Debora Cumino | Faculdade de Ciências Médicas da Santa Casa de São Paulo (original) (raw)

Papers by Debora Cumino

Translated questionnaire applied for the research subjects. (DOCX 14 kb)

Brazilian Journal of Allergy and Immunology (BJAI)

BMC Anesthesiology

Background: An anesthesiologists' work presents with numerous occupational risks owing to the lar... more Background: An anesthesiologists' work presents with numerous occupational risks owing to the large amount of time spent inside the operating room where constant noise, anesthetic vapors, ionizing radiation, infectious agents, and psychological stress are present. Herein, we evaluated anesthesiologists' knowledge about occupational health. Methods: A cross-sectional study was conducted to assess 158 anesthesiologists from a tertiary hospital on their knowledge about occupational health using a structured questionnaire. Results: The survey revealed a lack of knowledge on the forms of prevention of occupational accidents (74.6% did not know how to act in case of a fire during surgery, 56% failed to identify the post-anesthesia care unit as the place with the highest contamination by inhalation anesthetics, and 42.7% failed to identify all personal protective equipment) and a surprisingly high rate of lack of observance of preventive measures (30.3% washed their hands before touching every patient, 52.5% did not use gloves during intravenous access, and 88.6% used protective equipment against ionizing radiation). Conclusions: Despite improvements in safety standards in healthcare facilities, our research showed lack of knowledge about major topics on occupational health by physicians. Improving safety awareness is an important goal of training programs and continued medical education.

Revista Brasileira De Anestesiologia, 2005

Revista Brasileira De Anestesiologia, Feb 1, 2005

Brazilian Journal of Anesthesiology (English Edition), 2013

Background and objectives: Preoperative Anxiety is a negative factor in anesthetic and surgical e... more Background and objectives: Preoperative Anxiety is a negative factor in anesthetic and surgical experience. Among the strategies for reducing children's anxiety, non-pharmacological strategies are as important as the pharmacological ones, but its validity is still controversial. Objectives: The aim of this study was to verify if the information provided to guardians interferes with child anxiety. Methods: 72 children, 4-8 years old, ASA I and II, undergoing elective surgical procedures and their guardians were randomly divided into two groups: control group (CG) = guardian received conventional information about anesthesia; informative group (IG) = guardian received an information leaflet about anesthesia. Children's anxiety was assessed using the modified Yale Preoperative Anxiety Scale (m-YPAS) on two occasions: at the surgical theater waiting room (WR) and at the operating room (OR). Parents' anxiety was assessed using the Hamilton Anxiety Scale (HAM-A) at the CT. Results: There was no difference in demographic data between groups. The level of anxiety in children showed no difference between groups at two measured times. There was statistically significant difference in anxiety levels between WR and OR in both groups, p = 0.0019 for CG and p < 0.0001 for GI, as well as the prevalence of anxiety for CG (38.9% WR and 69.4 % OR, p = 0.0174) and GI (19.4% WR and 83.3% OR, p < 0.0001). The anxiety level of guardians did not differ between groups. Conclusion: Regardless of the quality of information provided to the guardians, the level and prevalence of anxiety in children were low at WR time and significantly increased at OR time.

Brazilian Journal of Anesthesiology (Edicion en Espanol), 2013

Recibido el 4 de marzo de 2013; aceptado el 29 de abril de 2013 DESCRIPTORES Ansiedad; Anestesia;... more Recibido el 4 de marzo de 2013; aceptado el 29 de abril de 2013 DESCRIPTORES Ansiedad; Anestesia; Evaluación; Cuidados preoperatorios; Niño Resumem Justificativa y objetivos: La ansiedad preoperatoria es un factor negativo en la experiencia anestésico-quirúrgica. Entre las estrategias para la reducción de la ansiedad en niños, las no farmacológicas son tan importantes como las farmacológicas, pero su caducidad todavía es algo controversial. Verificar si la información ofrecida a los responsables interfiere en la ansiedad del niño. Métodos: quirúrgicos electivos y sus responsables, divididos aleatoriamente en: Grupo Control (GC) = responsable recibió una información anestésica convencional; y el Grupo Informativo (GI) = responsable recibió un folleto sobre la anestesia. Se evaluó la ansiedad de los niños por la escala de ansiedad preoperatoria de Yale modificada (EAPY-m), en dos momentos, en la sala de espera del centro quirúrgico (SE) y en el quirófano (Q), y de los padres, por la escala de Hamilton (HAM-A) en SE. Resultados: No hubo diferencia en los datos sociodemográficos entre los grupos. El nivel de ansiedad en los niños no presentó ninguna diferencia entre los grupos en los dos momentos. Hubo una diferencia estadística significativa en los niveles de ansiedad entre SE y Q en los dos grupos, p = 0,0019 en el GC y p < 0,0001 en el GI, como también en la prevalencia de nivel de ansiedad de los responsables no presentó diferencia entre los grupos. Conclusiones: Independientemente de la calidad de la información ofrecida a los responsables, el nivel y la prevalencia de ansiedad de los niños fueron bajos en el momento SE aumentando significativamente en el momento Q.

European Journal of Anaesthesiology

Preoperative anxiety negatively influences children&amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more Preoperative anxiety negatively influences children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s anaesthetic and surgical experience, and results in postoperative complications, such as emergence delirium and behavioural changes. Nonpharmacological management using alternative therapies that alleviate psychological stress can be as important as pharmacological ones in reducing children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s anxiety. Nevertheless, their validity as an effective anxiety-reducing strategy in children remains controversial. To verify whether nonpharmacological strategies, that is, leaflet and distraction with smartphone application presented to parents/guardians and children, respectively, were effective in preventing children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s anxiety during anaesthesia induction. Randomised clinical trial. A tertiary care teaching hospital. In total, 84 children (aged 4 to 8 years; American Society of Anesthesiologists I and II) undergoing minor-to-moderate elective surgical procedures and their parents/guardians. Children were randomised into four groups: control group, in which the parent/guardian was verbally informed about the anaesthetic procedure; the informed group, in which the parent/guardian was also provided with an information leaflet about the anaesthetic procedure; the smartphone group, in which the parent/guardian was verbally informed and the child received a smartphone application to play with while in the holding area before entering the operating room and the smartphone and informed group, in which the parent/guardian also received an information leaflet and the child, a smartphone application to play with while in the holding area before entering the operating room. Children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s anxiety at two time points: in the holding area of the surgical centre and in the operating room during induction of anaesthesia by facemask. Median (IQR) anxiety levels were greater at time point operating room for children in the control group (55.0; range: 30.0 to 68.4) than in the other groups: informed group, 28.4 (23.4 to 45.0); smartphone group, 23.4 (23.4 to 30.0); smartphone and informed group, 23.4 (23.4 to 25.9). The behavioural distraction strategies using smartphones were effective in preventing an increase in children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s anxiety during anaesthesia induction. clinicaltrials.gov identifier: NCT02246062.