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EXPERIENCE REPORT02-03-2023
Quality management in the COVID-19 pandemic: nursing action plan
Revista Brasileira de Enfermagem. 2023;76:e20220272
Abstract
EXPERIENCE REPORTQuality management in the COVID-19 pandemic: nursing action plan
Revista Brasileira de Enfermagem. 2023;76:e20220272
DOI 10.1590/0034-7167-2022-0272
Views0See moreABSTRACT
Objectives:
to describe the implementation of a nursing action plan to face the pandemic of COVID 19 in a University Hospital in the state of Rio de Janeiro. Methods: this is an experience report, in which two management tools were used: the Ishikawa Diagram to identify problems and the 5W2H spreadsheet to outline the actions according to the situations presented.
Results:
four categories were listed in two groups: 1- Actions of the Nurse Manager in the Organization of Logistics, Infrastructure and Care: materials and environment; and 2- Nursing Human Resources Management and Continuing Education: method and human resources.
Final Considerations:
the plan developed showed the role of nursing management, with the search for best care practices, development of protocols, carrying out multi-professional training and management of supplies.
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ORIGINAL ARTICLE01-30-2023
Development and content validity of a website for patients with coronary artery disease
Revista Brasileira de Enfermagem. 2023;76(1):e20220302
Abstract
ORIGINAL ARTICLEDevelopment and content validity of a website for patients with coronary artery disease
Revista Brasileira de Enfermagem. 2023;76(1):e20220302
DOI 10.1590/0034-7167-2022-0302
Views0ABSTRACT
Objectives:
to develop and analyze content validity evidence of a website for patients with coronary artery disease.
Methods:
a methodological study, carried out in the phases: Definition – determined contents for inclusion in the website, architecture and design; Implementation – subjects included in the website; Assessment – website submitted to analysis by 13 experts and eight laypersons regarding organization, content and design, on a scale of 1 (no agreement) to 4 (complete agreement). Items that reached Content Validity Ratio (CVR) higher than the established critical values and Content Validity Index greater than 0.80 were considered valid.
Results:
eight domains related to secondary prevention in coronary heart disease were included on the website. Critical CVR and adequate CVI were obtained according to professional and lay experts.
Conclusions:
the website was developed, achieving adequate content validity evidence, and can be used as an educational tool for this population.
Keywords:Computer Communication NetworksCoronary Artery DiseaseHealth EducationSecondary PreventionValidation StudySee more -
ORIGINAL ARTICLE01-30-2023
Development and validation of an instrument for the evaluation of HIV care in Primary Health Care
Revista Brasileira de Enfermagem. 2023;76(1):e20220247
Abstract
ORIGINAL ARTICLEDevelopment and validation of an instrument for the evaluation of HIV care in Primary Health Care
Revista Brasileira de Enfermagem. 2023;76(1):e20220247
DOI 10.1590/0034-7167-2022-0247
Views0See moreABSTRACT
Objective:
To develop and validate an instrument to evaluate the decentralization process of care for People Living with HIV in Primary Health Care.
Method:
Methodological study, developed in four stages: elaboration of the logical model based on the triad Structure-Process-Outcomes; development of the instrument; content validation by expert judges and technical reviewers; and semantic validation. Online questionnaires were used, and the Kappa index was used for analysis.
Results:
The instrument with 68 items and 8 factors was submitted to validation by expert judges who recommended the exclusion of 3 items and the alteration of 2 factors. In the validation by technical reviewers, 2 items were excluded and 6 factors were highlighted; the agreement index was ≥0.75. In the semantic validation, 87.3% of the judges answered “totally agree” for the items presented.
Conclusion:
The instrument is validated for its content, has 63 items and has the potential to assess the care provided for people living with HIV in Primary Health Care.
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REVIEW01-30-2023
Transition from parents to caregivers of a child with type 1 Diabetes Mellitus: a scoping review
Revista Brasileira de Enfermagem. 2023;76(1):e20220201
Abstract
REVIEWTransition from parents to caregivers of a child with type 1 Diabetes Mellitus: a scoping review
Revista Brasileira de Enfermagem. 2023;76(1):e20220201
DOI 10.1590/0034-7167-2022-0201
Views0See moreABSTRACT
Objectives:
to map and summarize the existing scientific evidence on parents’ transition experience to exercise the caregiver role of a child with 1DM, identifying gaps in knowledge of this experience.
Methods:
a scoping review was carried out based on JBI methodology, in two databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results:
we included 31 articles. From the studies, constitutive elements of parents’ transition experience to caregiver role of a child with 1DM were found, which focused on the nature of the experience, the feelings and emotions experienced, the hindering conditions, the facilitating conditions, the strategies used by parents and the results or effects obtained.
Final considerations:
the transition process’ characterizing elements were identified, but not a theoretical explanation of it. Additional research should be carried out in order to allow a deeper understanding of this process.
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ORIGINAL ARTICLE01-30-2023
Continued breastfeeding and work: scenario of maternal persistence and resilience
Revista Brasileira de Enfermagem. 2023;76(1):e20220191
Abstract
ORIGINAL ARTICLEContinued breastfeeding and work: scenario of maternal persistence and resilience
Revista Brasileira de Enfermagem. 2023;76(1):e20220191
DOI 10.1590/0034-7167-2022-0191
Views0See moreABSTRACT
Objectives:
to understand the challenges in mothers’ daily life and strategies adopted to reconcile activities outside the home and continued breastfeeding.
Methods:
a cross-sectional, qualitative study. Theoretical-methodological assumptions were discursive practices and production of meanings in everyday life. Participants were 22 women from a specific social media group who had breastfed at least one child for >7 months. Data were collected between November 2020 and March 2021.
Results:
themes: Around the world of activities outside the home; Work environment: routines, opportunities and difficulties to maintain breastfeeding.
Final Considerations:
women’s experiences reveal a daily life with difficulties in reconciling the desire to breastfeed and the work scenario. Support network and adaptation to children’s food routine were strategies adopted to minimize risks of weaning. The results show the need to consolidate policies to encourage continued breastfeeding in the labor market.
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ORIGINAL ARTICLE01-30-2023
Acurácia do diagnóstico de enfermagem desobstrução ineficaz de vias aéreas em pacientes de unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(1):e20220174
Abstract
ORIGINAL ARTICLEAcurácia do diagnóstico de enfermagem desobstrução ineficaz de vias aéreas em pacientes de unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(1):e20220174
DOI 10.1590/0034-7167-2022-0174
Views0RESUMEN
Objetivos:
analizar la precisión de indicadores clínicos de limpieza ineficaz de las vías aéreas en pacientes de unidades de cuidados intensivos adulto.
Métodos:
estudio de precisión diagnóstica en unidad de cuidados intensivos de hospital universitario en noreste brasileño. Muestra de 104 pacientes hospitalizados entre junio y octubre de 2019.
Resultados:
prevalencia de limpieza ineficaz de las vías aéreas del 36,54%. Indicadores con alta especificidad; ausencia de tos (0,8326), ortopnea (0,6817), ruidos respiratorios adventicios (0,8175) y ruidos respiratorios disminuidos (0,8326). Indicadores clínicos con alta sensibilidad y especificidad; cambio en la frecuencia respiratoria (0,9999) y cambio en el patrón de respiración (0,9999).
Conclusiones:
seis indicadores clínicos proporcionaron identificación precisa de la limpieza ineficaz de las vías aéreas; cambio en la frecuencia respiratoria y cambio en el patrón de respiración fueron los más precisos para pacientes críticos. Nuestros hallazgos contribuyen a inferencias diagnósticas precisas y la prevención de complicaciones respiratorias en estos pacientes.
Keywords:Diagnóstico de EnfermagemEnfermagemGestão de DadosSistema RespiratórioUnidades de Terapia IntensivaSee more -
ORIGINAL ARTICLE01-30-2023
Accuracy of the nursing diagnosis of ineffective airway clearance in intensive care unit patients
Revista Brasileira de Enfermagem. 2023;76(1):e20220174
Abstract
ORIGINAL ARTICLEAccuracy of the nursing diagnosis of ineffective airway clearance in intensive care unit patients
Revista Brasileira de Enfermagem. 2023;76(1):e20220174
DOI 10.1590/0034-7167-2022-0174
Views0See moreABSTRACT
Objectives:
to analyze the accuracy of the clinical indicators of ineffective airway clearance in adult intensive care unit patients.
Methods:
diagnostic accuracy study, performed in the intensive care unit of a university hospital in northeastern Brazil. The sample consisted of 104 patients hospitalized between June and October 2019.
Results:
the prevalence of ineffective airway clearance was 36.54%. The indicators with high specificity included absence of cough (0.8326), orthopnea (0.6817), adventitious breath sounds (0.8175), and diminished breath sounds (0.8326). The clinical indicators with high sensitivity and specificity were alteration in respiratory rate (0.9999) and alteration in respiratory pattern (0.9999).
Conclusions:
six clinical indicators provided an accurate identification of ineffective airway clearance. The clinical indicators alteration in respiratory rate and alteration in respiratory pattern were the most accurate for critical adult patients. The findings of this study contribute to accurate diagnostic inferences and to prevention of respiratory complications in these patients.
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ERRATUM01-13-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
DOI 10.1590/0034-7167.20247706e08
Views0In the article “Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(4):e20230520, Chart 1:Where it read:[…]See more -
ERRATUM01-13-2024
ERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
Abstract
ERRATUMERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
DOI 10.1590/0034-7167.20247706e06pt
Views0No artigo “Crenças e atitudes de pais ou responsáveis legais sobre a vacinação infantil: revisão de escopo”, com número DOI: , publicado no periódico Revista Brasileira de Enfermagem, 2024;77(4):e20240126, página 5:Onde se lia:[…]See more -
ORIGINAL ARTICLE01-13-2024
Indicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
Abstract
ORIGINAL ARTICLEIndicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
DOI 10.1590/0034-7167-2024-0204
Views0See moreABSTRACT
Objectives:
to compare the sociodemographic and clinical severity indicators of hospitalized people with HIV in relation to clinical outcomes and urgent hospital admission.
Methods:
a retrospective cohort study was conducted with 102 medical records of HIV-infected individuals hospitalized in a hospital in southern Brazil. In addition to descriptive analysis, Fisher’s exact test, Pearson’s Chi-square, and logistic regression were used.
Results:
the data showed a significant direct effect on severity indicators in the following variables: male sex (p=0.013), skin color (p=0.023), level of education (p=0.000), urgent admissions (p=0.000), late diagnosis (p=0.001), diabetes mellitus (p=0.001), hypertension (p=0.004), kidney disease (p=0.002), high viral load (p=0.006), CD4+ count below 200 (p=0.005), fever (p=0.016), weight loss (p=0.013), co-infection with hepatitis C (p=0.004), and mortality (p=0.007).
Conclusions:
three sociodemographic and thirteen clinical markers were identified as being associated with the risk of clinical deterioration in hospitalized people with HIV.
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ORIGINAL ARTICLE01-13-2024
Nurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
Abstract
ORIGINAL ARTICLENurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
DOI 10.1590/0034-7167-2023-0481
Views1See moreABSTRACT
Objectives:
to understand the perspective of nurses on the use of telemonitoring in the management of people with type 2 diabetes mellitus and arterial hypertension in primary care.
Methods:
this qualitative research involved sixteen nurses from eight municipalities in Paraná. Data were collected between November 2022 and January 2023 through inperson or remote interviews, which were audio-recorded and subjected to content analysis.
Results:
according to the nurses, telemonitoring enhances users’ knowledge about these conditions, communication and connection with the team, and productivity. However, the lack of electronic resources and equipment, high staff turnover, low user adherence, and the limited availability of professional time present significant challenges.
Final Considerations:
the effective implementation and operation of telemonitoring in the management of people with diabetes and hypertension involve both potential benefits and barriers. It is essential to have the availability of human and technological resources, managerial support, and the commitment of professionals and users.
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ORIGINAL ARTICLE01-13-2024
Knowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
Abstract
ORIGINAL ARTICLEKnowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
DOI 10.1590/0034-7167-2023-0424
Views0ABSTRACT
Objectives:
to investigate the knowledge, attitudes, and practices of nurses regarding blood culture collection.
Methods:
a cross-sectional study was conducted in five Brazilian public hospitals with 112 nurses. Data were collected using an adapted questionnaire and analyzed through descriptive and inferential statistics.
Results:
nurses who did not consider themselves capable of collecting blood cultures had a 72% lower chance of performing the collection at the recommended site and an 83% lower chance of using the same needle for blood inoculation into the vials. Nurses working in the emergency department had a 75% lower chance of knowing the international benchmark for blood culture contamination rates, and those with less than 5 years in the position decreased their chance of accuracy in this matter by 79%.
Conclusions:
there are gaps in the knowledge, attitudes, and practices of nurses regarding blood culture collection. Standardization of the technique, periodic education, supervision and guidance of the collection team, and process auditing are recommended coping strategies.
Keywords:Blood CultureBlood Specimen CollectionHealth Knowledge, Attitudes, PracticeNursing CareQuality of Health CareSee more -
ORIGINAL ARTICLE01-13-2024
Evaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
Abstract
ORIGINAL ARTICLEEvaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
DOI 10.1590/0034-7167-2023-0190
Views0ABSTRACT
Objectives:
to verify the construct validation of an instrument for evaluating care for people living with HIV in Primary Health Care.
Methods:
methodological study carried out in 2021 with 260 health professionals in Recife, PE. Validation based on the internal structure was carried out at this stage using exploratory and confirmatory factor analysis, and validity based on item response theory.
Results:
the validation determined the retention of five factors and 63 items. The instrument’s internal consistency and quality of fit was 0.90, the Tukey-Lewis index was 0.915 and the comparative fit index was 0.918 in the confirmatory factor analysis. The indication for the absolute majority of items is adequate fit.
Conclusions:
the instrument has construct validity, making it possible to use it to evaluate the decentralization process and care for People Living with HIV in Primary Health Care.
Keywords:Acquired Immunodeficiency SyndromeComprehensive Health CareHIVPrimary Health CareProgram EvaluationSee more -
ORIGINAL ARTICLE01-10-2024
Inventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
Abstract
ORIGINAL ARTICLEInventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
DOI 10.1590/0034-7167-2023-0539
Views0See moreABSTRACT
Objective:
to construct and validate the content of an inventory of ethical problems experienced by nurses in mobile pre-hospital care.
Method:
a psychometric approach study, developed with the following stages: (1) instrument construction through a theoretical matrix based on deliberative bioethics, scoping review and online qualitative research; (2) content validity by judges; (3) pre-testing with Mobile Emergency Care Service nurses in various Brazilian states. For content validity analysis, the Content Validity Ratio was calculated (CVR>0.45 for judges and CVR>0.35 for the target population).
Results:
the instrument had 44 items, distributed across four dimensions.
Final considerations:
the constructed instrument presented sources of evidence of content validity, providing good psychometric measurements and constituting a useful tool for nurses’ practice in the pre-hospital setting.
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Critical incidents in nursing academics: discovering a new identity
Revista Brasileira de Enfermagem. 2015;68(2):219-227
Abstract
Critical incidents in nursing academics: discovering a new identity
Revista Brasileira de Enfermagem. 2015;68(2):219-227
DOI 10.1590/0034-7167.2015680206i
Views0See moreABSTRACT
Objective:
a qualitative study that followed the principles of the grounded theory in order to analyze the professional identity of nursing academics through the analysis of the most disturbing critical incidents.
Method:
semi-structured interviews were conducted with seven nurses who worked as professors and researchers in a private university in Barcelona.
Results:
the resulting empirical material was organized into two categories: characterization of critical incidents and responsiveness to the incident.
Conclusion:
the professional identity of nurses regarding the academic area is still under construction and inexperience is the major obstacle in the management of critical incidents in the teaching career.
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RESEARCH01-01-2015
Body mass index, waist circumference, and arterial hypertension in students
Revista Brasileira de Enfermagem. 2015;68(2):214-218
Abstract
RESEARCHBody mass index, waist circumference, and arterial hypertension in students
Revista Brasileira de Enfermagem. 2015;68(2):214-218
DOI 10.1590/0034-7167.2015680205i
Views0See moreABSTRACT
Objective:
to investigate what is the best anthropometric predictor of arterial hypertension among private school students.
Method:
this was a cross-sectional study with 286 students between the ages of 10 and 14 from two private schools in the city of Paranavaí, Paraná, Brazil. The following variables were analyzed: body mass index, waist circumference and blood pressure. Statistical analysis was conducted with Pearson’s partial correlation test and multivariate logistic regression, with p<0.05.
Results:
both anthropometric indicators displayed weak correlation with systolic and diastolic levels, with coeffi cients (r) ranging from 0.27 to 0.36 (p < 0.001). Multivariate analysis showed that the only anthropometric indicator associated with arterial hypertension was waist circumference (OR= 2.3; 95% CI: 1.1-4.5), regardless of age or gender.
Conclusion:
this age group, waist circumference appeared to be a better predictor for arterial hypertension than body mass index.
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RESEARCH01-01-2015
Perception of primary healthcare management nurses on the nursing process
Revista Brasileira de Enfermagem. 2015;68(2):206-213
Abstract
RESEARCHPerception of primary healthcare management nurses on the nursing process
Revista Brasileira de Enfermagem. 2015;68(2):206-213
DOI 10.1590/0034-7167.2015680204i
Views0See moreABSTRACT
Objective:
this qualitative study aimed to analyze the perceptions of primary health care management nurses on the nursing process.
Method:
data were collected through interviews and analyzed by the Content Analysis proposed by Bardin’s theoretical framework.
Results:
managers recognize the importance of the nursing process, although its implementation was not a priority at the time of the interviews. A conceptual diffi culty and a lack of understanding that the implementation of the care methodology should be a cross-departmental action in the local healthcare management were clearly observed.
Conclusion:
managers should have their perspectives broadened concerning the relevance of the nursing process and the professional training. The active participation of legislative nursing bodies, local healthcare management and the federal government may open the way for the effective implementation of the nursing process.
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RESEARCH01-01-2015
Cross-cultural cultural adaptation of the “Nursing Students’ Attitudes Toward Mental Health Nursing and Consumers” in Brazil
Revista Brasileira de Enfermagem. 2015;68(2):198-205
Abstract
RESEARCHCross-cultural cultural adaptation of the “Nursing Students’ Attitudes Toward Mental Health Nursing and Consumers” in Brazil
Revista Brasileira de Enfermagem. 2015;68(2):198-205
DOI 10.1590/0034-7167.2015680203i
Views0See moreABSTRACT
Objective:
to make across-cultural adaptation of the “Nursing Students’ Attitudes Toward Mental Health Nursing and Consumers” scale in Brazil.
Method:
the scale was tested regarding conceptual, item, semantic, and operational equivalence.
Results:
content validation was conducted by an expert committee with a minimum consensus level of 80%. This process resulted in a 35-item scale divided into 6 factors. The experts reached 100% consensus on the scale’s clarity of language, practical pertinence and theoretical relevance, as well as on the need for excluding one factor. Data were collected in 2013 in the city of Londrina, Paraná, Brazil.
Conclusion:
the instrument was cross-culturally adapted to Brazilian Portuguese and presented satisfactory content validity. We propose further studies on the scale’s psychometric properties, such as construct validity, internal consistency and reliability.
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RESEARCH01-01-2015
Relational skills and preserving patient privacy in the caring process
Revista Brasileira de Enfermagem. 2015;68(2):191-197
Abstract
RESEARCHRelational skills and preserving patient privacy in the caring process
Revista Brasileira de Enfermagem. 2015;68(2):191-197
DOI 10.1590/0034-7167.2015680202i
Views0See moreABSTRACT
Objective:
to analyze the development and mobilization of relational skills central to the caring process among nursing students throughout their professional training.
Method:
this was a quantitative study, descriptive and cross-sectional in design. The sample consisted of nursing undergraduate students from the Higher School of Health Sciences, in the city of Évora, Portugal. Data were collected using the previously validated Helping Relational Skills Inventory.
Results:
the students gradually acquired “generic skills”, “communication skills” and “contact skills”, presenting the highest mean score in the last year of the program. However, the highest mean score for the “empathetic skills” subscale was presented by second-year students.
Conclusion:
age and year in program were found to be decisive variables regarding the acquisition of specifi c skills (empathetic and communication) by nursing students.
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EDITORIAL01-01-2015
The Brazilian Association of Nursing in the uncompromising defense of the Brazilian Unified Health System
Revista Brasileira de Enfermagem. 2015;68(2):185-186
Abstract
EDITORIALThe Brazilian Association of Nursing in the uncompromising defense of the Brazilian Unified Health System
Revista Brasileira de Enfermagem. 2015;68(2):185-186
DOI 10.1590/0034-7167.2015680201i
Views0The title of the 2015 Editor’s Comments could very well be from a journal published in decades past, a time when, in Brazil, all professional entities and civil society fought for the right to health, as was later established in the Brazilian Constitution of 1988. Twenty-five years later, despite its financial limitations and restricted operational […]See more -
EDITORIAL01-01-2015
A ABEn na defesa intransigente do SUS
Revista Brasileira de Enfermagem. 2015;68(2):185-186
Abstract
EDITORIALA ABEn na defesa intransigente do SUS
Revista Brasileira de Enfermagem. 2015;68(2):185-186
DOI 10.1590/0034-7167.2015680201i
Views0Este título do Editorial de 2015 bem poderia ser de uma revista publicada em décadas passadas, período em que todas as entidades profissionais e a sociedade civil lutaram pela saúde como direito, como conquistado na Constituição de 1988. Vinte e cinco anos depois, com o Sistema Único de Saúde capilarizado por todo o país, mesmo […]See more -
EXPERIENCE REPORT01-01-2015
Nursing diagnoses and interventions for a child after cardiac surgery in an intensive care unit
Revista Brasileira de Enfermagem. 2015;68(1):155-160
Abstract
EXPERIENCE REPORTNursing diagnoses and interventions for a child after cardiac surgery in an intensive care unit
Revista Brasileira de Enfermagem. 2015;68(1):155-160
DOI 10.1590/0034-7167.2015680121i
Views0See moreObjetivo:
descrever o julgamento clínico de enfermagem para identificar diagnósticos NANDA e desenvolver um plano de tratamento NIC para uma criança em pós-operatório de cirurgia cardíaca em terapia intensiva.
Método:
estudo de caso com coleta de dados retrospectiva no prontuário.
Resultados:
três enfermeiras identificaram diagnósticos NANDA e intervenções NIC. Criança de 6 meses, submetida a cirurgia cardíaca, necessitou oxigenação extracorpórea por membrana no pós-operatório. Foram identificados quatro principais diagnósticos, aos quais foram direcionadas dez intervenções. A proposta de intervenções para responder às necessidades humanas prioritárias da criança foi otimizada pelo uso das terminologias padronizadas. Todos os diagnósticos foram sustentados por indicadores diagnósticos; todas as intervenções foram cientificamente sustentadas.
Conclusão:
espera-se que os enfermeiros abordem não somente as respostas fisiológicas, mas também aquelas dos domínios psicossociais.
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