924 resultados para Nursing Evaluation Research
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The aim of this dissertation is to develop a theory on intercultural caring to deepen the understanding of caring between nurses and patients who have different cultural backgrounds. The research questions are: 1) What is intercultural caring? 2) How is intercultural caring described and understood? 3) How is intercultural caring described and understood in a maternity care context from the patients’ perspective? 4) What is the substance in a theory on intercultural caring? 5) What is the substance in a theory on intercultural caring in maternity care from the patients’ perspective? The theoretical perspective is based on caritative theory and the caring science-tradition (Eriksson, 2001, 2002) and has a hermeneutic approach. In the first study, 19 texts of Campinha-Bacote, Kim-Godwin, Leininger and Ray are analysed through content analysis. A model for intercultural caring is then created abductively. The second study is a metasynthesis of 40 studies on intercultural caring in maternity care research. The third study is a focused ethnography, in which 17 immigrant mothers are interviewed and observed. The theory on intercultural caring is created through a hermeneutic synthesis of the three studies. A synthesis of the studies with a maternity context results in five patterns of interpretation: the experience of caring is related to power; the family is always present; childbearing and change of culture can give women multiple vulnerabilities; both the mother and the nurse change when they meet; conflicts can cause change. The theory and patterns of interpretation consolidate into a contextual theory on intercultural caring for clinical maternity praxis. In this theory, caring consists of four dimensions: universal, cultural, contextual, and unique caring, which permeate each other. Universal caring is nondependent of time and space. Cultural caring considers the cultural background, the acculturation and the equality of each mother. In the maternity care culture, cultural competence, cultural safety, and acculturation of the nurse are emphasised. Contextual caring considers the specific cultural features of the childbearing mother. In this respect, the nurse is expected to be an expert and to clarify cultural assumptions in maternity care. In unique caring, the mother expects good communication, respect for the family, goodwill and somebody who cares for her and meets her needs, in order for trust to be built. In this respect, the nurse listens to the woman’s narrative, is flexible, open, courageous, and non-judgemental. The nurse shows an understanding for the life situation of the woman, and strives for continuity to preserve the care relationship. It was found that external circumstances affect intercultural caring. Moreover, intercultural caring is expected to decrease misunderstandings and conflicts, alleviate suffering and promote health and life. The theory adds knowledge to the phenomenon of intercultural caring for the nursing and caring sciences, and for the nursing care of patients with other cultural backgrounds than the nurses. The theory can be used in nursing, education, research and administration.
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This study investigates societal effectiveness of transport sector’s Research & Development (R&D) operations. In this study effectiveness refers to organization’s capability to produce the intended and desired impacts through its operations. The aim of this study is to identify the motives for evaluating societal effectiveness and recognize the critical success factors for improving effectiveness. The theoretical framework focuses first in the policy context of effectiveness evaluation in public sector and secondly the framework introduces the concept and process of effectiveness evaluation. The empirical part is carried out as a case study, which investigates societal effectiveness of Finnish Transport Agency’s (FTA’s) R&D. The aim is to recognize FTA’s critical success factors for improving R&D operations’ societal effectiveness. Based on these factors, the organization is able to define indicators for measuring effectiveness in the future operations. In this study societal effectiveness is investigated from R&D purchasers’ and R&D end- users’ points of views according to Purchaser-Provider-model. The results indicate that societal effectiveness evaluation is important part of R&D operations, but the implementation of the evaluation as part of daily operations is challenging. Because of limited resources, the organization is forced to strong priorization and therefore R&D tasks are secondary after the operational tasks. Based on the results the critical success factors can be recognized as resources and priorization, clear strategy and objectives, internal communications, cooperation between public and private sector and R&D implementation and dissemination.
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Hyvän syntymän hoidon tavoitteena on turvata synnyttäjän paras mahdollinen terveys, vähentää tarpeetonta puuttumista synnytyksen kulkuun ja mahdollistaa voimaannuttava synnytyskokemus perheelle. Hyvä syntymän hoito ja siihen liittyvä kätilöiden kliinisen hoitotyön osaaminen ei voi kehittyä, ellei hoitotyön käytäntöjä tutkita. Suomalaista hoitotieteellistä syntymän hoitoon liittyvää tutkimusta on vähän. Tämän tutkimuksen tarkoituksena oli kuvata synnytyksen ponnistusvaiheen hoidon käytäntöjä Suomen synnytyssairaaloissa. Lisäksi seurantatutkimuksen avulla selvitettiin, miten ensisynnyttäjät kokivat synnytyksen ponnistusvaiheen, sen aikana saamansa hoidon, ensisynnyttäjien synnytyskokemusta, kivun kokemista, vointia kolmena päivänä synnytyksen jälkeen sekä heidän seksuaaliterveyttään ensimmäisen vuoden aikana synnytyksen jälkeen. Tutkimuksen tavoitteena oli tuottaa tietoa, jonka avulla voidaan kehittää synnytyksen ponnistusvaiheen hoitoa ja lisätä tietoa synnyttäneiden naisten voinnista ja seksuaaliterveydestä. Tutkimuksen ensimmäinen osio toteutettiin poikkileikkaustutkimuksena (2009), johon osallistui Suomen synnytyssairaaloiden synnytysosastoilla työskentelevät kätilöt (N = 662). Tutkimuksen toinen osio toteutettiin seurantatutkimuksena (2009−2011), jossa oli neljä mittausajankohtaa: kolmantena päivänä synnytyksestä sekä kolmen, kuuden ja kahdentoista kuukauden kuluttua synnytyksestä. Tähän osioon osallistui spontaanisti alateitse yhden elävän lapsen (pää tarjoutuvana) synnyttäneet ensisynnyttäjät (N = 453) ja sikiön perätilan vuoksi suunnitellusti keisarileikatut ensisynnyttäjät (N = 84). Aineisto analysoitiin tilastollisin menetelmin. Tutkimustulosten mukaan osa kätilöiden käyttämistä synnytyksen ponnistusvaiheen hoitokäytännöistä ei ole näyttöön perustuvia. Synnytyssairaalan synnytyksen hoidon kulttuuri näyttää siirtyvän mallioppimisen kautta. Ensisynnyttäjät kokivat synnytyksen ponnistusvaiheen hoidon pääsääntöisesti myönteisenä. Alateitse synnyttäneillä ensisynnyttäjillä oli myönteisempi synnytyskokemus ja vähemmän kipua heti synnytyksen jälkeen ja kolmena synnytyksen jälkeisenä päivänä verrattuna keisarileikkauksella synnyttäneisiin ensisynnyttäjiin. Alateitse synnyttäneillä ensisynnyttäjillä kipu ja ompeleet eivät vaikuttaneet haitallisesti vastasyntyneen hoitoon tai imetykseen niin paljon kuin keisarileikkauksella synnyttäneillä ensisynnyttäjillä. Välilihan leikkaus-, repeämä- tai keisarileikkaushaavat olivat täysin parantuneet suurimmalla osalla naisista kolmen kuukauden kuluttua synnytyksestä. Yleisimpiä naisten kokemia oireita ensimmäisen vuoden aikana synnytyksestä olivat emättimen kostumisen vaikeus, yhdyntäkivut, peräpukamat sekä arpikudoksen kipu ja kiristys. Sukupuolinen halukkuus ja tyytyväisyys seksielämään olivat huonompaa ensimmäisen vuoden aikana synnytyksestä verrattuna aikaan ennen raskautta ja synnytystä. Synnytyksen aikaisella hoitotyöllä ja näyttöön perustuvalla synnytyksen ponnistusvaiheen hoidolla on suuri merkitys naisen synnytyskokemukseen, synnytyksen jälkeiseen vointiin ja seksuaaliterveyteen.
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Die Diskussion in den Planungswissenschaften beschreibt den Paradigmenwechsel vom so genannten DEAD-Model (Decide-Announce-Defend) zum Tripple-D-Model (Dialogue-Decide-Deliver) und beschäftigt sich intensiv mit dem Thema Governance. Komplexe Planungsaufgaben brauchen eine Vielfalt an Lösungsideen unterschiedlicher gesellschaftlicher Gruppen. Planung verfolgt u. a. die Umsetzung der Ziele einer nachhaltigen Entwicklung, die die Einbeziehung der Öffentlichkeit (Zivilgesellschaft, Unternehmen und Bürger) verlangt. Darüber hinaus wird eine Erweiterung der Perspektive über Verfahren und Steuerungsformen hinaus auf Akteure und Prozesse gefordert. Räumliche Entwicklungen sollen stärker im Zusammenhang mit Entscheidungsfindungsprozesse untersucht werden. Die Dissertation ergänzt eine wirkungsorientierte Perspektive, die Wirkungen, sowohl räumliche als auch soziale, in den Mittelpunkt der Betrachtung stellt. Sie stützt sich auf Beobachtungen, dass klassisches Projektmanagement für erfolgreiche Planungsprozesse nicht ausreicht, sondern zusätzlich Prozessmanagement braucht. Mit der Weiterentwicklung der partizipativen Planung, die zusätzlich in den Kontext gesellschaftlicher Lernprozesse und zukunftsfähiger Veränderungen gesellschaftlicher Bedingungen gestellt wird, ergänzt die Dissertation planungswissenschaftliche Theorien. Aus einem fachübergreifenden Blickwinkel wird die räumliche Planung in die Reihe von Management- und Organisationswissenschaften eingeordnet. Ausgehend von der Frage, welche räumlichen und sozialen Wirkungen durch Beteiligungsprozesse unter welchen Bedingungen erzielt werden, wurden Fallstudien aus der Wasserwirtschaft und ihre Prozessbiografien umfassend evaluiert. Als Evaluierungsmethode wurde ein von der EU-Kommission empfohlener Evaluierungsrahmen gewählt, der sowohl den Prozess selbst, seine Rahmenbedingungen und Durchführung, als auch Wirkungen analysiert und bewertet. Auf der Grundlage der Ergebnisse und theoretischer Erkenntnisse, vorrangig aus der Evaluationsforschung, wird ein umfassender Beteiligungsansatz konzipiert. Dabei handelt es sich um ein offenes Gerüst, in das sich bewährte und innovative Elemente strategisch gezielt integrieren lassen. Die Struktur verbindet verschiedene Beteiligungswerkzeuge unterschiedlicher Intensitäten und für unterschiedliche Zielgruppen zu einem Gesamtkonzept, mit dem Ziel, möglichst die gewünschten Wirkungen zu erreichen. Wesentlich an dem Ansatz ist, dass bereits das Prozessdesign unter Mitwirkung von Projektträgern, Beratern und Schlüsselakteuren erfolgt. Die partizipative Beteiligungsplanung bedeutet somit Klärung der Vorgehensweise und gleichzeitig Bewusstseins- und Kompetenzerweiterung der verantwortlichen Akteure. Im Ausblick werden künftige Forschungsaufgaben im Bereich der Mitwirkung in der räumlichen Planung formuliert und Handlungsmöglichkeiten aufgezeigt, um Partizipation als Teil planerischer „Alltagskultur“ weiterzuentwickeln. Dies erfolgt vor dem Hintergrund der Bedeutung von Partizipation und Bildung als Umsetzungsstrategie von Ideen der Landschaftsentwicklung und Nachhaltigkeit.
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Aplicar el método PERT a la función directiva en educación. Explica el proceso de elaboración de un grafo, el cálculo del método PERT y las etapas necesarias en dicho método, analiza la teoría del grafo y su descomposición en niveles y estudia el establecimiento de un programa de investigación. 1) El método PERT es un nuevo instrumento de planificación y control iniciado en América por el almirante W. F. Raborn para los programas Fleet Ballistic Missile (FBM) comúnmente conocidos como sistemas de proyectiles Polaris. 2) El equipo investigador constituido en 1958 le dió el nombre de Program evaluation research task (PERT) que más tarde se cambió por el de Programa evaluation and review technique. 3) El método PERT es una nueva técnica de planificación y control provista de aditamentos cuantitativos. Su fundamento es la red o grado, es decir, la gráfica para representar las operaciones necesarias para alcanzar un objetivo. 4) El grafo o red pert es una evolución del diagrama de barras llamado también diagrama de GANTT por ser este el nombre del iniciador de ese sistema. En dicho sistema las actividades se representan por barras en serie, ya que no comienza una actividad hasta que la anterior ha sido terminada. 5) Sin embargo, los diagramas no ponen de manifiesto la interdependencia de varias actividades, ni determinan el progreso de un proyecto cuando una barra representa un período largo de tiempo. Para cubrir esta dificultad se ideó el diagrama de etapas que descompone las barras en períodos de tiempo más pequeños, representando cada uno de ellos un acontecimiento del trabajo que representaba la barra completa. 6) No obstante, el diagrama de etapas no puede subsanar la primera dificultad del diagrama de barras, es decir, la interdependencia entre barras o etapas. Para ello, se necesita un elemento que una las etapas, y este elemento son las flechas. Así las etapas se transforman en acontecimientos y las flechas representan las actividades o tareas, y el resultado es el grafo. 7) Al ser la base de la planificación el grafo, pueden representarse mediante él, las relaciones existentes en los trabajos que el director escolar debe realizar para alcanzar los objetivos de su proyecto. Aunque para ello se necesita primeramente determinar las actividades que requiere la consecución de los objetivos. . El método PERT puede ser útil en la dirección por tres razones: 1) Hay una continua necesidad de comprobar la eficacia de las operaciones a través de controles más rápidos, directos y unidos y especialmente ver los resultados tangibles de las inversiones en la procesación de los datos. 2) La dirección desea comprobar su capacidad para detectar problemas en curso a largo plazo, discutir las desviaciones sufridas e intentar prevenir sus futuras consecuencias. 3) Los directores se enfrentan con la necesidad de reducir el tiempo y el coste de los programas de desarrollo. Es totalmente necesario que el director establezca un plan de sus actividades durante el curso.
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Aquesta tesi pretén respondre a la pregunta: Què pot fer la infermeria d'atenció primària i què és el què fa, en els problemes del peu en persones amb diabetis tipus 2 a Catalunya?. L'estat del tema exposa la importància de les complicacions en el peu i la possibilitat de reduir-les amb un paper rellevant de la infermeria d'atenció primària. La investigació s'ha centrat en conèixer de què disposa, les activitats que desenvolupa, i què li manca a la infermeria per desenvolupar el seu potencial. Els resultats observats són representatius i mostren clares desigualtats assistencials entre centres, regions sanitàries i tipus de gestió. Suggerint que en l'atenció primària convé organitzar i coordinar l'atenció als problemes del peu en la diabetis, millorar la formació i la capacitació infermera en el tema, fomentar i optimitzar la presència de professionals especialitzats, i potenciar l'educació en diabetis i la promoció de la salut.
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O estudo tem como objetivo elaborar um instrumento de avaliação da efetividade do FUNDEC - Fundo de Desenvolvimento Comunitário, programa instituído pelo Banco do Brasil S. A. em 1981, hoje sob a condução da Fundação Banco do Brasil. Trata-se de pesquisa metodológica, uma vez que pretende construir um instrumento de captação da realidade. A estratégia da pesquisa consistiu, basicamente, na elaboração de quesitos que possibilitassem comprovar ou não o desenvolvimento das comunidades onde o FUNDEC atua. O estudo considerou como mais importantes os atributos relacionados à melhoria das condições de vida das populações atendidas pelo Programa, dando maior ênfase aos aspectos referentes ao aperfeiçoamento da prática participante. As dimensões, os indicadores e as variáveis de avaliação foram determinados a partir de pesquisa exploratória junto a comunidades atendidas pelo Programa. O instrumento de pesquisa elaborado foi aplicado na comunidade de Boaventura, localizada no município de Itaperuna, estado do Rio de Janeiro.
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No Brasil, na última década, vários programas de transferência de renda foram implantados, mas os níveis de pobreza não têm diminuído na mesma proporção do aporte de recursos investidos nos programas. Verifica-se, especialmente, a falta de coordenação entre poderes governamentais, entre órgãos gestores, financiadores e executores de políticas públicas. O programa Cheque Cidadão, dado ao grande volume de recursos distribuídos e à participação de instituições religiosas na seleção e distribuição de benefícios, foi objeto de inspeção realizada pelo Tribunal de Contas do Estado do Rio de Janeiro (TCERJ), em Campos dos Goytacazes em setembro de 2004. No ano de 2002, foi tema de pesquisa realizada pelo Instituto de Estudo do Trabalho e Sociedade (IETS), que visava conhecer o programa em seus processos e impacto junto ao público beneficiário. Este trabalho visa à contextualização destes dois eventos nos paradigmas da Nova Gestão Pública (NGP) com indicadores de desempenho de eficiência, eficácia, efetividade e eqüidade, esperando inserir o TCE-RJ no campo das Auditorias Operacionais, e favorecendo a avaliação de políticas públicas como uma forma de contribuição para corresponder à crescente demanda social por um governo orientado para resultados.
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Objective: To evaluate the implementation of the Family Health Strategy (FHS) in Brazilian cities of the Northeast, expanding coverage, analyzing the progress, challenges and innovations. Methods: Multicentric Evaluation Research, Studies Baselines in urban centers, using as a case study method. Selected cases of Aracaju, being capital, advanced coverage with extended team, and Fortaleza, capital coverage incipient and minimal staff. In Fortaleza, purposive sample of 11 Units Primary (APS), 03 managers, 53 professionals and 109 users. In Aracaju, 09 units of APS, 02 managers, 36 professionals, and 90 users. Structured interviews for managers, and structured to professionals and users. Descriptive analysis focusing on the political and institutional dimensions, organization and comprehensive care. Results: There was consensus that the ESF is the preferred port users and acts as inducing changes in care. In the case of Fortaleza, the specificities were: care protocols and community activities aimed at chronic conditions (100%) , with greater participation of doctors and nurses (93%) ; conjunction with more complex services, but the teams reported difficulties with the examination center and experts, the long waits and poor access to local services were the main difficulties reported by users., As innovative practice, the therapeutic group of elderly caregivers mentioned by respondents; There was intersectoral initiatives and teams 87 % of users have participated in meetings about health problems. In the case of Aracaju, care protocols were directed to the lines of care and formulated locally, 85 % coverage of the population with FHS counterpart local financing; employees hired by public tender; 70 % of teams with expertise in public health center for continuing education acting; democratization in management; access technologies, welcoming and computerization in different integrated networks, and evaluation matrix. Conclusions: The ESF has promoted access to health care and inclusion of disadvantaged populations. Different perceptions and practices in the organization of care, with distinct trajectories of reorganization. In the case of Fortaleza, predominance of model programs valuing older, with evidence of advances in care practices and teamwork, but restricted to primary care practices and incipient in public policy perspective. In Aracaju, had network integration with technologies related to the family, in which the ESF is consolidated as public policy. It can be argued that the XII APS expanding coverage, exhibited efficacy, despite the challenges inherent to the different degrees of implementation
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Comprehending social representations of users relatives of Psychosocial Care Centers (CAPS) from Natal-RN, about their participation in the activities of these services, was the purpose of this study. The research instrument used was a semi-structured interview, led to 28 relatives of users of East and West CAPS II, East and North CAPS-ad, involved in the Relative Therapeutic Group, in Relative Meeting, in the Assembly of Users, Technicians and Relatives, according to the therapeutic schedule of each health services, between August to November 2007. Data obtained in family and users identification were characterized with the aid of charts and boards in absolute and/or percentage values. The discursive material from the guide from interviews was submitted to the informational resource ALCESTE (Analyse Lexicale par Contexte d'un Ensemble of Segments of Texte), and analyzed on the basis of the Theory of Social Representations and Central Nucleus Theory. Most of the relatives were women, married, aged over 50 years, who participated for more than two years in CAPS activities, and a coexistence of more than 11 years with the user. From the classification system of ALCESTE were selected categories, identified by: Category 1, Treatment Improvements and Expectations; Category 2, Living User Before and After; Category 3, Activities Relevance, Contradictions and Suggestions; Category 4, Guidelines -- Psychopharmacology and Medicalization; Category 5, Family Participation and Activities; and Category 6, Therapeutic Conditions Thanks, Tips and Vulnerability. The social representation of the family exists in the desire for change, identifying that we need to promote change by the continuity of therapeutic activities and overcome the detected inconsistencies, targeted by strengthening and by the stability of improvements in living and health conditions of users, experienced in CAPS treatment. The central nucleus had corresponded to positive changes in health and living conditions of users, and the peripheral elements were constituted by family conducts before and during treatment, and the expectations of changes in activities, especially in workshops. Despite this family participation be considered important, it still does not meet conditions to promote the inclusion of family, under an emancipating point of view, capable of causing in subject the hope for autonomy, initiative, individual and collective growths, a closer and active involvement in therapeutic activities, in workshops and discussions
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The studies paths in the maze: life story of individuals with oncological diseases into use of blood transfusion in Natal has the hemotherapy as a primordial procedure to review the relationship between users of oncological health and the due ramifications. The hemotherapy looks for supply the organic needs through blood transfusion, which acquires vital function to the ones that have cancer, because it might reestablish the functionality of the organism throughout the raising of blood components. The impact over the transfusion affects emotionally and physically the users life. Aiming to reflect on these impacts, this study tried, through narratives of lives, rescue their experience since their knowledge of the disease until the time of blood transfusion using. It s about an exploratory-descriptive study, where the qualitative approach uses the theoretical-methodological reference of the oral life history to analyze a colony consisting of five users of health diagnosed with cancer, with achievement of at least three blood transfusions, the clinic Núcleo de Hematologia e Hemoterapia - UFRN, in Natal-RN. The network, in turn, was composed by employees of both sexes, regardless of age, who voluntarily agreed to participate in the study. The data collection, with approval of the Ethics Committee in Research, Liga Norte Riograndense Contra o Cancer, on the number 001/001/2012, occurred through semi-structured interviews, recorded individually in the home context that was previously chosen by employees. The methodological procedure occurred with the transcription of the interviews and their transcreations, and analysis of reports by thematic content analysis. At the reading orientation and interpretation of the employees stories, were discussed three categories of analysis: the impact on psychological REVIEW; impact on socialization and group membership, the environment and the impact of blood transfusion on treatment. Based on the narrative of the life histories of employees, we conclude that the experiences and feelings, hope and sorrow, pain and faith, even when facing a disease like cancer, bring lots of teaching and learning to health professional that deposits humanization health and reinstate hemotherapy forms of clinical critical
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The present work aimed the elaboration of an environmental study focused on the hotel sector in order to present an analysis of the environmental aspects of Ponta Negra Beach, in Natal, RN, Brazil and also the aspects of the small and medium hotels existing in this area. By means of this work, it is possible to elaborate a model of a simplified System of Environmental Management which can attend to the exigencies required by NBR ISO 14001: 2004, as well as to present economical viability and possibility to be implemented in a way that hotels may converge to the sustainable environmental development of the tourism in Ponta Negra Beach. The research methodology presents itself divided into three items: execution of the environmental characterization of Ponta Negra Beach, by way of technical visits and interpretation of satellite images and cartograms of the main environmental characteristics of the region; execution of the work already made concerning the development, application and interpretation of the evaluation of the environmental aspects of each hotel, considering the hotels and the period of data collection, these used in evaluation, research instrument and a description of the procedure utilized for the analysis of the collected data and the utilized methodology for the elaboration of a model of a simplified System of Environmental Management. In a general way, it has been concluded that the practices executed by hotels in Ponta Negra Beach are impact-like and harmful to the environment. The simple implementation of analysis procedures and control of the environmental aspects could suggestively contribute to the reduction of environmental impacts promoted by the hotel section at this beach and in the nearby areas. It had been noticed that the study contributed to the sensitization of managers concerning the environmental problems since, in many other times, the detected problem was, in fact, the non-acquaintance about the environmental aspects and impacts from those hotels administrators, because of the lack of surveys and studies about the theme. It had also been noticed the arousing of a possible environmental attitude from some managers
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O objetivo desta investigação foi elaborar e experimentar procedimentos avaliativos que buscaram acessar as aprendizagens propiciadas em aulas de Educação Física que se valeram de matérias televisivas. A metodologia utilizada foi a pesquisa-ação. Concluiu-se que os alunos aprofundaram sua percepção e entendimento sobre o tema desenvolvido nas aulas (exclusão/discriminação); que as estratégias utilizadas contemplaram uma avaliação integrada ao processo de ensino e aprendizagem; e que o uso da matéria televisiva escolhida deu-se de forma integrada ao processo, caracterizando-se como imprescindível para o seu desenvolvimento.
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The study aims at exploring the experience of the patients suffering from high blood pressure, analysing the difficulties they evoke and trying to generate similarities. It is a qualitative study, based on the phenomenological method. The interviews highlight the fact that the patients are preoccupied only by the symptoms of high blood pressure. They also show that all the patients live through the disease with a lot of emotions, with feelings of frustration, stress, anxiety and helplessness. A better understanding of the patients' experience must enable the nurses to have better targeted actions.
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Incluye Bibliografía