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J Adv Nurs ; 79(11): 4356-4364, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37358005

RESUMO

AIM: To assess the servant leadership behaviour of head nurse and its linkage with nurse work engagement in China. DESIGN: A cross-sectional study. METHODS: A anonymous investigation with the stratified cluster randomized sampling of nurse was conducted in Hunan Province of China in December 2020. We administered the Perceived Head Nurse Service Leadership Behaviour Scale and the Chinese version of Utrecht work engagement scale to survey, and analyse its relationships by multiple linear regression. RESULTS: A number of 890 nurses participated in this study. The average score of the perceived servant leadership of head nurse reported by nurses was 78.90 ± 14.04, which was at a medium level. Among its six dimensions, the dimension of promote nurse development scored highest (16.04 ± 2.84), while the dimension of dedication scored lowest (11.39 ± 2.46). Official nurses reported higher perceived servant leadership scores of head nurses than those who were employed and temporary nurses (b = 1.727, 95% CI: 0.054-3.400); nurses in tertiary hospitals reported higher perceived servant leadership scores of head nurses than nurses in primary and secondary hospitals (b = 2.703, 95% CI: 0.305-5.100); and lower perceived servant leadership scores were associated with nurses' job overtime (b = -4.935, 95% CI: -6.891 to -2.978). Nurses' perceived servant leadership of head nurses were positively associated with nurses' work engagement (r = 0.336, p < .05). Multiple linear regression analysis indicated that the perceived servant leadership of head nurse affected nurses' work engagement strongly (b = 0.585, 95% CI: 0.479-0.691). CONCLUSION: The servant leadership behaviour of head nurse in China was at the medium level, which was positively associated with nurses' work engagement. Further research should improve the power of the servant leadership behaviour of head nurse by integrating additional training, policies and support. IMPACT: It is time to consider the servant leadership behaviour of head nurses and its linkage with nurses' work engagement in China seriously, and address the policies, guidelines, curriculum, and practice culture. PATIENT OR PUBLIC CONTRIBUTION: The study was conducted to explore the situation of servant leadership behaviour of head nurses and its linkage with nurses' work engagement in China, which did not include input from the public or the intended participants.


Assuntos
Enfermeiras e Enfermeiros , Supervisão de Enfermagem , Humanos , Liderança , Engajamento no Trabalho , Estudos Transversais , China , Inquéritos e Questionários , Satisfação no Emprego
4.
Nurs Open ; 10(7): 4756-4765, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36960566

RESUMO

AIM: To develop a standardized training for charge nurses. DESIGN: A developmental research design divided into three parts will be undertaken. METHODS: (1) A scoping review will be used to develop standardized training focusing on charge nurse skills and sub-skills; (2) a Delphi review with nurses, managers and researchers will validate the content of the training; content validity will be assessed over sufficient rounds of review to obtain a content validity index of over 0.7 and (3) a cross-sectional study will pilot test the training with 30 charge nurses. RESULTS: This study will describe the development of updated and empirically validated training to be systematically implemented in healthcare institutions and offered to charge nurses when they begin.


Assuntos
Instalações de Saúde , Supervisão de Enfermagem , Humanos , Estudos Transversais , Literatura de Revisão como Assunto
5.
BMJ Open ; 13(2): e067307, 2023 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-36822804

RESUMO

INTRODUCTION: The charge nurse (CN) holds a position in clinical-administrative management and is essential for improving the quality and safety of care in healthcare institutions. The position requires five essential skills: leadership; interpersonal communication; clinical-administrative caring; problem solving; and knowledge and understanding of the work environment. The scientific literature has not widely examined the importance of providing these skills as part of initial training, nor when CNs begin their duties. This study aims to fill this gap through an exhaustive review of the literature with the aim of developing standardised training for the CN when they start in their position. METHODS AND ANALYSIS: A scoping review using the Joanna Briggs Institute framework will be conducted. The CINAHL, MEDLINE, Science Direct and Cairn, databases as well as grey literature from ProQuest dissertations and thesis global database, Google Scholar and the website of the Order of Nurses of Quebec will be queried using keywords. Relevant literature in French and English, published between 2000 and 2022 will be retained. The CN is the target population. Outcomes address at least one of the five CN skills, describe how they are operationalised and what their impact is on the organisation of work and quality of care. This analysis will identify essential and relevant elements for the development of standardised, up-to-date and appropriate training for the position of CN. ETHICS AND DISSEMINATION: Ethical approval is not required, as data does not include individual patient data. The results will be published in peer-reviewed journals, presented at conferences and presented to nursing managers and directors. SCOPING REVIEW REGISTRATION: Research Registry ID: researchregistry7030.


Assuntos
Currículo , Supervisão de Enfermagem , Humanos , Atenção à Saúde , Competência Clínica , Revisão por Pares , Projetos de Pesquisa , Literatura de Revisão como Assunto
6.
Nurs Open ; 10(5): 3378-3387, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36622948

RESUMO

AIM: To develop a Head Nurse Research Leadership Scale and evaluate its reliability and validity. DESIGN: A psychometric instrument validation study was conducted in two phases. METHODS: The item tool was generated based on a literature review, semi-structured interview and brainstorming. Twenty experts validated the content of the initial version for two rounds. Thirty-nine clinical nurses conducted the HNRLS-v3 to test the readability of the items in pilot study I. Items were screened based on the critical ratio, correlation coefficient analysis, Cronbach's α coefficient and factor analysis using the data collected from 265 nurses in pilot study II. A cross-sectional survey was conducted in six hospitals to evaluate the reliability and validity between 4 January 2022 and 15 January 2022. Three hundred and sixteen nurses participated in this survey, and 60 completed the questionnaire to validate the test-retest reliability between 1 February and 6 February. RESULTS: A 15-item Head Nurse Research Leadership Scale based on 5 dimensions was developed, and the content validity was satisfied. The 15 items accounted for 77.9% of the variance. Confirmatory factor analysis showed acceptable convergent validity and discriminant validity. The Cronbach's α coefficient, split-half reliability and test-retest reliability of the scale were 0.966, 0.9633 and 0.927, respectively.


Assuntos
Liderança , Enfermeiras e Enfermeiros , Humanos , Psicometria/métodos , Reprodutibilidade dos Testes , Estudos Transversais , Projetos Piloto , Supervisão de Enfermagem
7.
PLoS One ; 18(1): e0278721, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36656899

RESUMO

BACKGROUND: Head nurses are vital in understanding and encouraging knowledge sharing among their followers. However, few empirical studies have highlighted their contribution to knowledge-sharing behaviour in Online Health Communities (OHCs). In addition, scant literature has examined the moderating role of knowledge self-efficacy in this regard. PURPOSES: This study examines the moderating role of self-efficacy between the association of four selected individual factors of head nurses (i.e., Trust, Reciprocity, Reputation, and Ability to Share) and their knowledge-sharing behaviour in OHCs in Jordan. METHOD: The data were obtained by using a self-reported survey from 283 head nurses in 22 private hospitals in Jordan. A moderation regression analysis using a structural equation modelling approach (i.e. Smart PLS-SEM, Version 3) was utilised to evaluate the study's measurement and structural model. RESULTS: Knowledge self-efficacy moderates the relationship between the three individual factors (i.e., Trust, Reciprocity, and Reputation) and knowledge-sharing behaviours. However, self-efficacy did not moderate the relationship between the ability to share and knowledge-sharing behaviours. IMPLICATIONS: This study contributes to understanding the moderating role of knowledge self-efficacy among head nurses in online healthcare communities. Moreover, this study provides guidelines for head nurses to become active members in knowledge sharing in OHCs. The findings of this study offer a basis for further research on knowledge sharing in the healthcare sector.


Assuntos
Supervisão de Enfermagem , Autoeficácia , Humanos , Atenção à Saúde , Inquéritos e Questionários , Autorrelato
8.
Hu Li Za Zhi ; 70(2): 34-45, 2023 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-38532673

RESUMO

BACKGROUND: The increasing complexity of the healthcare environment in recent years highlights the importance of cultivating in head nurses the leadership and management competencies necessary to effectively handle complicated administrative tasks and lead nurses in facing various challenges. Identifying the core administrative management competencies required of head nurses and evaluating competency level using behavioral indicators are fundamental to evaluating related training outcomes. PURPOSE: This study was designed to identify the core administrative management competencies required of head nurses as well as the associated job responsibilities, tasks, behavioral evaluation indicators, work outputs, and requisite knowledge and skills. METHODS: This study was conducted in two phases using a qualitative method. The first phase identified the core administrative management competencies and their behavioral definitions. The second phase established competency-related job responsibilities, tasks, behavioral evaluation indicators, work outputs, and requisite knowledge and skills. Each phase consisted of (1) a qualitative interview (first stage) or focus group discussion (second stage) to establish the prototype content; (2) a head nurse workshop to obtain multiple perspectives to modify the prototype content; and (3) a focus group discussion to achieve consensus regarding the content. RESULTS: Nine core competencies related to head nurse administration were identified, including: strategic planning, care supervision, quality improvement, communication, crisis management, responsible leadership, evidence-based practice, digital technology application, and presentation persuasion. Corresponding to these competencies, four responsibilities and associated work tasks were identified. Finally, the related behavioral evaluation indicators, work outputs, and requisite knowledge and skills were confirmed. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results of this study may be used as the basis for head nurse administrative management training programs, while the identified behavioral evaluation indicators may be used to evaluate head nurse work performance and training outcomes. We recommend other institutions apply the results of this study and develop their own administrative core competencies and evaluation indicators for head nurses.


Assuntos
Enfermeiras e Enfermeiros , Supervisão de Enfermagem , Humanos , Competência Clínica , Consenso , Liderança , Comunicação
10.
J Med Life ; 15(8): 1018-1024, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36188650

RESUMO

Nowadays, organizations understand that they need the best talent to succeed in the complex world economy and survive in a competitive business environment. Therefore, talent management can ensure that each employee with a unique talent or ability will be placed in the correct position. This article aimed to study the relationship between talent management, senior and middle managers, and head nurses from educational health and research centers in Tabriz, in 2016. The target population included senior and middle managers and head nurses from Tabriz University of Medical Sciences, approximately 197 people. The sample for this study was selected based on Morgan's table, which rounds up to 123 people. The Kolmogorov-Smirnov test was used to analyze data, and if data were normal, correlation and regression analysis were performed. There was a significant relationship between talent management and the efficiency of senior and middle management and head nurses from the educational and medical centers in Tabriz. Therefore, when talent management increases, the efficiency level also rises to a noticeable degree. Also, the linear regression showed a linear relationship between talent management as an independent variable and efficiency as a dependent variable. Applying talent management strategies in the management selection process in organizations with demanding environments such as hospitals seems inevitable so that managers with the highest efficiency are hired.


Assuntos
Hospitais , Supervisão de Enfermagem , Escolaridade , Humanos , Irã (Geográfico) , Inquéritos e Questionários
11.
CJEM ; 24(7): 695-701, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36138325

RESUMO

BACKGROUND: Debriefing is increasingly used in clinical environments. Surveys indicate staff support for debriefing clinical events, but little is known about the specific effects of debriefing on healthcare workers in the workplace. INFO (Immediate, Not for personal assessment, Fast facilitated feedback, and Opportunity to support and ask questions) is a charge nurse facilitated clinical event debriefing program implemented in 2016 and currently used in five Emergency Departments (ED) in Calgary, Alberta, Canada. There have been more than 840 documented INFO debriefings. METHODS: Thirty interprofessional ED healthcare workers were recruited through posters and email to take part in voluntary one-on-one interviews using a standardized question script that asked participants about their experience with INFO debriefing assessments. Specifically, participants were asked to provide demographic information, give feedback about their involvement in INFO clinical debriefings, impact of debriefings on their clinical practice, stress levels and wellbeing. Interviews were transcribed and analysed using NVivo software. RESULTS: Forty-five healthcare workers replied to the initial recruitment methods with fifteen not responding to follow-up communication. Overall, staff satisfaction with INFO debriefing was highly rated. A qualitative thematic analysis to saturation approach was used to analyse the data. Five main themes were identified: 1.Effect of debriefing on clinical practice and patient care. 2. Psychological safety and teamwork. 3. Emotional acknowledgment after critical events. 4. Managing work stress in the ED. 5. Barriers to debriefing. CONCLUSIONS: In this study, debriefing in the ED helped interprofessional healthcare workers manage stress, provide improved patient care and teamwork while acknowledging emotions. This study specifically involved INFO, however, there are similarities that make our findings applicable to other clinical event debriefing programs. We believe this study provides further evidence supporting debriefing in clinical care areas.


RéSUMé: CONTEXTE: Le débriefing est de plus en plus utilisé dans les environnements cliniques. Les enquêtes indiquent que le personnel est favorable au débriefing des événements cliniques, mais on sait peu de choses sur les effets spécifiques du débriefing sur les travailleurs de la santé sur le lieu de travail. INFO (Immediate, Not for personal assessment, Fast facilitated feedback, and Opportunity to support and ask questions) est un programme de débriefing d'événements cliniques animé par l'infirmière en chef, mis en œuvre en 2016 et actuellement utilisé dans cinq services d'urgence (SU) à Calgary, Alberta, Canada. Il y a eu plus de 840 débriefings INFO documentés. MéTHODES: Trente travailleurs interprofessionnels des services d'urgence ont été recrutés par le biais d'affiches et de courriels pour participer à des entretiens individuels volontaires à l'aide d'un script de questions standardisé qui demandait aux participants de parler de leur expérience des évaluations de débriefing INFO. Plus précisément, les participants ont été invités à fournir des informations démographiques, à donner leur avis sur leur participation aux débriefings cliniques INFO, sur l'impact des débriefings sur leur pratique clinique, sur leur niveau de stress et sur leur bien-être. Les entretiens ont été transcrits et analysés à l'aide du logiciel NVivo. RéSULTATS: Quarante-cinq travailleurs de la santé ont répondu aux méthodes de recrutement initiales, quinze n'ont pas répondu à la communication de suivi. Dans l'ensemble, la satisfaction du personnel à l'égard du compte rendu d'INFO a été très bonne. Une analyse thématique qualitative jusqu'à saturation a été utilisée pour analyser les données. Cinq thèmes principaux ont été identifiés : 1. l'effet du débriefing sur la pratique clinique et les soins aux patients. 2. La sécurité psychologique et le travail en équipe. 3. Reconnaissance émotionnelle après des événements critiques. 4. Gestion du stress au travail dans les services d'urgence. 5. Obstacles au débriefing. CONCLUSIONS: Dans cette étude, le débriefing aux urgences a aidé les travailleurs de la santé interprofessionnels à gérer le stress, à améliorer les soins aux patients et le travail d'équipe tout en reconnaissant les émotions. Cette étude a porté spécifiquement sur INFO, mais il existe des similitudes qui rendent nos résultats applicables à d'autres programmes de débriefing d'événements cliniques. Nous pensons que cette étude apporte des preuves supplémentaires en faveur du débriefing dans les domaines des soins cliniques.


Assuntos
Serviço Hospitalar de Emergência , Supervisão de Enfermagem , Humanos , Retroalimentação , Pessoal de Saúde , Alberta , Equipe de Assistência ao Paciente
13.
Cien Saude Colet ; 27(9): 3419-3428, 2022 Sep.
Artigo em Português, Inglês | MEDLINE | ID: mdl-36000633

RESUMO

This article focuses on the perception of nursing as a low-prestige occupation in the 19th century. The history of nursing produced by professionals in the area supported this understanding. However, the profile of the enfermeiro-mor (head nurse), a position in the Santas Casas, demonstrates that the nursing profession was present throughout a broader social spectrum. The authors support the hypothesis that the typical negative assessment is based only on the more visible patient care activities. The presence of the enfermeiro-mor exemplifies the limits of a generalization of the social undervaluation of nursing. The conclusion is that the generalized assumption that nursing was only about basic health care is not acceptable.


Este artigo trata da percepção da enfermagem como uma ocupação de baixo prestígio no século XIX. A história da enfermagem produzida pelos profissionais da área reforçou essa concepção. No entanto, o perfil do cargo de enfermeiro-mor, presente nas Santas Casas, indica um espectro social mais amplo para a profissão de enfermagem. As autoras defendem a hipótese de que essa avaliação negativa se baseia apenas em atividades de cuidado ao paciente que eram mais visíveis. A presença do enfermeiro-mor exemplifica os limites de uma generalização da desvalorização social da enfermagem. A conclusão é que a suposição generalizada de que a enfermagem se limitava a cuidados básicos de saúde não se sustenta.


Assuntos
Supervisão de Enfermagem , Brasil , Humanos
14.
J Adv Nurs ; 78(12): 4199-4209, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35957536

RESUMO

AIM: To explore clinical supervisors' perceptions and use of the Fundamentals of Care framework in supervising nursing students in clinical placement in hospital settings. DESIGN: A qualitative study using focus group interviews. Reported in accordance with Consolidated Criteria for Reporting Qualitative Research. METHODS: Twelve clinical nurse supervisors working in medical, surgical or psychiatric wards in hospitals in Denmark participated in four focus groups conducted from September to November 2020. Data were analysed using thematic analysis. RESULTS: Clinical supervisor's perceptions and use of the framework are described in three themes: structuring students' clinical learning, supporting tool for learning what nursing care is and developing own supervision practice. CONCLUSION: Supervisors perceive the Fundamentals of Care framework positively and use it as a supporting tool to structure and facilitate students' reflection on what nursing is and requires. They perceive that having a shared framework across school and clinical setting contributes to a safe and positive learning environment. Furthermore, using the framework develops their own practice as clinical supervisors.


Assuntos
Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Supervisão de Enfermagem , Pesquisa Qualitativa , Grupos Focais , Aprendizagem
15.
J Nurs Manag ; 30(7): 3178-3188, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35852872

RESUMO

AIM: The aim of this study to describe a research protocol for evaluating the relationship between nursing leadership, organisational well-being and nurse and patient outcomes. BACKGROUND: The head nurses' leadership style influences the organisational context. When an organisation promotes nurses' well-being, they perform better performances and are more satisfied and engaged with their job. This reduces stress levels, burnout and absenteeism and improves physical and psychological health. METHODS: A multicentre study will be conducted. A self-report questionnaire will be administered to head nurses and nurses they coordinate. Study findings will include nurse-sensitive outcomes (e.g., pressure injuries, infections and mortality). Descriptive and correlational analyses will be conducted, and a structural equation model will be tested. RESULTS: Results might verify that a correctly judged leadership style of the head nurse will enhance the organisational context experienced by nurses and improve nursing sensitive outcomes. CONCLUSION: This study will demonstrate the organisational role of middle managers and the direct repercussions on their staff and patients, understanding the relationship between organisational, process and outcomes variables. IMPLICATIONS FOR NURSING MANAGEMENT: If the results confirmed the hypothesis, health care managers would cultivate and stimulate the head nurses' leadership style, thus increasing nurses' organisational well-being and achieving better patient outcomes. No Patient or Public Contribution.


Assuntos
Esgotamento Profissional , Recursos Humanos de Enfermagem no Hospital , Humanos , Liderança , Estudos Transversais , Recursos Humanos de Enfermagem no Hospital/psicologia , Supervisão de Enfermagem , Esgotamento Profissional/etiologia , Esgotamento Profissional/prevenção & controle , Inquéritos e Questionários , Satisfação no Emprego , Estudos Multicêntricos como Assunto
17.
J Emerg Nurs ; 48(4): 390-405, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35660060

RESUMO

INTRODUCTION: Charge nurses (CNs) are shift leaders who manage resources and facilitate patient care, yet CNs in EDs receive minimal training, with implications for patient safety and emergency nursing practice. The purpose of the study was to describe the experiences of emergency nurses related to training, preparation, and function of the CN role. METHODS: An explanatory sequential mixed methods design using survey data (n = 2579) and focus group data (n = 49) from both CN and staff nurse perspectives. RESULTS: Participants reported minimal training for the CN role, with divergent understandings of role, required education and experience, the need for situational awareness, and the acceptability of the CN taking on other duties. CONCLUSIONS: The ED CN is critical to the safety of both nursing environment and patient care. Nurses in this pivotal role do not receive adequate leadership orientation or formal training in the key areas of nurse patient assignment, communication, and situational awareness. Formal training in nurse-patient assignment, communication, and situational awareness are critical to appropriate patient care and maintenance of interprofessional trust necessary for successful execution of the CN role. ED nurse managers should advocate for this training.


Assuntos
Enfermeiras Administradoras , Supervisão de Enfermagem , Serviço Hospitalar de Emergência , Humanos , Liderança , Motivação , Papel do Profissional de Enfermagem
18.
Nurs Ethics ; 29(5): 1304-1317, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35724976

RESUMO

BACKGROUND: Head nurses have duties in providing nursing care and ethical supervision to the nurses in the unit. Compliance with the ethical competence framework for head nurses is essential in fostering an ethical climate in the organization. OBJECTIVE: The objective of this research is to study the head nurses' compliance with the ethical competence framework by the Thailand Nursing and Midwifery Council (TNMC). METHODS: The study is a qualitative research, using in-depth interviews conducted among 20 head nurses practicing in a super tertiary hospital in Bangkok, Thailand. The sample was selected using a criterion sampling method. The head nurses' ethical experience relating to work practice was analyzed by thematic analysis. ETHICAL CONSIDERATIONS: The ethical approval of this study was obtained from the Committee for Research Ethics (Social Sciences), Mahidol University, and from the Institutional Review Board of the hospital in which the study was conducted. RESULTS: From the thematic analysis of the ethical experience practiced by the head nurses, 8 themes and 16 sub-themes were categorized across 5 ethical competencies based on the ethical competence framework by the TNMC. It was found that all the identified themes and sub-themes conformed to the ethical competence framework, and demonstrated the head nurses' compliance with the framework. DISCUSSION: Head nurses' ethical experience in practice conforms to the ethical competence framework by the TNMC. The framework that is based on the Code of conduct and the nursing culture that places the importance of the seniority system may facilitate the compliance with the ethical competence framework. CONCLUSION: Head nurses demonstrated compliance with the ethical competence framework by the TNMC. Nevertheless, improvements could be done to the framework by adding details such as more examples of ethical decision-making scenarios, personnel's rights, and social media usage guidelines.


Assuntos
Ética em Enfermagem , Enfermeiras e Enfermeiros , Humanos , Princípios Morais , Supervisão de Enfermagem , Pesquisa Qualitativa , Tailândia
19.
J Nurs Manag ; 30(7): 3074-3082, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35695044

RESUMO

AIM: The aim of this study is to explore midwives' coping and functioning in the labour wards during the Covid-19 pandemic from the Labour Ward Head Nurses' perspective. BACKGROUND: The World Health Organization announced the Covid-19 outbreak to be a pandemic in March 2020. Midwives worldwide were affected by this outbreak, working in risky environments, confronting the anxiety and fear of childbearing women. METHODS: A qualitative study using thematic analysis was conducted using semi-structured interviews done over the telephone. Thirteen Labour Ward Head Nurses were interviewed, and the texts were analysed. The study took place in April 2020 during the first Covid-19 lockdown in Israel. RESULTS: Three main themes were generated in the coding process: (a) stress, fear and anxiety, (b) joint efforts and (c) frustration. CONCLUSION: Our study illustrates the difficulties that arose at the beginning of the pandemic, a new and unfamiliar chaotic period. Midwives' managers can use the current research to learn about actions that may assist in improving staff resilience and cohesion during times of crisis. IMPLICATIONS FOR NURSING MANAGEMENT: Understanding the psychological impact of the Covid-19 pandemic among health care professionals is crucial for guiding policies and interventions to maintain staff's psychological well-being.


Assuntos
COVID-19 , Tocologia , Enfermeiras Obstétricas , Gravidez , Feminino , Humanos , Enfermeiras Obstétricas/psicologia , COVID-19/epidemiologia , Pandemias , Supervisão de Enfermagem , Controle de Doenças Transmissíveis , Pesquisa Qualitativa , Adaptação Psicológica
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