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ARTÍCULO ORIGINAL08/12/2023
Efecto de la deambulación temprana y la terapia dhikr en el movimiento peristáltico de pacientes sometidos a colecistectomía abierta
Revista Brasileira de Enfermagem. 2023;76:e20220636
Resumen
ARTÍCULO ORIGINALEfecto de la deambulación temprana y la terapia dhikr en el movimiento peristáltico de pacientes sometidos a colecistectomía abierta
Revista Brasileira de Enfermagem. 2023;76:e20220636
DOI 10.1590/0034-7167-2022-0636
Visualizações1RESUMEN
Objetivos:
analizar y determinar el efecto de una intervención que combinó la deambulación temprana y la terapia dhikr sobre la recuperación peristáltica intestinal de pacientes sometidos a colecistectomía abierta.
Métodos:
se utilizó un diseño preexperimental con un grupo pretest y postest. Las muestras incluyeron 15 pacientes sometidos a colecistectomía abierta y seleccionados mediante muestreo intencional. Los datos se recopilaron por medio de fichas de observación del instrumento y se analizaron mediante la prueba de Wilcoxon. La deambulación temprana utilizó el procedimiento operativo estándar en el hospital y la terapia dhikr se realizó durante 10 a 15 minutos, dos horas después de la operación.
Resultados:
la deambulación temprana asociada con la terapia dhikr afectó la recuperación peristáltica intestinal de los pacientes que se sometieron a colecistectomía abierta con anestesia general (Z =-3,442; p=0,001).
Conclusiones:
la combinación de la deambulación temprana con la terapia dhikr puede recomendarse como una intervención para mejorar el movimiento peristáltico intestinal de los pacientes después de una colecistectomía abierta con anestesia general.
Palavras-chave: Anestesia GeneralColecistectomiaDeambulación TempranaEnfermería PerioperatoriaTerapias ComplementariasVer mais
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ARTÍCULO ORIGINAL08/12/2023
Systematization of perioperative nursing care in robotic surgery: instrument validation
- Laís Vilanova Tavares Vitoriano
, - Adriana Carla Bridi ,
- Osnir Claudiano da Silva Junior ,
- Carlos Roberto Lyra da Silva ,
- Thiago Quinellato Louro , [ … ],
- Daniel Aragão Machado
Resumen
ARTÍCULO ORIGINALSystematization of perioperative nursing care in robotic surgery: instrument validation
Revista Brasileira de Enfermagem. 2023;76:e20220666
DOI 10.1590/0034-7167-2022-0666
- Laís Vilanova Tavares Vitoriano ,
- Adriana Carla Bridi ,
- Osnir Claudiano da Silva Junior ,
- Carlos Roberto Lyra da Silva ,
- Thiago Quinellato Louro ,
- Daniel Aragão Machado
Visualizações0Ver maisABSTRACT
Objective:
To develop and validate an instrument to assist in the systematization of perioperative nursing care in robotic surgery.
Methods:
Methodological study developed in four phases: content survey; textual elaboration; content validation by the group of expert judges and target audience; and elaboration of the electronic instrument layout.
Results:
Eleven expert judges and seven evaluators of the target audience participated. For validation, the Content Validity Index (CVI) was used with a 0.78 cutoff point. The instrument total CVI after evaluation was 0.90 by the expert judges and 0.88 by the target audience.
Conclusion:
The tool built was proved satisfactory for the systematization of perioperative nursing care. The instrument construction was based on the updated scientific literature and validated by the expert judges and target audience.
- Laís Vilanova Tavares Vitoriano
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08/12/2023
Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies
- Priscilla de Oliveira Luz ,
- Adriana Almeida de Souza ,
- Gabriella de Andrade Boska ,
- Marilia Mastrocolla de Almeida Cardoso ,
- Bruna de Paula Candido , [ … ],
- Márcia Aparecida Ferreira de Oliveira
Resumen
Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies
Revista Brasileira de Enfermagem. 2023;76:e20220550
DOI 10.1590/0034-7167-2022-0550
- Priscilla de Oliveira Luz ,
- Adriana Almeida de Souza ,
- Gabriella de Andrade Boska ,
- Marilia Mastrocolla de Almeida Cardoso ,
- Bruna de Paula Candido ,
- Márcia Aparecida Ferreira de Oliveira
Visualizações1Ver maisABSTRACT
Objective:
to synthesize evidence from qualitative studies on nursing experiences regarding child and adolescent mental health care in specialized services.
Method:
a systematic review with meta-synthesis of qualitative studies according to JBI guidelines. CINAHL, EMBASE, MEDLINE, LILACS, PSYCinfo, Scopus and Web of Science databases were used. The findings were classified according to the level of reliability and credibility and categorized by similarity between contents.
Results:
229 articles were identified, and five were included in the final sample and organized into the categories: Emotional impact; and Understanding nursing role. The level of evidence found was moderate.
Final considerations:
nursing experiences are permeated by emotional exhaustion, feelings of frustration and difficulty in understanding their professional role. The need for training spaces that qualify this care is highlighted.
- Priscilla de Oliveira Luz
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ARTÍCULO ORIGINAL08/12/2023
La relación entre el nivel de conocimiento y la conducta de prevención del flujo vaginal para estudiantes de enfermería
- Antonia Diti Juniar ,
- Arusta Yohana Simamora ,
- Corry Natasya Parniaty Manalu ,
- Joice Cathryne ,
- Mega Tri Anggraini Setia Ningsih
Resumen
ARTÍCULO ORIGINALLa relación entre el nivel de conocimiento y la conducta de prevención del flujo vaginal para estudiantes de enfermería
Revista Brasileira de Enfermagem. 2023;76:e20220602
DOI 10.1590/0034-7167-2022-0602
- Antonia Diti Juniar ,
- Arusta Yohana Simamora ,
- Corry Natasya Parniaty Manalu ,
- Joice Cathryne ,
- Mega Tri Anggraini Setia Ningsih
Visualizações1Ver maisRESUMEN
Objetivo:
la salud reproductiva de las adolescentes es muy importante. Determinar la relación entre el nivel de conocimientos y la conducta de prevención del flujo vaginal en estudiantes de enfermería.
Métodos:
estudio cuantitativo, transversal, con 155 estudiantes de primer año de una facultad privada de enfermería. Los datos se recopilaron de febrero a marzo de 2022 a través de un cuestionario electrónico.
Resultados:
los participantes con buen nivel de conocimientos correspondieron al 98,1% y los que practican buenas conductas para prevenir el flujo vaginal, el 92,3%.
Conclusión:
un buen conocimiento produce conductas de prevención adecuadas. El resultado de este estudio puede contribuir con reflexiones y referencias para un estudio más profundo de los factores que influyen en el nivel de conocimiento y comportamiento sobre la enfermedad de los genitales y los peligros del flujo vaginal patológico.
- Antonia Diti Juniar
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ARTÍCULO ORIGINAL08/12/2023
Fear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?
- Ana Júlia de Paula ,
- Paulo César Condeles ,
- Jéssica Aparecida da Silva ,
- Luciano Marques dos Santos ,
- Luciana Mara Monti Fonseca , [ … ],
- Monika Wernet
Resumen
ARTÍCULO ORIGINALFear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?
Revista Brasileira de Enfermagem. 2023;76:e20220755
DOI 10.1590/0034-7167-2022-0755
- Ana Júlia de Paula ,
- Paulo César Condeles ,
- Jéssica Aparecida da Silva ,
- Luciano Marques dos Santos ,
- Luciana Mara Monti Fonseca ,
- Mariana Torreglosa Ruiz ,
- Monika Wernet
Visualizações0Ver maisABSTRACT
Objective:
to identify factors associated with fear of COVID-19 among women who experienced pregnancy or childbirth during the pandemic.
Methods:
a cross-sectional study, nested within a prospective cohort, using an online survey, from August 2021 to February 2022, based on descriptive data analysis.
Results:
of the 431 participants, 52.8% were postpartum women and 20.1% were pregnant women. With regard to fear of COVID-19, a mean score of 20.46 was obtained (moderate fear). The highest fear scores were present in women whose newborns were admitted to hospital in neonatal critical units (p=0.032), and the lowest among those covered by supplementary health (insurance) (p=0.016).
Conclusion:
among pregnant and postpartum women, high fear of COVID-19 translated into the possibility of having newborns admitted to hospital in a critical unit. The importance of supporting actions to support pregnant/postpartum women’s mental health in relation to COVID-19 or other threats that may influence the neonatal outcome stands out.
- Ana Júlia de Paula
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ARTÍCULO ORIGINAL08/12/2023
Care for older adults with disabilities in Long Term Care Facility
- Isadora Queiroz Correa Garchet Furtado ,
- Isabela Silva Cancio Velloso ,
- Carolina Salles Galdino ,
- Alexandre de Pádua Carrieri
Resumen
ARTÍCULO ORIGINALCare for older adults with disabilities in Long Term Care Facility
Revista Brasileira de Enfermagem. 2023;76:e20220767
DOI 10.1590/0034-7167-2022-0767
- Isadora Queiroz Correa Garchet Furtado ,
- Isabela Silva Cancio Velloso ,
- Carolina Salles Galdino ,
- Alexandre de Pádua Carrieri
Visualizações0Ver maisABSTRACT
Objective:
to analyze the constitution of care offered to older adults with disabilities, from Long Term Care Facility professionals’ perspective.
Methods:
this is a discourse analysis based on the post-structuralist framework. Participants in this study are professionals involved in the care for older adults, totaling 14 respondents, 13 women and one man.
Results:
from professionals’ perspective, there is a fine line between caring for older adults with disabilities and maintaining their autonomy. Care in which autonomy is restricted predisposes older adults to a process of dependency.
Final considerations:
caring for older adults with disabilities constitutes the challenge between caring and maintaining independence. Thus, older adult-centered care should be taken as a premise so that their individualities are respected.
- Isadora Queiroz Correa Garchet Furtado
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ARTÍCULO ORIGINAL08/12/2023
Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
- Carine Teles Sangaleti ,
- Maicon Henrique Lentsck ,
- Dannyele Cristina da Silva ,
- Andrielli Machado ,
- Maria Regiane Trincaus , [ … ],
- Fernanda Marciano Consolim Colombo
Resumen
ARTÍCULO ORIGINALPolypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
DOI 10.1590/0034-7167-2022-0785
- Carine Teles Sangaleti ,
- Maicon Henrique Lentsck ,
- Dannyele Cristina da Silva ,
- Andrielli Machado ,
- Maria Regiane Trincaus ,
- Maria Cristina Umpierrez Vieira ,
- Bruno Bordin Pelazza ,
- Fernanda Marciano Consolim Colombo
Visualizações0Ver maisABSTRACT
Objective:
to identify the prevalence and associations of polypharmacy and potentially inappropriate medication use among older adults with hypertension treated in primary care.
Methods:
a cross-sectional study carried out with older adults with hypertension treated at a Family Health Strategy unit. Data collection included analysis of medical records, interviews and multidimensional assessment of older adults. Socio-demographic information and clinical variables were collected. Statistical analysis was performed by multiple logistic regression.
Results:
polypharmacy prevalence was 38.09%, and potentially inappropriate medication (PIM), 28.57%. There was a significant association between polypharmacy and PIM use, altered sleep and ethnicity. PIM use was associated with polypharmacy, worse family functioning, and absence of a caregiver. Cognitive decline reduces the prevalence of these medications.
Conclusions:
polypharmacy and PIM use among older adults with hypertension represent a problem in this population, especially among the most vulnerable.
- Carine Teles Sangaleti
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ARTÍCULO ORIGINAL08/12/2023
Social support networks and life cycle stage of Venezuelan immigrant families
- Marcela Possato Correa da Rosa ,
- Gisele Cristina Manfrini ,
- Janaína Medeiros de Souza ,
- Ana Cristina Oliveira da Silva Hoffmann ,
- Rosane Goncalves Nitschke , [ … ],
- Jaime Alonso Caravaca-Morera
Resumen
ARTÍCULO ORIGINALSocial support networks and life cycle stage of Venezuelan immigrant families
Revista Brasileira de Enfermagem. 2023;76:e20220790
DOI 10.1590/0034-7167-2022-0790
- Marcela Possato Correa da Rosa ,
- Gisele Cristina Manfrini ,
- Janaína Medeiros de Souza ,
- Ana Cristina Oliveira da Silva Hoffmann ,
- Rosane Goncalves Nitschke ,
- Ivonete Teresinha Schülter Buss Heidemann ,
- Jaime Alonso Caravaca-Morera
Visualizações0Ver maisABSTRACT
Objective:
To understand the structures of social networks of interiorized Venezuelan immigrant families and the life cycle stage they are in.
Methods:
Qualitative multiple-case study with families from the Interiorization Program residing in the Greater Florianópolis, Brazil. Screening occurred through social networks and key informants. For data collection, the photovoice technique and semi-structured interviews were used, categorized with the help of the Atlas.ti software. Genograms and ecomaps were elaborated.
Results:
Of the 4 families interviewed, totaling 7 members with young children, the nuclear family was identified as the main informal support network. Formal networks included schools, churches, and civil society.
Conclusion:
Families rely heavily on their nuclear structure for support, with formal institutions acting as secondary resources. The predominant life cycle stage is focused on families with young children. More efforts are needed to strengthen formal support networks.
- Marcela Possato Correa da Rosa
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INFORME DE EXPERIENCIA01/01/2018
Clinical and epidemiological teaching of dengue through simulated practice
Revista Brasileira de Enfermagem. 2018;71(2):451-456
Resumen
INFORME DE EXPERIENCIAClinical and epidemiological teaching of dengue through simulated practice
Revista Brasileira de Enfermagem. 2018;71(2):451-456
DOI 10.1590/0034-7167-2016-0503
Visualizações2Ver maisABSTRACT
Objective:
to describe the experience of clinical teaching on dengue and the practice of epidemiological surveillance using problematization methodology.
Method:
report of experience on educational activity with undergraduate nursing students, held in March 2016, at a public university in the city of São Paulo, conceived in four stages: dialogic lecture, active search of Aedes aegypti, case study and simulation of nursing consultation to individuals with dengue.
Results:
The activity allowed to retrieve previous knowledge about the disease, respond to exercises that addressed different clinical situations and epidemiological surveillance, including in situ evaluation of possible mosquito outbreaks, and discuss the need to expand prevention and health of the individual and the community, the impact of the media in the dissemination of cases and the coping difficulties experienced in the different levels of attention.
Conclusion:
the methodology adopted enabled qualified training of students to cope with dengue.
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ARTÍCULO ORIGINAL18/07/2022
Beliefs, knowledge, actions of nursing techniques in breastfeeding in pain management in immunization
- Isadora Trinquinato Rosa ,
- Lisabelle Mariano Rossato ,
- Danila Maria Batista Guedes ,
- Vanessa Dias Fogaça ,
- Flávia Domingues , [ … ],
- Lucía Silva
Resumen
ARTÍCULO ORIGINALBeliefs, knowledge, actions of nursing techniques in breastfeeding in pain management in immunization
Revista Brasileira de Enfermagem. 2022;75(6):e20210546
DOI 10.1590/0034-7167-2021-0546
- Isadora Trinquinato Rosa ,
- Lisabelle Mariano Rossato ,
- Danila Maria Batista Guedes ,
- Vanessa Dias Fogaça ,
- Flávia Domingues ,
- Lucía Silva
Visualizações1Ver maisABSTRACT
Objective:
Understand the beliefs, knowledge, and actions of nursing technicians on breastfeeding as a form of non-pharmacological intervention to relieve pain in newborns and infants during immunization.
Methods:
Qualitative study carried out through semi-structured interviews with nine nursing technicians from three Basic Health Units in a city in the state of São Paulo. The theoretical approach of the Belief Model and the methodological framework of Thematic Analysis supported this study.
Results:
Three themes originated: Beliefs, Knowledge, and Actions of nursing technicians.
Final considerations:
Despite knowledge about the benefits of breastfeeding as the most effective method for relieving pain in newborns and infants during vaccination, their restrictive beliefs overrode the evidence, leading them to act in ways that discourage or prevent the mother from breastfeed during vaccination. Formal training is recommended to align with current evidence-based practices.
- Isadora Trinquinato Rosa
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ARTÍCULO DE REVISIÓN08/12/2023
Educational technologies for accident prevention due to falls in childhood: a scoping review
- Abiúde Nadabe e Silva ,
- Aline Costa de Oliveira ,
- Jefferson Abraão Caetano Lira ,
- Ana Roberta Vilarouca da Silva ,
- Lídya Tolstenko Nogueira
Resumen
ARTÍCULO DE REVISIÓNEducational technologies for accident prevention due to falls in childhood: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20220807
DOI 10.1590/0034-7167-2022-0807
- Abiúde Nadabe e Silva ,
- Aline Costa de Oliveira ,
- Jefferson Abraão Caetano Lira ,
- Ana Roberta Vilarouca da Silva ,
- Lídya Tolstenko Nogueira
Visualizações2Ver maisABSTRACT
Objectives:
to map evidence on educational technology use for accident prevention due to falls in childhood.
Methods:
a scoping review, carried out in October and November 2022, in the MEDLINE, Web of Science, BDENF and CINAHL databases and LILACS bibliographic index. There was no delimitation of language or time. Data were extracted and analyzed descriptively by two independent researchers. The research protocol was registered in the Open Science Framework.
Results:
twenty-six studies were selected. Booklets, pamphlets and leaflets were the most used technologies, presenting health services as the most frequent environment to develop research on fall prevention. The technologies developed were important outcomes: increased knowledge of children, family members, caregivers, health and education professionals.
Conclusions:
educational technology use makes it possible to increase knowledge, adopt safe practices and reduce falls.
- Abiúde Nadabe e Silva
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ARTÍCULO DE REVISIÓN15/03/2024
Resources for health literacy among caregivers of prematurely born children: a scoping review
- Ana Clara Gomes Andrade ,
- Giovanna Barbosa Mendes ,
- Mariana Fuentes Mendoza Rodrigues Soares ,
- Suelen Rosa de Oliveira ,
- Luciano Marques dos Santos , [ … ],
- Elysângela Dittz Duarte
Resumen
ARTÍCULO DE REVISIÓNResources for health literacy among caregivers of prematurely born children: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20230062
DOI 10.1590/0034-7167-2023-0062
- Ana Clara Gomes Andrade ,
- Giovanna Barbosa Mendes ,
- Mariana Fuentes Mendoza Rodrigues Soares ,
- Suelen Rosa de Oliveira ,
- Luciano Marques dos Santos ,
- Elysângela Dittz Duarte
Visualizações1Ver maisABSTRACT
Objectives:
to map the available evidence on resources used to promote health literacy among caregivers of prematurely born children during outpatient follow-up.
Methods:
the Joanna Briggs Institute’s scope review protocol was utilized. The search encompassed six databases, incorporating studies from 2012 to 2022.
Results:
the three included publications revealed that the resources employed are: mobile applications, phone calls, individual counseling, videos, educational pamphlets, and group discussions. Implementing an education protocol during the transition home enhances scientifically grounded health promotion rates.
Conclusions:
there is limited literature addressing the health literacy of these caregivers. The nursing team plays a crucial role in health education and in developing resources applicable to these families.
- Ana Clara Gomes Andrade
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ARTÍCULO ORIGINAL13/01/2024
Social representations of oncologic surgery for patients with cancer
- Rômulo Frutuoso Antunes ,
- Rachel Verdan Dib ,
- Raquel de Souza Ramos ,
- Antonio Marcos Tosoli Gomes ,
- Manassés Moura dos Santos , [ … ],
- Karen Paula Damasceno dos Santos Souza
Resumen
ARTÍCULO ORIGINALSocial representations of oncologic surgery for patients with cancer
Revista Brasileira de Enfermagem. 2024;77(6):e20230273
DOI 10.1590/0034-7167-2023-0273
- Rômulo Frutuoso Antunes ,
- Rachel Verdan Dib ,
- Raquel de Souza Ramos ,
- Antonio Marcos Tosoli Gomes ,
- Manassés Moura dos Santos ,
- Margarida Maria Rocha Bernardes ,
- Carolina Cristina Scrivano dos Santos ,
- Karen Paula Damasceno dos Santos Souza
Visualizações2Ver maisABSTRACT
Objectives:
to analyze the social representations of patients with cancer regarding oncologic surgery.
Methods:
a qualitative study based on Social Representation Theory was conducted with 126 participants between October 2021 and May 2022 in a public hospital in Rio de Janeiro. A characterization questionnaire, free evocations of the inducing term “surgery”, and semi-structured interviews with 60 participants were applied. Data were analyzed using Microsoft Excel® and IRaMuTeQ.
Results:
the central core of the representation is composed of fear, cure, hope, and removing the disease. The analysis of interviews resulted in six classes that highlight the social changes caused by treatment as well as the need for a support network to cope with the surgical process.
Final Considerations:
the representations reflect fear and hope towards the procedure and the desire to remove the disease, thus translating the cure through surgery.
- Rômulo Frutuoso Antunes
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ARTÍCULO ORIGINAL13/01/2024
Nurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
- Camila Wohlenberg Camparoto ,
- Maria do Carmo Fernandez Lourenço Haddad ,
- Elen Ferraz Teston ,
- Pamela dos Reis ,
- Sonia Silva Marcon
Resumen
ARTÍCULO ORIGINALNurses’ 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
- Camila Wohlenberg Camparoto ,
- Maria do Carmo Fernandez Lourenço Haddad ,
- Elen Ferraz Teston ,
- Pamela dos Reis ,
- Sonia Silva Marcon
Visualizações3Ver maisABSTRACT
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.
- Camila Wohlenberg Camparoto
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ERRATUM13/01/2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
Resumen
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
DOI 10.1590/0034-7167.20247706e08
Visualizações2In 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:[…]Ver mais -
ARTÍCULO ORIGINAL29/09/2022
Palliative care production for health professionals in the context of home care
Revista Brasileira de Enfermagem. 2022;75(1):e20210030
Resumen
ARTÍCULO ORIGINALPalliative care production for health professionals in the context of home care
Revista Brasileira de Enfermagem. 2022;75(1):e20210030
DOI 10.1590/0034-7167-2021-0030
Visualizações1Ver maisABSTRACT
Objectives:
to analyze palliative care production developed by health professionals to home care patients.
Methods:
this is an exploratory study, with a qualitative approach, using the transpersonal care theoretical framework. Thirteen interviews were conducted with health professionals and 18 observations were conducted on different cases. Content analysis was performed using MAXQDA©.
Results:
actions performed: maintenance and follow-up measures to people eligible for palliative care, in acts of dialogue and «listening» to caregivers and users, conducting guidelines for the care and self-care process, performing technical procedures, delivery of materials, referrals and medical prescriptions to users.
Final Considerations:
it is perceived the need for advances in the implementation of government policies in Brazil that insert palliative care into the Health Care Network through educational, managerial and care actions that ensure human dignity, thus allowing the development of these and other palliative care interventions.
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