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1.
Arch Psychiatr Nurs ; 51: 108-113, 2024 08.
Artículo en Inglés | MEDLINE | ID: mdl-39034065

RESUMEN

BACKGROUND: Nurses have significant levels of depression, anxiety, and stress as a result of their exposure to various stressors at work. Emotional intelligence and resilience are relatively new notions essential for nurses to naturalize high levels of psychological problems. The study aimed to investigate the relationship between emotional intelligence and resilience and their impact on depression, anxiety, and stress among nurses. METHODS: A cross-sectional descriptive design was used and recruited 152 nurses from three private hospitals in Jordan. Variables were measured using the Depression Anxiety Stress Scale, Brief Resilience Scale, and Brief Emotional Intelligence Scale. RESULTS: The participants' average age was 27.6 years, and they were mostly female (66.4 %). Resilience earned an average of 3.1, while emotional intelligence averaged 31.7. Depression, anxiety, and stress were all significantly higher among nurses. Also, negative relationships were found between emotional intelligence, resilience, and psychological problems (p < .001). Emotional intelligence is positively associated with resilience (r = 0.83, p < .001). In addition, emotional intelligence and resilience were both significant predictors of depression, anxiety, and stress. CONCLUSION: Emotional intelligence is critical to nurses' well-being. Higher emotional intelligence is associated with higher resilience and lower levels of depression, anxiety, and stress among nurses. Interventions and education programs emphasizing emotional intelligence and resilience are essential to improving their mental health. Healthcare organizations and governments should promote these attributes to enhance nurses' psychological wellness in challenging healthcare settings.


Asunto(s)
Ansiedad , Depresión , Inteligencia Emocional , Distrés Psicológico , Resiliencia Psicológica , Humanos , Jordania , Femenino , Masculino , Adulto , Estudios Transversales , Depresión/psicología , Ansiedad/psicología , Encuestas y Cuestionarios , Enfermeras y Enfermeros/psicología , Estrés Psicológico/psicología
2.
Int J Nurs Pract ; 28(2): e13023, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34676618

RESUMEN

AIMS: To assess the effect of nurse-guided use of incentive spirometer on postoperative oxygenation and pulmonary complications after coronary artery bypass graft surgery. BACKGROUND: Deep breathing exercises have been shown to improve postoperative lung expansion and reduce pulmonary complications. An incentive spirometer is a deep breathing exercises device that imitates continuous sigh-like maximal inspiration. DESIGN: Randomized control trial, two groups nonblinded parallel design. METHODS: A total of n = 89 eligible patients were randomized to either control or intervention group. Patients in the intervention group received bihourly nurse-guided incentive spirometry for 48-h postextubation. The endpoints were: the number and duration of hypoxic events during the first 24-hr postsurgery, pneumonia and pulmonary function parameters. Data were collected May to September 2019. RESULTS: Patients in the intervention group had a significantly lower mean number of hypoxic events with shorter duration and shorter length of stay in the hospital and the ICU. Patients in the intervention group also had greater postoperative forced expiratory volume in 1 second. CONCLUSION: Nurse-guided use of the incentive spirometer reduces the risk of pulmonary complications and hospital length of stay after cardiac surgery.


Asunto(s)
Motivación , Atelectasia Pulmonar , Puente de Arteria Coronaria/efectos adversos , Humanos , Pulmón , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Atelectasia Pulmonar/etiología , Espirometría/efectos adversos
3.
Crit Care Nurs Q ; 44(2): 187-202, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33595966

RESUMEN

Violence against health care providers is one of the most pressing problems faced by health care systems around the world. Because of unpredictability and acuity of emergency cases, emergency nurses are more vulnerable to workplace violence. Violence against emergency nurses is a complex and multidimensional problem that has a devastating impact on the physical, psychological, and social well-being of nurse victims. The purpose of this review is to integrate evidence on manifestations, contributing factors, and consequences of workplace violence perpetrated by patients and/or their relatives against emergency nurses, in addition to behavioral responses of emergency nurse victims toward workplace violence. An integrative review was conducted by searching 3 main electronic databases: Web of Sciences, MEDLINE, and ScienceDirect. Eighteen studies met the inclusion criteria and were included in the final review process. The review identified the most common forms, contributing factors, unpleasant consequences of workplace violence, and behavioral reaction of nurse victims toward violence acts. Reporting rates of workplace violence among emergency nurses were found to be low. It is recommended to develop more effective workplace violence prevention and reporting programs.


Asunto(s)
Enfermería de Cuidados Críticos , Enfermeras y Enfermeros , Violencia Laboral , Estudios Transversales , Servicio de Urgencia en Hospital , Personal de Salud , Humanos , Encuestas y Cuestionarios , Lugar de Trabajo
4.
Nurs Crit Care ; 26(2): 73-78, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-31800159

RESUMEN

BACKGROUND: Previous studies emphasized that the noise and light levels in intensive care units (ICUs) exceeded the recommended levels by the World Health Organization and the Environmental Protection Agency. This might disturb patients' sleep in these units. AIMS AND OBJECTIVES: The aim of this study is to explore the effect of noise and light levels on the perceived quality of sleep (QOS) of patients in ICUs. DESIGN: A cross-sectional exploratory correlational design was used. METHODS: The noise and light levels were measured on an hourly basis from 10 pm to 6 am, and their impact on ICU patients' QOS was evaluated. RESULTS: The overall light level correlation with the overall QOS was statistically significant at an α level of .05, r (101) = - 0.35, P < .001. The Pearson correlation between the overall ICU nocturnal sound level and patients' overall perceived QOS was statistically significant at an α level of .05, r (101) = - 0.42, P < .001. CONCLUSION: The noise and light levels in the ICUs in the selected hospitals are higher than the recommended levels. High noise and light levels have a negative correlation with the patients' QOS. RELEVANCE TO CLINICAL PRACTICE: High levels of light and sound are associated with poor QOS among ICU patients.


Asunto(s)
Cuidados Críticos , Unidades de Cuidados Intensivos , Luz/efectos adversos , Ruido/efectos adversos , Privación de Sueño/psicología , Estudios Transversales , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Autoinforme , Encuestas y Cuestionarios
5.
Int J Nurs Pract ; 25(3): e12740, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31090172

RESUMEN

AIM: This study aims to assess the effect of using a combination of eye mask and earplugs on the perceived quality of sleep among patients admitted to intensive care units. DESIGN: Control group, pretest and posttest, quasi-experimental design was used. METHODS: Data were collected from 103 intensive care patients in two governmental hospitals in Jordan. The participants were assigned either an experimental or a control group. The experimental group participants received routine care in the first night and used the eye mask and earplug during their sleep in the second night. Control group participants, on the other hand, received routine care only in both nights. The number of hours slept was reported by nurses, and the perceived quality of sleep was self-reported by participants using the Richards-Campbell Sleep Scale. RESULTS: Experimental group participants slept more hours and reported significantly better perceived quality of sleep after the use of eye mask and earplugs, as compared both with themselves in the first night and with control group participants. CONCLUSION: Combining eye masks and earplugs is effective in prolonging the sleep of intensive care patients and improving its quality.


Asunto(s)
Dispositivos de Protección de los Oídos , Dispositivos de Protección de los Ojos , Pacientes Internos , Unidades de Cuidados Intensivos , Sueño , Adulto , Estudios de Casos y Controles , Femenino , Hospitalización , Hospitales Públicos , Humanos , Jordania , Masculino , Persona de Mediana Edad , Percepción , Proyectos de Investigación , Autoinforme
6.
J Psychosoc Nurs Ment Health Serv ; 57(4): 32-39, 2019 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-30376587

RESUMEN

The purpose of the current literature review was to critically review studies related to the use of restraint and seclusion in psychiatric settings across cultures, identify ethical principles regarding restraint and seclusion, and generate a clear view about patients' perspectives and factors that influence use of these measures worldwide. Use of restraint and seclusion in daily nursing practice is controversial. Previous studies have shown variation in the types, frequency, and duration of restraint and seclusion across different countries and differences in the perception of restraint and seclusion between nurses and patients. Whereas some mental health staff members have positive attitudes toward restraint and seclusion, others have negative attitudes. The current analysis found that restraint and seclusion should be used as a last resort measure. [Journal of Psychosocial Nursing and Mental Health Services, 57(4), 32-39.].


Asunto(s)
Actitud , Hospitales Psiquiátricos , Aislamiento de Pacientes , Restricción Física , Humanos , Trastornos Mentales/psicología , Enfermería Psiquiátrica
7.
Crit Care Nurs Q ; 41(2): 170-177, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29494372

RESUMEN

Investigating sleep disturbances among intensive care unit (ICU) patients and its serious consequences is considered a crucial issue for nurses. The need of sleep increases during hospitalization time to preserve energy for the healing process. Previous studies have demonstrated that sleep disturbance is one of the most common complaints of patients in the ICUs, with a prevalence of more than 50%. Although the total sleep time might be normal, the patients' sleep is fragmented and light in the intensive care settings. The main purpose of this review is to generate a clear view of what is known about sleep disturbances among ICU patients as well as to identify the gap in knowledge regarding this issue. This was done by describing, summarizing, clarifying, and evaluating well-selected previous studies about this topic. In addition, this concise review has focused on the prevalence of sleep disturbances in the ICU, factors contributing to poor quality of sleep among ICU patients, and the physiological effects of poor sleep on the patients' prognosis.


Asunto(s)
Unidades de Cuidados Intensivos , Trastornos del Sueño-Vigilia/epidemiología , Trastornos del Sueño-Vigilia/terapia , Sueño , Humanos , Polisomnografía , Prevalencia
8.
Int J Nurs Pract ; 20(4): 438-45, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25039325

RESUMEN

This study described the impact of adopting person-centred care approach for people with Alzheimer's disease on professional caregivers' burden. The participants were subjected to a 4-week structured training programme about person-centred care. The programme's effectiveness was proven by using the Global Behavior Scale. Then a qualitative descriptive phenomenological approach was used to explore the impact of applying this programme on professional caregivers' burden. Data were collected from a sample of 10 professional caregivers using semi-structured interviews. A total of three themes were identified: acceptance of disease-related behaviours of people with Alzheimer's, therapeutic understanding of people with Alzheimer's feelings (empathy) and enhanced caregivers' adaptation to people with Alzheimer's demands (resiliency). Findings suggested that adopting person-centred care approach for people with Alzheimer's disease reduces professional caregivers' burden.


Asunto(s)
Enfermedad de Alzheimer/enfermería , Cuidadores/psicología , Atención Dirigida al Paciente , Adaptación Psicológica , Adulto , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad
9.
Int J Nurs Pract ; 20(1): 79-88, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24580978

RESUMEN

The purpose of this paper is to examine the impact of demographic variables, organizational commitment levels, perception of health and quality of work on turnover intentions. A self-reported cross-sectional survey design was used to collect data from Jordanian registered nurses who were working between June 2011 and November 2011. The findings showed strong effects of the quality of work, perception of health and normative organizational commitments on turnover intentions. This study sheds the light on the important work outcomes in health-care organizations. Increasing nursing quality of work and normative organizational commitment are good strategies for reducing turnover intentions.


Asunto(s)
Actitud del Personal de Salud , Demografía , Personal de Enfermería/psicología , Reorganización del Personal , Estudios Transversales , Humanos
10.
Crit Care Nurs Q ; 36(2): 218-27, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23470707

RESUMEN

BACKGROUND: The presence of family members during cardiopulmonary resuscitation (CPR) of an adult patient remains a contentious area of practice that has attracted wide international debate. However, the attitude and experience of Jordanian nurses concerning this area of practice are not known yet. METHOD: This descriptive quantitative study was aimed at identifying the attitudes and experiences of Jordanian nurses toward the presence of family members during CPR of adult patients. A questionnaire that was developed by Fulbrook et al was completed by 136 nurses. RESULTS: There were 91.9% (n = 125) nurses who did not have any experience or a protocol or policy document on family presence during CPR and 97.7% (n = 133) nurses stated that they did not have any experience of inviting a family member to be present during CPR. Also, the result of this study revealed that Jordanian nurses had negative attitudes toward the presence of family members during CPR of an adult patient. CONCLUSIONS: Before initiating hospital policy regarding the option of family presence during resuscitation, attitudes and experiences of patients and relatives on witnessed resuscitation should be explored. Also, educating nurses about the importance of practicing to have the presence of family members during CPR of adult patients should be considered.


Asunto(s)
Actitud del Personal de Salud , Reanimación Cardiopulmonar , Familia , Enfermeras y Enfermeros/psicología , Adulto , Femenino , Humanos , Jordania , Masculino , Política Organizacional , Encuestas y Cuestionarios , Visitas a Pacientes
11.
J Contin Educ Nurs ; 54(12): 581-588, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37855822

RESUMEN

BACKGROUND: The stress level among nurses is significantly high, which negatively affects the nurses' well-being and the quality of care provided to patients. The goal of this study was to measure the impact of implementing a resiliency training program on nurses. METHOD: A pretest-posttest quasi-experimental design was used to measure the impact of nurses' participation in a resiliency training program. The sample was recruited with the convenience sampling technique. Participants were allocated to groups according to their ability to attend all intervention sessions. A total of 137 participants completed all phases of the study. The study was conducted at a private hospital in Amman, Jordan. Data were collected at two time points, before the intervention and 1 week after the intervention. RESULTS: Analysis of covariance was used to measure differences between groups after the intervention. The results indicated that there were statistically significant differences (p < .001) in resilience and stress levels between the groups after the intervention. CONCLUSION: Nurses in the intervention group showed a significant improvement in resilience scores and a significant reduction in stress scores. [J Contin Educ Nurs. 2023;54(12):581-588.].


Asunto(s)
Enfermeras y Enfermeros , Personal de Enfermería en Hospital , Humanos , Personal de Enfermería en Hospital/educación , Educación Continua en Enfermería , Competencia Clínica
12.
SAGE Open Nurs ; 9: 23779608231189128, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37528905

RESUMEN

Introduction: Psychological aspects are common in patients with heart failure (HF). Psychological aspects have negative consequences in patients with HF. Objective: This study was conducted to gain a deeper understanding of the consequences of psychological aspects in Jordanian patients with HF. Methods: This study is a qualitative study conducted with the participation of 24 patients with HF. Data were collected using semi-structured interviews. Results: The main theme of the findings can be expressed as "Consequences of psychological aspects of HF." The following four sub-themes emerged from the data: social isolation, disturbance of feelings, being non-compliant, and growing burden on the health care system. Conclusion: The findings revealed the need for informing healthcare providers about the negative consequences of psychological aspects and develop clinical guidelines to evaluate psychological aspects to support these patients.

13.
Nurs Forum ; 55(4): 603-610, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32497275

RESUMEN

BACKGROUND: A deeper understanding of the nurses' characteristics that influence their positive attitudes toward coercion is necessary if coercive measures rates are to be effectively reduced. AIM: To identify the difference in psychiatric staff attitudes toward coercive measures in relation to their sociodemographic characteristics. SETTING: The study conducted at the National Center for Mental Health, which is regulated under the authority of the Jordanian Ministry of Health. PARTICIPANTS: A total of 85 psychiatric staff recruited from the National Center for Mental Health. METHODS: A cross-sectional, descriptive, correlational design was used. Data were collected using a self-administered questionnaire, which consisted of 15 items that focused on assessing a staff's attitude toward coercion. RESULTS: The relationship between clinical unit and attitude toward coercion was significant (r = -.30; P = .006). Similarly, the correlations between gender-based units and attitudes toward coercion were significant (r = -.38; P = .002). Another significant correlation was revealed with different years of experience (r = .22; P = .04). CONCLUSION: The more years of experience in the field of psychiatric nursing the more positive attitude toward coercion. Moreover, working with male psychiatric patients and in acute psychiatric units increase the risk of coercive measures use.


Asunto(s)
Coerción , Enfermeras y Enfermeros/psicología , Clase Social , Adulto , Actitud del Personal de Salud , Correlación de Datos , Estudios Transversales , Femenino , Humanos , Masculino , Enfermeras y Enfermeros/normas , Enfermeras y Enfermeros/estadística & datos numéricos , Enfermería Psiquiátrica/ética , Enfermería Psiquiátrica/métodos , Enfermería Psiquiátrica/normas , Encuestas y Cuestionarios
14.
J Contin Educ Nurs ; 40(1): 43-8, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19226999

RESUMEN

BACKGROUND: Continuing education helps nurses maintain and improve practice and keep up-to-date with rapidly changing health care information. METHODS: This descriptive study aimed to identify the attitudes of Jordanian nurses toward continuing education in nursing. A questionnaire was completed by 472 nurses. RESULTS: Jordanian nurses have positive attitudes toward continuing education. There were no statistically significant differences in nurses' attitudes toward continuing education according to age or gender. CONCLUSION: Educators need to focus on continuing education content, not on convincing nurses that they need continuing education.


Asunto(s)
Actitud del Personal de Salud , Educación Continua en Enfermería , Personal de Enfermería en Hospital/educación , Adulto , Análisis de Varianza , Femenino , Encuestas de Atención de la Salud , Humanos , Jordania , Masculino
15.
J Contin Educ Nurs ; 40(4): 187-92, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-19418759

RESUMEN

BACKGROUND: Recently, nursing education in Jordan has been radically reformed to fit social and organizational processes of globalization. Jordanian nurses are attending international courses to improve their nursing practice. METHODS: This descriptive, qualitative study was aimed at identifying the impact of Jordanian nurses' participation in international courses on nursing practice in Jordan. Purposive sampling techniques were used. Two focus groups of Jordanian nurses who participated in international courses provided rich data. RESULTS: Findings from the focus groups suggested that participation in international courses makes a significant contribution to nurses' professional and personal development. CONCLUSION: Jordanian nurses are challenged to find ways to actually apply the new skills and knowledge gained from these courses in their work.


Asunto(s)
Actitud del Personal de Salud , Educación Continua en Enfermería/organización & administración , Intercambio Educacional Internacional , Personal de Enfermería en Hospital/educación , Personal de Enfermería en Hospital/psicología , Adulto , Curriculum , Femenino , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Jordania , Masculino , Rol de la Enfermera/psicología , Investigación en Educación de Enfermería , Investigación Metodológica en Enfermería , Personal de Enfermería en Hospital/organización & administración , Autonomía Profesional , Competencia Profesional , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa
16.
Perspect Psychiatr Care ; 55(4): 734-742, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31332798

RESUMEN

PURPOSE: To evaluate the effectiveness of a training program on the attitudes of psychiatric nurses toward using coercive measures. DESIGN AND METHODS: A repeated measures time-series design with two-equivalent groups was used. A convenience sample of 48 psychiatric nurses were recruited. Data collection was conducted using the Staff Attitude to Coercion Scale. FINDINGS: Results showed the effectiveness of the training program in improving nurses' attitude toward coercive measures. After 4 weeks of the training, nurses in the intervention group demonstrated significant improvements in their attitude mean scores. PRACTICE IMPLICATIONS: Equipping the psychiatric nurses with essential clinical knowledge and skills concerning the appropriate application of coercive measures policy were imperative issues that might help the nurses in dealing with these clinical complex situations effectively.


Asunto(s)
Actitud del Personal de Salud , Coerción , Conocimientos, Actitudes y Práctica en Salud , Trastornos Mentales/enfermería , Personal de Enfermería en Hospital , Enfermería Psiquiátrica , Proyectos de Investigación , Adulto , Femenino , Humanos , Personal de Enfermería en Hospital/educación , Enfermería Psiquiátrica/educación
17.
Turk J Med Sci ; 46(3): 614-9, 2016 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-27513228

RESUMEN

BACKGROUND/AIM: Measles, mumps, rubella, and varicella can affect susceptible healthcare workers who might subsequently spread the infection to susceptible patients and workers. Here, we aim to determine the seroprevalence of these infections among physicians and nurses and to compare the history of varicella with the results of varicella antibodies among study participants. MATERIALS AND METHODS: Two randomly selected groups, one group of physicians and one of nurses, from a university hospital in Jordan were interviewed and their serum IgG antibodies were measured. RESULTS: The physicians and nurses group had 252 and 241 participants, respectively. The physicians group had significantly more males and younger participants. The percentage of individuals in the physician and nurse groups with positive antibodies to measles was 75.4% and 75.1%, respectively; mumps, 88.5% and 94.2%; rubella, 89.3% and 87.1%; and varicella, 92.1% and 92.5%. Immunity was similar between the 2 groups except for mumps, where significantly more nurses were immune. The positive and negative predictive values for the history of varicella to predict immunity in all participants were 95% and 13.5%, respectively. CONCLUSION: A small but important proportion of our healthcare workers are still susceptible to measles, mumps, rubella, and varicella. In addition, the recall history to varicella showed suboptimal ability to predict immunity.


Asunto(s)
Varicela , Sarampión , Paperas , Rubéola (Sarampión Alemán) , Anticuerpos Antivirales , Femenino , Humanos , Jordania , Masculino , Estudios Seroepidemiológicos
18.
Cancer Inform ; 10: 1-11, 2011 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-21340020

RESUMEN

Skin cancer is the most prevalent cancer in the light-skinned population and it is generally caused by exposure to ultraviolet light. Early detection of skin cancer has the potential to reduce mortality and morbidity. There are many diagnostic technologies and tests to diagnose skin cancer. However many of these tests are extremely complex and subjective and depend heavily on the experience of the clinician. To obviate these problems, image processing techniques, a neural network system (NN) and a fuzzy inference system were used in this study as promising modalities for detection of different types of skin cancer. The accuracy rate of the diagnosis of skin cancer by using the hierarchal neural network was 90.67% while using neuro-fuzzy system yielded a slightly higher rate of accuracy of 91.26% in diagnosis skin cancer type. The sensitivity of NN in diagnosing skin cancer was 95%, while the specificity was 88%. Skin cancer diagnosis by neuro-fuzzy system achieved sensitivity of 98% and a specificity of 89%.

19.
Nurse Educ Pract ; 11(5): 320-6, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21367660

RESUMEN

BACKGROUND: The effects of student-faculty interactions in higher education have received considerable empirical attention. However, there has been no empirical study that has examined the relation between student-faculty interaction and college grade point average. PURPOSE: This is aimed at identifying the effect of nursing student-faculty interaction outside the classroom on students' semester college grade point average at a public university in Jordan. METHODS: The research was cross-sectional study of the effect of student-faculty interaction outside the classroom on the students' semester college grade point average of participating juniors and seniors. RESULTS: Total interaction of the students was crucial as it is extremely significant (t = 16.2, df = 271, P ≤ 0.001) in relation to students' academic scores between those students who had ≥70 and those who had <70 academic scores. However, gender differences between students, and other variables were not significant either to affect students' academic scores or students' interaction. CONCLUSION: This study provides some evidence that student-faculty interactions outside classrooms are significantly associated with student's academically achievements.


Asunto(s)
Bachillerato en Enfermería , Evaluación Educacional/estadística & datos numéricos , Docentes de Enfermería , Relaciones Interprofesionales , Estudiantes de Enfermería , Adulto , Estudios Transversales , Femenino , Humanos , Jordania , Masculino , Sector Público , Facultades de Enfermería , Estudiantes de Enfermería/estadística & datos numéricos , Adulto Joven
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