65), average depersonalization (53.0%; n=44) and average emotional exhaustion (55.4%; n=46). There was a statistical difference between the scores of the syndrome and the pain (p=0.03), vitality (p=0.04) and social aspect (p=0.03); significant correlation between the syndrome and vitality (p<0.001), mental health (p=0.01) and general quality of life (p=0.04).
Conclusion:
The burnout syndrome has an influence on the outcome of quality of life of nursing professionals, being more prevalent among professionals with older age, high income and among nurses.
- Emelly Kerolayne do Amaral Ribeiro
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ORIGINAL ARTICLE05-03-2021
Medical device-related pressure injury prevention in critically ill patients: nursing care
- Sabrina Guterres da Silva Galetto ,
- Eliane Regina Pereira do Nascimento ,
- Patrícia Madalena Vieira Hermida ,
- Josefine Busanello ,
- Luciana Bihain Hagemann de Malfussi , [ … ],
- Daniele Delacanal Lazzari
Abstract
ORIGINAL ARTICLEMedical device-related pressure injury prevention in critically ill patients: nursing care
Revista Brasileira de Enfermagem. 2021;74(2):e20200062
DOI 10.1590/0034-7167-2020-0062
- Sabrina Guterres da Silva Galetto ,
- Eliane Regina Pereira do Nascimento ,
- Patrícia Madalena Vieira Hermida ,
- Josefine Busanello ,
- Luciana Bihain Hagemann de Malfussi ,
- Daniele Delacanal Lazzari
Views0See moreABSTRACT
Objectives:
to know the care implemented by the nursing team to prevent medical device-related pressure injuries in critically ill patients.
Methods:
this is a qualitative research conducted with 15 nursing professionals from Intensive Care Unit. Sampling was carried out by theoretical saturation. For data analysis, the Discourse of the Collective Subject technique was used.
Results:
six speeches emerged, whose central ideas were interventions for medical device-related pressure injury prevention: care in fixation; frequent repositioning; protection and padding of body areas in contact; preferences for flexible materials, when available; attention of professionals so that they do not comer under patients; early assessment and removal, when clinically possible.
Final Considerations:
nursing care was directed mainly to respiratory devices, catheters in general and monitoring equipment, indicating that professionals have the knowledge to provide safe assistance consistent with the literature.
- Sabrina Guterres da Silva Galetto
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ORIGINAL ARTICLE10-01-2022
Factors associated with presenteeism in nursing workers
- Bruno da Silva Santos ,
- Fernanda Ludmilla Rossi Rocha ,
- Juliano Bortolini ,
- Fábio de Souza Terra ,
- Marília Duarte Valim
Abstract
ORIGINAL ARTICLEFactors associated with presenteeism in nursing workers
Revista Brasileira de Enfermagem. 2022;75(1):e20201290
DOI 10.1590/0034-7167-2020-1290
- Bruno da Silva Santos ,
- Fernanda Ludmilla Rossi Rocha ,
- Juliano Bortolini ,
- Fábio de Souza Terra ,
- Marília Duarte Valim
Views0See moreABSTRACT
Objective:
to analyze factors associated with presenteeism in nursing workers with sociodemographic variables, health and work conditions, productivity and musculoskeletal symptoms.
Methods:
this is a cross-sectional, descriptive and analytical study, with 306 nursing workers from a hospital and municipal emergency room in a Brazilian capital. The Stanford Presenteeism Scale, the Work Limitations Questionnaire, the Nordic Musculoskeletal Questionnaire and a demographic questionnaire on nursing professionals’ working conditions and health were used. Bivariate and multivariate analyzes were performed, respecting a significance level of 5%.
Results:
presenteeism was found in 43.8% of professionals and significant associations with CLT work (p=0.002), workplace – Intensive Care Units (p=0.008), physical exercise twice a week (p=0.008), presence of musculoskeletal symptoms, with low back pain being representative (p=0.001). The productivity loss was 8.8.
Conclusions:
the study confirms a high rate of presenteeism among nursing workers.
- Bruno da Silva Santos
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EXPERIENCE REPORT06-07-2019
Humanitude in the humanization of elderly care: experience reports in a health service
- Rosa Cândida Carvalho Pereira de Melo ,
- Paulo Jorge Costa ,
- Liliana Vanessa Lúcio Henriques ,
- Luiza Hiromi Tanaka ,
- Paulo Joaquim Pina Queirós , [ … ],
- João Pärtel Araújo
Abstract
EXPERIENCE REPORTHumanitude in the humanization of elderly care: experience reports in a health service
Revista Brasileira de Enfermagem. 2019;72(3):825-829
DOI 10.1590/0034-7167-2017-0363
- Rosa Cândida Carvalho Pereira de Melo ,
- Paulo Jorge Costa ,
- Liliana Vanessa Lúcio Henriques ,
- Luiza Hiromi Tanaka ,
- Paulo Joaquim Pina Queirós ,
- João Pärtel Araújo
Views0See moreABSTRACT
Objective:
To describe the experience in the implementation of the Humanitude Care Methodology (MCH) in the humanization of care for the elderly.
Methodology:
This is an experience report about the implementation of the MCH, in a Health Service in Portugal, with capacity for 30 elderly people, most of them having cognitive alterations.
Results:
The implementation of the MCH has shown positive results in the humanization of care for the elderly, namely in the reduction of agitation behaviors and better acceptance of care. There was a change in organizational culture, more focused on the person and on the humanization of care.
Conclusion:
The results reflect the need to introduce innovative care methodologies in the training of health professionals, with a focus on interaction, for a professionalized relational care that dignifies the person cared for and the care giver.
- Rosa Cândida Carvalho Pereira de Melo
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ORIGINAL ARTICLE08-19-2019
Factors related to impaired comfort in chronic kidney disease patients on hemodialysis
- Geórgia Alcântara Alencar Melo ,
- Letícia Lima Aguiar ,
- Renan Alves Silva ,
- Glauberto da Silva Quirino ,
- Ana Karina Bezerra Pinheiro , [ … ],
- Joselany Áfio Caetano
Abstract
ORIGINAL ARTICLEFactors related to impaired comfort in chronic kidney disease patients on hemodialysis
Revista Brasileira de Enfermagem. 2019;72(4):889-895
DOI 10.1590/0034-7167-2018-0120
- Geórgia Alcântara Alencar Melo ,
- Letícia Lima Aguiar ,
- Renan Alves Silva ,
- Glauberto da Silva Quirino ,
- Ana Karina Bezerra Pinheiro ,
- Joselany Áfio Caetano
Views0See moreABSTRACT
Objective:
to analyze the factors related to the impaired comfort of chronic kidney diseases (CKD) patients on hemodialysis.
Method:
this is a cross-sectional study with 80 patients undergoing hemodialysis in a renal replacement therapy unit through interviews using two instruments, one for clinical and sociodemographic characteristics and the General Comfort Questionnaire, during the hemodialysis session. Mann-Whitney tests and the logistic regression model were used for data analysis.
Results:
the study found that being younger (p=0.045); being married (p=0.05); and absence of impaired physical mobility (p=0.007) were contributing factors for greater comfort in CKD patients on hemodialysis. Thus, when establishing the odds ratio, it was possible to observe that being 55 years of age or older, being single and having impaired physical mobility represents a 45.7% chance of developing this diagnosis.
Conclusions:
sociodemographic and clinical variables contribute to the study outcome, demanding attention during the planning of nursing interventions.
- Geórgia Alcântara Alencar Melo
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