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1.
J Nurs Adm ; 50(3): 142-151, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32068623

RESUMO

Nurse executives must embody the principles of transformational leadership to meet the leadership imperative of achieving high-quality outcomes in this ever-changing healthcare environment. This article describes the 4 domains of transformational leadership and provides pragmatic examples a nurse executive used to impact culture, outcomes, and the journey to Magnet designation. The strategies were utilized to support enculturation of Magnet principles by engaging clinical nurses, nursing leadership, and colleagues. Helping clinical nurses understand the alignment of their existing practice and values to the Magnet standards was ultimately a successful strategy.


Assuntos
Relações Interprofissionais , Liderança , Enfermeiras Administradoras/organização & administração , Recursos Humanos de Enfermagem no Hospital/organização & administração , Tomada de Decisões Gerenciais , Humanos , Satisfação no Emprego , Cultura Organizacional , Estados Unidos
2.
J Nurs Adm ; 50(2): 78-84, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31977944

RESUMO

OBJECTIVE: To examine factors that influence nurses' perceptions of organizational compassion and their engagement with the organization. BACKGROUND: Despite agreement about the importance of compassionate healthcare, it is difficult for employees to consistently act compassionately when organizational leaders, managers, and systems of care fail to support compassion as a value. METHODS: The study used a cross-sectional design, and quantitative and qualitative data were collected through an online survey of nurses. RESULTS: Higher individual compassion and team compassion were associated with higher perceived organizational compassion, and higher organizational compassion was associated with greater engagement with the hospital. In contrast, high turnover rates and inadequate staffing were associated with lower perceived organizational compassion and lower engagement with one's organization. CONCLUSIONS: Adequate staffing, resource allocation, and practices that contribute to the sense that one is a supported member of a caring team focused on addressing patients' needs build the capacity for compassion within an organization.


Assuntos
Atitude do Pessoal de Saúde , Empatia , Recursos Humanos de Enfermagem no Hospital/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Cultura Organizacional , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
3.
J Nurs Adm ; 50(1): 9-11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31809451

RESUMO

Despite Health Resources and Services Administration projecting a national excess of approximately 300 000 RNs as compared with demand by 2030, continued regional and local shortages have been confirmed. Pockets of chronic nurse shortages for various reasons, continued margin pressures, increased inpatient care complexity, continued RN turnover, and overall RN resilience are prompting chief nurse executives to investigate staffing model innovations. Next-generation staffing models include those that significantly embrace new teams and technology, as well as the philosophy of primary nursing care. Chief nurse executives must carefully analyze all models from the standpoint of organizational, cultural, and professional norms, as well their role in spearheading such efforts.


Assuntos
Modelos Organizacionais , Enfermeiras Administradoras , Recursos Humanos de Enfermagem no Hospital/organização & administração , Admissão e Escalonamento de Pessoal , Humanos , Cultura Organizacional
4.
J Clin Nurs ; 29(1-2): 53-59, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31241794

RESUMO

AIMS AND OBJECTIVES: To examine the association between registered nurses' (referred to as "nurses" for brevity) shifts of 12 hr or more and presence of continuing educational programmes; ability to discuss patient care with other nurses; assignments that foster continuity of care; and patient care information being lost during handovers. BACKGROUND: The introduction of long shifts (i.e., shifts of 12 hr or more) remains controversial. While there are claims of efficiency, studies have shown long shifts to be associated with adverse effects on quality of care. Efficiency claims are predicated on the assumption that long shifts reduce overlaps between shifts; these overlaps are believed to be unproductive and dangerous. However, there are potentially valuable educational and communication activities that occur during these overlaps. DESIGN: Cross-sectional survey of 31,627 nurses within 487 hospitals in 12 European countries. METHODS: The associations were measured through generalised linear mixed models. The study methods were compliant with the STROBE checklist. RESULTS: When nurses worked shifts of 12 hr or more, they were less likely to report having continuing educational programmes; and time to discuss patient care with other nurses, compared to nurses working 8 hr or less. Nurses working shifts of 12 hr or more were less likely to report assignments that foster continuity of care, albeit the association was not significant. Similarly, working long shifts was associated with reports of patient care information being lost during handovers, although association was not significant. CONCLUSION: Working shifts of 12 hr or more is associated with reduced educational activities and fewer opportunities to discuss patient care, with potential negative consequences for safe and effective care. RELEVANCE TO CLINICAL PRACTICE: Implementation of long shifts should be questioned, as reduced opportunity to discuss care or participate in educational activities may jeopardise the quality and safety of care for patients.


Assuntos
Continuidade da Assistência ao Paciente/normas , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Jornada de Trabalho em Turnos/estatística & dados numéricos , Estudos Transversais , Educação Continuada/estatística & dados numéricos , Europa (Continente) , Feminino , Hospitais , Humanos , Relações Interprofissionais , Masculino , Recursos Humanos de Enfermagem no Hospital/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Jornada de Trabalho em Turnos/psicologia , Inquéritos e Questionários
5.
Rev Lat Am Enfermagem ; 27: e3238, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31826169

RESUMO

OBJECTIVE: construct and test a proposal to measure the qualitative dimension of nursing workload; identify the workload cut-off point and its indicator as predictors of the good and optimal nursing care product score. METHOD: this is a descriptive study conducted in four inpatient units and four intensive care units of a Brazilian teaching hospital, considering 308 evaluations performed by 19 nurses. Four measurement instruments were used: three to assess the care demand in relation to nursing and the other to classify the care product delivered at the end of the shift. The workload was calculated and its indicator was constructed. RESULTS: a weak and inverse correlation was found between the care product score, workload and the workload indicator and the workload indicator in the units and moderate and inverse between Nursing care planning and Care needs assistance with the number of hospitalized patients. CONCLUSION: it is possible to associate workload and its indicator with the care product. Nursing workload ≤ 173 hours (24 hours) and indicator ≤ 12.3 hours / professional were associated with a higher probability of obtaining a "good" and "optimal" score in the care product in the inpatient units.


Assuntos
Recursos Humanos de Enfermagem no Hospital/organização & administração , Carga de Trabalho/normas , Adulto , Estudos Transversais , Feminino , Humanos , Pacientes Internados , Unidades de Terapia Intensiva , Masculino , Avaliação em Enfermagem , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Curva ROC , Carga de Trabalho/estatística & dados numéricos
6.
J Nurs Adm ; 49(12): 575-576, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31725514

RESUMO

The pace of change in today's healthcare environment is unprecedented. What used to happen every few months now seems to happen every day. From rapidly shifting technology to evolving models of care to new payment systems, nursing leaders must navigate constant change to stay relevant. How well they manage it has a direct bearing on everything from patient safety and outcomes to nursing cohesion and satisfaction. In this month's Magnet Perspectives column, we explore the essential elements that contribute to successful change management and the strategies leaders can employ to keep their nurses, and their organizations, forward-focused. In addition, we take a deep dive into the Magnet Model component of transformational leadership and examine its impact on creating and sustaining an environment where change flourishes and nurses thrive.


Assuntos
Atitude do Pessoal de Saúde , Liderança , Enfermeiras Administradoras/psicologia , Recursos Humanos de Enfermagem no Hospital/organização & administração , Inovação Organizacional , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
J Stroke Cerebrovasc Dis ; 28(12): 104398, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31585774

RESUMO

BACKGROUND: In-hospital strokes account for up to nearly 1 in 5 strokes. Clinical outcomes, such as length of stay, disability, and mortality are worse for in-hospital strokes than for those that occur in the community. For a variety of reasons, stroke can be more difficult to recognize and treat in hospitalized patients. Earlier recognition of stroke results in better clinical outcomes, presumably due to faster diagnosis and subsequently, prompt treatment. METHODS: This investigation was a retrospective, interrupted time series, observational study of all in-hospital stroke patients between 2008 and 2017. This investigation was a quality improvement project, and a waiver was granted from the institutional review board. We used Lean methodologies to standardize our stroke protocol and optimize skill-task alignment to improve the time from onset of symptoms to brain imaging (primary outcome). RESULTS: Overall, we observed significant improvement in the time from onset of symptoms to brain imaging from a median of 69 minutes to 37 minutes (P = .002). CONCLUSIONS: If successfully implemented, this approach may be useful in other care settings with potential to improve stroke outcomes, and decrease associated complications of stroke.


Assuntos
Isquemia Encefálica/enfermagem , Equipe de Respostas Rápidas de Hospitais/organização & administração , Pacientes Internados , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/organização & administração , Acidente Vascular Cerebral/enfermagem , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/diagnóstico por imagem , Diagnóstico Precoce , Feminino , Humanos , Análise de Séries Temporais Interrompida , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Melhoria de Qualidade , Indicadores de Qualidade em Assistência à Saúde , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnóstico por imagem , Fatores de Tempo , Resultado do Tratamento
8.
Rev Lat Am Enfermagem ; 27: e3170, 2019.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31596407

RESUMO

OBJECTIVE: to translate, adapt and test the psychometric properties of the Brazilian Nurse-Work Instability Scale. METHOD: this was a methodological study following the translation steps: synthesis, back-translation, specialist´s committee, semantics analysis, pretest, and psychometric tests. The committee was composed of 5 specialists. For the semantics analysis, 18 nursing workers evaluated the instrument and 30 pretested it. For the psychometric tests, the sample size was 214 nursing workers. The internal construct validity was analyzed by the Rasch model. Reliability was assessed using internal consistency, and concurrent validity with Pearson's correlation between the Nurse-Work Instability Scale, and the Work Ability Index, Job Stress Scale. RESULTS: a Nurse-Work Instability Scale in Brazilian Portuguese with 20 items showed an adequate reliability (0.831), stability (p <0.0001), and an expected correlation with Work Ability Index (r = -0.526; P<0.0001) and Job Stress Scale (r = 0.352; p <0.0001). CONCLUSION: the instrument is appropriated to detect work instability in Brazilian nursing workers with musculoskeletal disorders. Its application is fundamental to avoid long-term withdrawal from work by early identification of the work instability. Furthermore, the scale can assist the development of actions and strategies to prevent the abandonment of the profession of nursing workers affected by musculoskeletal disorders.


Assuntos
Emprego/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Saúde do Trabalhador/normas , Psicometria/métodos , Inquéritos e Questionários/normas , Carga de Trabalho/psicologia , Adulto , Brasil , Feminino , Humanos , Linguagem , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/organização & administração , Reprodutibilidade dos Testes , Traduções , Avaliação da Capacidade de Trabalho , Local de Trabalho/organização & administração
9.
Rev Lat Am Enfermagem ; 27: e3178, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31596413

RESUMO

OBJECTIVE: to analyze the expectation of nurses about the succession of leaders in the hospital context. METHOD: a descriptive and exploratory study of a qualitative approach carried out with 36 nurses from a public university hospital selected using the snowball technique. The data collection was done through semi-structured interviews that were recorded and analyzed based on the assumptions of the Content Analysis technique, Thematic modality. Ethical criteria were adequately met. RESULTS: the reports comprised two central categories, "Who Will Take My Place?" and "Potential and Openness to Plan the Succession of Leadership in Nursing," the latter being divided into two subcategories: "Nursing leadership in the hospital five years from now" and "Strengths for the implementation of a leadership succession plan". CONCLUSION: from the results, positive aspects of the diagnosis of the leadership profile in the institution that favor the development of succession planning were verified. In addition, it was possible to perceive the necessity of the development of this planning in the hospital and its importance for the succession of leadership in Nursing. In this context, this study presents itself with an innovative character for exposing a theme that aims to potentiate the future of Nursing.


Assuntos
Liderança , Enfermeiras Administradoras , Recursos Humanos de Enfermagem no Hospital/organização & administração , Desenvolvimento de Pessoal/organização & administração , Feminino , Humanos , Masculino , Motivação , Recursos Humanos de Enfermagem no Hospital/psicologia
10.
Rev Esc Enferm USP ; 53: e03496, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31618312

RESUMO

OBJECTIVE: To apply the standard time parameters of nursing activities proposed by COFEN Resolution No. 543/2017 to determine the number of nursing technicians in the material and sterilization center of a university hospital and compare the projected framework with the existing one in the sector. METHOD: An exploratory and descriptive study with data collection performed on the sterilization control sheets and direct observation of the work process stages in the different sector areas. RESULTS: Only one of the 15 described activities was not conducted in the sector; those most performed which presented more workload and required more personnel were the receiving of contaminated materials and the organization and distribution of sterilized materials; the areas that required the highest number of employees were for materials preparation and cleaning/disinfection. No difference was observed between the number of staff required in the different work shifts, and the calculated staff quantity was similar to that existing in the result of the staff sizing performed using the functional sites. CONCLUSION: The proposals analyzed in this study can be used to calculate staff size in the studied sector and in other institutions.


Assuntos
Hospitais Universitários/organização & administração , Recursos Humanos de Enfermagem no Hospital/organização & administração , Esterilização , Humanos , Fatores de Tempo , Carga de Trabalho
12.
BMC Res Notes ; 12(1): 612, 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31547843

RESUMO

OBJECTIVE: The objective of this study was to investigate documentation practice and factors affecting documentation practice among nurses working in public hospital of Tigray region, Ethiopia. RESULTS: In this study, there were 317 participants with 99.7% response rate. The result of this study shows that practice nursing care documentation was inadequate (47.8%). Inadequacy of documenting sheets AOR = 3.271, 95% CI (1.125, 23.704), inadequacy of time AOR = 2.205, 95% CI (1.101, 3.413) and with operational standard of nursing documentation AOR = 2.015, 95% CI (1.205, 3.70) were significantly associated with practice of nursing care documentation. To conclude, more than half of nurses were not documented their nursing care. Employing institutions should provide training on documentation of nursing care to enhance knowledge and create awareness on nurses' documentation to nursing directors and chief executive officer to access adequate documenting supplies besides employing more nurses.


Assuntos
Documentação/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Públicos/organização & administração , Registros de Enfermagem/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/organização & administração , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , Guias de Prática Clínica como Assunto , Inquéritos e Questionários
14.
Rev Esc Enferm USP ; 53: e03490, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389487

RESUMO

OBJECTIVE: To explore the actions and factors associated to patient advocacy by intensivist nurses using the Protective Nursing Advocacy Scale. METHOD: A quantitative, descriptive-exploratory, cross-sectional study. The questionnaire was answered by nurses who worked in Intensive Care Units in the South and Southeast regions of Brazil. A factorial exploratory analysis of the data, T-tests and the chi-square test were used for association between factors. RESULTS: 451 nurses participated in the study. A greater number of nurses disagreed with the negative consequences that patient advocacy may have or bring to them. Greater dialogue among nursing staff would enhance teamwork results. Nurses with two or more job relationships need more physical and mental effort, which compromises their quality of life and work, leading to them being those who least practice patient advocacy. CONCLUSION: Nurses understand patient advocacy as an important part of their work, as well as factors which may influence their decision to defend their patients, but are still unaware of the benefits of advocacy.


Assuntos
Unidades de Terapia Intensiva , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Defesa do Paciente/psicologia , Adulto , Atitude do Pessoal de Saúde , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/organização & administração , Qualidade de Vida , Inquéritos e Questionários
15.
Cien Saude Colet ; 24(8): 2895-2908, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389537

RESUMO

An integrative review was performed to identify and analyze national studies on barriers to patient safety incident reporting by health professionals within Brazilian health services. A search in the Virtual Health Library (BVS) Portal, PubMed and Web of Science was performed in January 2017 for papers published in the last ten years. One thousand and seven publications were identified and, following application of inclusion and exclusion criteria, eight papers were analyzed, five of which were qualitative and three quantitative. All research was conducted in hospitals, exclusively with nursing professionals, and 75% was conducted in Southeast Brazil. Most studies showed an under-reporting of incidents, and the main reasons were fear about reporting, reporting focused on more severe incidents, lack of knowledge about the subject or how to report and, registered nurse-centered reporting. While study of this theme is still incipient in Brazil, this review found important weaknesses in the process and barriers to incident reporting by professionals, revealing a need for encouraging their participation, eliminating or reducing such barriers with a view to strengthening patient safety.


Assuntos
Recursos Humanos de Enfermagem no Hospital/organização & administração , Segurança do Paciente , Gestão de Riscos/métodos , Brasil , Pessoal de Saúde/organização & administração , Humanos , Erros Médicos/estatística & dados numéricos
16.
Nurs Manag (Harrow) ; 26(4): 22-28, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31468826

RESUMO

NHS regulators, such as NHS Improvement and the Care Quality Commission, promote staff involvement in quality improvement (QI), while national nursing leaders and the Nursing and Midwifery Council advocate nurses' involvement in improving services. This article critically explores the evidence base for a national nursing strategy to involve nurses in QI using a literature review. A thematic analysis shows that nurse involvement in QI has several positive outcomes, which are also included in the NHS Improvement's Single Oversight Framework for NHS Providers. The article concludes that nurse involvement in QI helps improve hospital performance.


Assuntos
Hospitais/normas , Recursos Humanos de Enfermagem no Hospital/organização & administração , Melhoria de Qualidade/organização & administração , Medicina Estatal/organização & administração , Inglaterra , Humanos , Pesquisa em Avaliação de Enfermagem
18.
Prof Case Manag ; 24(5): 249-258, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31369488

RESUMO

BACKGROUND: Care management roles and responsibilities are frequently called out in leading white papers and exemplars; yet, the actual roles and responsibilities are poorly defined. METHOD: A qualitative content analysis using 6 landmark white papers and exemplars from national organizations to collect emerging care management and coordination roles and responsibilities. RESULTS: Three major themes emerged from the content analysis: (1) care management is about complex systems and complex medical and social needs, (2) nurses are central to the interdisciplinary team, and (3) informatics is vital to support and enhance care management. IMPLICATIONS FOR PRACTICE: Care managers need to be experienced with complex systems of care as well as complex diagnoses and conditions that our clients and their caregiver's experience. A nurse being central to the clients and embedded within the interdisciplinary team aids in diminishing the burden of negotiating the trajectory of a condition/illness as well as improves the interdisciplinary communication and teamwork. This review of literature has defined the complexity of care management and the discreet roles and responsibilities, as well as how informatics is vital for care managers to target and monitor key populations needing care management.


Assuntos
Administração de Caso/organização & administração , Competência Clínica , Cuidados de Enfermagem/organização & administração , Recursos Humanos de Enfermagem no Hospital/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Papel Profissional , Adulto , Feminino , Humanos , Comunicação Interdisciplinar , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
19.
Rev Esc Enferm USP ; 53: e03483, 2019 Aug 19.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31433014

RESUMO

OBJECTIVE: To measure the attitudes of nurses on nursing process at a public teaching hospital. METHOD: A cross-sectional and analytical study conducted with nurses at a tertiary hospital. It was applied an instrument to characterize sample, as well as the Positions on the Nursing Process instrument, which measures nurses' attitudes in relation to the nursing process. There are 20 items to be considered, in which the minimum possible value is 20 and the maximum of 140. The data were submitted to descriptive statistics and the variables of interest were analyzed by the Mann-Whitney, Student's t-test, Chi-square test, Kruskal-Wallis, Spearman's correlation coefficient and hierarchical multiple regression models, as appropriate. RESULTS: In a sample of 226 nurses, 80.5% (182) stated that they performed pdaily. The mean score of the instrument was 102.50 (SD = 21.76). The item "routine/creative" had a lower score (3.54), while "unimportant/important" had a higher score (5.81). CONCLUSION: The nurses reported being in favor and presented positive attitudes about nursing process, in addition to considering it important, but routine, as well as affirming little or no contact with research, classes or events on the subject.


Assuntos
Atitude do Pessoal de Saúde , Processo de Enfermagem , Recursos Humanos de Enfermagem no Hospital/organização & administração , Adulto , Idoso , Estudos Transversais , Feminino , Hospitais Públicos , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/psicologia , Inquéritos e Questionários
20.
Niger J Clin Pract ; 22(7): 906-912, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31293253

RESUMO

Objective: The aim of this study was to investigate how Queen bee syndrome, which is known as the mobbing behaviors of female employees from other female employees or managers, as perceived by nurses who are predominantly female workers. Materials and Methods: The universe of the qualitative type patterned research was formed by 12 nurses between the ages of 20 and 40 who worked for at least one year in different parts of a private hospital on the Anatolian side of Istanbul province. Maximum diversity sampling method for purposes was used for sample selection. The research data were collected in the form of written recording and voice recording with an unstructured interview form, which includes the structure, gender, competence, support, conflict, and competition themes created by the researchers to evaluate the characteristics of Queen bee syndrome. Focus group interviews were held on 30 April 2018. The results were evaluated using descriptive analysis and indicator methods. Results: In the study, the nurses' responses to interview questions were examined and women managers felt more emotional than men managers, and therefore they were less successful in problem-solving than men managers, but they were more successful in communication among women. The majority of nurses stated that women managers are more suitable for management in healthcare, that they are open to change, but they are not enough for men to solve the problem due to the fact that they are more concerned with the details. In addition, a significant part of the nurses, more than one female managers can cause competition and conflict in the workplace, especially women managers with similar status, said that this situation is seen more. Conclusions: The results of this study indicate that the woman is adapting to the Queen bee syndrome because of her ambition, competition, and emotional approaches, but that she has not been able to produce enough of it due to the environment.


Assuntos
Atitude do Pessoal de Saúde , Recursos Humanos de Enfermagem no Hospital/psicologia , Local de Trabalho/psicologia , Adolescente , Adulto , Animais , Feminino , Grupos Focais , Hospitais Privados , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Enfermeiras Administradoras/organização & administração , Enfermeiras Administradoras/psicologia , Recursos Humanos de Enfermagem no Hospital/organização & administração , Percepção , Pesquisa Qualitativa , Adulto Jovem
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