Papers by Janine Schirmer
Einstein (São Paulo), 2007
Objectives: To know the opinion of senior high school students in publicand private schools on th... more Objectives: To know the opinion of senior high school students in publicand private schools on the process of donating and transplanting organsand tissues, and their desire to be donors. Methods: A descriptive crosssectionalstudy, conducted from 2004 to 2005, on the opinion/knowledgeof senior high school students in public and private schools in the VilaMariana region of the city of São Paulo, on the process of organ and tissuedonation and transplantation. The convenience sample was made up of140 (81%) students from two private schools and 167 (51%) studentsfrom a public school. The project was approved by the Research EthicsCommittee of the UNIFESP. Results: Data showed that 163 (53.1%)students believe that donation is by presumed consent and 147 (47.9%)that consider that it occurs by informed consent. Of the public schoolstudents, 120 (71.9%) believe that transplants are public and free ofcharge in Brazil versus 94 (67.1%) of the students from private schools.Students know that do...
How to cite Complete issue More information about this article Journal's homepage in redalyc... more How to cite Complete issue More information about this article Journal's homepage in redalyc.org Scientific Information System
Revista da Escola de Enfermagem da U S P, 2020
OBJECTIVE To measure medication non-adherence in patients after heart transplantation using the B... more OBJECTIVE To measure medication non-adherence in patients after heart transplantation using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS) and the Visual Analogue Scale (VAS); to compare the results of biopsies performed with the prevalent comorbidities and survival. METHOD Quantitative historical cohort. The population consisted of patients undergoing transplantation between 2009 and 2016. RESULTS Participation of 60 patients. The measurement using the BAASIS was 46.7% of non-adherence and 53.3% of patient adherence. The group with greater difficulty in non-adherence reported up to 2 hours delay of medication intake in relation to the prescribed time (25%), although there was no interruption in medications. The initial diagnosis was Chagas disease (33.3%). The studied comorbidities were systemic arterial hypertension (SAH), diabetes mellitus (DM), dyslipidemia (DLP) and chronic renal failure (CRF). CONCLUSION Assessment using the BAASIS showed med...
Transplantation Proceedings
BACKGROUND From 1968 until 1997, transplantation-related activities were not properly regulated a... more BACKGROUND From 1968 until 1997, transplantation-related activities were not properly regulated and were informally practiced. During 20 years, many legal and political changes influenced it. OBJECTIVE To provide a historical overview of the 20 years with a descriptive data analysis of a 20-year data set. METHODOLOGY We investigated information from Brazilian Transplantation Reports between 1997 and 2017. In this way, we classified all data into 5 Brazilian macro regions: Center-West, Northeast, North, Southeast, and South. In total, we included 27 states (including Capital District) and limited study to the heart, liver, and kidney. RESULTS We analyzed 2835 data entries and associated population information from the Brazilian Institute of Geography and Statistics. We observed 2 distinct groups, one uniquely formed by the North region, with figures significantly lower than the remaining regions. After 2003, Southeast, South, and Northeast regions indicated a growing movement, whereas Center-West indicated certain stability in 50 and ranging between 50 and 100 cases (yearly basis) after 2011. Recently (2016 and 2017), the South region indicates another crescendo movement suggesting another detachment from the other regions, but it is something not clearly observed and, if true, should be figured in new reports of Brazilian Association of Organ Transplantation. CONCLUSION This study identified and observed the time-spatial progress of organ transplantation in Brazil. In conclusion, after analysis of this 20-year data consolidation related to organ transplantation in Brazil, we observed a public investment in implementing quality evaluation and safety to provide figures that deliver visibility to the numbers reported in this article.
Transplantation
Background: To optimize organ donation performance the nature and impact of complex factors need ... more Background: To optimize organ donation performance the nature and impact of complex factors need to be understood. Some factors are well known and might not be modifiable (contra-indications for transplant, age limit of organ donor, etc), but others (collaboration and relationships) that contribute to variations among similar hospitals in the same province, are poorly understood. Thus, the overall aim of this research is to understand the nature and impact of relationships within the organizational context of organ donation programs in Ontario. Methods: We will employ an exploratory, prospective, diagnostic study consisting of three approaches: (1) to describe the characteristics of social networks of health care professionals of the organ donation programs (Social Network Analysis) and (2) to describe the organizational attributes and processes of on organ donation programs (Multiple Case-Study), and (3) to compare the influence of social networks and organizational attributes on the performance of organ donation programs (Network Comparison).The study siteswill includeOntario hospitals designated as typeA based on trauma centre level (Public Hospitals Act classification); and hospitals partners of the Ontario’s Organ Procurement Organization. At least five sites will be purposely selected to capture the greatest variability of settings possible. Expected/Preliminary Outcomes: Understanding the influences of informal networks on organ donation outcomes is essential to the development and informing of interventions to optimize performance. This research will increase organ donation rates in Ontario by providing to the scientific community a novel measure of organ donation programs’ performance and by identifying successful collaboration paths during organ donation processes. We will present the development process of the research as well as preliminary findings. P.664
Revista Latino-Americana de Enfermagem
Objective: To validate the quality assessment and performance improvement instrument of US transp... more Objective: To validate the quality assessment and performance improvement instrument of US transplant programs to the Brazilian reality. Method: Methodological study developed for semantic validation and cultural adaptation of the Quality assessment and Performance Improvement instrument in the following steps: 1) translation; 2) synthesis; 3) back translation; 4) review by expert committee; 5) pretest and 6) content validation. To evaluate the agreement between the five judges, the Kappa coefficient was used and for content validation, the content validation index. Results: Kappa coefficient showed the agreement of the judges for semantic, idiomatic, cultural and conceptual equivalences. Content validation index values for relevance and item sequence of at least 0.80 for all blocks. Conclusion: The instrument of Quality Evaluation and Performance Improvement of Transplantation Programs proved to be valid and reliable. This instrument will contribute to the development of quality as...
Revista Latino-Americana de Enfermagem
Objetivo identificar os motivos da recusa de córneas. Método estudo transversal, retrospectivo, d... more Objetivo identificar os motivos da recusa de córneas. Método estudo transversal, retrospectivo, descritivo e correlacional, composto por 5.560 córneas ópticas. As informações foram extraídas do banco de dados da Central de Notificação, Captação e Doação de Órgãos (CNCDO), bem como de prontuários de doadores. A estatística descritiva foi utilizada para a análise das variáveis categóricas e testes específicos, com nível de significância de 5% para avaliar as associações entre as variáveis. Este estudo atendeu aos aspectos éticos da pesquisa científica. Resultados 60% dos doadores eram do sexo masculino e 40% morreram por problemas circulatórios. Os principais motivos de recusa informados pelas equipes de transplante são a idade do doador e a contagem de células endoteliais. Para cada ano adicionado à idade do doador, há uma redução de 1% na chance de que essa córnea seja usada para transplante, e para cada acréscimo de 100 células por mm2 aumenta as chances de que essa córnea seja usa...
Acta Paulista de Enfermagem
Resumo Objetivo Avaliar a completude e a tendência de completude de dados dos prontuários de idos... more Resumo Objetivo Avaliar a completude e a tendência de completude de dados dos prontuários de idosas acometidas por câncer de mama, diagnosticadas e atendidas entre os anos de 2001 e 2006 em um centro de referência em saúde da mulher do Estado de São Paulo. Métodos Estudo descritivo analítico baseado em dados secundários. Para análise da não completude, utilizou-se a classificação: excelente (< 5%), bom (5 a 10%), regular (10 a 20%), ruim (20 a 50%) e muito ruim (≥50%). Resultados Variáveis socioeconômicas e demográficas, bem como as de fatores de risco e comportamentais predominaram dentre as classificadas como regular, ruim e muito ruim. Os melhores escores foram das variáveis pós-tratamento, seguidas pelas relacionadas ao diagnóstico e ao tratamento. A única variável com tendência de não completude decrescente foi história familiar de câncer de mama (p = 0,05). Apresentaram tendência de não completude crescente: raça/cor (p = 0,01), anos de estudo (p = 0,01), uso de contracepti...
... Jussara Mendes LipinskiI, Mariana Bello P , Mariana Bello PorciunculaI ... de duas pesquisas ... more ... Jussara Mendes LipinskiI, Mariana Bello P , Mariana Bello PorciunculaI ... de duas pesquisas realizadas nas capitais brasileiras e no Distrito Federal, sendo que a primeira aborda indicadores de aleitamento materno analisados em 1999 e, a segunda, analisa a evolução dos ...
Journal of Nursing Ufpe on Line Jnuol Doi 10 5205 01012007, Feb 6, 2014
Objective: introducing theoretical elements of the anthropology of health as a contribution to st... more Objective: introducing theoretical elements of the anthropology of health as a contribution to studies of the cultural meanings of the birth process. Method: a descriptive study of reflexive type analysis, from Geertzian understanding about the culture. This is the Anthropology of Health in the light of the thought of Kleinman and Menéndez. Results: the Anthropology of Health, represented by Kleinman, branch of interpretive aspect, proposes subsidies for the analysis of cultural factors that mediate the meanings of health and disease and are useful for the study of cultural systems of health care. Menéndez, representative of critical anthropology, argues for the existence of different modes of health care, among which stand out the "self-attention" and "hegemonic medical model." Conclusion: these two different theoretical models, but complementary to each other, prove useful for the study of the birth process, supporting the development of culturally congruent practices that respect the plurality of knowledge. Descriptors: Parturition; Pregnancy; Postpartum Period; Nursing; Cultural Anthropology. RESUMO Objetivo: apresentar elementos teóricos da antropologia da saúde como aporte para estudos dos significados culturais do processo do nascimento. Método: estudo descritivo do tipo análise reflexiva, a partir do entendimento Geertziano sobre a cultura. Trata-se da Antropologia da Saúde à luz do pensamento de Kleinman e de Menéndez. Resultados: a Antropologia da Saúde representada por Kleinman, ramo da vertente interpretativista, propõe subsídios para a análise de fatores culturais que medeiam os significados relativos à saúde e à doença e que são úteis para o estudo dos sistemas culturais de cuidado em saúde. Menéndez, representante da antropologia crítica, defende a existência de diferentes modos de atenção à saúde, dentre os quais se destacam a "autoatenção" e o "modelo médico hegemônico". Conclusão: esses dois modelos teóricos distintos, mas complementares entre si, mostram-se úteis para o estudo do processo do nascimento, fornecendo subsídios para o desenvolvimento de práticas culturalmente congruentes que respeitem a pluralidade dos conhecimentos. Descritores: Parto; Gravidez; Período Pós-Parto; Enfermagem; Antropologia Cultural. RESUMEN Objetivo: introducir elementos teóricos de la antropología de la salud como contribución a los estudios de los significados culturales del proceso de nacimiento. Método: un estudio descriptivo de tipo análisis reflexivo de comprensión geertziana sobre la cultura. Esta es la Antropología de la Salud, a la luz del pensamiento de Kleinman y Menéndez. Resultados: la Antropología de la Salud representada por Kleinman, rama del aspecto interpretativo, propone subsidios para el análisis de los factores culturales que median los significados de la salud y la enfermedad y que son útiles para el estudio de los sistemas culturales de atención de la salud. Menéndez, representante de la antropología crítica, aboga por la existencia de diferentes formas de atención de la salud, entre los que se destacan el "auto-atención" y "modelo médico hegemónico". Conclusión: estos dos modelos teóricos diferentes, pero complementarios entre sí, resultan útiles para el estudio del proceso de nacimiento, el apoyo al desarrollo de las prácticas culturalmente congruentes que respeten la pluralidad de conocimientos.
Revista Enfermagem Uerj, Oct 16, 2012
Para se identificar os caminhos da doação, há uma necessidade inexorável de se entender a experiê... more Para se identificar os caminhos da doação, há uma necessidade inexorável de se entender a experiência da família que ocorre num contexto de relacionamentos interpessoais que afetam crenças, emoções, comportamentos e decisões. A morte cerebral e a doação de órgãos e tecidos são práticas culturais contemporâneas 1. A doação de tecidos, tanto como a de órgãos, ainda enfrenta problemas de carência de informação junto à so
Acta Paulista De Enfermagem, 2011
Objectives: To analyze the survival rate of women undergoing treatment for cervical cancer in the... more Objectives: To analyze the survival rate of women undergoing treatment for cervical cancer in the state of Mato Grosso and identify the prognostic factors that most influenced the survival time. Methods: A cohort study, conducted by analysis of medical records, among others. The population included 55 women who experienced this type of carcinoma and had clinical follow-up between 2002 and 2007. Results: The overall survival rate was 66.7%. The prognostic factors that influenced survival rate were: age, presence of symptoms suggestive of cervical cancer, and late stage of disease at diagnosis. Conclusion: Although the overall survival rate was similar to the rates of developed countries, it was lower in women with unfavorable social conditions. Descriptors: Survival rate; Uterine cervical neoplasms; Multivariate analysis; Prognosis RESUMO Objetivos: Analisar a taxa de sobrevida de mulheres submetidas ao tratamento de câncer do colo do útero no Estado de Mato Grosso e identificar os fatores prognósticos que mais influenciaram no tempo de sobrevida. Métodos: Estudo tipo coorte, realizado por meio da análise dos prontuários clínicos, e dados do Sistema de Informação do Colo do Útero, Sistema de Informação sobre Mortalidade, Sistema de Informação Autorização de Procedimentos Alta Complexidade. A população correspondeu a 55 mulheres que apresentaram esse tipo de carcinoma e tiveram seguimento clínico entre 2002 e 2007. Resultados: A taxa de sobrevida global foi de 66,7%. Os fatores prognósticos que influenciaram na taxa de sobrevida foram: idade, presença de sintomatologia sugestiva de câncer cervical e estágio tardio da doença no momento do diagnóstico. Conclusão: Apesar da taxa de sobrevida global encontrada assemelhar-se às taxas de países desenvolvidos, foi menor em mulheres com condições sociais desfavoráveis. Descritores: Taxa de sobrevida; Neoplasias do colo do útero; Análise multivariada; Prognóstico RESUMEN Objetivos: Analizar la tasa de sobrevida de mujeres sometidas al tratamiento de cáncer de cuello de útero en el Estado de Mato Grosso e identificar los factores pronósticos que más influyeron en el tiempo de sobrevida. Métodos: Estudio de tipo cohorte, realizado por medio del análisis de las historias clínicas, entre otros. La población correspondió a 55 mujeres que presentaron ese tipo de carcinoma y tuvieron seguimiento clínico entre 2002 y 2007. Resultados: La tasa de sobrevida global fue del 66,7%. Los fatores pronósticos que influyeron en la tasa de sobrevida fueron: edad, presencia de sintomatología sugestiva de cáncer cervical y estadío tardío de la enfermedad en el momento del diagnóstico. Conclusión: A pesar de que la tasa de sobrevida global encontrada se asemeje a las tasas de países desarrollados, fue menor en mujeres con condiciones sociales desfavorables. Descriptores: Tasa de supervivencia; Neoplasias del cuello uterino; Análisis mutivariante; Prognostico
Rev Latino Am Enfermagem, 2006
Revista de Saúde Pública, 2015
OBJECTIVE To evaluate the viability of a professional specialist in intra-hospital committees of ... more OBJECTIVE To evaluate the viability of a professional specialist in intra-hospital committees of organ and tissue donation for transplantation. METHODS Epidemiological, retrospective and cross-sectional study (2003-2011 and 2008-2012), which was performed using organ donation for transplants data in the state of Sao Paulo, Southeastern Brazil. Nine hospitals were evaluated (hospitals 1 to 9). Logistic regression was used to evaluate the differences in the number of brain death referrals and actual donors (dependent variables) after the professional specialist started work (independent variable) at the intra-hospital committee of organ and tissue donation for transplantation. To evaluate the hospital invoicing, the hourly wage of the doctor and registered nurse, according to the legislation of the Consolidation of Labor Laws, were calculated, as were the investment return and the time elapsed to do so. RESULTS Following the nursing specialist commencement on the committee, brain deat...
Jornal Brasileiro de Nefrologia, 2015
The need of increasing the number of notifications of potential and actual donors is a worldwide ... more The need of increasing the number of notifications of potential and actual donors is a worldwide problem. There is still much loss of donors, which can be avoided. Objective: To use instruments adapted from the Model of Quality Management of the Spanish National Organization of Transplants in pilot hospitals in Brazil. Methods: This was a quantitative research developed in three large hospitals in Santa Catarina, The option by the three institutions is related to the number of Intensive Care Unit (ICU) beds and the number of potential donors notifications Central Catchment Notification and Distribution of Organs and Tissues of State (CNCDO-SC). Data collection was performed in medical records from deceased patients in the units of critical patients using two validated instruments, period of three months, in two steps as directed by ONT. Results: In one of the hospitals, there was a higher percentage of losses due to maintenance problems (17.6%), family refusal (64.3%) and escapes (16.7%), and there also was a lower real effectuation index (29.4%). In 70.3%, losses due to maintenance were associated with irreversible cardiac arrest and hemodynamic instability. Family refusal was associated in 48.4% with the fact that the family was against donation and ample desire to keep the body integrate. Conclusion: Information obtained allows the manager to administer these data and therefore to implement actions of improvement, increasing the number of donator of organs and tissues.
Introdução O processo do nascimento (PN) vivenciado por mulheres residentes no campo é o tema des... more Introdução O processo do nascimento (PN) vivenciado por mulheres residentes no campo é o tema desta pesquisa. Parte-se da ideia de que esse processo, que envolve gravidez, parto e pós-parto, é multidimensional, mantendo estreita associação com questões atinentes à cultura. A cultura é entendida como uma rede de significados contidos em sistemas simbólicos e estabelecidos socialmente, nos termos da qual as pessoas se comportam. É um universo de símbolos e significados que possibilita aos indivíduos de determinado grupo interpretar a experiência e guiar suas ações. (GEERTZ, 2008). O interesse nos aspectos simbólicos relacionados ao PN sustenta-se nas noções de Langdon (2014), para quem os conhecimentos culturais específicos podem ser utilizados pelos profissionais da saúde, dentre os quais os enfermeiros, bem como por formuladores de políticas públicas neste campo que estejam interessados no desenvolvimento de práticas e cuidados culturalmente congruentes, o que implica o estabelecime...
Objective-To evaluate the impact of organ and tissue donation processes on family members of dece... more Objective-To evaluate the impact of organ and tissue donation processes on family members of deceased donors and the probability that they would be an organ or tissue donor in the future. Methods-Cross-sectional survey of 69 families of deceased donors of the organ procurement organizations of the Federal University of São Paulo. Results-Donors were predominantly men (57%vs 43%) with a median age of 35.9 years. The primary causes of death were classified as natural (65%), traumatic injury (33%), and other (1%). Of the family members surveyed, 40% had an elementary school education and 59% were unemployed. Family members expressed an understanding of the brain death diagnosis (67%). Among them, 74% had no doubt about brain death and had time to ask questions. The diagnosis was provided by the doctor responsible for the patient (89%). Family members also used funeral aid benefit (63%), perceived organ donation positively (97%), and indicated that they would donate again (79%). A significant relationship was found between families that took advantage of the funeral aid benefit and families that would donate again (79% vs 22%, P = .002). Conclusion-The intent to donate organs for transplantation may be based more on moral and cultural factors that go beyond the family members' knowledge about the donation process per se.
Progress in Transplantation, 2010
Objective-To evaluate the impact of organ and tissue donation processes on family members of dece... more Objective-To evaluate the impact of organ and tissue donation processes on family members of deceased donors and the probability that they would be an organ or tissue donor in the future. Methods-Cross-sectional survey of 69 families of deceased donors of the organ procurement organizations of the Federal University of São Paulo. Results-Donors were predominantly men (57%vs 43%) with a median age of 35.9 years. The primary causes of death were classified as natural (65%), traumatic injury (33%), and other (1%). Of the family members surveyed, 40% had an elementary school education and 59% were unemployed. Family members expressed an understanding of the brain death diagnosis (67%). Among them, 74% had no doubt about brain death and had time to ask questions. The diagnosis was provided by the doctor responsible for the patient (89%). Family members also used funeral aid benefit (63%), perceived organ donation positively (97%), and indicated that they would donate again (79%). A significant relationship was found between families that took advantage of the funeral aid benefit and families that would donate again (79% vs 22%, P = .002). Conclusion-The intent to donate organs for transplantation may be based more on moral and cultural factors that go beyond the family members' knowledge about the donation process per se. (
Ciência, Cuidado e Saúde, 2011
RESUMO Este estudo teve como objetivo analisar os fatores que mais se associam à evolução das les... more RESUMO Este estudo teve como objetivo analisar os fatores que mais se associam à evolução das lesões precursoras do carcinoma invasivo do colo do útero no Estado de Mato Grosso. O tipo de estudo utilizado foi transversal, desenvolvido a partir de amostra representativa. A fonte de dados utilizada foram os prontuários clínicos. Para avaliar o risco de carcinoma invasor utilizou-se o teste de qui-quadrado e análise de regressão logística multivariada. Houve maior prevalência de carcinoma invasivo entre as mulheres de 35 a 50 anos. A partir da regressão logística multivariada, observou-se que a doença na forma invasiva depende da idade, seguida do município de residência, do estado civil, da idade da menarca e da ocupação. Assim, as mulheres com risco de apresentar carcinoma invasivo são as que estão na faixa etária acima de 35 anos, as que residem no Interior do Estado, as não casadas, as que tiveram menarca antes dos 12 anos de idade e as donas de casa. O carcinoma invasivo mostrou-se fortemente associado com as condições sociais desfavoráveis e a doença manifesta-se precocemente no Estado de Mato Grosso. Palavras-chave: Neoplasias do Colo do Útero. Fatores de Risco. Modelos Logísticos.
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Papers by Janine Schirmer