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ORIGINAL ARTICLE
Construction and validation of a checklist for the management of totally implanted catheters in children
Revista Brasileira de Enfermagem. 2024;77(4):e20230447
20/09/2024
Resumo
ORIGINAL ARTICLEConstruction and validation of a checklist for the management of totally implanted catheters in children
Revista Brasileira de Enfermagem. 2024;77(4):e20230447
20/09/2024DOI 10.1590/0034-7167-2023-0447
Visualizações0Ver maisABSTRACT
Objectives:
to construct and validate the content of a checklist for the management of totally implanted catheters in hospitalized children and adolescents.
Methods:
methodological research conducted from October 2021 to December 2022 in two stages: development of the instrument with care guidelines and content validation of the checklist. The instrument, containing 23 items presented in Likert format, was evaluated online by specialists in two rounds. The Content Validity Index was applied, considering indices above 0.8 as valid.
Results:
the final checklist included four domains and 22 checklist items, validated with a Content Validity Index of 0.98. The overall evaluation of the instrument presented a global score of 9.9.
Conclusions:
the validation and application of instruments that standardize procedures, in addition to supporting professionals, promote autonomy and quality of care for children and adolescents using this device.
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ORIGINAL ARTICLE
Cross-cultural adaptation and validation of the Healthy Work Environment Assessment Tool in Brazilian culture
Revista Brasileira de Enfermagem. 2024;77(4):e20230505
20/09/2024
Resumo
ORIGINAL ARTICLECross-cultural adaptation and validation of the Healthy Work Environment Assessment Tool in Brazilian culture
Revista Brasileira de Enfermagem. 2024;77(4):e20230505
20/09/2024DOI 10.1590/0034-7167-2023-0505
Visualizações0ABSTRACT
Objectives:
to adapt and validate the content of the Healthy Work Environment Assessment Tool for Brazilian culture, and evaluate the practical aspects of its application.
Methods:
methodological study that followed six stages: translation; synthesis; back translation; content validation by a group of experts, pre-testing and approval of the process by the author of the original instrument.
Results:
the first three stages were carried out by contracted companies. In the committee, two items and the title of a subscale were evaluated in a second round, when consensus was reached among experts. In the pre-test, more than 93% of professionals agreed that the tool was easy to understand. The average completion time was 8.53 minutes. The American Association of Critical-Care Nurses authorized publication of the results.
Conclusions:
the adaptation of the tool to Brazilian culture was completed following the adopted framework. In addition to the evidence of content validity, the tool appears promising for managerial use.
Palavras-chave: Cross-Cultural ComparisonHealth Facility EnvironmentTranslatingValidation StudyWorking ConditionsVer mais -
Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study
Revista Brasileira de Enfermagem. 2024;77(4):e20230520
20/09/2024
Resumo
Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study
Revista Brasileira de Enfermagem. 2024;77(4):e20230520
20/09/2024DOI 10.1590/0034-7167-2023-0520
Visualizações0ABSTRACT
Objectives:
to map the nursing theories developed in stricto sensu graduate programs in nursing in Brazil.
Methods:
a bibliometric study, carried out on the Coordination for the Improvement of Higher Education Personnel Theses and Dissertations Portal in October 2023. The controlled descriptors “Nursing Theory” and “Nursing Models” and the uncontrolled descriptors “Theories” and “Middle-Range Theory” were used. Selected studies were cataloged for analysis, which was conducted by the study authors, who have a doctoral degree and expertise in research on nursing theories.
Results:
thirty-nine nursing theories were mapped, with a predominance of middle-range theories (79.5%), focusing on nursing diagnostic concepts and use of the theoretical-methodology strategy of theoretical-causal validity.
Conclusions:
the study identified nursing theories developed in Brazil, recognizing trends, development strategies, theorized objects of disciplinary interest and investments necessary for practical application in Brazilian contexts.
Palavras-chave: BibliometricsHealth Postgraduate ProgramsNursing ModelsNursing ResearchNursing TheoryVer mais -
ORIGINAL ARTICLE
Middle-range theory for nursing for care in the context of cardiovascular risk
Revista Brasileira de Enfermagem. 2024;77(4):e20240190
20/09/2024
Resumo
ORIGINAL ARTICLEMiddle-range theory for nursing for care in the context of cardiovascular risk
Revista Brasileira de Enfermagem. 2024;77(4):e20240190
20/09/2024DOI 10.1590/0034-7167-2024-0190
Visualizações0ABSTRACT
Objectives:
to develop a middle-range nursing theory for care in the context of cardiovascular risk.
Methods:
a theoretical development study, through induction through research and ICNP® practice standards, carried out in six stages: concept analysis; ICNP® terminological subset structuring; theory contextualization and purpose; proposition construction; modeling; and assumption construction.
Results:
the Theory of Care in the Context of Cardiovascular Risk has a middle-range scope, describing care, prescribing actions to promote health and reduce cardiovascular risk. Thirteen propositions were constructed in three categories (nursing metaparadigm, central and factorial concepts), two models and 16 assumptions.
Final Considerations:
the theory contributes to the construction of knowledge arising from the nursing process for care in the context of cardiovascular risk, generating propositions, assumptions and modeling, which will enable theoretical testing.
Palavras-chave: Concept FormationHeart Disease Risk FactorsNursing TheoriesStandardized Nursing TerminologyTheoretical ModelsVer mais -
ORIGINAL ARTICLE
Content validity of guidance on self-care in the post-operative period for breast cancer
Revista Brasileira de Enfermagem. 2024;77(4):e20240188
20/09/2024
Resumo
ORIGINAL ARTICLEContent validity of guidance on self-care in the post-operative period for breast cancer
Revista Brasileira de Enfermagem. 2024;77(4):e20240188
20/09/2024DOI 10.1590/0034-7167-2024-0188
Visualizações0Ver maisABSTRACT
Objectives:
to validate the content of a guidance guide on self-care in the postoperative period of breast surgery for breast cancer.
Methods:
a methodological study with content validity, carried out with 15 expert nurses and physiotherapists, between May and July 2022. Recruitment took place from the Lattes Platform, using snowball sampling. The level of relevance and representativeness for each item was verified using the Content Validity Index (CVI). It was considered valid when CVI was equal to or greater than 78% (0.78).
Results:
from the initial total of 37 items, two were excluded, as they had insufficient practical relevance and theoretical relevance, and another five items which, although presenting a CVI lower than the established cut-off, were suggested to be rewritten and grouped with other similar items.
Conclusions:
thirty items were considered valid and demonstrated important and significant characteristics, constituting suitable material for application in clinical practice.
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ORIGINAL ARTICLE
Construction and enhancement of a prototype for a medical-hospital equipment for hypodermoclysis: a qualitative study
Revista Brasileira de Enfermagem. 2024;77(4):e20240059
20/09/2024
Resumo
ORIGINAL ARTICLEConstruction and enhancement of a prototype for a medical-hospital equipment for hypodermoclysis: a qualitative study
Revista Brasileira de Enfermagem. 2024;77(4):e20240059
20/09/2024DOI 10.1590/0034-7167-2024-0059
Visualizações0ABSTRACT
Objectives:
to construct a Subcutaneous Hydration Device semi-functional prototype and gather initial information to improve this prototype design and realize its acceptance potential.
Methods:
a qualitative, descriptive and exploratory study, which used focus group, following the Technology Acceptance Model. The group was held at the Escola Superior de Enfermagem de Coimbra, Portugal, in December 2022, composed of nine participants from six different disciplinary areas, and followed thematic analysis.
Results:
four topics emerged associated with the device components: elastomeric infusion pump; needle/access device; clamp; administration set. From these topics, topics were triggered that highlighted: characteristics about the target population; ease of use and accessories; patient comfort and safety; and device application context.
Final Considerations:
the Subcutaneous Hydration Device semi-functional prototype is viable and interesting for the clinic. The results support its improvement and direct future investments for experimental studies.
Palavras-chave: Equipment and SuppliesHypodermoclysisInfusionsSubcutaneousTechnologyUser-Centered DesignVer mais -
ORIGINAL ARTICLE
Predictor variables effect on the development of Burnout Syndrome in higher education professor
Revista Brasileira de Enfermagem. 2024;77(4):e20240132
20/09/2024
Resumo
ORIGINAL ARTICLEPredictor variables effect on the development of Burnout Syndrome in higher education professor
Revista Brasileira de Enfermagem. 2024;77(4):e20240132
20/09/2024DOI 10.1590/0034-7167-2024-0132
Visualizações0Ver maisABSTRACT
Objectives:
to correlate the development of Burnout Syndrome in higher education professors with the following variables: sociodemographic, economic, work, sleep pattern, level of anxiety and quality of life.
Methods:
observational, analytical, cross-sectional study with a quantitative approach. Data collection took place from August to November 2022, with 140 professors from a private higher education institution in the Western Brazilian Amazon.
Results:
professors who carried out activities outside institutional hours and who had sleep duration < 5 hours, presented lower scores in the personal fulfillment dimension of burnout, with (p=0.002) and (p=0.001), respectively. The higher the scores for the physical (p=0.001), psychological (p=0.000) and social relationships (p=0.002) domains of quality of life, the lower the personal fulfillment scores for the syndrome.
Conclusions:
through linear regression, it was evidenced that several variables explain the development of burnout. Institutional and governmental actions can minimize the negative influence of these variables.
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EDITORIAL
Potential of Artificial Intelligence in Evidence-Based Practice in Nursing
Revista Brasileira de Enfermagem. 2024;77(5):e770501
09/09/2024
Resumo
EDITORIALPotential of Artificial Intelligence in Evidence-Based Practice in Nursing
Revista Brasileira de Enfermagem. 2024;77(5):e770501
09/09/2024DOI 10.1590/0034-7167.2024770501
Visualizações0Evidence-based practice (EBP) has established itself as a fundamental pillar in nursing, driving effective clinical decision-making based on high-quality scientific research. The primary goal of EBP is to ensure that patients receive the most appropriate and safe care, based on the best available evidence. In this context, knowledge synthesis methods are essential tools for EBP, […]Ver mais
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ORIGINAL ARTICLE
Fatores associados ao bem-estar materno em situação de parto de puérperas em Minas Gerais
Revista Brasileira de Enfermagem. 2024;77(6):e20230304
16/12/2024
Resumo
ORIGINAL ARTICLEFatores associados ao bem-estar materno em situação de parto de puérperas em Minas Gerais
Revista Brasileira de Enfermagem. 2024;77(6):e20230304
16/12/2024DOI 10.1590/0034-7167-2023-0304pt
Visualizações1RESUMO
Objetivos:
analisar os fatores associados ao bem-estar materno em situação de parto de puérperas em Minas Gerais.
Métodos:
estudo transversal, aninhado a uma coorte, realizado com puérperas em um município mineiro. Foi adotada a escala Bem-Estar Materno em Situação de Parto 2. Estimaram-se as prevalências do bem-estar materno em situação de parto. A magnitude da associação entre mal-estar materno e práticas assistenciais foi estimada pela Razão de Prevalência (RP), utilizando-se a regressão de Poisson.
Resultados:
participaram 183 puérperas com idade entre 15 e 46 anos, sendo que 26,2%, 27,9% e 45,9% relataram, respectivamente, ótimo, adequado e mal-estar na assistência ao parto. O mal-estar materno foi mais prevalente entre puérperas que passaram por parto cesárea (RP = 1,60) e que não receberam informações sobre amamentação (RP = 1,59).
Conclusões:
observou-se elevada prevalência de mal-estar no parto, associada à realização de cesáreas e à falta de informações sobre amamentação.
Palavras-chave: Assistência ao PartoBem-Estar MaternoHumanização da AssistênciaParto ObstétricoPeríodo Pós-PartoVer mais -
ORIGINAL ARTICLE
The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
16/12/2024
Resumo
ORIGINAL ARTICLEThe nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
16/12/2024DOI 10.1590/0034-7167-2023-0315
Visualizações1ABSTRACT
Objectives:
to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.
Methods:
a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach.
Results:
the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment.
Conclusions:
the study results indicate a relationship between these constructs, with implications for the quality and the safety of care.
Palavras-chave: Complexity AnalysisHealth Facility EnvironmentNursingPatient SafetyQuality of Health CareVer mais -
Recommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
16/12/2024
Resumo
Recommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
16/12/2024DOI 10.1590/0034-7167-2024-0086
Visualizações1Ver maisABSTRACT
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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ORIGINAL ARTICLE
Desafios da prática na segurança do paciente
Revista Brasileira de Enfermagem. 2019;72(6):1504-1511
21/10/2019
Resumo
ORIGINAL ARTICLEDesafios da prática na segurança do paciente
Revista Brasileira de Enfermagem. 2019;72(6):1504-1511
21/10/2019DOI 10.1590/0034-7167-2018-0441
Visualizações0RESUMO
Objetivo:
compreender os desafios da prática profissional para o alcance das metas e objetivos do Programa Nacional de Segurança do Paciente.
Método:
estudo de caso qualitativo, fundamentado na Sociologia Compreensiva, realizado com 31 profissionais do Núcleo de Segurança do Paciente e da equipe de enfermagem, que trabalhavam em um hospital de ensino. A coleta de dados ocorreu entre maio e dezembro de 2015 por meio de entrevistas, observação e análise documental. A análise procedeu conforme as prerrogativas da Análise de Conteúdo.
Resultados:
emergiram três categorias, sendo elas: A realidade prescrita; Os recursos materiais e seus impactos no cuidado; e A realidade relacionada aos recursos humanos.
Considerações finais:
os desafios para a prática profissional segura perpassam pela estrutura física inadequada, insuficiência de recursos materiais e humanos, mas, principalmente, invadem a transição das mudanças no âmbito prescritivo para o real.
Palavras-chave: EnfermagemHospitaisPrática ProfissionalQualidade da Assistência à SaúdeSegurança do PacienteVer mais -
EDITORIAL
Monkeypox: between precision public health and stigma risk
Revista Brasileira de Enfermagem. 2022;75(5):e750501
01/08/2022
Resumo
EDITORIALMonkeypox: between precision public health and stigma risk
Revista Brasileira de Enfermagem. 2022;75(5):e750501
01/08/2022DOI 10.1590/0034-7167.2022750501
Visualizações0The World Health Organization (WHO) is on alert due to an unprecedented Monkeypox outbreak in non-endemic countries, such as Europe, which have been affected recently. Despite the low pandemic potential, the recent SARS-CoV-2 pandemic has contributed to heightened levels of public concern in the face of the threat of new global health emergencies().As of May […]Ver mais -
ORIGINAL ARTICLE
Clinical simulation in teaching Pediatric Nursing: students’ perception
Revista Brasileira de Enfermagem. 2020;73(2):e20180720
30/03/2020
Resumo
ORIGINAL ARTICLEClinical simulation in teaching Pediatric Nursing: students’ perception
Revista Brasileira de Enfermagem. 2020;73(2):e20180720
30/03/2020DOI 10.1590/0034-7167-2018-0720
Visualizações0Ver maisABSTRACT
Objectives:
to comprehend the perception of undergraduate nursing students about learning to care for the child and family through clinical simulation.
Methods:
this is a qualitative research conducted with ten nursing students through semi-structured interviews. Data were analyzed through content analysis.
Results:
data were organized into two categories: “learning a new way to learn,” in which students describe their experiences during the simulation, and “learning a new way to care,” in which they reflect on learning through simulation.
Final considerations:
we believe that clinical simulation practice in teaching should be encouraged because of the benefits it can offer to the students, faculty, patients and their families. However, we recommend further studies to validate scenarios of child and family healthcare.
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ORIGINAL ARTICLE
Health literacy of adults with and without arterial hypertension
Revista Brasileira de Enfermagem. 2019;72(3):646-653
27/06/2019
Resumo
ORIGINAL ARTICLEHealth literacy of adults with and without arterial hypertension
Revista Brasileira de Enfermagem. 2019;72(3):646-653
27/06/2019DOI 10.1590/0034-7167-2018-0366
Visualizações0Ver maisABSTRACT
Objective:
Assess the level of health literacy of adults, with and without hypertension, treated in three basic health units (UBS) in Picos, Piauí.
Methods:
Cross-sectional study conducted with 357 adults. Data were collected using a questionnaire with sociodemographic variables, and literacy was assessed by the Test of Functional Literacy in Adults. Descriptive analysis was performed followed by the association between literacy and exposure variables with Pearson’s chi-squared (X2) test and Mann-Whitney U test.
Results:
Inadequate or marginal health literacy was found in three units investigated (71.5%; 77.8% and 85.2%);. Age and the years of schooling were factors associated with inadequate literacy in adults with hypertension (p<0.0001).
Conclusion:
Inadequate literacy was found in more than 70% of the hypertensive patients investigated. This finding reinforces the need to improve the self-care skills of hypertensive patients, especially the older ones and those with few years of schooling.
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ORIGINAL ARTICLE
Efeito de vídeo educativo sobre cuidados ao recém-nascido no conhecimento de gestantes, puérperas e familiares
Revista Brasileira de Enfermagem. 2022;75:e20201371
10/11/2022
Resumo
ORIGINAL ARTICLEEfeito de vídeo educativo sobre cuidados ao recém-nascido no conhecimento de gestantes, puérperas e familiares
Revista Brasileira de Enfermagem. 2022;75:e20201371
10/11/2022DOI 10.1590/0034-7167-2020-1371
Visualizações0Ver maisRESUMO
Objetivos:
avaliar o efeito de vídeo educativo sobre cuidados ao recém-nascido para o aumento do conhecimento de gestantes, puérperas e familiares.
Métodos:
estudo quase experimental, com avaliação pré-intervenção e pós-intervenção com grupo único. Participaram 58 gestantes, puérperas e familiares atendidos em Unidades Básicas de Saúde e hospital no Ceará, Brasil. Para a análise, utilizaram-se os testes de McNemar e binomial.
Resultados:
após a intervenção, houve aumento na frequência de acertos, passando de 70,82% para 92,97%. A maioria das questões apresentou aumento significativo (p < 0,05) de acertos, com destaque para aspectos sobre: posição para dormir, secagem das roupas, livre demanda do aleitamento materno e o que deve ser evitado (como acessórios no local de dormir e talco na troca de fraldas).
Conclusões:
o vídeo educativo se mostrou eficaz na aquisição de conhecimentos pelos participantes nos cuidados aos recém-nascidos e pode auxiliar nas atividades de educação em saúde realizadas pelos enfermeiros.
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ORIGINAL ARTICLE
Inclusão digital e o uso da internet pela pessoa idosa no Brasil: estudo transversal
Revista Brasileira de Enfermagem. 2020;73:e20200241
06/11/2020
Resumo
ORIGINAL ARTICLEInclusão digital e o uso da internet pela pessoa idosa no Brasil: estudo transversal
Revista Brasileira de Enfermagem. 2020;73:e20200241
06/11/2020DOI 10.1590/0034-7167-2020-0241
Visualizações0Ver maisRESUMO
Objetivos:
Descrever o perfil de pessoas idosas brasileiras que utilizam a internet, o meio de acesso e a finalidade desse uso, e verificar a existência de associação entre variáveis sociodemográficas e aquelas relacionadas ao uso da internet.
Método:
Estudo transversal com idosos brasileiros usuários das redes sociais Facebook e WhatsApp, analisados de modo descritivo, uni e bivariado.
Resultados:
Participaram 384 idosos, em maioria mulheres (52,08%), com idade média de 64,6 anos e que utilizavam a internet para sanar dúvidas de saúde (65,36%). Principais atividades na internet foram ler, ouvir música, jogar, ver vídeos e fotos (37,30%). Principais benefícios apontados são interação (74,5%), aprendizado (19,2%) e entretenimento (19,25%). Houve diferenças estatísticas entre tempo de permanência conectado e variáveis sexo, idade e estado civil.
Conclusão:
Este estudo mostrou características de idosos que utilizam a internet, algo que desperta para possibilidade do uso de tecnologias digitais na otimização dos cuidados em saúde nessa população.
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ORIGINAL ARTICLE
Transitional care from hospital to home for older people: implementation of best practices
Revista Brasileira de Enfermagem. 2020;73:e20200187
02/11/2020
Resumo
ORIGINAL ARTICLETransitional care from hospital to home for older people: implementation of best practices
Revista Brasileira de Enfermagem. 2020;73:e20200187
02/11/2020DOI 10.1590/0034-7167-2020-0187
Visualizações0ABSTRACT
Objective:
to assess the conformity of nursing care concerning best evidence in transitional care from hospital to home for older people.
Methods:
a project to implement best evidence based on the model proposed by the Joanna Briggs Institute in surgical clinic of a university hospital with older people, caregivers or family members, and nurses, between July and August 2019. Eight evidence-based criteria have been audited through interviews, medical records and computerized system, presented in percentages.
Results:
the highest non-compliance rate found in a baseline audit was absence of continued training on transitional care and hospital discharge plan. Identifying barriers to best practices included educational programs; afterwards, there was an improvement in compliance rates in all the criteria assessed.
Final considerations:
the criteria based on audited evidence showed an increase in compliance rates with the strategies implemented, contributing to improving transitional care for older people.
Palavras-chave: Continuity of Patient CareNursingPatient DischargePrimary Health CareTransitional CareVer mais -
REVISÃO
Ambiente da prática de enfermagem na Atenção Primária à Saúde: revisão scoping
Revista Brasileira de Enfermagem. 2020;73(6):e20190479
14/08/2020
Resumo
REVISÃOAmbiente da prática de enfermagem na Atenção Primária à Saúde: revisão scoping
Revista Brasileira de Enfermagem. 2020;73(6):e20190479
14/08/2020DOI 10.1590/0034-7167-2019-0479
Visualizações0RESUMO
Objetivo:
Examinar a evidência científica acerca do ambiente da prática de enfermagem na Atenção Primária à Saúde.
Métodos:
Revisão scoping da literatura, com 3 etapas: 1) uma pesquisa inicial na CINAHL e MEDLINE; 2) uma pesquisa mais ampliada, utilizando as mesmas palavras-chave e termos de pesquisa, nas bases de dados restantes da plataforma EBSCOHost; 3) pesquisa nas referências bibliográficas dos artigos selecionados. Os estudos selecionados foram do período entre 2007 e 2018.
Resultados:
Foram incluídos 19 artigos; a maioria relatou achados do ambiente da prática de enfermagem e resultados para os clientes, para os enfermeiros, para os enfermeiros gerentes e para a eficiência das organizações, na Atenção Primária à Saúde.
Conclusão:
Melhorar o ambiente da prática de enfermagem tem consequências na qualidade dos cuidados de enfermagem, com aumento de resultados para os clientes, para a enfermagem e para a Atenção Primária à Saúde.
Palavras-chave: Administração de Serviços de SaúdeAmbiente de TrabalhoAtenção Primária à SaúdeEnfermagemRevisãoVer mais
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