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EDITORIAL
Fundamentals and practice of care in Gerontological Nursing
Revista Brasileira de Enfermagem. 2017;70(4):671-672
01-01-2017
Abstract
EDITORIALFundamentals and practice of care in Gerontological Nursing
Revista Brasileira de Enfermagem. 2017;70(4):671-672
01-01-2017DOI 10.1590/0034-7167.2017700401
Views0Intense social, economic, political, cultural, environmental, epidemiological, and demographical transformations, coupled with accelerated technological innovation, have significantly affected life in society, requiring people to reflect about the conceptions of human nature itself. This context of transformation has incentivized individuals to value technological advances and the construction of more autonomous, global, and unstable human relationships, outlining […]See more -
EDITORIAL
Fundamentos e práticas do cuidar em Enfermagem Gerontológica
Revista Brasileira de Enfermagem. 2017;70(4):671-672
01-01-2017
Abstract
EDITORIALFundamentos e práticas do cuidar em Enfermagem Gerontológica
Revista Brasileira de Enfermagem. 2017;70(4):671-672
01-01-2017DOI 10.1590/0034-7167.2017700401
Views0As intensas transformações sociais, econômicas, políticas, culturais, ambientais, epidemiológicas e demográficas, em conjunto com as aceleradas inovações tecnológicas, têm afetado significativamente a vida em sociedade, exigindo que as pessoas reflitam sobre as próprias concepções da natureza humana. Esse contexto de transformações tem estimulado os indivíduos a valorizar os avanços tecnológicos e a construção de relações […]See more -
The importance of empathy in health and nursing care
Revista Brasileira de Enfermagem. 2017;70(3):669-670
01-01-2017
Abstract
The importance of empathy in health and nursing care
Revista Brasileira de Enfermagem. 2017;70(3):669-670
01-01-2017DOI 10.1590/0034-7167-2016-0032
Views0“In her book “Cultivating Empathy”(), Kathleen Stephany, psychologist and professor at the College of Health Sciences at Douglas College, writes about empathy, which she considers to be the basis of effective communication and one of the most important skills to be developed by human beings. Empathy is the ability to put oneself in the place […]See more -
REFLECTION
Clinical reasoning in nursing: teaching strategies and assessment tools
Revista Brasileira de Enfermagem. 2017;70(3):662-668
01-01-2017
Abstract
REFLECTIONClinical reasoning in nursing: teaching strategies and assessment tools
Revista Brasileira de Enfermagem. 2017;70(3):662-668
01-01-2017DOI 10.1590/0034-7167-2016-0509
Views0See moreABSTRACT
Objective:
To present the concept and development of teaching strategies and the assessment tools regarding clinical reasoning for accurate practice.
Method:
This is a theoretical reflection based on scientific studies.
Results:
Comprehension of the essential concepts of the thought process and its articulation with the different teaching strategies and the assessment tools which has allowed presenting ways to improve the process of diagnostic or therapeutic clinical reasoning.
Conclusion:
The use of new strategies and assessment tools should be encouraged in order to contribute to the development of skills that lead to safe and effective decision making.
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REFLECTION
Continuing education in health from the perspective of Augustine of Hippo
Revista Brasileira de Enfermagem. 2017;70(3):656-661
01-01-2017
Abstract
REFLECTIONContinuing education in health from the perspective of Augustine of Hippo
Revista Brasileira de Enfermagem. 2017;70(3):656-661
01-01-2017DOI 10.1590/0034-7167-2016-0484
Views0See moreABSTRACT
Objective:
To reflect about continuing education from the perspective of Augustine of Hippo and his theories based on the construction of knowledge and the learning process.
Method:
This is a theoretical reflection study whose aim is to propose dimensions of analysis, emphasizing the history and challenges of continuing education. Such dimensions analyze the production of knowledge in Augustinian pedagogy, its historical aspects and its close relationship with lifelong education in health professions.
Results:
The results show the difficulty of continuing education to reach adequate importance in health services, and that of academia in appropriating the thoughts of renowned philosophers such as Augustine. This is a result of ignorance about the convergence of these principles and their relevance.
Final considerations:
Continuing education and Augustinian pedagogy walk hand in hand in terms of care, meeting the needs that originate from practice and that are reflected in it, challenging isolated knowledge and putting different areas of knowledge to work together.
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REVIEW
Influence of hormonal contraceptives and the occurrence of stroke: integrative review
Revista Brasileira de Enfermagem. 2017;70(3):647-655
01-01-2017
Abstract
REVIEWInfluence of hormonal contraceptives and the occurrence of stroke: integrative review
Revista Brasileira de Enfermagem. 2017;70(3):647-655
01-01-2017DOI 10.1590/0034-7167-2016-0056
Views0See moreABSTRACT
Objective:
To identify scientific evidence regarding the influence of hormonal contraceptive use and the occurrence of stroke.
Method:
Integrative review of the literature, through database search using the descriptors “contraceptive agents“, “contraceptive devices“, “contraceptives, Oral” and “Stroke”. Original studies in Portuguese, Spanish and English, published in full and available online were included. Studies that did not answer our guiding questions and duplicated studies were excluded.
Results:
Women using combined oral contraceptives have higher risk of stroke, even with a lower hormonal dosage and different types of progestogen, regardless of the duration of use. The use of contraceptives associated with smoking, hypertension, migraine, hypercholesterolemia, obesity and sedentary lifestyle increases the chance of stroke. Contraceptive patch and vaginal ring are associated to increased risk.
Conclusion:
Use of combined hormonal contraceptives, except for the injectable and the transdermal ones, increases the chance of occurrence of the event. Progestogen-only contraceptives were considered safe.
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RESEARCH
Health Conditions and Memory Performance: a study with older adult women
Revista Brasileira de Enfermagem. 2017;70(3):640-646
01-01-2017
Abstract
RESEARCHHealth Conditions and Memory Performance: a study with older adult women
Revista Brasileira de Enfermagem. 2017;70(3):640-646
01-01-2017DOI 10.1590/0034-7167-2016-0529
Views0See moreABSTRACT
Objective:
to verify the correlation between health condition and memory performance of older adult women in the community.
Method:
Analytical cross-sectional study developed with 28 older adult women living in Cuiabá-MT. They answered the Mini-Mental State Examination (MMSE), and a shortened Geriatric Depression Scale (GDS-15) to screen for dementia and depression symptoms. Memory skills were assessed through Rey Auditory Verbal Learning Test (RAVLT).
Results:
The mean age was 66.36 years and 75% of the participants had educational level higher than 7 years. The MMSE mean score was 28.45. The correlations found were: educational level and immediate memory (r = 0.49; p = 0.008); delayed recall and immediate memory (r = 0.71; p < 0.001); memory recognition and immediate memory (r = 0.43; p = 0.021) and recognition memory with delayed recall (r = 0.47; p = 0.012).
Conclusion:
High scores in the MMSE and a satisfactory health perception among the participants were evident. There was no correlation between memory performance and health perception.
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RESEARCH
Comprehension of the education handout and health literacy of pacemaker users
Revista Brasileira de Enfermagem. 2017;70(3):633-639
01-01-2017
Abstract
RESEARCHComprehension of the education handout and health literacy of pacemaker users
Revista Brasileira de Enfermagem. 2017;70(3):633-639
01-01-2017DOI 10.1590/0034-7167-2016-0336
Views0See moreABSTRACT
Objective:
To verify the comprehension of the education handout and the level of Functional Health Literacy of individuals with cardiac pacemaker (PM) and whether there is correlation between the comprehension and Functional Health Literacy (FHL).
Method:
Cross-sectional study with 63 individuals with PM who answered to comprehension tests of the handout, literacy assessment (SAHLPA-50) and cognition (MMSE). Measurements of dispersion, Pearson correlation and multiple linear regression were calculated.
Results:
Most women, study time ≤ 9 years, 66.21 (average age) presented no cognitive changes. An adequate literacy level was evidenced in 50.8% individuals with PM and satisfactory comprehension of the handout. No correlation was identified between FHL, handout comprehension, age, years of study and cognition.
Conclusion:
The handout comprehension assessed by individuals with appropriate FHL indicated that it can be a printed material suitable for use, aiming to improve care process and knowledge of individuals with PM.
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ORIGINAL ARTICLE
Validity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
06-14-2024
Abstract
ORIGINAL ARTICLEValidity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
06-14-2024DOI 10.1590/0034-7167-2023-0195
Views1See moreABSTRACT
Objectives:
to describe the validity process of the TBApp mobile application for self-care management for people with tuberculosis linked to Primary Health Care.
Methods:
methodological research developed with ten expert judges, carried out virtually. The application was assessed in relation to content and technology quality in seven domains (objectivity; structure and appearance; relevance; functionality; reliability; usability; and efficiency), using an instrument with a Likert scale.
Results:
TBApp was considered valid, relevant, functional, reliable and effective by expert judges. The objectives, structure and presentation and relevance domains presented an overall Content Validity Index of 0.93, and the functionality, reliability, usability and efficiency domains presented characteristics and sub-characteristics values greater than 0.80.
Conclusions:
TBApp is a creative and innovative tool that can be used by people with TB and disseminated in the scientific community.
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Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
05-21-2021
Abstract
Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
05-21-2021DOI 10.1590/0034-7167-2020-0422
Views1See moreABSTRACT
Objective:
To identify and map the technological tools of information and communication to support the teaching learning process in Nursing teaching courses.
Methods:
This is a scoping review whose search was carried out in seven databases and in grey literature. After an initial analysis of the selection, 88 texts were read integrally, and 29 made up the final sample.
Results:
Virtual learning environment and object, simulation, hypermedia, and software or cellphone applications were the tools the nursing professors used the most. Studies highlight that the application of technology was important in the teaching-learning process, since it encouraged teaching based on safe care, motivating and developing abilities/competences, supported on significant, effective, flexible, and autonomous learning.
Conclusion:
The contribution of the technology for nursing formation stands out, but it should be highlighted that its employment must be critical, reflective, based on pedagogical theories and developed by trained professors.
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ORIGINAL ARTICLE
Self-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
10-01-2022
Abstract
ORIGINAL ARTICLESelf-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
10-01-2022DOI 10.1590/0034-7167-2020-1257
Views1INTRODUCTIONChronic non-communicable diseases are the main causes of death and health problems in the world, causing about 41 million deaths each year, which corresponds to approximately 71% of all deaths. Among these diseases, diabetes mellitus has stood out due to the increase in its incidence and prevalence().Estimates indicate that 463 million people live with diabetes […]See more -
ORIGINAL ARTICLE
Adaptation and validation of an adult patient classification instrument with emphasis on the family dimension
Revista Brasileira de Enfermagem. 2023;76(2):e20220530
03-27-2023
Abstract
ORIGINAL ARTICLEAdaptation and validation of an adult patient classification instrument with emphasis on the family dimension
Revista Brasileira de Enfermagem. 2023;76(2):e20220530
03-27-2023DOI 10.1590/0034-7167-2022-0530
Views1ABSTRACT
Objectives:
to adapt and validate an instrument for classifying adult patients that emphasizes the family support network in the demand for nursing care.
Methods:
methodological study, carried out in three phases: adaptation of an instrument considering the reality of adult patients; content validation with seven experts and assessment of measurement properties (construct validity and internal consistency) with 781 hospitalized patients.
Results:
in content validation, the indicators reached the values established for the Content Validity Index (0.85-1.00). In the confirmatory factor analysis, the 11 indicators were distributed in three domains and presented average variance extracted and factor loading greater than 0.5. Composite reliability was greater than 0.7.
Conclusions:
the present study adapted and made available, with evidence of validity and reliability, an instrument for classifying adult patients that considers the family support network in the demand for nursing care.
Keywords:Factor AnalysisFamilyHospital Organization and AdministrationPatient-Centered CareValidation StudiesSee more -
ORIGINAL ARTICLE
Guide for Systematization of Care and Nursing Process: educational technology for professional practice
Revista Brasileira de Enfermagem. 2023;76:e20210975
04-14-2023
Abstract
ORIGINAL ARTICLEGuide for Systematization of Care and Nursing Process: educational technology for professional practice
Revista Brasileira de Enfermagem. 2023;76:e20210975
04-14-2023DOI 10.1590/0034-7167-2021-0975
Views1ABSTRACT
Objective:
to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process.
Methods:
applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout.
Results:
the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges.
Final considerations:
the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.
Keywords:Educational TechnologyNursing ProcessNursing RecordsProfessional PracticeStandardized Nursing TerminologySee more -
ERRATUM
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
01-15-2024
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
01-15-2024DOI 10.1590/0034-7167.20247701e01
Views1In the article “The ethics of nursing care for transgender people”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 3):e20220797, in authorship:Where it read:[…]See more -
REVIEW
Telenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
11-22-2024
Abstract
REVIEWTelenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
11-22-2024DOI 10.1590/0034-7167-2024-0093
Views1See moreABSTRACT
Objective:
to identify telenursing contributions in Primary Health Care during the COVID-19 pandemic.
Methods:
an integrative literature review, conducted between January and August 2022 in the PubMed, CINAHL, LILACS, BDENF, Scopus, WoS, EMBASE and SciELO databases. A total of 493 studies was found, 62 were read in full, and of these, 16 were selected. For analysis, a dynamic reading of the studies and synthesis of the main results were carried out.
Results:
the main results highlighted telenursing practice as a challenge for professionals and the population. Among the contributions and positive points and aspects that require improvement, practice showed promise when considered in a post-pandemic scenario.
Final considerations:
through telenursing, the population’s access to Primary Health Care was guaranteed in the face of the COVID-19 pandemic. However, a critical look at current technological advances in healthcare is necessary.
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REVIEW
Recommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
12-16-2024
Abstract
REVIEWRecommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
12-16-2024DOI 10.1590/0034-7167-2024-0086
Views1See moreABSTRACT
Objectives:
to summarize the recommendations of guidelines for promoting mental health in the workplace.
Methods:
an umbrella review, according to Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses methodological assumptions. Data collection was carried out in January 2021 and updated in July 2023 in the American Psychological Association, Cochrane Library, EMBASE, National Library of Medicine, and Scopus databases. Systematic reviews that assessed guidelines with recommendations for mental health care for workers were included. PROSPERO registration CRD42023461845.
Results:
four systematic reviews published between 2015 and 2018 were identified. The abstracts highlighted actions that facilitate and inhibit the recommendations as well as three categories of intervention: primary prevention – worker protection; secondary prevention – promoting workers’ mental health; and tertiary prevention – supporting, monitoring and rehabilitating workers upon returning to work.
Conclusions:
the interventions are based on prevention, promotion and early recognition, support and rehabilitation of mental health problems.
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Socioeconomic factors related to leprosy: an integrative literature review
Revista Brasileira de Enfermagem. 2019;72(5):1405-1415
09-16-2019
Abstract
Socioeconomic factors related to leprosy: an integrative literature review
Revista Brasileira de Enfermagem. 2019;72(5):1405-1415
09-16-2019DOI 10.1590/0034-7167-2017-0651
Views0See moreABSTRACT
Objective:
To investigate in the literature the relation of socioeconomic factors in the incidence of the disease and other outcomes related to leprosy.
Method:
Integrative review conducted in Lilacs, Medline, Scopus databases and SciELO online library with studies from 2000 to 2016.
Results:
32 studies were included. Only studies that analyzed statistical associations of socioeconomic factors and outcomes related to leprosy were selected.
Conclusion:
Leprosy is greatly affected by the social context in which the patient is inserted, the chances of exposure to illness are the result of a set of not only individual aspects, but also of contexts or collective conditions. It is imperative for Nursing, as an essential part of the multiprofessional team entrusted with the care and surveillance of the disease, to recognize these factors to predict unfavorable outcomes and to develop new practices capable of reducing inequities.
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ORIGINAL ARTICLE
Literacy in health and self-care in people with type 2 diabetes mellitus
Revista Brasileira de Enfermagem. 2019;72(3):700-706
06-27-2019
Abstract
ORIGINAL ARTICLELiteracy in health and self-care in people with type 2 diabetes mellitus
Revista Brasileira de Enfermagem. 2019;72(3):700-706
06-27-2019DOI 10.1590/0034-7167-2018-0291
Views0See moreABSTRACT
Objective:
To evaluate the effect of educational intervention in the adherence to self-care activities and functional health literacy and numeracy in people with type 2 diabetes mellitus.
Methods:
This was a quasi-experimental study conducted in two units of the Brazilian Family Health Strategy, involving people with diabetes. Educational interventions occurred in three meetings, weekly, lasting 60 minutes on average. Data were collected using the Questionário de Autocuidado com o Diabetes, before and after the interventions.
Results:
55 people participated in the study. After the interventions, the greatest difference for a better adherence to self-care was the item “inspecting the inside of the shoes before putting them on”, with 3.29 days in the week delta at analytical level. The worst was “taking insulin shots as recommended”, with 0.00 days a week delta at basic level.
Conclusion:
Educational interventions had a positive effect on adherence to self-care and functional literacy in health.
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EDITORIAL
Qualitative research in health: a reflective approach
Revista Brasileira de Enfermagem. 2019;72(4):830-831
08-19-2019
Abstract
EDITORIALQualitative research in health: a reflective approach
Revista Brasileira de Enfermagem. 2019;72(4):830-831
08-19-2019DOI 10.1590/0034-7167.2019-720401
Views0Qualitative research makes possible the development of health knowledge, because it works with complex phenomena whose totality, besides depth, depends on the intensity. For Minayo, the objective of the qualitative research is to make explicit data, indicators, verified trends and/or construct theoretical models applicable to practice. Therefore, its purpose is to study history, representations, relationships, […]See more -
REFLECTION
How to translate scientific knowledge into practice? Concepts, models and application
Revista Brasileira de Enfermagem. 2020;73(5):e20190179
07-01-2020
Abstract
REFLECTIONHow to translate scientific knowledge into practice? Concepts, models and application
Revista Brasileira de Enfermagem. 2020;73(5):e20190179
07-01-2020DOI 10.1590/0034-7167-2019-0179
Views0See moreABSTRACT
Objectives:
to present the concept of Knowledge Translation and Exchange as it has been used in the international literature and in Canada, particularly. Next, to describe a renowned conceptual model to guide its implementation, entitled Knowledge-to-Action Cycle.
Results:
we described the use of the model in the context of the municipal primary health care system in southern Brazil for the implementation of pain management strategies during vaccination.
Conclusions:
in this theoretical reflection, we argue that in order to promote health equity and quality of care in the Unified Health System (Brazilian SUS) it is important to translate scientific knowledge to various practice settings and create opportunities for exchange with users of this knowledge, such as health professionals, managers, policy makers, patients, family members and other stakeholders.
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REVIEW
Polycyclic aromatic hydrocarbons and development of respiratory and cardiovascular diseases in workers
Revista Brasileira de Enfermagem. 2020;73(3):e20180965
04-22-2020
Abstract
REVIEWPolycyclic aromatic hydrocarbons and development of respiratory and cardiovascular diseases in workers
Revista Brasileira de Enfermagem. 2020;73(3):e20180965
04-22-2020DOI 10.1590/0034-7167-2018-0965
Views0ABSTRACT
Objectives:
to identify the scientific evidence on the development of cardiovascular and respiratory diseases due to workplace contamination by polycyclic aromatic hydrocarbons.
Methods:
integrative literature review. The search for primary articles was held in October 2017 in the Medical Literature Analysis and Retrieval System Online (through Pubmed), Web of Science and Latin American and Caribbean Literature in Health Sciences (LILACS).
Results:
the 16 studies analyzed showed that exposure to polycyclic aromatic hydrocarbons was associated with cardiovascular diseases, such as increased blood pressure, heart rate variation, and ischemic heart disease; and respiratory disorders, such as decreased lung function, chronic obstructive pulmonary disease, asthma, wheeze, coughing, pulmonary wheezing, chest tightness, effort dyspnea, and sore throat.
Conclusions:
polycyclic aromatic hydrocarbons cause deleterious effects on the cardiovascular and respiratory systems through mutations and cellular inflammation, being a risk to exposed individuals.
Keywords:Cardiovascular DiseasesPolycyclic Aromatic HydrocarbonsRespiratory DiseasesVolatile Organic CompoundsWorkersSee more -
ORIGINAL ARTICLE
Occupational stress in nursing professionals of a university hospital
Revista Brasileira de Enfermagem. 2020;73(2):e20180997
02-17-2020
Abstract
ORIGINAL ARTICLEOccupational stress in nursing professionals of a university hospital
Revista Brasileira de Enfermagem. 2020;73(2):e20180997
02-17-2020DOI 10.1590/0034-7167-2018-0997
Views0ABSTRACT
Objectives:
To identify the presence of occupational stress in nursing professionals of a university hospital in the inlands of the state of Minas Gerais and examine influence of sociodemographic and occupational characteristics in this disease.
Methods:
Cross-sectional, exploratory and quantitative study with 124 professional nurses from a university hospital in the inlands of the state of Minas Gerais. The adapted and validated Portuguese version of the Job Stress Scale (JSS) was used for the performance of the study.
Results:
Most professionals were women (87.9%) with a mean age of 40.2 years, 80.6% were nursing technicians and 71.8% of the sample had some degree of exposure to occupational stress.
Conclusions:
The occupational stress index was higher than that observed in previous studies. Data obtained in the study point to the need to implement institutional measures for the prevention of occupational stress, especially by strengthening social support at work.
Keywords:Nursing ProfessionalsNursing, TeamOccupational HealthOccupational StressUniversity HospitalSee more -
ORIGINAL ARTICLE
Development and validation a nursing care protocol with educational interventions for family caregivers of elderly people after stroke
Revista Brasileira de Enfermagem. 2020;73:e20180894
07-08-2020
Abstract
ORIGINAL ARTICLEDevelopment and validation a nursing care protocol with educational interventions for family caregivers of elderly people after stroke
Revista Brasileira de Enfermagem. 2020;73:e20180894
07-08-2020DOI 10.1590/0034-7167-2018-0894
Views0See moreABSTRACT
Objective:
development and validation the content of a nursing care protocol with educational interventions for family caregivers of elderly people after stroke.
Methods:
a methodological study conducted in three stages: (1) protocol development through literature review; (2) pretest with multidisciplinary team, analyzed with literature articulation; (3) protocol validation by the Delphi Technique.
Results:
the protocol was structured in the following areas: Disease Guidelines; Emotional Support; Using the Health Care Network; Diet; Airways; Medications; Hygiene; Skin Care; Disposal; Dressing/Undressing; Positioning and Transfer; Fall Prevention. In the pretest, eight experts assessed protocol clarity and content. In validation, there were two rounds by the Delphi Technique. The validated protocol consisted of 12 domains, containing 42 items and 240 care guidelines.
Conclusion:
the protocol qualifies the transition of care after hospital discharge assisting nurses in home care practice.
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