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ORIGINAL ARTICLE12-04-2023
Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
- Tita Rohita
, - Nursalam Nursalam ,
- Muhammad Hadi ,
- Iqbal Pramukti ,
- Dedeng Nurkholik , [ … ],
- Ika Adelia Susanti
Abstract
ORIGINAL ARTICLEWork-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
DOI 10.1590/0034-7167-2022-0586
- Tita Rohita ,
- Nursalam Nursalam ,
- Muhammad Hadi ,
- Iqbal Pramukti ,
- Dedeng Nurkholik ,
- Arifah Septiane ,
- Idyatul Hasanah ,
- Ika Adelia Susanti
Views0See moreABSTRACT
Objective:
To analyze the contributing factors of work-related stress among nurses in the COVID-19 pandemic.
Methods:
A cross-sectional study was conducted with 101 nurse practitioners from two hospitals in West Java, Indonesia. We distributed an online questionnaire to evaluate work-related stress and the data were analyzed using ordinal logistic regression.
Results:
More than half of the nurses experienced moderate work-related stress. The study revealed that nurses aged over 35 years old had a lower likelihood of experiencing work-related stress (AOR: 0.173; 95%CI: 0.038-0.782). Married nurses had a higher likelihood (AOR: 7.156; 95% CI: 1.456-35.163). Additionally, nurses with low and moderate workloads had a lower likelihood (AOR: 0.003; 95%CI: 0.000-0.051) and (AOR: 0.025; 95%CI: 0.005-0.116), respectively.
Conclusion:
The consideration of age, marital status, and workload is essential in effectively addressing work-related stress among nurse practitioners.
- Tita Rohita
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ORIGINAL ARTICLE12-04-2023
Incidence and risk factors of pressure injuries in critically ill patients with COVID-19
- Aline de Oliveira Ramalho ,
- Rodrigo Augusto Gonçalves Fonseca ,
- Eliane Mazócoli ,
- Alessandra Marin ,
- Paula Cristina Nogueira
Abstract
ORIGINAL ARTICLEIncidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
DOI 10.1590/0034-7167-2022-0553
- Aline de Oliveira Ramalho ,
- Rodrigo Augusto Gonçalves Fonseca ,
- Eliane Mazócoli ,
- Alessandra Marin ,
- Paula Cristina Nogueira
Views0See moreABSTRACT
Objective:
to analyze pressure injury (PI) incidence and risk factors in patients with COVID-19 admitted to an Intensive Care Unit and characterize the identified PIs.
Method:
a retrospective cohort study, consisting of 668 patients, carried out between March 2020 and February 2021. Clinical/demographic and PI variables were collected from medical records and electronic database. Data were analyzed using descriptive and inferential statistics. Logistic regression was performed to analyze risk factors for PI.
Results:
PI incidence was 30.2% (n=202), with the majority located in the sacral region (52.9%) and in stage 1 (39%). Risk factors were age (p<0.001), Diabetes Mellitus (p=0.005), length of stay (p<0.001), immunosuppression (p=0.034), nutritional risk (p=0.015) and mechanical ventilation (p<0.001).
Conclusion:
PI incidence in critically ill patients with COVID-19 was high.
- Aline de Oliveira Ramalho
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12-04-2023
La ética de la atención de enfermería a las personas transgénero
Revista Brasileira de Enfermagem. 2023;76:e20220797
Abstract
La ética de la atención de enfermería a las personas transgénero
Revista Brasileira de Enfermagem. 2023;76:e20220797
DOI 10.1590/0034-7167-2022-0797es
Views0See moreRESUMEN
Objetivos:
debatir sobre aspectos éticos en la atención de enfermería a personas transgénero.
Métodos:
estudio reflexivo fundamentado sobre los dilemas que se plantean en los cuidados de enfermería a personas transgénero. El relato se ha estructurado en torno a los cuatro principios bioéticos.
Resultados:
la atención sanitaria a las personas trans es compleja, transversal a muchos dispositivos y especialidades y longitudinal en el tiempo por lo que precisa de la actuación coordinada. Existe un marco ético en el que se encuadran los cuidados de enfermería que se precisan en la atención a este colectivo.
Consideraciones Finales:
la enfermera como agente de salud puede asumir diversas líneas generales en la atención a pacientes transgénero. Para ello, se debe brindar formación adicional no solo a los profesionales, también a los estudiantes de enfermería y de las demás ciencias de la salud.
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ORIGINAL ARTICLE12-04-2023
Working conditions in nursing in the face of Covid-19 from the perspective of precariousness
- Ana Paula Nogueira de Magalhães ,
- Diego de Oliveira Souza ,
- Fernanda Pereira de Macêdo ,
- Sabrina Ângela França da Silva Cruz ,
- Camila Pereira-Abagaro , [ … ],
- Roselia Arminda Rosales-Flores
Abstract
ORIGINAL ARTICLEWorking conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
DOI 10.1590/0034-7167-2022-0679
- Ana Paula Nogueira de Magalhães ,
- Diego de Oliveira Souza ,
- Fernanda Pereira de Macêdo ,
- Sabrina Ângela França da Silva Cruz ,
- Camila Pereira-Abagaro ,
- Roselia Arminda Rosales-Flores
Views0See moreABSTRACT
Objective:
To investigate working conditions in nursing when facing the Covid-19 pandemic, in light of aspects of precarious work.
Methods:
Cross-sectional study, with 131 nursing workers who worked against Covid-19 in hospitals in Alagoas State, Northeast Brazil. Data were collected online, using a workers’ health assessment questionnaire. The Chi -Square or Fisher’s Exact test and logistic regression were used.
Results:
among nursing workers, 71% had precarious contracts, 33.6% reported extended working hours and 23.7% were union members. In the multivariable analysis, having little hospital experience was a predictor for poor employment (OR= 2.408; 95%CI= 1.051-5.518). The predictor variables for lengthening the working day were being a nurse (OR= 3.824; 95%CI= 1.274-11.483); overtime (OR= 3.668; 95%CI= 1.009-13.333) and inadequate number of workers (OR= 10.872; 95%CI= 3.409-34.675). Being a nursing technician was a predictor of being a union member (OR= 8.967; 95%CI=2.560-31.410).
Conclusions:
The pandemic has accentuated the precariousness of working conditions in nursing professionals, especially among nurses.
- Ana Paula Nogueira de Magalhães
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12-04-2023
Estresse laboral entre enfermeiros na pandemia de COVID-19: Quais são os fatores contribuintes?
- Tita Rohita ,
- Nursalam Nursalam ,
- Muhammad Hadi ,
- Iqbal Pramukti ,
- Dedeng Nurkholik , [ … ],
- Ika Adelia Susanti
Abstract
Estresse laboral entre enfermeiros na pandemia de COVID-19: Quais são os fatores contribuintes?
Revista Brasileira de Enfermagem. 2023;76:e20220586
DOI 10.1590/0034-7167-2022-0586
- Tita Rohita ,
- Nursalam Nursalam ,
- Muhammad Hadi ,
- Iqbal Pramukti ,
- Dedeng Nurkholik ,
- Arifah Septiane ,
- Idyatul Hasanah ,
- Ika Adelia Susanti
Views0See moreRESUMEN
Objetivo:
Analizar los factores contribuyentes del estrés laboral entre enfermeros en la pandemia de COVID-19.
Métodos:
Estudio transversal realizado con 101 enfermeros de dos hospitales de Java Occidental, Indonesia. Se distribuyó un cuestionario en línea para evaluar el estrés laboral y los datos se analizaron mediante regresión logística ordinal.
Resultados:
Más de la mitad de los enfermeros experimentaron un estrés laboral moderado. El estudio reveló que los enfermeros mayores de 35 años tenían una menor probabilidad de experimentar estrés laboral (AOR: 0.173; IC95%: 0.038-0.782) y los enfermeros casados tenían una mayor probabilidad (AOR: 7.156; IC95%: 1.456-35.163). Los enfermeros con cargas de trabajo bajas y moderadas tenían una probabilidad menor, (AOR: 0.003; IC95%: 0.000-0.051) y (AOR: 0.025; IC95%: 0.005-0.116), respectivamente.
Conclusión:
Es fundamental considerar la edad, el estado civil y la carga de trabajo para un abordaje eficaz del estrés laboral entre los enfermeros.
- Tita Rohita
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12-04-2023
Fatores que afetam a atitude da comunidade em relação à vacinação contra a COVID-19: estudo transversal
- Chintia Gracelia Amalo ,
- Ezra Amarya Ekaristy ,
- Maretty Wattileo ,
- Martina Pakpahan ,
- Ester Silitonga
Abstract
Fatores que afetam a atitude da comunidade em relação à vacinação contra a COVID-19: estudo transversal
Revista Brasileira de Enfermagem. 2023;76:e20220597
DOI 10.1590/0034-7167-2022-0597
- Chintia Gracelia Amalo ,
- Ezra Amarya Ekaristy ,
- Maretty Wattileo ,
- Martina Pakpahan ,
- Ester Silitonga
Views0See moreRESUMEN
Objetivo:
El objetivo de este estudio fue analizar los factores que afectan la actitud de la comunidad hacia la vacunación contra el COVID-19 en el distrito de Tangerang.
Métodos:
Estudio transversal en el que se utilizó un muestreo por conveniencia para seleccionar a 400 encuestados. Los criterios de inclusión fueron vivir en el distrito de Tangerang, edad 18-55 años y trabajar. Se utilizó un cuestionario en línea, el cual pasó pruebas de validez y confiabilidad. Este estudio recibió aprobación ética.
Resultados:
La mayoría de los encuestados tenía un alto nivel de educación (48,50%), bajos ingresos (72,50%), alto conocimiento (78%) y una actitud positiva (76,50%) respecto a la vacunación contra el COVID-19. La prueba chi-cuadrado reveló una correlación entre el conocimiento y las actitudes hacia la vacunación contra el COVID-19 (p=0,001) y los niveles educativos (p=0,001). No hubo correlación entre los ingresos y las actitudes (p=0,094).
Conclusiones:
Los profesionales de la salud deben realizar una amplia socialización y visitas cara a cara con personas con acceso limitado a la información para promover una actitud positiva y ampliar el alcance de la vacunación contra el COVID-19.
- Chintia Gracelia Amalo
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ORIGINAL ARTICLE11-28-2023
Factors associated with psychopathological symptoms among nurses at a university hospital
- Sheila Janaína Oliveira Araújo Lima ,
- Danielle Christine Moura dos Santos ,
- Maria de Fátima de Souza Santos ,
- Felicialle Pereira da Silva ,
- Darine Marie Rodrigues da Silva , [ … ],
- Jael Maria de Aquino
Abstract
ORIGINAL ARTICLEFactors associated with psychopathological symptoms among nurses at a university hospital
Revista Brasileira de Enfermagem. 2023;76(1):e20220075
DOI 10.1590/0034-7167-2022-0075
- Sheila Janaína Oliveira Araújo Lima ,
- Danielle Christine Moura dos Santos ,
- Maria de Fátima de Souza Santos ,
- Felicialle Pereira da Silva ,
- Darine Marie Rodrigues da Silva ,
- Jael Maria de Aquino
Views0See moreABSTRACT
Objectives:
to analyze the factors associated with psychopathological symptoms among nurses at a university hospital.
Methods:
a cross-sectional study developed at a university hospital in Pernambuco, in which 90 nurses participated. A questionnaire with social and professional characteristics and the Symptom Assessment Scale were used.
Results:
an association was found between the variable changing profession and the presence of characteristic symptoms of psychoticism, somatization and anxiety among nurses.
Conclusions:
the emergence of psychopathological symptoms has influenced nurses’ desire to search for another profession. This evidence reinforces the need for greater investments in better working conditions and welcoming actions in the work environment, in order to provide a better quality of professional life and promote the health of these workers.
- Sheila Janaína Oliveira Araújo Lima
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11-28-2023
O diagnóstico e o tratamento da tuberculose latente por enfermeiros no Brasil: estratégia necessária
Revista Brasileira de Enfermagem. 2023;76(1):e760101
Abstract
O diagnóstico e o tratamento da tuberculose latente por enfermeiros no Brasil: estratégia necessária
Revista Brasileira de Enfermagem. 2023;76(1):e760101
DOI 10.1590/0034-7167.2023760101pt
Views0A prevenção da tuberculose (TB), de impedir a progressão da infecção para a TB ativa, é a principal estratégia para reduzir a sua incidência e para o alcance das metas definidas pela Organização Mundial da Saúde, conforme a estratégia End TB().O Brasil, que ocupa a 19ª posição quanto ao número de casos, assumiu seu compromisso […]See more
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ORIGINAL ARTICLE09-21-2020
Nurses’ attitudes facing the family involvment in caring for people with mental disorder
- Maria do Perpétuo Socorro de Sousa Nóbrega ,
- Carla Sílvia Neves da Nova Fernandes ,
- Sonia Regina Zerbetto ,
- Francisco Miguel Correia Sampaio ,
- Estela Duarte , [ … ],
- Wanderson Carneiro Moreira
Abstract
ORIGINAL ARTICLENurses’ attitudes facing the family involvment in caring for people with mental disorder
Revista Brasileira de Enfermagem. 2020;73:e20200041
DOI 10.1590/0034-7167-2020-0041
- Maria do Perpétuo Socorro de Sousa Nóbrega ,
- Carla Sílvia Neves da Nova Fernandes ,
- Sonia Regina Zerbetto ,
- Francisco Miguel Correia Sampaio ,
- Estela Duarte ,
- Suellen Cristina da Silva Chaves ,
- Wanderson Carneiro Moreira
Views0See moreABSTRACT
Objective:
To characterize the attitudes of Primary Health Care nurses, regarding the involvement of the family in the care for people with Mental Disorder.
Methods:
Correlational study with 257 nurses from the city of São Paulo. The scale “Importance of Families in Nursing Care- Nurses’ Attitudes” was used. For the analysis, descriptive and inferential statistics were used.
Results:
The scale scores were high, with a mean value of 82.1 (SD=8.4) favorable to the families’ involvement, and are related to being a nurse in the Family Health Strategy (p<0.001), having received education/training in family nursing (p<0.005), the workload of 40 hours/week (p<0.005), working in the West, East and Center Regions (p<0.005).
Conclusion:
Most nurses have positive attitudes towards the involvement of families, a relevant indicator for their inclusion in the health-mental care process.
- Maria do Perpétuo Socorro de Sousa Nóbrega
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ORIGINAL ARTICLE02-10-2020
Night Admission at a Psychosocial Care Center III
- Thuany Cristine Santos da Silva ,
- Tatiana Marques dos Santos ,
- Izabella de Góes Maciel Tavares Campelo ,
- Maria Manuela Vila Nova Cardoso ,
- Adriana Dias Silva , [ … ],
- Maria Angélica de Almeida Peres
Abstract
ORIGINAL ARTICLENight Admission at a Psychosocial Care Center III
Revista Brasileira de Enfermagem. 2020;73(1):e20170964
DOI 10.1590/0034-7167-2017-0964
- Thuany Cristine Santos da Silva ,
- Tatiana Marques dos Santos ,
- Izabella de Góes Maciel Tavares Campelo ,
- Maria Manuela Vila Nova Cardoso ,
- Adriana Dias Silva ,
- Maria Angélica de Almeida Peres
Views0See moreABSTRACT
Objective:
to analyze night admission characteristics at a Psychosocial Care Center III (CAPS III – Centro de Atenção Psicossocial).
Method:
a qualitative research, whose data were collected with 15 nursing professionals from November to April 2016, through a semi-structured interview.
Results:
it was verified that night admission is provided by the nursing team in different dynamics from the day care. This team has strategies of care during crisis, avoiding search for other network services and maintaining the CAPS in its function within the psychosocial model.
Final considerations:
service operation depends on the nursing team for its permanence condition in all shifts, which leads to the need to think about the legislation reformulation that structures the CAPS III team, in order to guarantee the interdisciplinary care provided by the Brazilian Psychiatric Reform in this device, which should replace hospitalization in a specialized institution.
- Thuany Cristine Santos da Silva
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CASE STUDY08-19-2019
Decision making from the perspective of nursing students
Revista Brasileira de Enfermagem. 2019;72(4):1102-1108
Abstract
CASE STUDYDecision making from the perspective of nursing students
Revista Brasileira de Enfermagem. 2019;72(4):1102-1108
DOI 10.1590/0034-7167-2018-0311
Views0See moreABSTRACT
Objective:
To analyze the decision making of students from a nursing higher school and understand how they make decisions in the care process.
Method:
A qualitative study with an exploratory and descriptive approach was carried out with the case study method.
Results:
Six types of decision making were categorized by the students as follows: Decision about communication (15 record units [RU]); Decision about understanding (14 RU); Decision about intervention (9 RU); Decision about timing (5 RU); Decision about targeting (4 RU); and Decision about management (0 RU), with a total of 47 RU.
Final considerations:
Analysis of the learning diaries showed that students make more decisions regarding communication with patients and understanding of the care situation, than with the acting decision.
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ORIGINAL ARTICLE12-21-2020
Nurses’ work at Family Health Strategy: possibilities to operate health needs
- Anna Maria Meyer Maciel Rodríguez ,
- Silvana Martins Mishima ,
- Angelina Lettiere-Viana ,
- Silvia Matumoto ,
- Cinira Magali Fortuna , [ … ],
- Débora de Souza Santos
Abstract
ORIGINAL ARTICLENurses’ work at Family Health Strategy: possibilities to operate health needs
Revista Brasileira de Enfermagem. 2020;73:e20190704
DOI 10.1590/0034-7167-2019-0704
- Anna Maria Meyer Maciel Rodríguez ,
- Silvana Martins Mishima ,
- Angelina Lettiere-Viana ,
- Silvia Matumoto ,
- Cinira Magali Fortuna ,
- Débora de Souza Santos
Views0See moreABSTRACT
Objectives:
to identify and analyze possibilities for recognizing health needs in the nurses’ work at Family Health Strategy.
Methods:
a qualitative study with interviews and observation of the nurses’ work in the countryside of São Paulo. The empirical material was subjected to thematic content analysis and interpreted in the light of the health work process.
Results:
two themes emerged: Possibilities utilized and Possibilities neglected to recognize health needs. Careful observation, welcoming, attention, listening, bonding and dialogue developed by nurses, in live work in action with users, touched on the possibilities, which, taken advantage of, were evidenced in care in spontaneous demand, scheduled consultation, examination gynecological and group activities.
Final Considerations:
nurses are able to recognize health needs, which can expand their clinical practice and interprofessionality in Family Health.
- Anna Maria Meyer Maciel Rodríguez
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ORIGINAL ARTICLE08-19-2019
Social Determinants of Health and their influence on the choice of birth control methods
- Hellen Lívia Oliveira Catunda Ferreira ,
- Denise de Fátima Fernandes Barbosa ,
- Vivianne Melo Aragão ,
- Tyane Mayara Ferreira de Oliveira ,
- Régia Christina Moura Barbosa Castro , [ … ],
- Ana Karina Bezerra Pinheiro
Abstract
ORIGINAL ARTICLESocial Determinants of Health and their influence on the choice of birth control methods
Revista Brasileira de Enfermagem. 2019;72(4):1044-1051
DOI 10.1590/0034-7167-2017-0574
- Hellen Lívia Oliveira Catunda Ferreira ,
- Denise de Fátima Fernandes Barbosa ,
- Vivianne Melo Aragão ,
- Tyane Mayara Ferreira de Oliveira ,
- Régia Christina Moura Barbosa Castro ,
- Priscila de Souza Aquino ,
- Ana Karina Bezerra Pinheiro
Views0See moreABSTRACT
Objective:
To verify the association between Social Determinants of Health and birth control methods used by women of childbearing age.
Methods:
Documentary and retrospective study, performed at a Brazilian Natural Birth Center with evaluation of the medical records of patients seen between 2003 and 2011 (n=2410). Data were collected on identification and general history, gynecological, sexual and obstetric.
Results:
Hormone birth control methods were the most used among participants (25.0%); followed by barrier methods (21.5%) and surgical methods (19.3%). Statistical associations were observed regarding age, menarche, onset of sexual activity, pregnancy, miscarriage, smoking, hypertension, marital status, gynecological care and schooling with the choice of methods.
Conclusion:
The results confirm the importance of studies involving Social Determinants of Health, since they interfere in the way women choose birth control methods and the risks that this choice may pose to their health.
- Hellen Lívia Oliveira Catunda Ferreira
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REVIEW07-13-2020
Augmentative and Alternative Communication in Ventilated Patients: A Scoping Review
- Sara Pina ,
- Madalena Canellas ,
- Rita Prazeres ,
- José Lopes ,
- Tânia Marcelino , [ … ],
- Cândida Ferrito
Abstract
REVIEWAugmentative and Alternative Communication in Ventilated Patients: A Scoping Review
Revista Brasileira de Enfermagem. 2020;73(5):e20190562
DOI 10.1590/0034-7167-2019-0562
- Sara Pina ,
- Madalena Canellas ,
- Rita Prazeres ,
- José Lopes ,
- Tânia Marcelino ,
- Duarte Reis ,
- Cândida Ferrito
Views0See moreABSTRACT
Objectives:
to map the benefits of Augmentative and Alternative Communication in ventilated adults in Intensive Care Unit and identify strategies used.
Methods:
a Scoping Review was carried out according to the Joanna Brigs Institute Protocol. The research question was: “In adult patients ventilated in Intensive Care Units, what are the benefits of Augmentative and Alternative Communication?”. An article research was carried out at PubMed, EBSCOhost and B-On databases. It was held between October and November 2018, from 2013 to 2018, in Portuguese and in English.
Results:
61 references were obtained. After selection according to the inclusion criteria, 7 articles were analyzed.
Conclusions:
studies enunciate Augmentative and Alternative Communication as a strategy to enhance communication, describing methods and tools. There is no agreement on the most effective tool.
- Sara Pina
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REFLECTION12-13-2019
Women with fetal death: nurses’ care limitations
Revista Brasileira de Enfermagem. 2019;72:365-368
Abstract
REFLECTIONWomen with fetal death: nurses’ care limitations
Revista Brasileira de Enfermagem. 2019;72:365-368
DOI 10.1590/0034-7167-2018-0261
Views0See moreABSTRACT
Objective:
To present the limitations of the nursing care for women with fetal death, reflecting on this challenge for care practices.
Method:
Reflective study with theoretical focus on national and international publications, along with the experience of the authors in the area of women’s health and obstetrics.
Results:
There are limitations related to nursing care, which involve feelings of insecurity and powerlessness, inappropriate attitudes of these professionals in front of women, difficulties to manage emotional aspects, and structural problems of health services.
Final Considerations:
This study points out that there are challenges to qualify nursing care for women with fetal death, which included academic studies and continuing education in health services. Relational aspects should be valued and demand more sensitivity from nurses, with more empathic relationships in the care for women with fetal death.
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REVIEW10-07-2022
Strategies for thirst management in postoperative adult patients: a scoping review
- Tâmara Taynah Medeiros da Silva ,
- Joyce Karolayne dos Santos Dantas ,
- Sara Cristina Matias de Araújo ,
- Silmara de Oliveira Silva ,
- Daniele Vieira Dantas , [ … ],
- Rodrigo Assis Neves Dantas
Abstract
REVIEWStrategies for thirst management in postoperative adult patients: a scoping review
Revista Brasileira de Enfermagem. 2022;75(4):e20220154
DOI 10.1590/0034-7167-2022-0154
- Tâmara Taynah Medeiros da Silva ,
- Joyce Karolayne dos Santos Dantas ,
- Sara Cristina Matias de Araújo ,
- Silmara de Oliveira Silva ,
- Daniele Vieira Dantas ,
- Rodrigo Assis Neves Dantas
Views0See moreABSTRACT
Objectives:
to map the strategies for managing thirst in postoperative adult patients.
Methods:
scoping review was conducted in October 2021 in 19 data sources: 14 databases and 5 platforms to search in the grey literature. It was prepared according to the recommendations of the Joanna Briggs Institute and the checklist of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Nine selected articles were part of the final sample.
Results:
there is evidence of strategies to manage postoperative thirst using interventions such as water, ice, mentholated measures, carbohydrate and protein enriched fluid, oral hydrator, flavored gargling, cold gargling, wet gauze, 0.75% citric acid spray, and cold water.
Final Considerations:
the strategies observed may be reduced to cold and menthol use, salivary stimulants, and early introduction of fluids. The outcomes were positive in all the studies reviewed.
- Tâmara Taynah Medeiros da Silva
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