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
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Confirmatory Factor Analysis of the WHO Violence Against Women Instrument in Pregnant Women: Results from the BRISA Prenatal Cohort(2014) RIBEIRO, Marizelia Rodrigues Costa; ALVES, Maria Teresa Seabra Soares de Britto E; BATISTA, Rosangela Fernandes Lucena; RIBEIRO, Cecilia Claudia Costa; SCHRAIBER, Lilia Blima; BARBIERI, Marco Antonio; BETTIOL, Heloisa; SILVA, Antonio Augusto Moura daBackground: Screening for violence during pregnancy is one of the strategies for the prevention of abuse against women. Since violence is difficult to measure, it is necessary to validate questionnaires that can provide a good measure of the phenomenon. The present study analyzed the psychometric properties of the World Health Organization Violence Against Women (WHO VAW) instrument for the measurement of violence against pregnant women. Methods: Data from the Brazilian Ribeirao Preto and Sao Luis birth cohort studies (BRISA) were used. The sample consisted of 1,446 pregnant women from Sao Luis and 1,378 from Ribeirao Preto, interviewed in 2010 and 2011. Thirteen variables were selected from a self-applied questionnaire. Confirmatory factor analysis was used to investigate whether violence is a uni-or-multidimensional construct consisting of psychological, physical and sexual dimensions. The mean-and-variance- adjusted weighted least squares estimator was used. Models were fitted separately for each city and a third model combining data from the two settings was also tested. Models suggested from modification indices were tested to determine whether changes in the WHO VAW model would produce a better fit. Results: The unidimensional model did not show good fit (Root mean square error of approximation [RMSEA] = 0.060, p<0.001 for the combined model). The multidimensional WHO VAW model showed good fit (RMSEA=0.036, p=0.999 for the combined model) and standardized factor loadings higher than 0.70, except for the sexual dimension for SL (0.65). The models suggested by the modification indices with cross loadings measuring simultaneously physical and psychological violence showed a significantly better fit compared to the original WHO model (p<0.001 for the difference between the model chi-squares). Conclusions: Violence is a multidimensional second-order construct consisting of psychological, physical and sexual dimensions. The WHO VAW model and the modified models are suitable for measuring violence against pregnant women.
- Medicine under the lens of history: theoretical and methodological reflections(2014) MOTA, Andre; SCHRAIBER, Lilia BlimaThe need for studies in the field of health to be based on a historical perspective has opened up new horizons for the analysis of the conditions for the creation of a body of knowledge aimed at explaining the role of social elements in determining pathological processes and health practices. The purpose of this paper is to examine how historical science, with its methodological aspects of analysis, has contributed to the physician's practice, especially raising broader critical aspects of the issues related to the field of health care. It is based on dialogues between culture and society molded around a discursive order to act not just as a language, but in its effective implementation within a medical rationale, with attention to the ruptures and continuities of a scientific discourse.
- Psychological violence against pregnant women in a prenatal care cohort: rates and associated factors in Sao Luis, Brazil(2014) RIBEIRO, Marizelia Rodrigues Costa; SILVA, Antonio Augusto Moura da; ALVES, Maria Teresa Seabra Soares de Britto e; BATISTA, Rosangela Fernandes Lucena; ROCHA, Lourdes Maria Leitao Nunes de; SCHRAIBER, Lilia Blima; MEDEIROS, Nilzangela Lima; COSTA, Danielle Cristina Silva; BETTIOL, Heloisa; BARBIERI, Marco AntonioBackground: Violence against pregnant women has been associated with gestational and perinatal disorders. Psychological violence is the type least investigated and its associated factors have been little studied. The present study was conducted in order to estimate prevalence rates and analyze the factors associated with exclusive and recurrent psychological violence in the municipality of Sao Luis, Brazil. Methods: Data regarding 982 pregnant women, aged from 14 to 45 years, interviewed in 2010 and 2011 in a prenatal cohort were used. A self-applied questionnaire was used to screen for violence. Pregnant women submitted to physical and sexual violence were excluded from the analysis of factors associated with exclusive psychological violence. Prevalence ratios and 95% confidence intervals were estimated by a Poisson regression model with a hierarchical approach at three levels. At level 1 of the theoretical-conceptual model, we analyzed demographic and socioeconomic characteristics and variables that express gender inequalities; at level 2, we analyzed social support received by the women, and at level 3, the life experiences of the pregnant women. Results: Prevalence rate of exclusive psychological violence was 41.6% and of recurrent violence was 32.6%. Exclusive psychological violence was associated with pregnant women's age of 14 to 18 years (PR: 1.32 95% CI: 1.04 - 1.70), pregnant women's schooling superior to that of her intimate partner (PR: 1.54 95% CI: 1.09 - 2.16), inadequate social affective support/positive social interaction (PR: 1.34 95% CI: 1.11 - 1.62), use of illicit drugs by the pregnant women (PR: 1.80 95% CI: 1.16 - 2.81) and having had six or more intimate partners in life (PR: 1.52 95% CI: 1.18 - 1.96). Recurrent exclusive psychological violence was associated with inadequate social affective support/positive social interaction (PR: 1.47 95% CI: 1.15 - 1.87), use of illicit drugs by the pregnant women (PR: 2,28 95% CI: 1,40 - 3,71) and having had six or more intimate partners in life (PR: 1.47 95% CI: 1.06 - 2.03). Conclusions: Psychological violence was a common phenomenon in this population of pregnant women that was associated with gender inequalities, inadequate social support and illicit drug use and should be routinely investigated during prenatal visits at health care services.
article 2 Citação(ões) na Scopus The gender perspective and health professionals: notes from the Brazilian collective health field(2014) SCHRAIBER, Lilia Blima; D'OLIVEIRA, Ana Flavia Pires LucasWe examine the incorporation of the gender perspective in the health field, considering scientific production, health policies and programs and everyday professional practices within the health services. These distinct layers are necessary given the different possibilities each presents for the incorporation of gender. In scientific production, we identify increasing inclusion of the gender perspective, but with little methodological use of the concept; in health policies and programs, the incorporation of the gender perspective is not comprehensive and varies temporally; and in professional practices, incorporation is anchored more in practical knowledge than in a technical and scientific basis. In the daily work of health professionals, this set of difficulties generates different tensions regarding the scientific and technological basis and the moral basis for intervention.- A construção do cuidado: o atendimento às situações de violência doméstica por equipes de Saúde da Família(2014) MOREIRA, Tatiana das Neves Fraga; MARTINS, Cleide Lavieri; FEUERWERKER, Laura Camargo Macruz; SCHRAIBER, Lilia BlimaAs violence has proved to be an important public health issue, it has stimulated scientific production and the development of public policies, The objective of the present article is to understand the care strategies developed by Family Health Program Teams in Diadema to handle domestic violence situations, A qualitative analysis approach of selected cases identified by the teams as ""difficult"", ""typical"" and ""successful"" was adopted, Two Family Health Program teams and different professionals from the intersectoral network were interviewed, Organizing services according to the Family Health Strategy guidelines has shown to be a facilitating factor to develop care strategies to handle domestic violence, Professionals identified different kinds of violence in the assisted families, but the actions of the teams focused mainly on the child abuse related situations. Violence against women in general was not taken into account by the teams, which shows different degrees of ""visibility"" among the various types of violence. Strategies included actions to promote deeper bonds with the family, cases monitoring and biomedical aspects evaluation, as well as more acute actions such as mandatory hospitalization, The strategies developed alternate from a prescriptive perspectivel to one more centered in the concept of Care, during the interaction with the families and regarding their needs, The community health agents and NASF professionals were the main protagonists in these cases, articulating practical and technical knowledge.
- Violência: questão de interface entre a saúde e a sociedade(2014) SCHRAIBER, Lilia Blima