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 Spirituality: A pedagogical resource in the practice of child care in health

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ORIGINAL ARTICLE

GERONE, Lucas Guilherme Teztlaff de [1]

GERONE, Lucas Guilherme Teztlaff de. Spirituality: A pedagogical resource in the practice of child care in health. Revista Científica Multidisciplinar Núcleo do Conhecimento. Year 05, Ed. 09, Vol. 01, pp. 89-107. September 2020. ISSN: 2448-0959, Access link: https://www.nucleodoconhecimento.com.br/science-of-religion/childcare

SUMMARY

Context: Throughout human history, it is common to find the relationship between education, health and spirituality. Currently, the discussion about the integrality of the human being is by reflection of the relationship between education, health and spirituality. Objectives: This study presents a reflection on spirituality as a pedagogical resource, specifically for a better practice of child care among health professionals. Methodological: we sought an initial overview of the notion of terms of study and their history, also, reflections are made that involve spirituality as a resource for child care. For this, references are used that address themes about education, health and spirituality. Considerations: Spirituality as a pedagogical resource in child care enables: a) a reflection on self-knowledge; b) disciplinary training; c) cognitive and behavioral development; (d) a therapeutic form; e) and an integral vision and guarantee of human rights and values.

Keywords: Care, spirituality, health, professional, education.

INTRODUCTION

In the history of humanity, education, religion, and health have been intertwined. It is in this context that we seek to commin a reflection on spirituality as a pedagogical resource in child care among health professionals.

The theme addressed here is justified because education is linked to religion and health in the construction of the integral view of the human being. This is perceived, for example, in the practices of the Jesuits, who throughout history carry out integral actions through religious institutions, teaching and health.  The second justification is the significant contribution of pedagogical methods for better quality in professional practice, for example, in the humanization of care. Especially in this study it is about the practice of child care promoted by health professionals. To better understand the relationship between religion, health and education, this study seeks to reflect on:

a) Etymological views on spirituality, pedagogy and health.

b) To know the theoretical and practical relationship between pedagogical and spirituality, pedagogy and health;

c) Relationship between pedagogy and health professionals;

d) Relationship between spirituality and health professionals;

e) Finally, to analyze the contribution of spirituality as a humanized pedagogical resource for the practice of child care among health professionals.

1. DIRECTIONS: PEDAGOGY, SPIRITUALITY HEALTH

Knowing the terminologies becomes essential for understanding the theme to be researched, it is the most appropriate beginning for the learning process. Thus, the following principles will be coined here: pedagogy, spirituality and health. Also, as an element of the notion of health, the notion of care will be defined, specifically, the care promoted by health professionals. It is emphasized that these are not terminologies and final definitions, but a parameter within the academic understanding of the areas of religion, education and health.

Pedagogy: within the most in-law, pedagogy is inserted in the concept of teaching and education, mostly children. Etymologically “peda”, derives from the Greek “paidós”, which means child, and gogia in Greek, means to guide or drive. Making the first junction and interpretation, pedagogy, in its meaning is to guide, to lead the child (LIBANEO, 2001). In fact, pedagogy can be understood as guiding the child, or denoting a role of training of children. However, between the 17th and 18th centuries with great social, political and technological advances, education is rethought with a proposal to update pedagogical processes, such as: the understanding of the child phase, and the practice of the teacher (LANZ, 2016). In the 20th century education has positive influences from other areas of knowledge that communicate with the vision of the child’s teaching and guidance, such as the emergence of psychology and its studies on development and learning resulted in a new way of educating and guiding the child, Within this context, it began to approach the pedagogical methods and resources of teaching , with this, there are also approaches that signify the meaning of pedagogy. The emergence of the notion of Waldorf Pedagogy, in it, the pedagogical approach is based on integrality and the physical, spiritual, intellectual and artistic development of children (LANZ, 2016).  So:

Pedagogy is, then, the field of knowledge that deals with the systematic study of education − of the educational act, of educational practice as an integral component of human activity, as a fact of social life, inherent to the set of social processes. It is thus a human practice, a social practice, which modifies human beings in their physical, mental, spiritual and cultural states, which gives a configuration to our individual and group human existence (LIBANEO, 2001, p. 6-7).

This notion of pedagogy becomes comprehensive and allows reflections and relationships with other important dimensions of the human being. For Paulo Freire (2005) pedagogy necessarily needs to contemplate the experientials of the human being, his values and morals, build friendship, connection, solidarity, promote meaning and purpose of life. These factors that permeate the notion of pedagogy are also glimpsed within the notion of spirituality.

Spirituality is a notion that refers to the state of the nature of the spirit, something integrated into the human being, which impels the conscious human being in his knowledge and vital choices, his knowledge of himself and about the world: his values and morals, friendship, connection, solidarity, humanism, well-being, meaning and purpose of life (SOUZA, 2013, p. 97). In this context, spirituality is an existential dimension that develops from the experiences that unfolds in religious behavior, thus arising religious practice, or religiosity[2]. In this sense, religiosity and spirituality are associated.

As a notion of health, it is understood as: the human being and his condition of life in a cultural context, principles and values with which he relates, his objectives and experiences, such as friendship, solidarity and meaning of life, a situation of complete physical, mental and social well-being (LUZ, 2009).

Finally, within the understanding of the practice of health care[3], Pessini (2002) states that it is necessary to build humanization, awaken professional solidarity, empathy and sympathy, a look that sparks the sense and confidence of the human being.

2. PEDAGOGY AND SPIRITUALITY

Spirituality is related to pedagogy in the integral reflection of the human being, in the processes of self-knowledge, in human construction and its moral values and paths of truth, such as goodness, love, life, honesty, justice. Spirituality also appears as an exercise of spirit in the process of pedagogical examination when educators seek to find a deeper meaning of being.  For, it is in the interiority at the core of the spirit, that is, a pure state of consciousness, personality, thought and emotions, that the creative sense of ideas, the connections between the subjects and the realities, the abstractions and concreteness, the thoughts and references of wisdom, the self-reflection on habits and behaviors, in which the subject begins to know and transform the limits , weaknesses and fears in learning and virtues (GARDNER, 1994).

As a pedagogical resource, spirituality composes the discipline of religious teaching. According to Boeing, religious teaching is not just a religious concept, but:

The knowledge of the Religious Phenomenon, elaborated by the Sciences of Religion and systematized by the curriculum of Basic Education is part of the cultural construction of society. With the Spirit of resignifying the different dimensions of human life. And Religious Education as a component of citizen education becomes not a space for rereading and resignification of the Religious Phenomenon but also of respect for the plurality of each sociocultural context (BOEING, 2009, p. 10-11)

In this context, spirituality is a pedagogical resource to meet the proposed demands of religious education, because it occupies an intermediary role, values religious and human cultural diversity, religious freedom, aggregates significant moral values such as respect, love and charity. For Delors religious education has:

the purpose of referring the world to a greater mutual understanding, more sense of responsibility and more solidarity, in accepting our spiritual and cultural differences. Education allowing everyone access to knowledge has a very concrete role to play in fulfilling this universal task: helping to understand the world and the other in order to better understand oneanother (DELORS, 1999, p.50).

3. PEDAGOGY AND HEALTH

Pedagogical development is inserted in several contexts, such as social and family relations, communication, political movements, and health care. That is, it is within this broad context that the action of the pedagogue is included. Especially in the health area, the pedagogical work carried out in hospitals or health environments is highlighted.

In the hospital setting, the pedagogue’s performance is focused on the care of children, young people, and seeks to ensure affective, cognitive and emotional development, as well as to integrate the caretaker in the school context. According to Aquino, the performance of the pedagogue in the hospital context can be defined in three areas:

 to broker the integration between the child, family, school and hospital, making the traumas of hospitalization more lenient, in a proposal to mitigate the possible demotivation and stress caused by hospitalization; b) to provide a relationship and proximity between the child’s new experience and that of the adolescent in the hospital with their daily routine, prior to hospitalization; and c) to enable hospitalized children access to education, even if they are in a hospital environment (AQUINO, SARAIVA, BRAÚNA, 2012, p. 131).

Within these principles, it is understood that the care of the pedagogue to the hospitalized promotes the well-being and integration of pedagogical resources, and aims to improve the clinical picture, helping the patient in coping with the suffering caused by the disease. In this context, the pedagogue can, for example, teach a class or cognitive play workshop. The objective is the development of the functional system of language, functions and abilities, favoring the reintegration to daily activities (AQUINO; SARAIVA; BRAÚNA, 2012).

It is important to point out that Ordinance No. 336 of February 19, 2002 establishes that the pedagogue is part of the clinical staff for psychosocial care:

 in intensive care, it will consist of: a – 01 (one) physician with mental health training; b – 01 (one) nurse; c – 03 (three) higher education professionals among the following professional categories: psychologist, social worker, occupational therapist, pedagogue or other professional necessary for the therapeutic project.

About the therapeutic project that glimpses health care and has pedagogical principles:

By more critically analyzing the mechanisms of care production through the construction of “therapeutic projects” and the different models of health care that define the competent professional profiles to operate them, we can open new lands to seek a “new” type of professional competence within the teaching practices of schools, and thus govern our available resources and our pedagogical processes in other ways (MERHY , 1999).

In view of this, the pedagogue is: a) a professional in the area of education who has quality to conduct, govern the pedagogical processes that are part of the therapeutic project. b) A professional qualified to deal with issues involving health care, especially mental care, such as the learning and cognitive process, and educational guidance.

About the pedagogue as a therapeutic promoter in health:

The field of action of the pedagogue who first draws attention is what he does with the child. It is the diagnostic and therapeutic measures, the pedagogical exercises, the interventions suggested by the school physician and others. These are the so-called direct measures of action in therapeutic education. One of them is posture, that is, how the educator acts indirectly in the child’s environment, how he can configure the environment and what effects this has on the child. The other is to reflect on how he can act in an educational-therapeutic way about the child, by the type and quality of their encounter and their relationship with the child (CALLEGARO, 2014, p.118)

It is understood that the function of therapeutic pedagogue in the health context is to create a pedagogical method reflecting on care, in other words, a form of care that considers the environment, reality, the state of the child with what one intends to learn, an empathic relationship of emotional bonds. In this sense, the therapeutic function of the pedagogue is to develop educational actions with a broad and harmonious look, including other dimensions of the patient, his interests, purposes and meanings of life.

In this context, the pedagogue “seeks to build knowledge about this new learning context that can contribute to the well-being of the sick child” (FONTES, 2005, p. 122). For this, it is necessary for the pedagogue to consider some dimensions:

The contribution of pedagogical activities to the well-being of the sick child goes through two aspects of analysis. The first triggers the playful as a communication channel with the hospitalized child, trying to make them forget, for a few moments, the aggressive environment in which she finds himself, rescuing sensations of childhood lived before entering the hospital. This aspect seeks to distract the child and, often, what manages to annoy him, and certainly does not help him to reflect on his own experience and learn from it. The second works, albeit in a playful way, hospitalization as a field of knowledge to be explored. By knowing and demystifying the hospital environment, resignifying its practices and routines as one of the proposals for pedagogical care in hospital, the fear of the child, which paralyzes actions and creates resistance, tends to disappear, emerging, in its place, intimacy with space and trust in those who act there (FONTES, 2005, p. 122).

In view of the above, it is understood that the role of the pedagogue in the hospital environment has educational dimensions that make interfaces with health, where one happens in dependence on the other. Promoting education for a hospitalized child is not only teaching, but also helping, helping to bring health and well-being. It will not be enough for the pedagogue to promote knowledge if the hospitalist is not healthy to learn.  In the hospital space it is necessary to awaken playful dimensions, enhance creativity about knowledge and self-knowledge, give existential meaning to the hospitalized in the midst of their suffering and pain, rescue hope and confidence, create identity to establish humanization in the pedagogical process and hospital care and transform the physical, mental, cognitive and spiritual states.

4. PEDAGOGY IN THE CONTEXT OF HEALTH PROFESSIONALS

In a research done in the bars of health courses: nursing, medicine, psychology, social assistance, physiotherapy and physiotherapy (BRASIL, 1989), only nursing and psychology have themes about education related to professional practice.

In nursing, health education is studied with the objective of the educational dimension of the professional profile of nurses. The Programmatic Content addresses: the Educational Relationship and the Society; Pedagogical conceptions, their purposes and implications in Brazilian education; Teaching process, learning, teaching methodology; Curricular structures and integration teaching, service, community; Elements of the evaluation of learning, its role and implications; Stages of pedagogical practice and its elements, applying in education and health activities (BRASIL, 1989). For Quadros et al. (2019, p. 11):

the benefit of the dialogue between pedagogy and nursing. For nursing, despite already having room to experiment as an educator, has much to improve in this practice; and pedagogy despite having its holistic view of the world thinking of its students as inseparable beings in their political, social, personal and cultural concepts still want to acquire new knowledge about the most different themes that arise in their daily lives, among them health.

According to the above, on the one hand, pedagogy contributes to nursing in the integral-holistic view of the human being and its reality, on the other hand, nursing can contribute to pedagogy in care issues, such as how pedagogue inserted in the health environment can react to diseases and epidemics through guidance on hygiene, first aid , indications of disease and others.

In Psychology, questions of pedagogy are addressed:

a) In learning in the cognitivism process: Cognitive psychology seeks to understand how learning to seize information and the immediate knowledge of a metal object (CORREIA, 2001).

b) In behavioral psychology and learning, which is:

a theory of learning based on the idea that all behaviors are acquired through conditioning. Conditioning occurs through interaction with the environment. Behavioralists believe that our responses to environmental stimuli shape our actions (ALVES, 2019).

c) In psychoanalysis and learning, and:

Education and Psychoanalysis walk a complex path, intertwining their knowledge about the development of the human being. This intertwining allowed the survey of questions related to the psychic functioning of the human being, the relationship of student-teacher transference, the pleasure in learning (question of desire), the therapy of Education, language, etc. Thus, Psychoanalysis – as a theoretical body – and Education – as a social discourse – were intertwined in a process of change that affected both in terms of their areas of activity (RIBEIRO, 2014, p. 15).

d) In humanism and learning that:

It argues that teaching must be centered on the trainee, that is, each person has his own path and has greater responsibility to decide what he wants to learn, making him autonomous in his learning process. The student tries to discover by his own path, in an attitude of self-realization and cost-evaluation, in a process of “becoming a person”, which is the key to the learning process (APRENDIZAGEM HUMANISTA, 2019).

e) In constructivist psychology and learning:

Constructivism is one of the currents committed to explaining how human intelligence develops based on the principle that the development of intelligence is determined by the mutual actions between the individual and the environment. The idea is that man is not born intelligent, but is also not passive under the influence of the environment, that is, he responds to external stimuli acting on them to build and organize his own knowledge in an increasingly elaborate way (MENDES, 2019).

Also, there is in the curriculum of Psychology: the approach on psychology and the school that treats the specific functions of the school psychologist, the competencies and skills of the school psychologist; Theoretical views of School Psychology; Technical instruments for the use of the psychologist in school; Areas of intervention of the psychologist in school; Areas of challenge to the School Psychologist; Possibilities of reeducation and preventive actions (BRASIL, 1989).

In view of the above, it can be understood that nursing and psychology courses include in their curricula themes of education-pedagogy to better relate practice with theory, improve professional self-assessment, apply methods of knowledge of subjects involved in professional practice, qualify professional practice, enable professionals to act in other spaces such as in schools and in the community in general , and as a continuing education aimed at humanization in health (LIBANEO, 2001). According to Batista:

training professionals to work in the health system has always been a challenge. Bringing the field of the real, the daily practice of professionals, users and managers is fundamental for solving the problems encountered in health care and for the qualification of the care provided to the subjects. The change in the academic education of students and teachers in the field of health has also been necessary (BATISTA, 2011, p. 884).

It is understood that the training of health professionals has been one of the central guidelines for the success of health programs. The training acquired by pedagogical processes appears as the most effective instrument to improve work between health professionals and users, such as acquiring real experiences that contribute to the learning and problem solving.  In this context, the Ministry of Health in 2004 created the Política Nacional de Educação Permanente em Saúde (PNEPS) as a strategy of the Unified Health System. It is a learning proposal for professional practice, establishing a relationship between learning and teaching on a daily life, thus enhancing and enabling changes and transformations in the practice of health professionals (BRASIL, 2004).

5. SPIRITUALITY IN THE CONTEXT OF HEALTH PROFESSIONALS

Spirituality in the context of health professionals is a theoretical historical factor, for example, the beginning of medicine is characterized by spiritual dimensions, such as: master healers, magic and the mystic of healing. This is a constant in all civilizations and times (HEIMANN, 2003).

In the Middle Ages and at the beginning of modernity due to advances in health courses, specifically in medicine, the universities of Europe grant to medical students the title of doctor in order to create a professional personality, since previously doctors were seen as healers, mystical and priestly figures (LANDMANN, 1984).

However, for Pitta (1991) only in the 19th century did health professionals begin to develop their professional practices without direct relation to spiritual practices.  The advent of the Industrial Revolution had as its principle the technological advance, which influenced medicine to provide a health care and service in a technical way (HEIMANN, 2003).

This is good when technology provides better quality of life, however, the use of technology too much, even if it provides positive improvements in health and disease status can result in helplessity of important human dimensions, such as: respect for human dignity, understanding of pain, valuing communication, religious beliefs and spiritual issues. It is in this context that a purpose in responding to the human dimensions of the sick emanated among health professionals ,among them the spiritual one (PERES, 2007).

In a study Gerone (2014) researched how health professionals understand the issue of spirituality and health. The results of the research indicate that spirituality helps improve quality of life and health. It is believed that spirituality is not only a support, but a resource and important aspect of health care.

In times of pain and suffering, the patient uses his spirituality as a resource to face adversity caused by the absence of health. Therefore, many health professionals recognize the positive influence of spirituality on health. Spirituality as a psychic and transcendental factor has the ability to promote resilience and emotional support, awaken questions from the core of existence and give meaning to the subject in the midst of pain, suffering and stress, and provide the presence of solidarity through love, comfort and hope (GERONE, 2015).

In view of this, health professionals are integrating or valuing spirituality in the practice of care as a way to promote health, because, even in the face of limitation in diagnosing or curing a disease, it is possible to take care of the human being, to see it beyond illness, a multifaceted Being with a biopsychosociospiritual dimension, meanings and purposes in existences that transcend its state of illness.

6. SPIRITUALITY AS A PEDAGOGICAL RESOURCE IN CHILD CARE AMONG HEALTH PROFESSIONALS

Specifically, health professionals in children need to understand that caring for a child is not the same as caring for an adult. The professional needs to have pedagogical conceptions to better care for the child, such as using playful resources to stimulate treatment, speaking in an appropriate language with the child, valuing dimensions such as empathy, creativity, discovery and welcoming (BARBOSA, 2002). It is in this context that spirituality can be integrated as a pedagogical resource, because spirituality has in its essence meanings similar to that of pedagogy. When thinking about spirituality, feelings arise such as: empathy, creativity, acceptance, human value, playful and mystical. In view of this, it highlights the convergences and results of spirituality as a pedagogical resource in the practice of child care among health professionals:

a) Spirituality in child care can be a promoter of self-knowledge. Spirituality develops in the same perspective of self-knowledge, in an intrinsic search in a subjective space of seeking identity, meanings and purposes of life (DANTAS, 2019). In this scenario, it is known that the learning process is more used when the child, when learning, finds meaning, existential purpose. That is, learning is not about transferring or acquiring content, but, finding (in)formation that they share with the child’s reality, his senses and purposes of life.

Furthermore, learning is a process of subjectivity: one learns to live and Be (ALMEIDA, 2019). In this context, spirituality as a promoter of self-knowledge enables important dimensions to learn, thus becoming a pedagogical resource for the practice of care. In which the professional by integrating spirituality as a pedagogical resource in the practice of care enables the child self-knowledge: meanings and purposes life, living and Being.

b) Spirituality as the formation of moral values that ensure the well-being of the child in the care process. For Machado (2019) the values are: a) a set of personal or social characteristics that determine the form of behavior. b) talent, reputation, courage and courage. In this sense, spirituality helps the professional to develop a child care that aims at discipline as a pedagogical resource to ensure well-being and value the behavior that transmits talent and courage.

c) Spirituality can be a resource for better pedagogical development and health care. Coping stands out here as a spiritual and educational resource for health. According to Compas (2006) coping is a cognitive and behavioral resource used to deal with problematic situations, stress and suffering. Coping can be: positive when providing resilience, resilience, and acceptance. Or negative when it causes feelings of guilt, shame, fear, aggression and stress. For Takiuti (1997) the infant phase is a stage of great stress and turbulence that interferes with emotional, cognitive and behavioral states. According to Takiuti (1997) children who have negative coping have behavior problems, such as insecurity, disobedience and aggression. In this sense, the professional can insert spirituality in care through positive coping and educate, guide the child in his cognitive and emotional need, providing positive feelings, such as resilience in the midst of problems, courage, self-esteem and others that are important for health treatment as well as to learn.

d) Therapeutic education: it is a junction between pedagogy and psychology. According to the World Health Organization, therapeutic education is a harmonious way to acquire, develop, maintain skills to manage life in a state of illness (CALLEGARO, 2014). For Callegaro (2014) therapeutic education has some aspects, among them, the spiritual, which is manifested through pedagogical practices of language and gestures.

In the context as pedagogical resources for care, language is understood with an empathic and constructive communication to deal with the disease. Gestures are expressions and attitudes that seek to convey harmonious feeling and creativity to deal with diseases.  For Piaget (1978) creativity is more evident in childhood and is an instrument of change, development and evolution.

e) Spirituality as a promoter of integral education: the notion of integral education is a multidimensional view that integrates phenomena, cognitive, emotional, psychological, social, cultural and spiritual. Integral education is guaranteed in the 1988 Constitution – Estatuto da Criança e do Adolescente, Law No. 8,069/1990 (ECA); Lei de Diretrizes e Bases da Educação Nacional, Law No. 9,394/1996 (LDB); Plano Nacional de Educação, Law 10.172/2001 (PNE, 2001-2010). That is, integral education is a full vision and promotion of the values of the human being, among them, the spiritual dimension, a right guaranteed in Law (CAMARGO, 2019).

In this sense, spirituality as an aspect of integral education is a cultivator of human values. In the context of child care, it becomes a pedagogical resource by guaranteeing the right to an integral education respecting and building human values, solidarity and respect, the awareness of the Being, and belonging and transcending (CAMARGO, 2019).

FINAL CONSIDERATIONS

It is considered that theme is opportune, because it deals with important dimensions of the human being, spirituality, education and health. As seen, such dimensions are etymologically related. The meanings of words: health, spirituality and pedagogy are related both in the theoretical and practical aspects. Therefore, as seen throughout this work, it is appropriate to reflect on the theme addressed here, which brought an interdisciplinary reflection between areas of health, education and religion. It is considered that in the development of this work, he realized that there is no way to speak of education without spirituality and health, and vice versa.

As seen in this study, it is noteworthy that nursing and psychology include in the curriculum questions about spirituality and education. This has enabled new ways of caring, guiding, teaching.

It is considered that in the context of health, spirituality is an indispensable resource for the pedagogue, especially for those who work in hospitals. Spirituality appears as a promoter of health and education, and manages to give meaning and purposes that transcend the state of disease. That is, it is not limited to health and teaching in one condition, but in the production of self-knowledge and learning.

It is considered that specifically that professionals who work in the child environment need to understand and have pedagogical conceptions. Some pedagogical resources are considered indispensable for health professionals to promote child care:

a) Use playful resources to stimulate treatment.

b) Speak in appropriate language with the child.

c) Valuing dimensions such as empathy, creativity, discovery and acceptance.

It is considered that it is in these points that there is convergence for spirituality to be a pedagogical resource for child care:

a) in the reflection on self-knowledge;

b) in disciplinary training;

c) cognitive and behavioral development;

d) in therapeutic form;

e) in the integral vision and guarantee of human rights and values.

Finally, we perceive the need for new studies that deepen a reflection on spirituality as a pedagogical resource in the practice of teachers and learning; about spirituality as a promoter of knowledge and self-knowledge in the teaching and learning process; on spirituality as a manifesto of an integral and humanist education; on spirituality as a discipline in the formation of students and teachers.

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APPENDIX – FOOTNOTE REFERENCES

2. A quality of what is part of religion, understood from its Latin etymology, religare, which means “reconnection” between man and God (DERRIDA, 2000, p. 52)

3. Understood as health treatment, health monitoring, health promotion.

[1] Master in Theology from PUC/PR. He has a specialization in Organizational Behavior; Specialization in Neuropsychopedagogy; Specialization in Philosophy and Sociology; Specialization in Teaching higher education. MBAs in Administration and Management with emphasis on spirituality and religiosity in companies. Graduated in Commercial Management. Bachelor of Theology. He holds a Degree in Philosophy and a Degree in Pedagogy.

Submitted: August, 2020.

Approved: September, 2020.

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