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09-23-2024
Brazilian National Palliative Care Policy: reflections based on the 2030 Agenda for Sustainable Development
Revista Brasileira de Enfermagem. 2024;77(6):e770601
Abstract
Brazilian National Palliative Care Policy: reflections based on the 2030 Agenda for Sustainable Development
Revista Brasileira de Enfermagem. 2024;77(6):e770601
DOI 10.1590/0034-7167.2024770601
Views1The 2030 Agenda for Sustainable Development, an action plan for people, planet and prosperity, is a global action plan adopted by representatives of all 193 United Nations Member States, meeting at United Nations Headquarters, in New York, from September 25 to 27, 2015. By achieving 17 sustainable objectives, the Agenda aims to promote sustainable development […]See more
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09-23-2024
Política Nacional de Cuidados Paliativos: reflexões a partir da Agenda 2030 para o Desenvolvimento Sustentável
Revista Brasileira de Enfermagem. 2024;77(6):e770601
Abstract
Política Nacional de Cuidados Paliativos: reflexões a partir da Agenda 2030 para o Desenvolvimento Sustentável
Revista Brasileira de Enfermagem. 2024;77(6):e770601
DOI 10.1590/0034-7167.2024770601pt
Views2A Agenda 2030 para o Desenvolvimento Sustentável, um plano de ação para as pessoas, para o planeta e para a prosperidade, é um plano de ação global adotado por representantes de todos os 193 Estados-Membros das Nações Unidas, reunidos na sede das Nações Unidas, em Nova York, de 25 a 27 de setembro de 2015. […]See more -
ORIGINAL ARTICLE09-20-2024
Transgender people’s knowledge about the adverse effects of cross-hormonization: challenges for nursing
- Andréa Felizardo Ahmad
, - Adriana Lemos ,
- Cláudia Regina Ribeiro ,
- Luciane Marques de Araujo ,
- Vanessa de Almeida Ferreira Corrêa , [ … ],
- Beatriz Rodrigues Silva Selles Dantas
Abstract
ORIGINAL ARTICLETransgender people’s knowledge about the adverse effects of cross-hormonization: challenges for nursing
Revista Brasileira de Enfermagem. 2024;77(4):e20230346
DOI 10.1590/0034-7167-2023-0346
- Andréa Felizardo Ahmad ,
- Adriana Lemos ,
- Cláudia Regina Ribeiro ,
- Luciane Marques de Araujo ,
- Vanessa de Almeida Ferreira Corrêa ,
- Janaína Pinto Janini ,
- Rosâne Mello ,
- Beatriz Rodrigues Silva Selles Dantas
Views0See moreABSTRACT
Objectives:
to identify trans women’s and men’s knowledge about the adverse effects of cross-hormonization and understand the repercussions of hormonization practices on trans women’s and men’s health.
Methods:
exploratory, descriptive, qualitative research, developed with 41 participants, from July 2019 to February 2020, in a trans health outpatient clinic. Thematic-categorical content analysis was used.
Results:
from the analysis, the categories emerged: Knowledge about the adverse effects of cross-hormonization; and Cross-hormonization practices and their meaning.
Final Considerations:
nursing practices, based on the identification of knowledge about adverse effects and the understanding of cross-hormonization practices in trans women’s and men’s health, can result in more inclusive care.
- Andréa Felizardo Ahmad
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ORIGINAL ARTICLE09-20-2024
Content validity of guidance on self-care in the post-operative period for breast cancer
- Cristina Poliana Rolim Saraiva dos Santos ,
- Natália Frota Goyanna ,
- Erilaine de Freitas Corpes ,
- Romel Jonathan Velasco Yanez ,
- José Jeová Mourão Netto , [ … ],
- Ana Fátima Carvalho Fernandes
Abstract
ORIGINAL ARTICLEContent validity of guidance on self-care in the post-operative period for breast cancer
Revista Brasileira de Enfermagem. 2024;77(4):e20240188
DOI 10.1590/0034-7167-2024-0188
- Cristina Poliana Rolim Saraiva dos Santos ,
- Natália Frota Goyanna ,
- Erilaine de Freitas Corpes ,
- Romel Jonathan Velasco Yanez ,
- José Jeová Mourão Netto ,
- Régia Christina Moura Barbosa ,
- Ana Fátima Carvalho Fernandes
Views0See moreABSTRACT
Objectives:
to validate the content of a guidance guide on self-care in the postoperative period of breast surgery for breast cancer.
Methods:
a methodological study with content validity, carried out with 15 expert nurses and physiotherapists, between May and July 2022. Recruitment took place from the Lattes Platform, using snowball sampling. The level of relevance and representativeness for each item was verified using the Content Validity Index (CVI). It was considered valid when CVI was equal to or greater than 78% (0.78).
Results:
from the initial total of 37 items, two were excluded, as they had insufficient practical relevance and theoretical relevance, and another five items which, although presenting a CVI lower than the established cut-off, were suggested to be rewritten and grouped with other similar items.
Conclusions:
thirty items were considered valid and demonstrated important and significant characteristics, constituting suitable material for application in clinical practice.
- Cristina Poliana Rolim Saraiva dos Santos
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ORIGINAL ARTICLE09-20-2024
Sociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic
- Andressa Silva Torres dos Santos ,
- Ana Cristina de Oliveira e Silva ,
- Fernanda Maria Vieira Pereira-Ávila ,
- Hemílio Fernandes Campos Coêlho ,
- Laelson Rochelle Milanês Sousa , [ … ],
- Elucir Gir
Abstract
ORIGINAL ARTICLESociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77(4):e20230301
DOI 10.1590/0034-7167-2023-0301
- Andressa Silva Torres dos Santos ,
- Ana Cristina de Oliveira e Silva ,
- Fernanda Maria Vieira Pereira-Ávila ,
- Hemílio Fernandes Campos Coêlho ,
- Laelson Rochelle Milanês Sousa ,
- Renata Karina Reis ,
- Elucir Gir
Views0See moreABSTRACT
Objectives:
to assess the socio-cognitive factors determining adherence to standard precautions by nursing professionals in care practice during the COVID-19 pandemic in Brazil.
Methods:
an analytical cross-sectional study, carried out with 9,039 nursing professionals in Brazil, using an electronic form containing participant sociodemographic, training and work variables, and the Brazilian version of the Standard Precautions Questionnaire. Descriptive and inferential statistics were used using the statistical software R.
Results:
participants recognize standard precautions as effective measures to reduce infections and report intention to perform them. Training regarding standard precautions was evidenced as a facilitator of adherence (4.72; SD: 0.73), and problems related to materials (3.78; SD: 1.45) were a hindrance.
Conclusions:
among the determining factors, facilitating organization presented the highest score, followed by intention to perform. Facilitating and hindering factor identification makes it possible to develop intervention strategies to strengthen patient safety and reduce occupational risks among professionals.
- Andressa Silva Torres dos Santos
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ORIGINAL ARTICLE09-20-2024
Predictor variables effect on the development of Burnout Syndrome in higher education professor
- Italo Everton Bezerra Barbosa ,
- Aristéia Nunes Sampaio ,
- Cristiane Pereira de Souza ,
- Breno de Souza Mota ,
- Carla Roberta Monteiro Miura , [ … ],
- Angélica Gonçalves Silva Belasco
Abstract
ORIGINAL ARTICLEPredictor variables effect on the development of Burnout Syndrome in higher education professor
Revista Brasileira de Enfermagem. 2024;77(4):e20240132
DOI 10.1590/0034-7167-2024-0132
- Italo Everton Bezerra Barbosa ,
- Aristéia Nunes Sampaio ,
- Cristiane Pereira de Souza ,
- Breno de Souza Mota ,
- Carla Roberta Monteiro Miura ,
- Cassiane Dezoti da Fonseca ,
- Angélica Gonçalves Silva Belasco
Views0See moreABSTRACT
Objectives:
to correlate the development of Burnout Syndrome in higher education professors with the following variables: sociodemographic, economic, work, sleep pattern, level of anxiety and quality of life.
Methods:
observational, analytical, cross-sectional study with a quantitative approach. Data collection took place from August to November 2022, with 140 professors from a private higher education institution in the Western Brazilian Amazon.
Results:
professors who carried out activities outside institutional hours and who had sleep duration < 5 hours, presented lower scores in the personal fulfillment dimension of burnout, with (p=0.002) and (p=0.001), respectively. The higher the scores for the physical (p=0.001), psychological (p=0.000) and social relationships (p=0.002) domains of quality of life, the lower the personal fulfillment scores for the syndrome.
Conclusions:
through linear regression, it was evidenced that several variables explain the development of burnout. Institutional and governmental actions can minimize the negative influence of these variables.
- Italo Everton Bezerra Barbosa
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ORIGINAL ARTICLE09-20-2024
Risk assessment for postoperative complications in patients undergoing cardiac surgical procedures
- Carolina Larrosa de Almeida ,
- Jones Sidnei Barbosa de Oliveira ,
- Cláudia Geovana da Silva Pires ,
- Cláudia Silva Marinho
Abstract
ORIGINAL ARTICLERisk assessment for postoperative complications in patients undergoing cardiac surgical procedures
Revista Brasileira de Enfermagem. 2024;77(4):e20230127
DOI 10.1590/0034-7167-2023-0127
- Carolina Larrosa de Almeida ,
- Jones Sidnei Barbosa de Oliveira ,
- Cláudia Geovana da Silva Pires ,
- Cláudia Silva Marinho
Views0See moreABSTRACT
Objectives:
to evaluate the risk of postoperative complications in cardiac patients.
Methods:
an evaluative study using the Tuman Score on medical records of 70 adult patients who underwent cardiac surgery at a University Hospital. The R for Windows software was used for the analyses. Descriptive statistics and bivariate analysis were employed to verify the association between the risk score and complications. The relative risk between the Tuman Score and postoperative complications was obtained through Quasi-Poisson regression, with a 95% confidence interval.
Results:
the majority of the patients were male (58.57%), aged between 41-64 years (50%), who underwent myocardial revascularization (50%). These patients were associated with a lower risk of postoperative complications (p=0.003), (p=0.008), and (p=0.000), respectively. High-risk patients had pulmonary complications (RR=1.32, p=0.002) and neurological complications (RR=1.20, p=0.047).
Conclusions:
preoperative risk assessment promotes qualified care to reduce postoperative complications.
- Carolina Larrosa de Almeida
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ORIGINAL ARTICLE09-20-2024
Construction and validation of a checklist for the management of totally implanted catheters in children
- Giselle Vieira de Souza ,
- Isabella Pavarine de Souza ,
- Maria Paula Custodio Silva ,
- Silmara Elaine Malaguti Toffano ,
- Divanice Contim
Abstract
ORIGINAL ARTICLEConstruction and validation of a checklist for the management of totally implanted catheters in children
Revista Brasileira de Enfermagem. 2024;77(4):e20230447
DOI 10.1590/0034-7167-2023-0447
- Giselle Vieira de Souza ,
- Isabella Pavarine de Souza ,
- Maria Paula Custodio Silva ,
- Silmara Elaine Malaguti Toffano ,
- Divanice Contim
Views0See moreABSTRACT
Objectives:
to construct and validate the content of a checklist for the management of totally implanted catheters in hospitalized children and adolescents.
Methods:
methodological research conducted from October 2021 to December 2022 in two stages: development of the instrument with care guidelines and content validation of the checklist. The instrument, containing 23 items presented in Likert format, was evaluated online by specialists in two rounds. The Content Validity Index was applied, considering indices above 0.8 as valid.
Results:
the final checklist included four domains and 22 checklist items, validated with a Content Validity Index of 0.98. The overall evaluation of the instrument presented a global score of 9.9.
Conclusions:
the validation and application of instruments that standardize procedures, in addition to supporting professionals, promote autonomy and quality of care for children and adolescents using this device.
- Giselle Vieira de Souza
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ORIGINAL ARTICLE05-15-2020
Stress and quality of sleep in undergraduate nursing students
- Kézia Katiane Medeiros da Silva ,
- Milva Maria Figueiredo de Martino ,
- Clarissa Maria Bandeira Bezerra ,
- Ângela Monic Lima de Souza ,
- Danila Maria da Silva , [ … ],
- Jacqueline Targino Nunes
Abstract
ORIGINAL ARTICLEStress and quality of sleep in undergraduate nursing students
Revista Brasileira de Enfermagem. 2020;73:e20180227
DOI 10.1590/0034-7167-2018-0227
- Kézia Katiane Medeiros da Silva ,
- Milva Maria Figueiredo de Martino ,
- Clarissa Maria Bandeira Bezerra ,
- Ângela Monic Lima de Souza ,
- Danila Maria da Silva ,
- Jacqueline Targino Nunes
Views0See moreABSTRACT
Objective:
to analyze the level of stress and sleep quality in nursing students according to terms of the nursing program.
Method:
descriptive and cross-sectional research developed in a higher education institution in Northeastern Brazil on 167 students. We used data collection, sociodemographic information, and a scale for assessing stress and sleep quality in nursing students.
Results:
we identified a statistically significant difference between domains of the stress scale and the terms of the undergraduate program, and between the quality of sleep and such terms such as as in the fourth and sixth semesters.
Conclusion:
different stress scores show that the semester which concerns students the most is the fifth. Quality of sleep was deemed good for the first, third, fifth, seventh, and eighth semesters; and poor for the fourth and sixth terms.
- Kézia Katiane Medeiros da Silva
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ORIGINAL ARTICLE09-21-2020
Clinical judgment and diagnostic reasoning of nursing students in clinical simulation
- Janaina Gomes Perbone Nunes ,
- José Joaquim Penedos Amendoeira ,
- Diná de Almeida Lopes Monteiro da Cruz ,
- Kathie Lasater ,
- Sheila Coelho Ramalho Vasconcelos Morais , [ … ],
- Emilia Campos de Carvalho
Abstract
ORIGINAL ARTICLEClinical judgment and diagnostic reasoning of nursing students in clinical simulation
Revista Brasileira de Enfermagem. 2020;73(6):e20180878
DOI 10.1590/0034-7167-2018-0878
- Janaina Gomes Perbone Nunes ,
- José Joaquim Penedos Amendoeira ,
- Diná de Almeida Lopes Monteiro da Cruz ,
- Kathie Lasater ,
- Sheila Coelho Ramalho Vasconcelos Morais ,
- Emilia Campos de Carvalho
Views0See moreABSTRACT
Objectives:
to determine the degree of association between clinical judgment and diagnostic reasoning of nursing students in clinical simulation.
Methods:
this is a correlational research design using a quantitative approach. The sample consisted of 41 nursing students who assisted a patient with vaso-occlusive crisis in a high-fidelity clinical simulation setting. The instruments used included the Lasater Clinical Judgment Rubric – Brazilian Version and the Diagnostic Thinking Inventory.
Results:
clinical judgment was associated with diagnostic reasoning (r=0.313; p=0.046), as well as the “noticing” aspect of clinical judgment with diagnostic reasoning (r=0.312; p=0.047).
Conclusions:
the results show that skills to interpret patient data are associated with diagnostic reasoning skills. Teaching clinical judgment skills is necessary to develop the diagnostic reasoning of nursing students.
- Janaina Gomes Perbone Nunes
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ORIGINAL ARTICLE12-05-2019
Quality of life of institutionalized aged with and without symptoms of depression
- Gerson Scherrer Júnior ,
- Meiry Fernanda Pinto Okuno ,
- Leticia Meazzini de Oliveira ,
- Dulce Aparecida Barbosa ,
- Angélica Castilho Alonso , [ … ],
- Angélica Gonçalves Silva Belasco
Abstract
ORIGINAL ARTICLEQuality of life of institutionalized aged with and without symptoms of depression
Revista Brasileira de Enfermagem. 2019;72:127-133
DOI 10.1590/0034-7167-2018-0316
- Gerson Scherrer Júnior ,
- Meiry Fernanda Pinto Okuno ,
- Leticia Meazzini de Oliveira ,
- Dulce Aparecida Barbosa ,
- Angélica Castilho Alonso ,
- Dayana Souza Fram ,
- Angélica Gonçalves Silva Belasco
Views0See moreABSTRACT
Objective:
compare the quality of life (QOL) of aged residents in homes for aged people with or without symptoms of depression, and identify social, physical activity; leisure; health and basic activities of daily living (ADL) variables that correlate with QOL scores.
Method:
cross-sectional study conducted with 101 institutionalized aged. Multiple linear regression was used for data analysis.
Results:
symptoms of depression changed negatively the QOL in the domains: autonomy; present, past and future activities; social participation; intimacy and total score. Dependent aged presented lower QOL for the performance of ADL in the domains: autonomy; social participation and total score; dancing without limitation of movement; liking the residential and not presenting symptoms of depression were the variables that positively influenced the QOL of the aged.
Conclusion:
social and psychological support, good living conditions and stimulating assistance can improve the QOL of institutionalized elderlies.
- Gerson Scherrer Júnior
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ORIGINAL ARTICLE07-08-2020
Spirituality and religiousity in the experience of suffering, guilt, and death of the elderly with cancer
- Raniele Araújo de Freitas ,
- Tânia Maria de Oliva Menezes ,
- Lucivalda Barbosa Santos ,
- Halanna Carneiro Guimarães Bastos Moura ,
- Marta Gabriele Santos Sales , [ … ],
- Fabiana Araújo Moreira
Abstract
ORIGINAL ARTICLESpirituality and religiousity in the experience of suffering, guilt, and death of the elderly with cancer
Revista Brasileira de Enfermagem. 2020;73:e20190034
DOI 10.1590/0034-7167-2019-0034
- Raniele Araújo de Freitas ,
- Tânia Maria de Oliva Menezes ,
- Lucivalda Barbosa Santos ,
- Halanna Carneiro Guimarães Bastos Moura ,
- Marta Gabriele Santos Sales ,
- Fabiana Araújo Moreira
Views0See moreABSTRACT
Objective:
to understand spirituality and religiosity in the experience of suffering, guilt, and death of the elderly with cancer.
Method:
qualitative research based on Viktor Frankl’s Existential Analysis. Twenty phenomenological interviews were conducted with people over 60 years old undergoing chemotherapy treatment at an oncology unit of a hospital in the city of Salvador, Bahia State, Brazil, between August and October 2018.
Results:
the following categories emerged: Experiences spirituality and religiosity in the face of the tragic triad and existential emptiness; Uses spirituality/religiosity as resilience strategies. After apprehension of ontic aspects, it was possible the ontological understanding of spirituality and religiosity in the face of suffering, guilt, and death experienced in the elderly with cancer’s daily life.
Final considerations:
spirituality and religiosity were understood as coping strategies used in the unstable experience of the elderly with cancer, providing comfort and resilience.
- Raniele Araújo de Freitas
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ORIGINAL ARTICLE02-10-2020
Mental health profile of the elderly community: a cross-sectional study
- Renata Cavalcanti Cordeiro ,
- Renata Clemente dos Santos ,
- Gleicy Karine Nascimento de Araújo ,
- Neyce de Matos Nascimento ,
- Rafaella Queiroga Souto , [ … ],
- Jeane da Silva Rocha Santos
Abstract
ORIGINAL ARTICLEMental health profile of the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73(1):e20180191
DOI 10.1590/0034-7167-2018-0191
- Renata Cavalcanti Cordeiro ,
- Renata Clemente dos Santos ,
- Gleicy Karine Nascimento de Araújo ,
- Neyce de Matos Nascimento ,
- Rafaella Queiroga Souto ,
- Albanita Gomes da Costa de Ceballos ,
- Fabia Alexandra Pottes Alves ,
- Jeane da Silva Rocha Santos
Views0See moreABSTRACT
Objective:
to describe the mental health profile of the elderly registered in a Family Health Unit in the city of Recife, Pernambuco State.
Method:
it was a descriptive quantitative study, conducted with 159 elderly through the scales Geriatric Depression, Resilience, Social Support, Life Satisfaction, and Positive and Negative Affects, Mini-Mental State Examination, Stressful Events Inventory and Brazil Old Age Shedule.
Results:
females, young and literate elderly predominated. Most were satisfied with life, 52.2% without depressive symptoms, 68.6% without cognitive impairment, 67.9% high resilience and 95.8% high social support, but 62% of elderly with depressive symptoms showed cognitive deficit. Negative correlation was identified between depression and cognitive impairment, resilience, social support and life satisfaction.
Conclusion:
assessment of these indicators identifies triggers of psychological distress, assisting the nursing staff in the development of preventive and care actions.
- Renata Cavalcanti Cordeiro
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EXPERIENCE REPORT10-26-2020
Collaborative practices from health care teams to face the covid-19 pandemic
- Adriano da Costa Belarmino ,
- Maria Eunice Nogueira Galeno Rodrigues ,
- Saiwori de Jesus Silva Bezerra dos Anjos ,
- Antonio Rodrigues Ferreira Júnior
Abstract
EXPERIENCE REPORTCollaborative practices from health care teams to face the covid-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200470
DOI 10.1590/0034-7167-2020-0470
- Adriano da Costa Belarmino ,
- Maria Eunice Nogueira Galeno Rodrigues ,
- Saiwori de Jesus Silva Bezerra dos Anjos ,
- Antonio Rodrigues Ferreira Júnior
Views0See moreABSTRACT
Objective:
To report the experience of collaborative practices facing the COVID-19 pandemic.
Methods:
This is a report about the experience of collaborative practices conducted by health care teams in emergency service in the Emergency Care Units facing of COVID-19 pandemic in the city of Fortaleza, State of Ceará, in the first semester of 2020.
Results:
Collaborative actions, cooperation and effective communication among nursing and medical team contribute to the management of mild and complex cases of COVID-19, as well as qualify them in suitable and necessary care and confrontation measures.
Final considerations:
The report shows the need for collaborative practices to minimize negative effects on the population in the face of the new coronavirus pandemic.
- Adriano da Costa Belarmino
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ORIGINAL ARTICLE11-25-2020
Family experiences in discovering Autism Spectrum Disorder: implications for family nursing
- Tassia de Arruda Bonfim ,
- Bianca Cristina Ciccone Giacon-Arruda ,
- Catchia Hermes-Uliana ,
- Sueli Aparecida Frari Galera ,
- Maria Angélica Marcheti
Abstract
ORIGINAL ARTICLEFamily experiences in discovering Autism Spectrum Disorder: implications for family nursing
Revista Brasileira de Enfermagem. 2020;73:e20190489
DOI 10.1590/0034-7167-2019-0489
- Tassia de Arruda Bonfim ,
- Bianca Cristina Ciccone Giacon-Arruda ,
- Catchia Hermes-Uliana ,
- Sueli Aparecida Frari Galera ,
- Maria Angélica Marcheti
Views0See moreabstract
Objectives:
to describe the family’s experience in the process of discovering the diagnosis and initiation of treatment of children with Autism Spectrum Disorder.
Methods:
this qualitative and descriptive study interviewed nine relatives of eight children on autism spectrum. They were inserted in health services, public education, and Association of Parents and Friends of The Exceptional of cities in the countryside of the Center-West. Data were collected through open interviews from July to September 2017. Data was submitted to thematic analysis.
Results:
at the beginning, the family was difficult to perceive the first atypical signs presented by the children. Families experience situations of vulnerability, since support networks are insufficient. The school played a significant role in recognizing unexpected behaviors.
Final Considerations:
support, offered by nurses, health professionals, school and social support devices, is important to family and children in this trajectory.
- Tassia de Arruda Bonfim
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ORIGINAL ARTICLE10-21-2019
Nurses defending the autonomy of the elderly at the end of life
- Rafael Barroso Gaspar ,
- Marcelle Miranda da Silva ,
- Karen Gisela Moraes Zepeda ,
- Ítalo Rodolfo Silva
Abstract
ORIGINAL ARTICLENurses defending the autonomy of the elderly at the end of life
Revista Brasileira de Enfermagem. 2019;72(6):1639-1645
DOI 10.1590/0034-7167-2018-0768
- Rafael Barroso Gaspar ,
- Marcelle Miranda da Silva ,
- Karen Gisela Moraes Zepeda ,
- Ítalo Rodolfo Silva
Views1See moreABSTRACT
Objective:
to understand how nurses deal with the elderly’s autonomy at the end of life.
Method:
qualitative, exploratory study, guided by the Grounded Theory. Ten nurses, eight doctors and 15 nursing technicians were interviewed between November 2016 and May 2017 at a university hospital in Rio de Janeiro/Brazil.
Results:
nurses deal with the elderly’s autonomy in compliance with the code of ethics and exercise leadership in actions and interactions to defend this right, evaluating, guiding and listening to the preferences of the elderly; interacting with the family; and sharing information with the health team.
Final considerations:
the elderly’s autonomy must be ensured in care planning, based on patient-centered communication and developed in the interaction among agents involved in care. The discussion on “Living Wills” Health Care Directives and principles of palliative care must be encouraged.
- Rafael Barroso Gaspar
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