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Interventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
Revista Brasileira de Enfermagem. 2024;77(1):e20230192
08/12/2024
Resumo
Interventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
Revista Brasileira de Enfermagem. 2024;77(1):e20230192
08/12/2024DOI 10.1590/0034-7167-2023-0192
Visualizações0Ver maisABSTRACT
Objective:
To assess the evidence regarding the effectiveness of interventions aimed at strengthening self-efficacy beliefs in college students.
Methods:
Integrative Review conducted on the Lilacs, PubMed, CinahL, Cochrane Collaboration Databases, Scopus, and PsycInfo databases. The methodological quality of the studies was assessed using tools proposed by the Joanna Briggs Institute, and the results were analyzed descriptively.
Results:
Out of the 10 selected studies, six demonstrated that interventions aimed at strengthening self-efficacy were effective (Levels of Evidence II and III), and four revealed contrary results (Levels of Evidence I and II). Programs aimed at enhancing self-efficacy should include content on positive mental health, psychoeducation strategies, cover a period of eight to twelve weeks, and consider the completion of homework assignments.
Conclusion:
The synthesis of evidence pointed to pathways for building an effective self-efficacy strengthening program to be implemented in universities.
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ORIGINAL ARTICLE
Safe practices for bed bathing in the intensive care unit: validation of a checklist
Revista Brasileira de Enfermagem. 2024;77(1):e20230135
08/12/2024
Resumo
ORIGINAL ARTICLESafe practices for bed bathing in the intensive care unit: validation of a checklist
Revista Brasileira de Enfermagem. 2024;77(1):e20230135
08/12/2024DOI 10.1590/0034-7167-2023-0135
Visualizações0Ver maisABSTRACT
Objective:
To validate a checklist for safe bathing in critically ill patients.
Methods:
This is a methodological and quantitative study. Researchers developed a checklist for safe bathing in critically ill patients consisting of 41 items, which were submitted to the apparent and content validation process, evaluated by eleven judges, and interobserver reliability. For reliability analysis, the instrument was applied in 54 bed bath procedures in the ICU; Kappa and CHF tests were used.
Results:
In the apparent and content validation, adjustments were made according to the judges’ suggestions. Kappa values ranged from moderate to almost perfect (0.462 to 0.962), and, in some items, there was 100% agreement; the reliability of the instrument was excellent (ICC = 0.962).
Conclusion:
The instrument proved to be dependable and easy to apply. Its use will contribute to safe bed bathing and subsidize interventions aimed at increasing the quality of care.
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Assessment of knowledge in oncology about care for transgender people: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230532
29/11/2024
Resumo
Assessment of knowledge in oncology about care for transgender people: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230532
29/11/2024DOI 10.1590/0034-7167-2023-0532
Visualizações0ABSTRACT
Objective:
to identify evidence available in the literature on instruments and methodologies used to assess healthcare professionals’ knowledge about cancer care for the transgender population.
Methods:
a scoping review was conducted in seven databases, including studies that answered the question: what is the healthcare professionals’ level of knowledge about cancer care for the transgender population?
Results:
forty-one articles were selected that dealt specifically with healthcare professionals’knowledge in relation to care for the LGBTQIAPN+ population, especially the transgender population. Eighteen studies assessed patients’ perceptions of professionals’knowledge, whereas other studies used their own assessment tools, considering the global context of LGBTQIAPN+ health.
Conclusions:
there is no tested and validated instrument that assesses the knowledge about the transgender population’s oncological health, highlighting the need to construct and validate an instrument focused on this population’s needs.
Palavras-chave: Health Services for Transgender PeopleNeoplasmsOncologyProfessional TrainingTransgender PeopleVer mais -
ORIGINAL ARTICLE
Prevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
22/11/2024
Resumo
ORIGINAL ARTICLEPrevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
22/11/2024DOI 10.1590/0034-7167-2023-0327
Visualizações0Ver maisABSTRACT
Objectives:
to assess pain management during labor.
Methods:
a cross-sectional study was carried out by reviewing medical records and conducting postpartum interviews. Prevalence and effectiveness of analgesia were assessed.
Results:
the prevalence of non-pharmacological analgesia was 61.86% of 215 women in labor in Obstetric Center and 82.51% of 62 in midwife-led unit. Prevalence of severe pain, on the Visual Analogue Scale, before and after non-pharmacological analgesia, was from 92.16% to 64.04% (p=0.00) in Obstetric Center and from 85.96% to 52.63% (p=0.01) in midwife-led unit. Prevalence of pharmacological analgesia in Obstetric Centers was 15.81%, with no variation in severe pain (p=0.57). Patients’ request for analgesia was associated with education (p=0.00) and pain intensity (p=0.02).
Conclusions:
non-pharmacological analgesia improved pain intensity. Prevalence of pharmacological analgesic prescription was lower than that identified in developed countries. Pain management needs to consider the preferences and needs of women in labor.
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ORIGINAL ARTICLE
Safe practices for prevention and management of antineoplastic agent extravasation: development of an educational video
Revista Brasileira de Enfermagem. 2024;77(5):e20240172
22/11/2024
Resumo
ORIGINAL ARTICLESafe practices for prevention and management of antineoplastic agent extravasation: development of an educational video
Revista Brasileira de Enfermagem. 2024;77(5):e20240172
22/11/2024DOI 10.1590/0034-7167-2024-0172
Visualizações0ABSTRACT
Objectives:
to develop, validate, and evaluate an educational video on the prevention and management of antineoplastic agent extravasation, aimed at nursing professionals.
Methods:
this methodological study was developed according to Falkembach’s theoretical framework, which outlines five phases in the production of educational video materials: analysis and planning, modeling, implementation, evaluation, and distribution.
Results:
content validation demonstrated agreement above the minimum threshold stipulated. The overall Content Validity Index was 90.8%, and it was 94.2% among the content and technical evaluation judges, respectively. The target audience evaluated the video positively, highlighting the importance of the content, the clarity of the language used, and the understanding of the information pertinent to the topic.
Conclusions:
the video proved to be an appropriate strategy for instructing interventions on the prevention and management of extravasation, with the potential to improve educational practices among nursing professionals.
Palavras-chave: Antineoplastic AgentsEducational TechnologyExtravasation of Diagnostic and Therapeutic MaterialsInstructional Film and VideoNursingVer mais -
Telenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
22/11/2024
Resumo
Telenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
22/11/2024DOI 10.1590/0034-7167-2024-0093
Visualizações0Ver maisABSTRACT
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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ORIGINAL ARTICLE
Interpersonal violence in the state of Espírito Santo: analysis of mandatory notifications between 2011 and 2018
Revista Brasileira de Enfermagem. 2024;77(5):e20230081
22/11/2024
Resumo
ORIGINAL ARTICLEInterpersonal violence in the state of Espírito Santo: analysis of mandatory notifications between 2011 and 2018
Revista Brasileira de Enfermagem. 2024;77(5):e20230081
22/11/2024DOI 10.1590/0034-7167-2023-0081
Visualizações0ABSTRACT
Objective:
To identify the frequency of notifications of interpersonal violence in Espírito Santo from 2011 to 2018, and the factors associated with this issue.
Methods:
This is a cross-sectional study in which all cases of interpersonal violence from the Information System for Notifiable Diseases in the state of Espírito Santo during the period from 2011 to 2018 were analyzed. Absolute and relative frequencies and 95% confidence intervals were calculated, as well as Poisson regression.
Results:
During the analyzed period, 27,277 cases were reported in Espírito Santo (P: 75%; 95% CI: 74.5-75.4), being more prevalent among females, children, and the elderly, individuals of black/mixed race, people without disabilities, and residents of urban areas. Regarding the perpetrator, there was a higher prevalence of individuals aged 25 years and older, males, with a current or former intimate partner relationship with the victim, and suspected alcohol use at the time of the aggression. In terms of the characteristics of the aggression, there was a higher prevalence of repeat violence, involving a single aggressor, and occurring in the residence.
Conclusions:
The notification of interpersonal violence in Espírito Santo showed a high prevalence and was associated with characteristics of the victim, aggressor, and event. This scenario reinforces the need for interventions such as professional qualification, expansion of intersectoral actions, and reformulation of public policies.
Palavras-chave: EpidemiologyExposure to ViolenceHealth Information SystemsMandatory ReportingViolenceVer 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
Associação entre conhecimento e adesão às práticas de autocuidado com os pés realizadas por diabéticos
Revista Brasileira de Enfermagem. 2020;73(5):e20190430
06/07/2020
Resumo
ORIGINAL ARTICLEAssociação entre conhecimento e adesão às práticas de autocuidado com os pés realizadas por diabéticos
Revista Brasileira de Enfermagem. 2020;73(5):e20190430
06/07/2020DOI 10.1590/0034-7167-2019-0430
Visualizações0Ver maisRESUMO
Objetivos:
verificar a associação entre o conhecimento e a adesão às práticas de autocuidado com os pés realizadas por pacientes com diabetes mellitus tipo 2. Métodos: estudo transversal, descritivo, realizado com 197 pacientes em unidades básicas de saúde localizadas na região Nordeste do Brasil. Para a coleta de dados, foi utilizado um questionário semiestruturado que abordava questões inerentes ao conhecimento e às Atividades de Autocuidado com o Diabetes.
Resultados:
observou-se que os pacientes com conhecimento moderado sobre as práticas de autocuidado tiveram mais chances de realizar autoexame dos pés, secar os espaços interdigitais, hidratar os pés com cremes e óleos, observar a presença de micose e unha encravada, quando comparados aos pacientes com conhecimento insuficiente.
Conclusões:
o nível de conhecimento dos pacientes apresentou estreita relação com as atividades de autocuidado realizadas, o que reforça a importância de o enfermeiro atuar na capacitação daqueles sobre os cuidados essenciais com sua saúde.
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ORIGINAL ARTICLE
Liderança autêntica entre profissionais de enfermagem: conhecimento e perfil
Revista Brasileira de Enfermagem. 2020;73(4):e20180888
18/05/2020
Resumo
ORIGINAL ARTICLELiderança autêntica entre profissionais de enfermagem: conhecimento e perfil
Revista Brasileira de Enfermagem. 2020;73(4):e20180888
18/05/2020DOI 10.1590/0034-7167-2018-0888
Visualizações0Ver maisRESUMO
Objetivos:
identificar o conhecimento dos profissionais de enfermagem sobre modelos de liderança e avaliar o perfil de liderança autêntica entre eles.
Métodos:
estudo analítico, realizado entre agosto e dezembro de 2015, que envolveu 84 profissionais de enfermagem atuantes em um hospital público e terciário. Utilizaram-se dois instrumentos: Questionário Sociodemográfico com questões sobre liderança e o Authentic Leadership Questionnaire.
Resultados:
tanto enfermeiros quanto técnicos de enfermagem desconheciam a liderança autêntica. Ambos apontaram a comunicação, o planejamento e a organização como competências do líder (n = 58, 95%). Referente ao perfil de liderança autêntica, observou-se que o escore foi “alto” entre enfermeiros e “baixo” entre os técnicos. Exercer cargo de liderança e atualizar-se influenciou positivamente o maior perfil de liderança autêntica.
Conclusões:
os enfermeiros demonstraram conhecer a liderança comportamental, enquanto os técnicos de enfermagem mostraram conhecimento sobre a liderança situacional. Os enfermeiros apresentaram escore alto de comportamentos de liderança autêntica, ao passo que os técnicos de enfermagem apresentaram escore baixo, contudo, não se evidenciou diferença significante entre eles. Exercer cargo de liderança e atualizar-se influenciou positivamente o comportamento de liderança autêntica.
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HIV infection in pregnant women and its challenges for the prenatal care
Revista Brasileira de Enfermagem. 2021;74:e20190784
22/01/2021
Resumo
HIV infection in pregnant women and its challenges for the prenatal care
Revista Brasileira de Enfermagem. 2021;74:e20190784
22/01/2021DOI 10.1590/0034-7167-2019-0784
Visualizações0ABSTRACT
Objective:
To analyze the epidemiological profile of HIV infections in pregnant women.
Methods:
Analytical study with a quantitative approach.
Results:
The HIV rate in pregnant women increased from 1.5/1000 babies born alive, in 2010, to 3.3/1000 in 2017. There was a significant association between the prenatal and the variables educational level (p<0.0001), occupation (p=0.0105), gestational age (p < 0.0001), and type of delivery (p < 0.0001). The mean rate of adherence to the antiretroviral treatment in the prenatal was 68.8% (DP = ± 3.7).
Conclusion:
The high rates of HIV detection in pregnant women suggest the need to intensify the health care to women during the prenatal, guaranteeing an integral care, early diagnoses, and enhancing the strategies to improve the adherence to the antiretroviral treatment, aiming to achieve the viral suppression of the mother by the time of childbirth, thus diminishing the risk of a vertical transmission.
Palavras-chave: HIV InfectionsInfectious Disease Transmission, VerticalPregnant WomenPrenatal CarePublic HealthVer mais -
EDITORIAL
Salud mental: enfoque en los profesionales de la salud
Revista Brasileira de Enfermagem. 2020;73:e73supl01
01/06/2020
Resumo
EDITORIALSalud mental: enfoque en los profesionales de la salud
Revista Brasileira de Enfermagem. 2020;73:e73supl01
01/06/2020DOI 10.1590/0034-7167.202073supl01
Visualizações0Es indiscutible que la salud mental es una parte inseparable de nuestra salud y que los temas relacionados con la salud mental han atraído la atención de la población, las instituciones y los administradores, especialmente en este momento de la pandemia de COVID-19. También es cierto que la vida cotidiana de los profesionales de la […]Ver mais -
ORIGINAL ARTICLE
Serious Game e-Baby Família: an educational technology for premature infant care
Revista Brasileira de Enfermagem. 2020;73(4):e20190116
24/06/2020
Resumo
ORIGINAL ARTICLESerious Game e-Baby Família: an educational technology for premature infant care
Revista Brasileira de Enfermagem. 2020;73(4):e20190116
24/06/2020DOI 10.1590/0034-7167-2019-0116
Visualizações0Ver maisABSTRACT
Objectives:
to develop and assess the serious game e-Baby Família with parents of premature infants.
Methods:
a methodological study regarding the development of the serious game, with participatory design in scope definition, starting from parents’ learning needs about premature infant care. A qualitative approach was performed in the assessment stage with parents, with content analysis of the speech of the eight participants.
Results:
the following categories emerged: Realistic appearance of the virtual setting and game content and Gameplay implications for the use of e-Baby Família. The game was satisfactorily assessed regarding content, appearance and dynamics use, motivating participants to learn.
Final Considerations:
in the context of prematurity as a public health problem in Brazil and the need to strengthen family health education for care, the serious game was assessed as motivating and appropriate for health learning.
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ORIGINAL ARTICLE
Spirituality and religiosity for the transcendence of the elderly being
Revista Brasileira de Enfermagem. 2019;72:259-265
05/12/2019
Resumo
ORIGINAL ARTICLESpirituality and religiosity for the transcendence of the elderly being
Revista Brasileira de Enfermagem. 2019;72:259-265
05/12/2019DOI 10.1590/0034-7167-2018-0840
Visualizações0Ver maisABSTRACT
Objective:
to understand the life experiences that favor transcendence of the elderly being.
Method:
a qualitative phenomenological hermeneutic study, in two groups of elderly coexistence. The selection of participants was by intentional sampling: 11 elderly, achieving theoretical saturation. Data collection was carried out through a phenomenological interview with a detonating question. Ethical principles of the General Health Law in health research were fulfilled. Analysis with Heideggerian hermeneutic circle was performed.
Results:
unity of meaning on the consciousness of a higher power for transcendence is highlighted, where spirituality and religiosity are resources of the elderly for strength, feel protected, overcome difficult situations and reach fullness; both favor the understanding of their historicity by manifesting enlightenment.
Final considerations:
transcendence of the elderly being is favored with spirituality and the experiences of their daily life are imbued with a spiritual and religious relationship that give meaning to their existence.
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ORIGINAL ARTICLE
Construção e validação de vídeo educacional para vacinação contra o papilomavírus humano
Revista Brasileira de Enfermagem. 2020;73(4):e20180900
18/05/2020
Resumo
ORIGINAL ARTICLEConstrução e validação de vídeo educacional para vacinação contra o papilomavírus humano
Revista Brasileira de Enfermagem. 2020;73(4):e20180900
18/05/2020DOI 10.1590/0034-7167-2018-0900
Visualizações0Ver maisRESUMO
Objetivos:
validar um vídeo educacional direcionado à adesão da vacinação contra o papilomavírus humano.
Métodos:
estudo metodológico, em que se identificou o conhecimento sobre a temática e a tecnologia a ser construída em seis grupos focais; organizou-se um referencial teórico e levantou-se os vídeos existentes. Após, seguiram-se os estágios de pré-produção, produção e pós-produção. Na validação de conteúdo, participaram 22 especialistas e, na de aparência, dez adolescentes, dez mães, dez professores e dez profissionais da área de audiovisuais. Calculou-se frequência absoluta, Teste Binomial e Content Validity Index.
Resultados:
a concordância foi satisfatória na maioria dos itens. Quanto à relevância, 20 itens tiveram índices acima de 0,80 entre os juízes. A avaliação foi positiva entre meninas e mães. Apenas três itens apresentaram índices menores que 0,80 entre os professores e profissionais de vídeo.
Conclusões:
o vídeo educacional foi validado, conferindo credibilidade para contribuir nas ações educativas e melhorar os índices vacinais.
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ORIGINAL ARTICLE
Envelhecimento, sexualidade e cuidados de enfermagem: o olhar da mulher idosa
Revista Brasileira de Enfermagem. 2019;72:71-78
05/12/2019
Resumo
ORIGINAL ARTICLEEnvelhecimento, sexualidade e cuidados de enfermagem: o olhar da mulher idosa
Revista Brasileira de Enfermagem. 2019;72:71-78
05/12/2019DOI 10.1590/0034-7167-2018-0015
Visualizações0Ver maisRESUMO
Objetivo:
analisar a percepção da mulher idosa sobre sexualidade e a prática do cuidado de enfermagem nesse contexto.
Método:
estudo qualitativo descritivo. Foram entrevistadas 50 mulheres idosas de Guanambi – Bahia, em 2016. A técnica de coleta de dados foi a entrevista direta com utilização de um roteiro não estruturado. Foi feita a análise de conteúdo semântica descrita, e foram levantadas duas categorias empíricas: o olhar da mulher idosa sobre o cuidado de enfermagem na promoção da saúde sexual e na vivência da sexualidade na terceira idade; o processo do cuidar de enfermagem no contexto do envelhecimento da mulher.
Resultados:
notou-se que as idosas têm receio de falar sobre sexualidade, principalmente com os profissionais da saúde. Pelas próprias influências da sociedade, muitas vezes excluem essa temática do cuidado da saúde da mulher idosa.
Considerações finais:
ressalta-se que mudanças devem ser pensadas sobre a assistência prestada no que cerne à sexualidade.
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