LILIA BLIMA SCHRAIBER
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Impact of exposure to intimate partner violence on children's behavior(2011) DURAND, Julia Garcia; SCHRAIBER, Lilia Blima; FRANCA-JUNIOR, Ivan; BARROS, ClaudiaOBJECTIVE: To analyze the relationship between intimate partner violence (IPV) against women and children's dysfunctional behaviors and school problems. METHODS: Population-based study part of the WHO Multicountry Study on Domestic Violence Against Women including 790 women living with their children aged five to 12 years in two different regions of Brazil: the city of Sao Paulo, Southeastern Brazil, and Zona da Mata area in the state of Pernambuco, Northeastern Brazil. Three multivariate models were developed to estimate the strength of the relationship between explanatory variables such as social and community support, stressful events of life, sociodemographic factors and ""IPV severity,"" among others, and three outcomes: number of dysfunctional behaviors; aggressive behavior; and school problems (interruption, drop out or failure). RESULTS: Exposure to severe physical and/or sexual IPV was associated to school problems, behavioral dysfunctions in general and aggressive behaviors in the univariate analysis. Exposure to severe IPV against women was associated to the occurrence of three or more dysfunctional behaviors in their children, regardless of common mental disorder, low schooling, physical IPV against maternal grandmother, social and community support in the multivariate models. Severe IPV remained associated to aggressive behavior and school problems after adjustment for other sociodemographic variables, among others. Maternal mental health status was identified as a mediating factor between IPV exposure and dysfunctional behaviors, especially aggressive behaviors. CONCLUSIONS: Severe IPV affects children's behaviors and should be addressed in health policies for school-aged children through the development of common interventions for mothers and children.
article 48 Citação(ões) na Scopus Concepções de gênero, masculinidade e cuidados em saúde: estudo com profissionais de saúde da atenção primária(2011) MACHIN, Rosana; COUTO, Marcia Thereza; SILVA, Georgia Sibele Nogueira da; SCHRAIBER, Lilia Blima; GOMES, Romeu; FIGUEIREDO, Wagner dos Santos; VALENCA, Otavio Augusto; PINHEIRO, Thiago FelixThis paper analyzes concepts of gender and masculinity among Primary Healthcare professionals in four Brazilian States (Pernambuco, Rio de Janeiro, Rio Grande do Norte, Sao Paulo). It is based on two perspectives: the meanings associated with being a man and the relations between masculinity and healthcare. This qualitative study is part of a multicentric investigation, which used triangulation methods as a benchmark. Sixty-nine in-depth interviews carried out among health professionals with higher education were analyzed. The discourses (re) produce the notion that health facilities are ""feminized spaces"". Within the daily routine, this notion is translated as reinforcing the idea that the male body is not a locus of this care, as opposed to the female body which is considered a locus of care. The presence of a hegemonic pattern of masculinity is prominent among professionals' representations of men and seems to influence the latter, in their lack of commitment with healthcare. The existence of a stereotyped gender model (re) produces disparities between men and women in healthcare and compromises the visibility of other meanings and expressions of gender identities.- Men don't come! Absence and/or invisibility in primary healthcare services(2011) GOMES, Romeu; MOREIRA, Martha Cristina Nunes; NASCIMENTO, Elaine Ferreira do; REBELLO, Lucia Emilia Figueiredo de Sousa; COUTO, Marcia Thereza; SCHRAIBER, Lilia BlimaThis article deals with the masculine absence and/or invisibility in primary health-care services and the consequent exclusion of men of the preventive care. The analytical frame is based on the literature that discusses care related to health and masculinity. Methodologically the study uses qualitative analysis of the empirical data (reports) gathered by semi-structured individual interviews of 20 professionals and by two focus groups with 12 workers of the nursing assistants staff of two primary healthcare services of the city of Rio de Janeiro (RJ). Results point out two significant dimensions: the structural and the symbolic one. The structural dimension reveals low investment in the services' organization related to gender perspective approach, reinforcing the common sense that men are not primary healthcare users. The symbolic dimension shows the non consideration of the masculine universe themes as the difficulty men have in revealing themselves to the professional, demanding a special privacy for attendance. Dealing with these questions enhance the possibility of changing practices that are making men invisible to the primary healthcare programs and taking them apart of the self care condition as well as the condition of carriers of others.
article 31 Citação(ões) na Scopus Association between intimate partner violence against women and HIV infection(2011) BARROS, Claudia; SCHRAIBER, Lilia Blima; FRANCA-JUNIOR, IvanOBJECTIVE: To analyze the association between intimate partner violence against women and infection or suspected infection by the human immunodeficiency virus (HIV). METHODS: A cross-sectional study was conducted, based on data from questionnaires applied face-to-face and medical records of 2,780 women aged between 15 and 49 years, cared for in Sistema Unico de Saude (Unified Health System) units of the Greater Sao Paulo area, Southeastern Brazil, in 2001-2002. Women were categorized into: users in treatment because they are ""HIV seropositive"", those ""suspected of having HIV"" and others who sought health services for different reasons. Intimate partner violence against women throughout life was categorized according to the severity and recurrence of episodes of violence. The association with the outcome was tested using the Poisson model with robust and adjusted variance for sociodemographic, sexual and reproductive variables. RESULTS: The prevalence of violence was 59.8%. Suffering repeated and severe violence was more closely associated with confirmed HIV infection (PR = 1.91). Violence independent from severity and recurrence of episodes showed greater association with suspected HIV infection (PR = 1.29). CONCLUSIONS: Intimate partner violence against women has a key role in situations of suspected and confirmed HIV infection. Thus, it is essential to include its detection, control and prevention as part of the comprehensive care provided for women's health.article 41 Citação(ões) na Scopus Social medical themes and the health intervention: violence against women in the professional's discourse(2011) KISS, Ligia Bittencourt; SCHRAIBER, Lilia BlimaThis study deals with violence against women as a health care matter. It was part of a research in public services of Sao Paulo (Brazil), including the prevalence of violence among users from 15 to 49 years old; the study of their medical records; the description of the services; and interview with 50 professionals, focusing the routine and the ideals of health work, the perception on the existence of violence cases, the offer of assistance or its obstacles and the representations on violence. This article analyses the content of the professional narratives and uses the other data to characterise the assistance context. Confirming the literature, violence was almost always regarded as a relevant problem but outside the professional's intervention boundaries. Isolated actions and in a personal basis were reported. Fear and professional impotence were mentioned, but none positive aspect for potential interventions. The professionals showed lack of knowledge of specialized reference services. In conclusion, the difficulties in the acceptance of violence cases should be worked in three dimensions: the narrow definition of professionals' competence that excludes violence as an object; the absence of technological definitions for professional actions; and effective support in their services.article 23 Citação(ões) na Scopus Male users' and primary care services health professionals' conceptions of gender and possible impacts on men's health, Sao Paulo, Brazil(2011) FIGUEIREDO, Wagner dos Santos; SCHRAIBER, Lilia BlimaThis paper studied the relation between the exercise of masculinities and health care of men in primary health care services. It focuses on representations and meanings of primary health care service users and professional of what it is to be a man. Male service users and professionals were interviewed in two primary health care facilities. Diverse models of masculinity were found, defining various forms of reasoning upon men's health care. This study indicates that issues such as work, sexuality, body structure, relationship with women, and transformations in gender relations are important for men, and should be considered in health care services.article 11 Citação(ões) na Scopus Primary Care in the Health System: debates from Sao Paulo in a historical perspective(2011) MOTA, Andre; SCHRAIBER, Lilia BlimaThe central aim of this paper was to historically retrieve the dimensions relating to the organization of healthcare practices in Brazil based on clues left in records. Primary healthcare had a special place within this context. To accomplish this, attention was focused on a very rich and complex period, during which alternatives within this field were proposed, especially by healthcare professionals whose working experiences were also marked by regional dimensions within the State of Sao Paulo, through their locations and institutional experiences. In this respect, looking at the past as a point of support for this understanding will be of great value, given that complete ruptures of past experiences do not occur; rather, such experiences are continually retrieved, either to go beyond certain conjectural links, or to use the experiences as points of reference for envisaging future developments in healthcare thinking and practice. The period between 1970 and 1990 was particularly covered, highlighting the Healthcare Program proposal, which was the official policy of the State of Sao Paulo for implementing primary care as a project for extending access at the first level of the system and for producing specific care. As a complement to this, the proposals of the State of Sao Paulo for Program Action and Life Protection were examined as formulations that criticized the Program and were the basis for debate on innovations in healthcare and professional practices.- Violence against women is strongly associated with suicide attempts: Evidence from the WHO multi-country study on women's health and domestic violence against women(2011) DEVRIES, Karen; WATTS, Charlotte; YOSHIHAMA, Mieko; KISS, Ligia; SCHRAIBER, Lilia Blima; DEYESSA, Negussie; HEISE, Lori; DURAND, Julia; MBWAMBO, Jessie; JANSEN, Henrica; BERHANE, Yemane; ELLSBERG, Mary; GARCIA-MORENO, ClaudiaSuicidal behaviours are one of the most important contributors to the global burden of disease among women, but little is known about prevalence and modifiable risk factors in low and middle income countries. We use data from the WHO multi-country study on women's health and domestic violence against women to examine the prevalence of suicidal thoughts and attempts, and relationships between suicide attempts and mental health status, child sexual abuse, partner violence and other variables. Population representative cross-sectional household surveys were conducted from 2000-2003 in 13 provincial (more rural) and city (urban) sites in Brazil, Ethiopia, japan, Namibia, Peru, Samoa, Serbia, Thailand and Tanzania. 20967 women aged 15-49 years participated. Prevalence of lifetime suicide attempts, lifetime suicidal thoughts, and suicidal thoughts in the past four weeks were calculated, and multivariate logistic regression models were fit to examine factors associated with suicide attempts in each site. Prevalence of lifetime suicide attempts ranged from 0.8% (Tanzania) to 12.0% (Peru city): lifetime thoughts of suicide from 7.2% (Tanzania province) to 29.0% (Peru province), and thoughts in the past four weeks from 1.9% (Serbia) to 13.6% (Peru province). 25-50% of women with suicidal thoughts in the past four weeks had also visited a health worker in that time. The most consistent risk factors for suicide attempts after adjusting for probable common mental health disorders were: intimate partner violence, non-partner physical violence, ever being divorced, separated or widowed, childhood sexual abuse and having a mother who had experienced intimate partner violence. Mental health policies and services must recognise the consistent relationship between violence and suicidality in women in low and middle income countries. Training health sector workers to recognize and respond to the consequences of violence may substantially reduce the health burden associated with suicidal behaviour.
article 10 Citação(ões) na Scopus Quando o 'êxito técnico' se recobre de 'sucesso prático': o sujeito e os valores no agir profissional em saúde(2011) SCHRAIBER, Lilia Blima