Introdução: Estudos epidemiológicos tem elucidado a associação entre diabetes mellitus (DM) e tuberculose (TB), reacendendo o debate quanto à suscetibilidade de indivíduos com DM tipo 1 e tipo 2, em adquirir a doença. Progressivamente, o DM tem apresentado alta prevalência, revelando-se como mais uma epidemia a ser superada. Considerando-se a continuidade das altas taxas de TB, acredita-se que a convergência destas com as taxas de DM constitui-se como problema importante de saúde pública. A literatura científica tem mostrado sobejamente a explicação de tais enfermidades, substantivamente na perspectiva clínica e biológica, ainda que no caso da TB, a sua associação às condições de vida adquira maior relevo. Entretanto, o que ocorre quando a TB e o DM encontram-se associadas? Quais são as tendências, na produção da literatura científica e que tipos de abordagens tem sido conduzidas para a interpretação de tais enfermidades? Destaca-se, portanto, a importância de analisar a produção científica mundial a respeito desta associação, em especial, buscando-se identificar se expõe a determinação social, quando estas enfermidades encontram-se associadas. Objetivo: Objetiva analisar como a literatura científica tem apresentado a associação entre o Diabetes Mellitus e a Tuberculose. Método: Trata-se de revisão integrativa. As buscas foram realizadas nas bases de dados PubMed, LILACS, CINAHL, Web of Science e Dedalus (USP). Resultados: Considerando-se o período de 2000 a 2012, foram identificadas e selecionadas 352 publicações por títulos e resumos, das quais 62 foram analisadas por ano de publicação e principal abordagem do estudo. As publicações foram classificadas nos seguintes enfoques: farmacológico (10; 16,1%), imunológico (13; 20,96%), apresentação clínica (13; 20,96%) ou epidemiológico (26; 41,93%). Foram encontrados 7 estudos que foram reclassificados como enfoque social (6). Conclusão: Apesar de realizados em países com forte desigualdade social e desigualdades em saúde, como Índia, China, México, Malásia e municípios de fronteira entre Texas (EUA) e o México localidades que apresentam bolsões importantes de pobreza, onde a incidência da TB permanece alta e a do DM se mantém crescente, a maior parte dos estudos (96,77%) não considera a forte determinação social posta na causalidade destas doenças, bem como os determinantes sociais de saúde como condicionantes para a coexistência destas enfermidades / Introduction: Epidemiological studies have clarified the association of diabetes mellitus (DM) with tuberculosis (TB), escalating the debate concerning the susceptibility of individuals with DM type 1 and type 2, to contract the disease. Progressively, DM has presented high prevalence, revealing as another epidemic to be overcome. Considering the steadily high rates of TB, we believe that the convergence of them with DM rates constitutes an important issue for the public health. The scientific literature has widely shown the interpretation of such illnesses, mainly in clinical and biological perspectives, although in the case of TB, its association with life conditions is highlighted. Nevertheless, what occurs when TB and DM are associated? What are the tendencies in the production of scientific literature and what types of approaches have been conducted to interpret such illnesses? Thus, the importance to analyze what is being produced worldwide concerning this association is pointed out, specially, seeking to identify whether the scientific literature exposes the social determination when these illnesses are associated. Objective: this study has as objective to analyze how the scientific literature has presented the association of Diabetes Mellitus with Tuberculosis. Method: it is an integrative review whose research was carried out on PubMed, LILACS, CINAHL, Web of Science and Dedalus (USP) data base. The study is based on the following questions: What are the approach tendencies in the association of TB with DM, considering the period of 2000 to 2012? and Since the association TB-DM was first documented, what has been the tendencies approached in the health-illness process? Results: 352 publications by titles and abstracts were identified and selected, from which 62 were analyzed considering the publication year and the main study approach, being therefore classified into pharmacological (10; 16,1%), immunological (13; 20,96%), clinical presentation (13; 20,96%) or epidemiological (26; 41,93%) approaches. Depending on the emphasis of the variables considered and on the discussion emphasis, the studies were subdivided in social approach (7). Conclusion: Despite being carried out in countries with high social inequality and inequalities in health, such as India, China, Mexico, Malaysia and cities bordering Texas (USA) and Mexico which are among the poorest municipalities in the USA, where TB incidence keeps high and DM increases, the majority of the studies (96,77%) looked into TB-DM association in clinical and programming scope, without considering the strong social determination laid on the causality of these diseases, as well as the social determinants of health as constraints for the coexistence of these illnesses

Made available in DSpace on 2016-04-28T20:56:47Z (GMT). No. of bitstreams: 1 Elisa Alves de Almeida.pdf: 1751217 bytes, checksum: fac74030987fd7e64bf4be807fe01637 (MD5) Previous issue date: 2014-09-05 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research aimed to identify and characterize Brazilian scientific production on Education, Activity and Animal Assisted Therapy. The study is an integrative literature review, which summarizes data from Brazilian scientific production on the subject published until December 2013, found in the databases SciELO, LILACS, BVS-Psi, PePSIC and Public Domain data, public and private universities libraries, references, national bookstores and authors. Was found 81 scientific publications which met the inclusion criteria of the study, with 26 scientific articles, ten courseworks/monographs, 19 dissertations/theses and 26 books. The main data extracted from the scientific productions were organized into a database that, then, were analyzed by means of analytical categories. It was observed that annually the animal-assisted interventions have been subject of studies in the last decade, especially in the area of psychology, in which the animal was shown to be an important therapeutic resource. Although the horse is the most common animal in the studies, there are many animals that provide various activities that allow the service of a different target audience, from children to elderly, from healthy people until ones with illnesses, disabilities or difficulties / Esta pesquisa teve por objetivo identificar e caracterizar produções científicas brasileiras sobre Educação, Atividade e Terapia Assistida por Animais. O estudo trata de uma revisão integrativa da literatura, que sintetiza os dados de produções científicas brasileiras sobre a temática publicadas até dezembro de 2013, encontradas nas bases de dados SciELO, LILACS, BVS-Psi, PePSIC e Domínio Público, bibliotecas de universidades públicas e particulares, referências, livrarias nacionais e autores. Encontraram-se 81 produções científicas que respeitavam os critérios de inclusão da pesquisa, sendo 26 artigos científicos, dez TCC/monografias, 19 dissertações/teses e 26 livros. Os principais dados extraídos das produções científicas foram organizados em banco de dados que, em seguida, foram analisados por meio de categorias analíticas. Observou-se que as intervenções assistidas por animais têm sido anualmente alvo de estudos na última década, em especial da área da psicologia, na qual o animal mostrou-se como um recurso terapêutico importante. Embora o cavalo seja o animal mais frequente nos estudos, são muitos os animais que possibilitam várias atividades que permitem o atendimento de um público alvo diferenciado, de crianças a idosos, de pessoas saudáveis a pessoas com doenças, dificuldades ou deficiências

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2016-11-09T10:57:41Z No. of bitstreams: 1 Sílvia de Paula Gorzoni.pdf: 898297 bytes, checksum: cde45e8817203e8a361749fa152c5524 (MD5) / Made available in DSpace on 2016-11-09T10:57:41Z (GMT). No. of bitstreams: 1 Sílvia de Paula Gorzoni.pdf: 898297 bytes, checksum: cde45e8817203e8a361749fa152c5524 (MD5) Previous issue date: 2016-08-12 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The current work aims to perform a mapping on the Professional teaching in the articles published in the five most consulted educational magazines , according to SciELO, over the years 2006 to 2014. This study is due to the lack of consensus of different researches on the aspects and conditions of professional teaching. Thirty three articles with the terms professional, professionalization, professionalism and professional development associated with the words: teacher, lecturer and teaching in issues subject, title and/or keywords were found. It was found that most items are essays and empirical research. This fact demonstrated a lack of questions about professional teaching concept. It has not been found any lack of consensus on aspects of the professional teaching, but emphasis on one or another aspect on professional teaching concept. There were found many more articles on professionalization teaching and professional teaching development if compared to articles on professionalism and professional teaching subject. This work stands out the wide professionalism and it suggests new studies on relationship between professional teaching and professional teaching development / O presente trabalho tem como objetivo realizar um mapeamento sobre a temática da profissionalidade docente nos artigos publicados nas cinco revistas de educação mais consultadas, segundo a SciELO, durante os anos de 2006 a 2014. Tal estudo se justifica perante a falta de consenso, em diversas pesquisas científicas, sobre os aspectos e as condições da profissionalidade docente. Foram encontrados 33 artigos que possuíam os termos profissionalidade, profissionalização, profissionalismo e desenvolvimento profissional, associados às palavras: professor, docente, docência nos tópicos assunto, título e/ou palavraschave. Constatou-se que a maioria dos artigos é do gênero ensaio e pesquisa empírica, demonstrando falta de indagações conceituais sobre a profissionalidade docente. Neste trabalho não se constatou falta de consenso sobre aspectos da profissionalidade docente, mas ênfase para um ou outro aspecto que envolve o seu conceito. Foram encontrados mais artigos sobre o tema da profissionalização docente e do desenvolvimento profissional docente se comparados aos poucos artigos referentes ao tema do profissionalismo docente e profissionalidade docente. Este estudo destaca a profissionalidade ampla/desenvolvida e sugere novos estudos sobre a relação entre profissionalidade docente e desenvolvimento profissional docente

Introdução: Estudos epidemiológicos tem elucidado a associação entre diabetes mellitus (DM) e tuberculose (TB), reacendendo o debate quanto à suscetibilidade de indivíduos com DM tipo 1 e tipo 2, em adquirir a doença. Progressivamente, o DM tem apresentado alta prevalência, revelando-se como mais uma epidemia a ser superada. Considerando-se a continuidade das altas taxas de TB, acredita-se que a convergência destas com as taxas de DM constitui-se como problema importante de saúde pública. A literatura científica tem mostrado sobejamente a explicação de tais enfermidades, substantivamente na perspectiva clínica e biológica, ainda que no caso da TB, a sua associação às condições de vida adquira maior relevo. Entretanto, o que ocorre quando a TB e o DM encontram-se associadas? Quais são as tendências, na produção da literatura científica e que tipos de abordagens tem sido conduzidas para a interpretação de tais enfermidades? Destaca-se, portanto, a importância de analisar a produção científica mundial a respeito desta associação, em especial, buscando-se identificar se expõe a determinação social, quando estas enfermidades encontram-se associadas. Objetivo: Objetiva analisar como a literatura científica tem apresentado a associação entre o Diabetes Mellitus e a Tuberculose. Método: Trata-se de revisão integrativa. As buscas foram realizadas nas bases de dados PubMed, LILACS, CINAHL, Web of Science e Dedalus (USP). Resultados: Considerando-se o período de 2000 a 2012, foram identificadas e selecionadas 352 publicações por títulos e resumos, das quais 62 foram analisadas por ano de publicação e principal abordagem do estudo. As publicações foram classificadas nos seguintes enfoques: farmacológico (10; 16,1%), imunológico (13; 20,96%), apresentação clínica (13; 20,96%) ou epidemiológico (26; 41,93%). Foram encontrados 7 estudos que foram reclassificados como enfoque social (6). Conclusão: Apesar de realizados em países com forte desigualdade social e desigualdades em saúde, como Índia, China, México, Malásia e municípios de fronteira entre Texas (EUA) e o México localidades que apresentam bolsões importantes de pobreza, onde a incidência da TB permanece alta e a do DM se mantém crescente, a maior parte dos estudos (96,77%) não considera a forte determinação social posta na causalidade destas doenças, bem como os determinantes sociais de saúde como condicionantes para a coexistência destas enfermidades / Introduction: Epidemiological studies have clarified the association of diabetes mellitus (DM) with tuberculosis (TB), escalating the debate concerning the susceptibility of individuals with DM type 1 and type 2, to contract the disease. Progressively, DM has presented high prevalence, revealing as another epidemic to be overcome. Considering the steadily high rates of TB, we believe that the convergence of them with DM rates constitutes an important issue for the public health. The scientific literature has widely shown the interpretation of such illnesses, mainly in clinical and biological perspectives, although in the case of TB, its association with life conditions is highlighted. Nevertheless, what occurs when TB and DM are associated? What are the tendencies in the production of scientific literature and what types of approaches have been conducted to interpret such illnesses? Thus, the importance to analyze what is being produced worldwide concerning this association is pointed out, specially, seeking to identify whether the scientific literature exposes the social determination when these illnesses are associated. Objective: this study has as objective to analyze how the scientific literature has presented the association of Diabetes Mellitus with Tuberculosis. Method: it is an integrative review whose research was carried out on PubMed, LILACS, CINAHL, Web of Science and Dedalus (USP) data base. The study is based on the following questions: What are the approach tendencies in the association of TB with DM, considering the period of 2000 to 2012? and Since the association TB-DM was first documented, what has been the tendencies approached in the health-illness process? Results: 352 publications by titles and abstracts were identified and selected, from which 62 were analyzed considering the publication year and the main study approach, being therefore classified into pharmacological (10; 16,1%), immunological (13; 20,96%), clinical presentation (13; 20,96%) or epidemiological (26; 41,93%) approaches. Depending on the emphasis of the variables considered and on the discussion emphasis, the studies were subdivided in social approach (7). Conclusion: Despite being carried out in countries with high social inequality and inequalities in health, such as India, China, Mexico, Malaysia and cities bordering Texas (USA) and Mexico which are among the poorest municipalities in the USA, where TB incidence keeps high and DM increases, the majority of the studies (96,77%) looked into TB-DM association in clinical and programming scope, without considering the strong social determination laid on the causality of these diseases, as well as the social determinants of health as constraints for the coexistence of these illnesses

Trata-se de uma revisão integrativa da literatura com os objetivos de identificar, avaliar criticamente e sintetizar as evidências científicas relacionadas ao direito à informação em saúde. A questão norteadora para a pesquisa foi: Quais as evidências disponíveis sobre o direito à informação em saúde? As bases de dados Hein Online, ISTA, Lilacs, LISA, PubMed e Web of Science foram selecionadas para a busca de estudos primários indexados nos últimos 10 anos. Os descritores controlados e não controlados foram selecionados de acordo com cada base de dados. Dos 6888 estudos localizados e considerando os critérios de seleção foram excluídos 2433 por não serem artigos de periódico, 907 por não serem estudos primários, 3346 devido à ausência de relação ao tema. Do total de 202 elegíveis, 183 não respondiam à questão norteadora e 15 estudos primários foram incluídos na revisão integrativa. Para a extração dos dados foi utilizado um instrumento validado. A análise dos dados foi descritiva e apresentada em três categorias: conhecimento de pacientes sobre seu direito à informação, conhecimento de pacientes e profissionais de saúde sobre direito à informação do paciente e conhecimento de profissionais de saúde sobre o direito à informação do paciente. O desenvolvimento desta revisão integrativa da literatura permitiu, por meio dos resultados obtidos, encontrar as principais evidências relacionadas ao direito à informação em saúde. Em todas as categorias verifica-se a necessidade de capacitação de profissionais de saúde em relação ao direito dos usuários de serviços de saúde. Assim, a educação dos profissionais mostra-se como uma possibilidade de se fazer cumprir o direito à informação do paciente, melhorando a prática assistencial e consequentemente as condições de saúde das pessoas / The aim of this integrative literature review was to identify, critically evaluate and summarize evidence from primary studies related to the right to health information. The guiding question for the research was : What evidence is available on the right to health information ? The Hein Online databases, ISTA, Lilacs, LISA, PubMed and Web of Science were selected for the search for primary studies indexed in the last 10 years. The controlled and uncontrolled descriptors were selected according to each database. From over 6888 studies and considering the selection criteria, 2433 were excluded for not being journal articles, 907 for not being primary studies, 3346 due to the lack of relationship with the theme. Of the 202 eligible ones, 183 did not respond to the guiding question and 15 primary studies were included in the integrative review. To entry the data, a validated instrument was used. Data analysis was descriptive and presented in three categories: knowledge of patients about their right to information, knowledge of patients and health professionals on patient\'s right to information and knowledge of health professionals on the right to patient information. The development of this integrative literature showed, through the results, the main evidence related to the right to health information. In all categories, there is a need to train health professionals in relation to the right of health services users. Thus the education of professionals emerges as a possibility to enforce the right to patient information, improving care practice and consequently the health of the people

Drygt 25 procent av alla barn som vårdas inom slutenvård i Sverige vårdas på vuxenavdelning. Orsakerna till detta varierar och kan bero på distans, platsbrist eller behov av specifik kompetens och vård. Likande anledningar kan ses i USA där över 70 % barn vårdas på en vuxenavdelning när de är i behov av sjukhusvård. Barnets delaktighet i sin egen behandling är en viktig aspekt vid vård på sjukhus. Barnets utvecklingsfaser bör tas i beaktning och deras åsikter respekteras för att kunna bedriva en trygg och patientsäker vård. Vårdnadshavarens närvaro ökar även trygghetskänslan för barnet. Syftet med denna integrativa litteraturöversikt var att granska tidigare forskning kring barns erfarenheter av att vårdas på en vuxenavdelning. Sökning i fem databaser genererade sju artiklar som har analyserats systematiskt utifrån en induktiv metod med innehållsanalys enligt Elo och Kyngäs. I resultatet framkom två huvudkategorier som visade sig vara problematiska: Betydelsen av delaktighet i vården och Den vårdande miljöns betydelse. För att främja hållbar utveckling för barn krävs att personalen som vårdar dem har rätt kunskap och kompetens. En väl anpassad och trygg vårdmiljö med adekvat information utifrån barnets kunskapsnivå kan generera en känsla av säkrare vård och en förståelse av sin omgivning. Det finns ännu ingen forskning i Sverige om hur barn upplever vård på en vuxenavdelning, vilket kan driva vården framåt för en sannolikt bättre vårdupplevelse utifrån barnperspektivet. / Just over 25 percent of children receiving inpatient care in Sweden end up in units for adults. Some of the reasons are due to lack of space on children’s units, distance and the need for specific competencies and care. Similar reasons can be seen in the USA where over 70% of children are cared for in an adult ward when they need hospital care. A child’s active participation in their own care is an important aspect of care at hospital. Children’s developmental stages should be considered, and their opinions respected in order to provide a safe environment and care. The parents’ and guardians’ presence will also increase the child’s feeling of safety. The purpose of this integrative literature review is to examine previous research studies on children’s experiences when receiving care at an adult unit. The search of five databases generated seven articles that were systematically analyzed based on the inductive method with content analysis according to Elo and Kyngäs. The results brought about two main categories that were identified as problematic: The importance of participation in care and The importance of the caring environment. To promote sustainable developmental care for children it is required that hospital personnel have age-appropriate knowledge and competence of treatment. A well-adapted and safe treatment environment with adequate knowledge based on the child’s level of knowledge could generate a safer feeling and understanding of the current situation. Children should not receive treatment at an adult unit but when unavoidable, research must be the driving force behind child centered care. In Sweden there is still no research based on children’s experiences receiving treatment at an adult medical unit. Further research is necessary for better care and understanding a child’s perspective.

Syftet är att undersöka konsekvenser för barn, unga och unga vuxna i åldern 0-25 år som växer upp tillsammans med syskon som har funktionsnedsättning. Dessutom är syftet att identifiera betydande faktorer för att uppnå ökad kunskap om hur professionella inom hälsooch sjukvård kan utveckla arbetet och bemötandet till barnen och deras familjer. Studiens teoretiska ramverk är Eriksons åtta utvecklingsfaser och Marcias identitetsstatusmodell som berör människors identitetsutveckling ur ett psykosocialt perspektiv samt copingstrategier för att hantera sin situation. Studien är utformad som en integrativ litteraturstudie, vilket innebär att vetenskapligt material med både kvalitativ och kvantitativ metod samlas in. Samtliga artiklar bearbetas och sammanställs genom tematisk analysmetod. Resultatet visar att målgruppen löper ökad risk för sociala konsekvenser, emotionell överbelastning och psykisk ohälsa. Resultatet tyder på att syskon med funktionsnedsättningen i sig inte bidrar till ökad psykisk ohälsa hos barnet, däremot eventuella konsekvenser av funktionsnedsättningen. Det framträder även positiva konsekvenser som utvecklad stresshantering, ökat tålamod samt värderingar om respekt för andra trots olikheter. Framträdande risk- och skyddsfaktorer är tillgång till socialt stöd, föräldrar, diagnosens karaktär och ålder. Utöver konsekvenser som mätbar hälsa framkommer även att identitetsutvecklingen kan påverkas och således även copingstrategiernas betydelse för att hantera situationen på ett framgångsrikt sätt. / The following study aims to investigate the consequences for children aged 0-25 growing up with a sibling with a developmental disorder. In addition, the study intends to identify significant factors to achieve knowledge on how professionals in healthcare can develop the work and treatment with the children and their families. The study's theoretical framework is a psychosocial perspective on identity development and coping strategies. The study is designed as an integrative review in which both qualitative and quantitative data have been included. The data is processed and compiled through thematic analysis. The results show that growing up with a sibling with a developmental disorder can be related to higher risk of social consequences, emotional overload and mental illness. The results indicate that it’s the potential consequences of the disorder that is the main reason for the higher risk of mental illness. There are also positive consequences such as developed stress management, increased patience and values about respect for others despite differences. Identified prominent factors are social support, parents, the diagnosis and age. Identity development can be affected and thus also the importance of coping strategies for managing the situation in a successful way.

<p><strong>Background.</strong> The nursing profession has a long tradition of migration. The migration of nurses from Canada has received little attention.</p> <p><strong>Objective.</strong> The purpose of this sandwich thesis was to understand the migration intentions of nurse graduates in a Canadian border city, their intention to become commuter migrants, and to explore the factors influencing these intentions.</p> <p><strong>Methods.</strong> Two qualitative studies of the migration literature included an analysis of the concept of migration and an integrative review of case study methodology in the study of nurse migration. A mixed methods study, guided by the Value-Expectancy framework, explored the migration intentions of nurse graduates in a Canadian border city and the factors influencing these intentions.</p> <p><strong>Results.</strong> The concept of nurse migration was found to be multifaceted. Its attributes, antecedents and consequences were defined. The mixed methods study provided insights into the migration intentions of recently graduated Canadian nurses. The majority preferred to work in Canada, but because of a perceived absence of valued jobs factors, were willing to migrate. Two thirds considered migrating and sixteen percent were interested in becoming commuter migrants. The findings supported the hypothesis that nurses weigh employment values (goals) against the expectation of achieving them, thus influencing intentions to migrate or stay.</p> <p><strong>Conclusion.</strong> The value-expectancy framework offered a novel approach for identifying the job factors that were driving migration intentions. There is a need for more primary research employing different methodologies to explore the characteristics, causes, and consequences of nurse migration that were identified through this research.</p> / Doctor of Philosophy (PhD)

Problématique. L’importance de la qualité de la relation entre de jeunes adultes présentant un trouble concomitant de santé mentale et lié aux substances et leurs intervenants pour la santé de ces jeunes est bien documentée. Or, ce phénomène complexe a surtout été étudié dans une perspective individuelle plutôt que systémique alors que plusieurs des résultats d’études antérieures soutiennent le caractère systémique de cette relation. But. Cette étude vise à mieux comprendre, selon une perspective systémique, le phénomène complexe de la relation entre les jeunes adultes atteints d'un trouble concomitant de santé mentale et lié aux substances et les intervenants. Méthode. Une revue intégrative basée sur un cadre théorique systémique a été effectuée. Six bases de données ont été consultées, une recherche de littérature grise et une vérification des références ont bonifié le processus. Résultats. Sur un total de 532 écrits recensés, 44 ont été inclus. L’analyse thématique a fait ressortir deux thèmes, soit a) le système de santé : un environnement contraignant et b) la relation au coeur des soins. Le premier thème décrit le contexte de la relation alors que le deuxième concerne l’influence des soins prodigués, de la confiance réciproque et du caractère hiérarchique de la relation sur la qualité de cette relation. Conclusion. Cette étude corrobore le rôle conjoint joué par le jeune et l’intervenant dans le développement et le maintien de leur relation. Elle peut donc constituer d’assise pour le développement d’interventions infirmières mettant à l’avant plan la relation selon une perspective systémique. / Problem. Importance of a quality relationship between young adults living with dual diagnosis and their health care providers is well documented. However, this complex phenomenon was mostly studied with an individual perspective instead of systemic perspective even if the results addressed the systemic nature of this relationship. Objective. This study aims to better understand the relationship between young adults living with dual diagnosis and their health care providers with a systemic perspective. Method. An integrative review framed by a systemic approach was completed. Six data bases were consulted, manual research in grey literature and references screening enhanced the process. Results. On a total of 500 studies and 32 reports identified, 44 were included in the review. Thematic data analysis was realized, and two themes were identified: (a) the health care system: a constraining environment and (b) the relationship: at the heart of care. The first theme describes the context of the relationship, and the second theme addresses the influence of cares, mutual confidence, and hierarchic relationship on the quality of this relationship. Conclusion. This study supports the joint role played by both young adult and health care provider on the development and the maintenance of their relationship. This integrative review can represent the foundation of future nursing interventions that brought the relationship to the forefront of nursing cares with a systemic approach.