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1.
Belitung Nurs J ; 9(6): 619-626, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38130676

RESUMO

Background: Assessing the professional interpersonal competency of novice nurses is crucial for preventing staff turnover and promoting effective work. However, none of the instruments identified in the literature specifically target novice nurses. Objective: This study aimed to develop and psychometrically test the perception dimension of the Professional Interpersonal Competency Assessment Scale for Novice nurses (PICASN) in Japan. Methods: The study comprised four steps: 1) concept identification, 2) item construction, 3) validity measure, and 4) reliability measure. A cross-sectional web-based questionnaire was administered from February to April 2023 and was completed by 203 novice nurses. Data quality was assessed using mean, item response, missing values, floor and ceiling effects, internal consistency, and item-rest correlations. Content validity index (CVI) was used to determine the instrument's validity, while exploratory factor analysis (EFA) using maximum likelihood estimation with Promax rotation was employed to assess the factor structure. Cronbach's alpha was used to evaluate reliability. Results: The 27-item PICASN demonstrated an Item-CVI of 0.94 and a Scale-CVI of 0.88. EFA revealed two factors: 1) Basic competencies as a novice nurse (15 items) and 2) Relationship building skills within the healthcare team (12 items), which explained 80% of the variance. Internal consistency reliability was excellent at 0.94 and 0.91 for the factors, and the overall scale reliability was 0.95. The item-rest (I-R) correlation values exceeding 0.6 were considered acceptable. Conclusion: The PICASN demonstrates satisfactory psychometric properties, making it an effective tool for measuring professional interpersonal competency among novice nurses in Japan. This instrument serves to assist novice nurses by promoting self-awareness and offering targeted insights into specific areas requiring improvement. Additionally, it provides experienced nurses and nurse managers with valuable insights into team dynamics, guiding interventions for continuous quality improvement.

2.
J Med Invest ; 70(3.4): 307-316, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37940512

RESUMO

This study aimed to conduct a systematic review to clarify patient understanding, understanding of caring concepts, understanding of technology, competency to express compassion, appropriate involvement in caring, and ethical and moral attitudes and responses toward patients. This systematic review was conducted through an electronic search across PubMed, Google Scholar, MEDLINE, and Science Direct. Authors independently appraised the methodological quality of the studies using the Mixed Method Appraisal Tool. A narrative synthesis approach was used to present these findings. Nine studies met the inclusion criteria and quality appraisal guidelines. Through thematic analysis, four major themes were identified:Technology and caring competency, Technology and patient-centered care, Empathetic skills, and Caring competency. This review has shown that patients choose physicians considering their emotions and communicate well with them, empowering them to take responsibility of their own or their loved ones' healthcare. In the age of technological advancement and availability of vast sources of information, it is expected of physicians to adapt to these character priorities while maintaining their sense of humanness, not only focusing on healing modalities, but also to guide, educate, and appropriately empower their patients toward achieving their healthcare goals. J. Med. Invest. 70 : 307-316, August, 2023.


Assuntos
Médicos , Tecnologia , Humanos , Empatia , Assistência Centrada no Paciente , Instalações de Saúde
3.
Belitung Nurs J ; 9(5): 512-519, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37901374

RESUMO

Background: Over the years, a few tools and instruments have been developed to assist in the assessment within a palliative care setting. However, many of these tools and instruments do not reflect a person-centered palliative care model. Objective: This study aims to develop a Person-centered Palliative Care Nursing Instrument (PPCNI) in the Philippines. Methods: An exhaustive search of the literature was conducted to develop a pool of items for the instrument. The validity of the instrument was evaluated using the content validity index (CVI), while the factor structure was assessed using exploratory factor analysis (EFA) using maximum likelihood estimation with Promax rotation. Also, the internal reliability was evaluated using Cronbach's alpha. Results: EFA yielded three factors: 1) Caring as maintaining person's dignity (13 items), 2) caring as empowerment of person's autonomy (14 items), and 3) caring as understanding person's momentary concerns (10 items). Whereas the internal consistency reliability of these subscales appeared excellent (i.e., 0.95, 0.96, and 0.93, respectively), the Cronbach's alpha for the overall scale was 0.98. The item-total correlation coefficients were >0.30 for all items, ranging from 0.310 to 0.726. Conclusion: Findings support a three-factor, 37-item PPCNI that can be used in clinical practice to ensure that nurses provide palliative care based on patient needs and preferences.

4.
Nurs Health Sci ; 25(3): 474-481, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37332058

RESUMO

This article is a theoretical discourse about technological machines and artificial intelligence, highlighting their effective interactive outcomes in nursing. One significant influence is technological efficiency which positively affects nursing care time, enabling nurses to focus more on their patients as the core of nursing. The article examines the impact of technology and artificial intelligence on nursing practice in this era of rapid technological advancements and technological dependence. Strategic opportunities in nursing are advanced, exemplified by robotics technology and artificial intelligence. A survey of recent literature focused on what is known about the influence of technology, healthcare robotics, and artificial intelligence on nursing in the contexts of industrialization, societal milieu, and human living environments. Efficient, precision-driven machines with artificial intelligence support a technology-centered society in which hospitals and healthcare systems become increasingly technology-dependent, impacting healthcare quality and patient care satisfaction. As a result, higher levels of knowledge, intelligence, and recognition of technologies and artificial intelligence are required for nurses to render quality nursing care. Designers of health facilities should be particularly aware of nursing's increasing dependence on technological advancements in their practice.


Assuntos
Enfermeiras e Enfermeiros , Cuidados de Enfermagem , Robótica , Humanos , Inteligência Artificial , Tecnologia
5.
Bioprocess Biosyst Eng ; 45(11): 1889-1904, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36245012

RESUMO

Flux balance analysis (FBA) is currently the standard method to compute metabolic fluxes in genome-scale networks. Several FBA extensions employing diverse objective functions and/or constraints have been published. Here we propose a hybrid semi-parametric FBA extension that combines mechanistic-level constraints (parametric) with empirical constraints (non-parametric) in the same linear program. A CHO dataset with 27 measured exchange fluxes obtained from 21 reactor experiments served to evaluate the method. The mechanistic constraints were deduced from a reduced CHO-K1 genome-scale network with 686 metabolites, 788 reactions and 210 degrees of freedom. The non-parametric constraints were obtained by principal component analysis of the flux dataset. The two types of constraints were integrated in the same linear program showing comparable computational cost to standard FBA. The hybrid FBA is shown to significantly improve the specific growth rate prediction under different constraints scenarios. A metabolically efficient cell growth feed targeting minimal byproducts accumulation was designed by hybrid FBA. It is concluded that integrating parametric and nonparametric constraints in the same linear program may be an efficient approach to reduce the solution space and to improve the predictive power of FBA methods when critical mechanistic information is missing.


Assuntos
Redes e Vias Metabólicas , Modelos Biológicos , Cricetinae , Animais , Cricetulus , Células CHO
6.
Healthcare (Basel) ; 10(8)2022 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-36011228

RESUMO

Technological advancements have led to the use of robots as prospective partners to complement understaffing and deliver effective care to patients. This article discusses relevant concepts on robots from the perspective of nursing theories and robotics in nursing and examines the distinctions between human beings and healthcare robots as partners and robot development examples and challenges. Robotics in nursing is an interdisciplinary discipline that studies methodologies, technologies, and ethics for developing robots that support and collaborate with physicians, nurses, and other healthcare workers in practice. Robotics in nursing is geared toward learning the knowledge of robots for better nursing care, and for this purpose, it is also to propose the necessary robots and develop them in collaboration with engineers. Two points were highlighted regarding the use of robots in health care practice: issues of replacing humans because of human resource understaffing and concerns about robot capabilities to engage in nursing practice grounded in caring science. This article stresses that technology and artificial intelligence are useful and practical for patients. However, further research is required that considers what robotics in nursing means and the use of robotics in nursing.

7.
Artigo em Inglês | MEDLINE | ID: mdl-35760691

RESUMO

INTRODUCTION: The main reason for high mortality in breast cancer is local recurrence and metastasis, despite surgery as the first therapeutic option. The anesthesia used in the operation room can determine the immune response. METHODS: A prospective, comparative and non- randomised study in patients undergoing breast cancer surgery was conducted in our hospital after obtaining approval from the Hospital's Institutional Review Board. Patients were divided in two groups: Group A received general anesthesia with propofol and opioids. Group B, in addition to general anesthesia, three interfascial blocks (Pec I, Pec II and BRILMA) were performed in all patients. Three blood samples were taken 1) previous anesthetic induction; 2) two hours after the end of the surgery and 3) 24-48 h after surgery. Leukocytes, CD3, CD4, CD8 and Natural Killer cells were determined at each time. RESULTS: 103 patients were included. 59 (group A) received general anesthesia and 54 (group B) general anesthesia and interfascial blocks. Regarding baseline characteristics, age was significantly higher in the group that received general anesthesia and mastectomy was more frequent in the group that received interfascial blocks. We observed after surgery an increase in leukocytes level that returns close to baseline levels. On the other hand, a reduction in the immune response was observed that also returns to the previous level 48 h after surgery. Group A and B get similar results and also subgroups of hormonal receptors (HER+, PR and/or ER+). CONCLUSIONS: Interfascial blocks in chest wall added to general anesthesia in breast cancer surgery has not shown a significant difference in the inflammatory response or immunological depression compared to general anesthesia as the only anesthetic technique. It seems to trend less immunological depression in the interfascial block group.


Assuntos
Anestésicos , Neoplasias da Mama , Bloqueio Nervoso , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Imunidade , Mastectomia/métodos , Bloqueio Nervoso/métodos , Dor Pós-Operatória , Estudos Prospectivos
8.
Rev. esp. anestesiol. reanim ; 69(6): 336-344, Jun - Jul 2022. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-205068

RESUMO

Introducción: El principal motivo de la alta mortalidad en el cáncer de mama es la recurrencia local y las metástasis, siendo la cirugía la primera opción terapéutica. La técnica anestésica utilizada en quirófano puede modificar la respuesta inmunológica del paciente. Métodos: Estudio prospectivo, comparativo y no aleatorizado en pacientes intervenidos de cáncer de mama en el Hospital Universitario de Getafe (Madrid) tras la aprobación del Comité Ético del Hospital.Dividimos a los pacientes en dos grupos: grupo A, que recibió anestesia general con propofol y fármacos opiáceos; grupo B, en el que además de la anestesia general, se realizaron tres bloqueos interfasciales (Pec I, Pec II y BRILMA) en todos los pacientes. Se obtuvieron tres muestras sanguíneas: 1) antes de la inducción anestésica; 2) 2h después de finalizar la cirugía y 3) 24-48h posquirúrgicas. En cada muestra, se analizaron el número de leucocitos, células CD3, CD4 y CD8, así como las células natural killer (NK). Resultados: Se incluyeron en el estudio un total de 103 pacientes; 59 (grupo A) recibieron anestesia general y 54 (grupo B) anestesia general y bloqueos interfasciales. Según las características basales, la edad fue significativamente superior en las pacientes que recibieron anestesia general. La mastectomía se realizó con más frecuencia en el grupo que recibió bloqueos interfasciales. Observamos que después de la cirugía hay un aumento en el número de leucocitos pero regresa a los niveles basales a las 48h, comportamiento que se repite a nivel inmunológico: disminuye después de la cirugía pero vuelve a niveles previos a las 48h de la cirugía. Los grupos A y B presentan resultados similares en el resto de parámetros estudiados, al igual que los subgrupos según los receptores hormonales (HER+, PR y/o ER+).(AU)


Introduction: The main reason for high mortality in breast cancer is local recurrence and metastasis, despite surgery as the first therapeutic option. The anesthesia used in the operation room can determine the immune response. Methods: A prospective, comparative and non-randomized study in patients undergoing breast cancer surgery was conducted in our hospital after obtaining approval from the Hospital's Institutional Review Board. Patients were divided in two groups: Group A received general anesthesia with propofol and opioids. Group B, in addition to general anesthesia, three interfascial blocks (Pec I, Pec II and BRILMA) were performed in all patients. Three blood samples were taken 1) previous anesthetic induction; 2) two hours after the end of the surgery and 3) 24-48hours after surgery. Leukocytes, CD3, CD4, CD8 and Natural Killer cells were determined at each time. Results: 103 patients were included. 59 (group A) received general anesthesia and 54 (group B) general anesthesia and interfascial blocks. Regarding baseline characteristics, age was significantly higher in the group that received general anesthesia and mastectomy was more frequent in the group that received interfascial blocks.We observed after surgery an increase in leukocytes level that returns close to baseline levels. On the other hand, a reduction in the immune response was observed that also returns to the previous level 48hours after surgery. Group A and B get similar results and also subgroups of hormonal receptors (HER+, PR and/or ER+). Conclusions: Interfascial blocks in chest wall added to general anesthesia in breast cancer surgery has not shown a significant difference in the inflammatory response or immunological depression compared to general anesthesia as the only anesthetic technique. It seems to trend less immunological depression in the interfascial block group.(AU)


Assuntos
Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/mortalidade , Neoplasias da Mama/cirurgia , Anestesia Geral , Terapia de Imunossupressão , Analgesia , Propofol , Recidiva Local de Neoplasia , Técnicas de Laboratório Clínico , Anestesiologia , Estudos Prospectivos
10.
Nurs Forum ; 57(5): 733-738, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35487879

RESUMO

BACKGROUND: The COVID-19 pandemic has resulted in school closures and the reopening of schools is considered to be a possible approach to start reversing learning deficits. However, the literature is scarce on the determinants of intention to attend face-to-face classes among nursing students. METHOD: This cross-sectional study examined students' intention to attend limited face-to-face classes on school reopening, and its association among the core constructs of the Theory of Planned Behavior. Undergraduate nursing students of one university in the Philippines (n = 322) answered an online questionnaire. Predictor variables were determined by multiple linear regression analysis. RESULTS: Results demonstrated that nursing students had a high intention (4.47 of 5) to attend limited face-to-face classes. First- and second-year students had significantly higher intention to attend limited face-to-face classes than third- and fourth-year nursing students. Multiple regression analysis suggested that attitude (ß = .127, p = .001), subjective norm (ß = .400, p = .000), and perceived behavioral control (ß = .326, p = .000) positively predicted students' intention to attend face-to-face classes. CONCLUSION: As many schools prepare for the gradual reopening of campuses, the different beliefs of students may be considered by nursing schools to better understand students' intention for face-to-face instruction.


Assuntos
COVID-19 , Bacharelado em Enfermagem , Estudantes de Enfermagem , Atitude do Pessoal de Saúde , Estudos Transversais , Humanos , Intenção , Pandemias , Inquéritos e Questionários
12.
Actas Dermosifiliogr ; 113(5): 451-458, 2022 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35431059

RESUMO

OBJECTIVE: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). MATERIAL AND METHODS: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. RESULTS: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). CONCLUSION: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Melanoma , Neoplasia de Células Basais , Neoplasias Cutâneas , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Estudos de Coortes , Feminino , Humanos , Masculino , Melanoma/complicações , Cirurgia de Mohs , Estudos Prospectivos , Fatores de Risco , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/cirurgia
13.
Omega (Westport) ; 85(2): 445-454, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32741246

RESUMO

The concept of death anxiety is expected of older persons as they age and are nearing their end-of-life. This study examined the relationship between religiosity, spirituality, and death anxiety among Filipino older adults. A convenience sample of 125 Filipino older adults were recruited in the study. Data were collected using the Spirituality Scale, Revised Death Anxiety Scale, and Dimensions of Religiosity Scale. Results of the study revealed that spirituality (r=-0.168, p = 0.061) and religiosity (r=-0.044, p = 0.623) had an inverse relationship with death anxiety. However, even with the inverse relationship, spirituality and religiosity were not significantly correlated with death anxiety, although participants were well aware of the importance of these concepts on their lives. It is suggested that assessing spirituality and religiosity of this age group can inform nurses to engage in quality nursing practice, by affirming the vulnerability, and preserving the personhood of older persons as they near their end-of-life.


Assuntos
Religião , Espiritualidade , Idoso , Idoso de 80 Anos ou mais , Ansiedade , Morte , Humanos
15.
Collegian ; 28(5): 551-558, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34720647

RESUMO

BACKGROUND: The incidence of social isolation among older adults is on the rise in today's health care climate. Consequently, preventing or ameliorating social isolation through technology in this age group is now being discussed as a significant social and health issue. AIM: The purpose of the opinion paper is to clarify social transformation through technology and shed light on a new reality for older adults in situations of social isolation. Our goal is to persuade the reader that our position on this topic is a valid one. We support our claims with practice-based evidence and published research studies. METHODS: To do so, we checked the most recent literature, most of which came from the last decade. Our literature survey focused primarily on what is known about technology and how technology can affect social transformation and perceptions of social isolation. FINDINGS: Two dominant transformative realities became the focal points: the precarious implications of loneliness for older adults and the emerging reality of social change through digital technology central to eHealth and mHealth. DISCUSSION: To benefit from new technologies and reduce the detrimental effects of social isolation, we must engage older adults in a meaningful way and adapt the system of smart devices to reflect the specific physiological and psychological characteristics of the ageing population. CONCLUSION: Older adults need to comprehend the meanings of their social experiences to preserve their active lifestyle. Human interactions may be desirable, but technological dominance may also minimize the adverse effects of social isolation.

16.
J Neurosci Nurs ; 53(3): 149-156, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33935264

RESUMO

ABSTRACT: INTRODUCTION: In August of 2020, the 4th International Neuroscience Nursing Research Symposium was held. The purpose of the symposium was to share neuroscience nursing research from around the world. One of the topics thought most notable that stimulated a crucial conversation was how different countries assessed pain and their use of opioids for pain management. BACKGROUND: Neuroscience nurses are global. What is not known is their experience with and what challenges exist with pain management for human beings in their country. Crossing geographic and cultural boundaries, pain affects all human beings. Each culture has unique values and beliefs regarding pain. Patient barriers, pivotal in this article, included poverty, poor health literacy, opioid phobia, and cultural as well as social beliefs. RESULTS: Neuroscience nurses from Australia, Brazil, Germany, Singapore, India, Ghana, Kenya, Philippines, South Africa, and the United States each collaborated to provide a short summary of assessing pain and use of opioids for pain management for the neuroscience patient. CONCLUSION: Neuroscience patients have varying degrees of pain based on many factors. Various countries have religious, spiritual, and cultural traditions that influence the reporting and management of pain. Pain assessment and management can be challenging, especially for the neuroscience nurses around the world.


Assuntos
Analgésicos Opioides , Pesquisa em Enfermagem , Analgésicos Opioides/uso terapêutico , Humanos , Enfermagem em Neurociência , Dor/tratamento farmacológico , Medição da Dor , Estados Unidos
18.
Palliat Support Care ; 19(6): 723-726, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33678214

RESUMO

OBJECTIVE: The study was conducted in order to determine the relationship between spiritual well-being and self-transcendence and to identify the spiritual practices utilized by Filipino patients who are recovering from breast cancer. METHODS: A descriptive correlational study was used, and a purposive sampling technique was utilized to select the participants in the study. Data were collected using self-administered questionnaires and were analyzed using frequency, percentage, mean, standard deviation, and Pearson's r correlation. RESULTS: The study revealed that the overall mean score of the spiritual index of well-being among the participants was 4.41 (±0.54), while the mean score of self-transcendence was 3.64 (±0.50). The results showed that there was a significant relationship between spirituality and self-transcendence among Filipino women with breast cancer. SIGNIFICANCE OF RESULTS: Filipino women with breast cancer rely on their spirituality, which enables them to find meaning in their illness. Hence, assessing spirituality among this population group will enable nurses to provide holistic nursing care, as this can help them cope with the challenges associated with their illness.


Assuntos
Neoplasias da Mama , Enfermagem Holística , Terapias Espirituais , Humanos , Feminino , Neoplasias da Mama/complicações , Espiritualidade , Enfermagem Holística/métodos , Inquéritos e Questionários
19.
Food Chem ; 352: 129375, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-33706138

RESUMO

In this paper, we present an analysis of the performance of Raman spectroscopy, combined with feed-forward neural networks (FFNN), for the estimation of concentration percentages of glucose, sucrose, and fructose in water solutions. Indeed, we analysed our method for the estimation of sucrose in three solid industrialized food products: donuts, cereal, and cookies. Concentrations were estimated in two ways: using a non-linear fitting system, and using a classifier. Our experiments showed that both the classifier and the fitting systems performed better than a Support Vector Machine (SVM), a Linear Discriminant Analysis (LDA), a Linear Regression (LR), and interval Partial Least Squares (iPLS). The best-case obtained by an FFNN for water solutions was 93.33% of classification and 3.51% of Root Mean Square Error in Prediction (RMSEP), compared with 82.22% obtained by a LDA. Our proposed method got an RMSEP of 1% for the best-case obtained with the food products.


Assuntos
Redes Neurais de Computação , Análise Espectral Raman , Açúcares/análise , Análise Discriminante , Análise dos Mínimos Quadrados , Modelos Lineares , Máquina de Vetores de Suporte , Água/química
20.
Crit Care Nurs Clin North Am ; 33(1): 75-87, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33526200

RESUMO

This article provides a brief background on critical care nursing in the Philippines, its trend on current practice, and its implication and future direction. An overview is given on the milieu and processes inherent in the critical care unit with the intensive care unit setup taken as its exemplar. The roles and responsibilities of critical care nurses within these units and nature of common issues within their practice is explored. The need for training in communication skills, conflict resolution, and palliative care is implied for these nurses to fully fulfill their roles as collaborative clinician and active patient advocate.


Assuntos
Enfermagem de Cuidados Críticos/normas , Previsões , Unidades de Terapia Intensiva , Equipe de Assistência ao Paciente/organização & administração , Humanos , Comunicação Interdisciplinar , Cuidados Paliativos , Filipinas
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