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ORIGINAL ARTICLE12-08-2024
Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
Abstract
ORIGINAL ARTICLEInitial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
DOI 10.1590/0034-7167-2022-0773
Views0See moreABSTRACT
Objective:
to analyze the initial nipple damage degree by breastfeeding practice and to associate findings with clinical manifestations of breastfeeding women.
Methods:
a retrospective, cross-sectional study with primary data and photographic images database from two randomized clinical trials. Photographic images were analyzed by two independent evaluators using the Nipple Trauma Score. For analysis, the chi-square, Mann-Whitney tests and Kappa coefficient were applied.
Results:
115 breastfeeding women and their respective 186 photographic images were analyzed. The degree of agreement of evaluators using the Nipple Trauma Score was 93.6%. The nipple pain score during breastfeeding was moderate and compromised more than 25% of the nipple surface area.
Conclusions:
assistance to breastfeeding women should prioritize nipple pain intensity instead of the nipple damage size.
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ORIGINAL ARTICLE12-08-2024
Safe practices for bed bathing in the intensive care unit: validation of a checklist
- Juliana Cristina Silva
, - Márcia Marques dos Santos Felix ,
- Rosa Helena Aparecida Gonçalves ,
- Isadora Braga Calegari ,
- Maria Beatriz Guimarães Raponi , [ … ],
- Maria Helena Barbosa
Abstract
ORIGINAL ARTICLESafe practices for bed bathing in the intensive care unit: validation of a checklist
Revista Brasileira de Enfermagem. 2024;77(1):e20230135
DOI 10.1590/0034-7167-2023-0135
- Juliana Cristina Silva ,
- Márcia Marques dos Santos Felix ,
- Rosa Helena Aparecida Gonçalves ,
- Isadora Braga Calegari ,
- Maria Beatriz Guimarães Raponi ,
- Maria Helena Barbosa
Views0See moreABSTRACT
Objective:
To validate a checklist for safe bathing in critically ill patients.
Methods:
This is a methodological and quantitative study. Researchers developed a checklist for safe bathing in critically ill patients consisting of 41 items, which were submitted to the apparent and content validation process, evaluated by eleven judges, and interobserver reliability. For reliability analysis, the instrument was applied in 54 bed bath procedures in the ICU; Kappa and CHF tests were used.
Results:
In the apparent and content validation, adjustments were made according to the judges’ suggestions. Kappa values ranged from moderate to almost perfect (0.462 to 0.962), and, in some items, there was 100% agreement; the reliability of the instrument was excellent (ICC = 0.962).
Conclusion:
The instrument proved to be dependable and easy to apply. Its use will contribute to safe bed bathing and subsidize interventions aimed at increasing the quality of care.
- Juliana Cristina Silva
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REVIEW11-29-2024
Assessment of knowledge in oncology about care for transgender people: a scoping review
- Fernanda Fachetti Xavier de Almeida ,
- Cremilson de Paula Silva ,
- Ricardo Souza Evangelista Sant’Ana ,
- Ruan Nilton Rodrigues Melo
Abstract
REVIEWAssessment of knowledge in oncology about care for transgender people: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230532
DOI 10.1590/0034-7167-2023-0532
- Fernanda Fachetti Xavier de Almeida ,
- Cremilson de Paula Silva ,
- Ricardo Souza Evangelista Sant’Ana ,
- Ruan Nilton Rodrigues Melo
Views0See moreABSTRACT
Objective:
to identify evidence available in the literature on instruments and methodologies used to assess healthcare professionals’ knowledge about cancer care for the transgender population.
Methods:
a scoping review was conducted in seven databases, including studies that answered the question: what is the healthcare professionals’ level of knowledge about cancer care for the transgender population?
Results:
forty-one articles were selected that dealt specifically with healthcare professionals’knowledge in relation to care for the LGBTQIAPN+ population, especially the transgender population. Eighteen studies assessed patients’ perceptions of professionals’knowledge, whereas other studies used their own assessment tools, considering the global context of LGBTQIAPN+ health.
Conclusions:
there is no tested and validated instrument that assesses the knowledge about the transgender population’s oncological health, highlighting the need to construct and validate an instrument focused on this population’s needs.
- Fernanda Fachetti Xavier de Almeida
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ORIGINAL ARTICLE11-29-2024
Sleep quality of vulnerable elderly people: associated factors
- Ariene Angelini dos Santos-Orlandi ,
- Ana Carolina Ottaviani ,
- Elén dos Santos Alves ,
- Tábatta Renata Pereira de Brito ,
- Keika Inouye
Abstract
ORIGINAL ARTICLESleep quality of vulnerable elderly people: associated factors
Revista Brasileira de Enfermagem. 2024;77:e20230283
DOI 10.1590/0034-7167-2023-0283
- Ariene Angelini dos Santos-Orlandi ,
- Ana Carolina Ottaviani ,
- Elén dos Santos Alves ,
- Tábatta Renata Pereira de Brito ,
- Keika Inouye
Views0See moreABSTRACT
Objective:
To identify factors associated with poor sleep quality in elderly dependent individuals in social vulnerability.
Method:
Cross-sectional study with 59 elderly dependent individuals assisted by Family Health Units in São Carlos/SP. The following tools were used: Katz Index, Lawton and Brody Scale, Pittsburgh Sleep Quality Index, Addenbrooke’s Cognitive Examination Revised, Fried’s Frailty Phenotype, Geriatric Depression Scale (15 items), Perceived Stress Scale, Family APGAR, Social Support Scale from the Medical Outcomes Study, and World Health Organization Quality of Life, abbreviated and “old” versions.
Results:
The majority of participants were women (52.5%), aged 60-74 years (71.1%), and had poor sleep quality (76.2%). Stress (OR=1.12; 95%CI=1.02-1.22) and polypharmacy (OR=7.39; 95%CI=1.22-44.73) increased the chances of poor sleep quality, while physical activity decreased these chances (OR=0.15; 95%CI=0.02-0.79).
Conclusion:
Stress and polypharmacy are associated with poor sleep quality in elderly dependent individuals.
- Ariene Angelini dos Santos-Orlandi
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REVIEW11-22-2024
Transition to family parenting in the face of the first child: a scoping review
- Maria Isabel Ventura Araújo ,
- Alberto Carlos Marques Duarte ,
- Maria Henriqueta de Jesus Silva Figueiredo ,
- Carmen Maria da Silva Maciel Andrade
Abstract
REVIEWTransition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
DOI 10.1590/0034-7167-2023-0487
- Maria Isabel Ventura Araújo ,
- Alberto Carlos Marques Duarte ,
- Maria Henriqueta de Jesus Silva Figueiredo ,
- Carmen Maria da Silva Maciel Andrade
Views1See moreABSTRACT
Objectives:
to identify and summarize the elements that characterize the family transition process in relation to the first child.
Methods:
a scoping review was carried out based on JBI methodology, in six databases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results:
ten articles were included with factors characterizing the transition, such as hindering/facilitating conditions that influence the process, important support structures in adaptation and strategies/responses used in the transition process.
Final Considerations:
elements characterizing the transition process in relation to the first child were identified. However, no theoretical explanation for this was identified. Further research should be carried out to obtain a deeper understanding of this process.
- Maria Isabel Ventura Araújo
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11-22-2024
Social Technology in the Prevention of Adolescent Violence: documentary production
- Daiane de Paulo Paltanin Silva ,
- Laura Christina Macedo ,
- Rafaela Gessner Lourenço ,
- Thammy Novakovski dos Santos
Abstract
Social Technology in the Prevention of Adolescent Violence: documentary production
Revista Brasileira de Enfermagem. 2024;77(5):e20230298
DOI 10.1590/0034-7167-2023-0298
- Daiane de Paulo Paltanin Silva ,
- Laura Christina Macedo ,
- Rafaela Gessner Lourenço ,
- Thammy Novakovski dos Santos
Views0See moreABSTRACT
Objective:
To report the development of a technological innovation in the form of a documentary, aimed at disseminating actions for preventing violence against adolescents within the context of Primary Health Care.
Methods:
The documentary was developed through action research and interventions with adolescents in the territory of a Health Unit, conducted between 2020 and 2022, using Social Technology as both an action strategy and a conceptual reference.
Results:
The Social Technology proposal, created through workshops and seminars, resulted in a documentary focusing on violence prevention, involving 48 adolescents. The documentary’s script, collectively developed, portrays a soccer match between teams symbolizing peace and violence, with peace ultimately prevailing. The documentary is six minutes long.
Final Considerations:
The documentary has proven to be an effective Social Technology tool among adolescents, as it fosters critical thinking, is accessible, has potential for digital dissemination, and appeals to the target audience.
- Daiane de Paulo Paltanin Silva
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ORIGINAL ARTICLE11-22-2024
Prevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
- Juan Ignacio Calcagno ,
- Sarah Iribarren ,
- Cristiane Flora Villarreal ,
- Patricia Santos de Oliveira ,
- Amado Nizarala de Ávila
Abstract
ORIGINAL ARTICLEPrevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
DOI 10.1590/0034-7167-2023-0327
- Juan Ignacio Calcagno ,
- Sarah Iribarren ,
- Cristiane Flora Villarreal ,
- Patricia Santos de Oliveira ,
- Amado Nizarala de Ávila
Views0See moreABSTRACT
Objectives:
to assess pain management during labor.
Methods:
a cross-sectional study was carried out by reviewing medical records and conducting postpartum interviews. Prevalence and effectiveness of analgesia were assessed.
Results:
the prevalence of non-pharmacological analgesia was 61.86% of 215 women in labor in Obstetric Center and 82.51% of 62 in midwife-led unit. Prevalence of severe pain, on the Visual Analogue Scale, before and after non-pharmacological analgesia, was from 92.16% to 64.04% (p=0.00) in Obstetric Center and from 85.96% to 52.63% (p=0.01) in midwife-led unit. Prevalence of pharmacological analgesia in Obstetric Centers was 15.81%, with no variation in severe pain (p=0.57). Patients’ request for analgesia was associated with education (p=0.00) and pain intensity (p=0.02).
Conclusions:
non-pharmacological analgesia improved pain intensity. Prevalence of pharmacological analgesic prescription was lower than that identified in developed countries. Pain management needs to consider the preferences and needs of women in labor.
- Juan Ignacio Calcagno
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ORIGINAL ARTICLE11-22-2024
Perceptions from people with physical disabilities about accessibility and social conditions: interventions for rehabilitation nursing
- Rute Salomé da Silva Pereira ,
- Salomé Sobral Sousa ,
- Maria Manuela Martins ,
- Wiliam César Alves Machado ,
- Soraia Dornelles Schoeller
Abstract
ORIGINAL ARTICLEPerceptions from people with physical disabilities about accessibility and social conditions: interventions for rehabilitation nursing
Revista Brasileira de Enfermagem. 2024;77(5):e20240005
DOI 10.1590/0034-7167-2024-0005
- Rute Salomé da Silva Pereira ,
- Salomé Sobral Sousa ,
- Maria Manuela Martins ,
- Wiliam César Alves Machado ,
- Soraia Dornelles Schoeller
Views0ABSTRACT
Objectives:
to analyze the experiences of people with acquired physical disabilities regarding accessibility and social conditions; to identify nurse-led rehabilitation interventions for accessibility and social conditions; to determine nursing-sensitive indicators to improve accessibility and social conditions.
Methods:
a descriptive-exploratory qualitative study employed semi-structured interviews with people with acquired physical disabilities through purposive snowball sampling to address all objectives. Data analysis followed Bardin’s content analysis principles. Furthermore, objectives 2 and 3 were achieved through a reflective theoretical approach.
Results:
the 27 participants reported accessibility challenges, impacting activities of living and social conditions. This influences rehabilitation nursing, leading to three intervention fields: Assess the ability to perform activities of living and influencing factors; Develop and implement training to perform activities of living; Promote mobility, accessibility, and social participation.
Final Considerations:
based on participants experiences, we identified nurse-led rehabilitation interventions to promote accessibility and social conditions.
Keywords:Architectural AccessibilityPeople with DisabilitiesRehabilitation NursingSocial ConditionsSustainable Development GoalsSee more
- Rute Salomé da Silva Pereira
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ORIGINAL ARTICLE08-10-2020
Transformational leadership in nursing practice: challenges and strategies
- Vanêska Brito Ferreira ,
- Simone Coelho Amestoy ,
- Gilberto Tadeu Reis da Silva ,
- Letícia de Lima Trindade ,
- Ises Adriana Reis dos Santos , [ … ],
- Patrícia Alves Galhardo Varanda
Abstract
ORIGINAL ARTICLETransformational leadership in nursing practice: challenges and strategies
Revista Brasileira de Enfermagem. 2020;73(6):e20190364
DOI 10.1590/0034-7167-2019-0364
- Vanêska Brito Ferreira ,
- Simone Coelho Amestoy ,
- Gilberto Tadeu Reis da Silva ,
- Letícia de Lima Trindade ,
- Ises Adriana Reis dos Santos ,
- Patrícia Alves Galhardo Varanda
Views0INTRODUCTIONLeadership stands out as one of the managerial skills necessary to nurses’ practice, especially in the current scenario of frequent overcrowding and scarcity of beds, material resource deficits and insufficient staffing. The reality of some public health services has weaknesses in serving the population and lacks nurses with the knowledge, skills and attitudes to act […]See more - Vanêska Brito Ferreira
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ORIGINAL ARTICLE10-05-2020
Factors associated with the performance of episiotomy
- Bruna Menezes Aguiar ,
- Thales Philipe Rodrigues da Silva ,
- Samire Lopes Pereira ,
- Ana Maria Magalhães Sousa ,
- Roberta Barbosa Guerra , [ … ],
- Fernanda Penido Matozinhos
Abstract
ORIGINAL ARTICLEFactors associated with the performance of episiotomy
Revista Brasileira de Enfermagem. 2020;73:e20190899
DOI 10.1590/0034-7167-2019-0899
- Bruna Menezes Aguiar ,
- Thales Philipe Rodrigues da Silva ,
- Samire Lopes Pereira ,
- Ana Maria Magalhães Sousa ,
- Roberta Barbosa Guerra ,
- Kleyde Ventura de Souza ,
- Fernanda Penido Matozinhos
Views0See moreABSTRACT
Objective:
To analyze the factors associated with the performance of episiotomy.
Methods:
Cross-sectional study, developed with data from the research “Born in Belo Horizonte: Labor and birth survey, “conducted with 577 women who had their children via vaginal birth. In order to verify the magnitude of the association between episiotomy and its possible determinants, logistic regression models were constructed to estimate the odds ratio.
Results:
Episiotomy was performed in 26.34% of women, and 59.21% knew they had been subjected to it. We observed that younger women, primiparous women, women assisted by a professional other than the obstetric nurse and women who had their babies in a private hospital have an increased chance of being submitted to this procedure.
Conclusion:
Considering the rates of episiotomy, this study highlights the need for the absolute contraindication to indiscriminate performing it.
- Bruna Menezes Aguiar
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ORIGINAL ARTICLE01-27-2020
Factors associated with depressive symptoms in elderly caregivers with chronic pain
- Marielli Terassi ,
- Estefani Serafim Rossetti ,
- Bruna Moretti Luchesi ,
- Karina Gramani-Say ,
- Priscilla Hortense , [ … ],
- Sofia Cristina Iost Pavarini
Abstract
ORIGINAL ARTICLEFactors associated with depressive symptoms in elderly caregivers with chronic pain
Revista Brasileira de Enfermagem. 2020;73(1):e20170782
DOI 10.1590/0034-7167-2017-0782
- Marielli Terassi ,
- Estefani Serafim Rossetti ,
- Bruna Moretti Luchesi ,
- Karina Gramani-Say ,
- Priscilla Hortense ,
- Sofia Cristina Iost Pavarini
Views0See moreABSTRACT
Objective:
to identify factors associated with depressive symptoms in elderly caregivers with chronic pain.
Method:
the study included people 60 years of age or older who reported chronic pain and cared for another elderly person living in the same household (n=186). Statistical analyzes were performed using the Mann-Whitney test, univariate and multiple logistic regression.
Results:
most participants had no depressive symptoms (70.4%), 24.2% had mild depressive symptoms and 5.4% had severe symptoms. Univariate analysis showed that the variables family income, number of diseases, number of medications in use, pain intensity, overload and perceived stress were associated with depressive symptoms. Multivariate analysis found an association with perceived stress (95% CI 1.101-1207) and number of medications (95% CI 1.139-1.540) in use.
Conclusion:
factors associated with depressive symptoms in elderly caregivers with chronic pain were stress and the number of medications in use.
- Marielli Terassi
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04-14-2021
COVID-19 patients in prone position: validation of instructional materials for pressure injury prevention
- Vinicius Batista Santos ,
- Daniele Cristina Bosco Aprile ,
- Camila Takáo Lopes ,
- Juliana de Lima Lopes ,
- Mônica Antar Gamba , [ … ],
- Tânia Arena Moreira Domingues
Abstract
COVID-19 patients in prone position: validation of instructional materials for pressure injury prevention
Revista Brasileira de Enfermagem. 2021;74:e20201185
DOI 10.1590/0034-7167-2020-1185
- Vinicius Batista Santos ,
- Daniele Cristina Bosco Aprile ,
- Camila Takáo Lopes ,
- Juliana de Lima Lopes ,
- Mônica Antar Gamba ,
- Karina Aparecida Lopes da Costa ,
- Tânia Arena Moreira Domingues
Views0See moreABSTRACT
Objective:
to perform the content and face validation of a checklist and a banner on pressure injury prevention in patients in prone position.
Method:
this is a methodological study of content and face validation with 26 nurses with specialization. Professionals assessed the checklist and the banner in relation to clarity, theoretical relevance, practical relevance, relation of the figures to the text and font size. The Content Validity Index was calculated for each item, considering one with a value equal to or greater than 0.8 as valid.
Results:
all the actions described in the checklist and in the banner had a Content Validity Index greater than 0.80, with standardization of verbal time and esthetic adjustments in the banner’s layout, as suggested.
Conclusions:
the checklist and the banner were validated and can be used in clinical practice to facilitate pressure injury preventions in patients in prone position.
- Vinicius Batista Santos
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REVIEW03-09-2020
Singular therapeutic project in mental health: an integrative review
Revista Brasileira de Enfermagem. 2020;73(2):e20180508
Abstract
REVIEWSingular therapeutic project in mental health: an integrative review
Revista Brasileira de Enfermagem. 2020;73(2):e20180508
DOI 10.1590/0034-7167-2018-0508
Views0See moreABSTRACT
Objectives:
to analyze the Singular Therapeutic Projects’ characteristics in mental health care used to assist the subject with psychological distress.
Methods:
it is an Integrative Literature Review study conducted in July 2017. The following databases used to collect the data were LILACS, MEDLINE and BDENF. After applying the inclusion and exclusion criteria, 12 articles were selected.
Results:
there was divergence between what was recommended by the Ministry of Health for PTS elaboration with that described in the studies analyzed. Emphasis is placed on the low participation and co-responsibility between team/user in PTS elaboration, excessive referrals to specialized mental health services, fragmentation of knowledge within the multidisciplinary team, and difficulty sharing and discussing information about cases.
Final considerations:
it is pointed out the need to adapt PTS elaboration, and its respective steps, to the needs of each individual.
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ORIGINAL ARTICLE12-13-2019
Obstetric Nursing in best practices of labor and delivery care
- Thales Philipe Rodrigues da Silva ,
- Érica Dumont-Pena ,
- Ana Maria Magalhães Sousa ,
- Torcata Amorim ,
- Luísa Castanheira Tavares , [ … ],
- Fernanda Penido Matozinhos
Abstract
ORIGINAL ARTICLEObstetric Nursing in best practices of labor and delivery care
Revista Brasileira de Enfermagem. 2019;72:235-242
DOI 10.1590/0034-7167-2018-0561
- Thales Philipe Rodrigues da Silva ,
- Érica Dumont-Pena ,
- Ana Maria Magalhães Sousa ,
- Torcata Amorim ,
- Luísa Castanheira Tavares ,
- Débora Cabral di Pietra Nascimento ,
- Kleyde Ventura de Souza ,
- Fernanda Penido Matozinhos
Views0See moreABSTRACT
Objective:
to evaluate the association of Obstetric Nursing in the best practices of delivery and birth care in maternity hospitals.
Method:
a cross-sectional study, with 666 women selected for delivery. Parturition obstetric practices performed by professionals were categorized into: clearly useful practices that should be encouraged, practices that are clearly harmful or ineffective and that should be eliminated and practices used inappropriately at the time of parturition.
Results:
clearly useful practices were used in greater proportions in the hospitals that had Obstetric Nursing working, while clearly harmful practices and those used inappropriately were practiced in smaller proportions in hospitals that had Obstetric Nursing, both with statistical difference.
Conclusion:
institutions with Obstetric Nursing adopt better practices of delivery and birth care, based on scientific evidence, when compared to those that do not act.
- Thales Philipe Rodrigues da Silva
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REVIEW08-20-2021
Assessment of patient safety culture in Brazilian hospitals through HSOPSC: a scoping review
- Marcela Moreira Nascimento Prieto ,
- Renata Elizabete Pagotti da Fonseca ,
- Silvia Helena Zem-Mascarenhas
Abstract
REVIEWAssessment of patient safety culture in Brazilian hospitals through HSOPSC: a scoping review
Revista Brasileira de Enfermagem. 2021;74(6):e20201315
DOI 10.1590/0034-7167-2020-1315
- Marcela Moreira Nascimento Prieto ,
- Renata Elizabete Pagotti da Fonseca ,
- Silvia Helena Zem-Mascarenhas
Views0See moreABSTRACT
Objectives:
to describe, from literature, the characteristics of patient safety culture in Brazilian hospitals that applied the Hospital Survey on Patient Safety Culture.
Methods:
this is a scoping review. A search was performed in the databases LILACS, PubMed, SciELO, CINAHL, Web of Science, Scopus and in the CAPES Dissertations and Theses Database in September and October 2020.
Results:
thirty-six studies were identified. Nine studies identified strengthened areas such as: “teamwork within the units”, “expectations of supervisor/boss and actions promoting safety”, “organizational learning”, “support of hospital management for patient safety” and “frequency of report of events”. As a critical area, the dimension “non-punitive response to error” was evidenced in 30 of 36 studies.
Conclusions:
the identification of areas of strength and critical areas of safety culture is relevant to encourage improvement of patient safety problems in an institution.
- Marcela Moreira Nascimento Prieto
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ORIGINAL ARTICLE07-31-2020
Maternal and child health care: adequacy index in public health services
- Flávia Françoso Genovesi ,
- Márcia Aparecida dos Santos Silva Canario ,
- Christine Bacarat de Godoy ,
- Sandra Mara Maciel ,
- Alexandrina Aparecida Maciel Cardelli , [ … ],
- Rosângela Aparecida Pimenta Ferrari
Abstract
ORIGINAL ARTICLEMaternal and child health care: adequacy index in public health services
Revista Brasileira de Enfermagem. 2020;73:e20170757
DOI 10.1590/0034-7167-2017-0757
- Flávia Françoso Genovesi ,
- Márcia Aparecida dos Santos Silva Canario ,
- Christine Bacarat de Godoy ,
- Sandra Mara Maciel ,
- Alexandrina Aparecida Maciel Cardelli ,
- Rosângela Aparecida Pimenta Ferrari
Views0See moreABSTRACT
Objectives:
to analyze the adequacy of maternal and child-care in prenatal care, childbirth and the puerperal period, in the public health service.
Methods:
longitudinal study carried out in a city in Paraná with 357 puerperal women in a public maternity ward, outpatient clinic for immediate puerperal return and home visit 42 days postpartum. Four care domains were grouped (1 – Prenatal, 2 – Maternity, 3 – Immediate puerperal return, 4 – Late puerperal return). Mean, median, standard deviation and coefficient of variance were calculated considering adequate assistance when ≥ 70%; and inadequate, inferior.
Results:
lowest suitability average in Domain 3 (39.37%) and highest for Domain 4 (74.82%); median of 50.00% at 3 and 76.90% at 4. The largest standard deviation, in Domain 3 (25.18%); and high coefficient of variance for 1 and 3.
Conclusions:
in maternal and child follow-up, rates close to adequate in maternity care and higher in late puerperal return, meanwhile prenatal and immediate puerperal return were below the recommended in the health care network.
- Flávia Françoso Genovesi
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