No período de março a maio de 2004, foram estudados 351 primo doadores de sangue do Centro Regional de Hemoterapia de Ribeirão Preto (CRHRP), objetivando investigar os seguintes itens: adequação do tempo utilizado na triagem clínica; entendimento acerca do processo de auto-exclusão e de suas implicações; compreensão sobre as orientações contidas em material informativo, de modo particular em relação ao conceito de janela imunológica; entendimento do termo de consentimento e suas implicações; e entendimento com relação aos comportamentos de risco para a AIDS e para as hepatites B e C. Os participantes foram entrevistados após o término da doação, com as informações sendo obtidas através da aplicação de um questionário e da busca junto à Central de Processamentos de Dados do CRHRP. As entrevistas foram realizadas em todos os dias da semana e durante o horário de funcionamento do Serviço, das 7:00 as 13:00. Nos dias em que o número de primo doadores ultrapassou a capacidade de aplicação do questionário, a escolha dos participantes foi realizada através de sorteio. As variáveis grau de instrução, número de doadores por dia, tempo médio utilizado na triagem clínica e triador foram determinantes para quantificar e qualificar o entendimento dos doadores com relação ao processo de seleção. Verificou-se que 11,4% dos doadores não recebeu o material informativo, e, dos que o receberam, 21,2% não realizou a leitura. O tempo médio gasto na triagem clínica foi igual ou inferior a 3 minutos em cerca de 42,7% dos casos, com variabilidade de 1,2 a 18,2 minutos. Boa compreensão do termo de consentimento e do conceito de janela imunológica ocorreu em 54,4% e 35,3% dos doadores, respectivamente. Evidenciou-se um nítido contraste de boa compreensão sobre comportamento de risco para AIDS e para hepatites B e C, com valores respectivamente iguais a 81,5% e 8,6%. Os resultados apontam para a necessidade de aprimoramento do processo de triagem clínica, bem com de novas pesquisas que contribuam para melhorar o entendimento acerca dos determinantes das deficiências verificadas. / Three hundred fifty-one first time blood donors at the Centro Regional de Hemoterapia in Ribeirão Preto (CRHRP) were studied from March to May 2004, in an attempt to investigate the following items: adequacy of the time spent in the clinical selection; agreement concerning the self-exclusion process and its implications; understanding information contained in informative material, particularly in relation to the immunologic window; understanding consent form and its implications; and understanding risk behaviors for AIDS and hepatitis B and C. The participants were interviewed just after donation; the information was pooled through a questionnaire and a data search at the Data Processing Center at CRHRP. The interviews were performed every weekday during working time, from 7:00 a.m. to 1:00 p.m. During the days when the number of first time blood donors exceeded allocated time for questionnaire completion, the participants were chosen through a raffle. The variables, educational level, number of donors a day, average time used for clinical selection and selector were determinants to quantify and qualify donors' understanding of the selection process. 11,4% of the donors were found not to have received informative material and among the ones who had, 21,2% had not read it. The average time spent in clinical selection was less or equal to 3 minutes in about 42,7% of the cases, with variability of 1,2 to 18,2 minutes. A clear understanding of the consent form and the immunologic window was found in 54,4% and 35,3% of the donors respectively A clear understanding contrast about risky behavior for AIDS and for types B and C hepatitis, 81,5% and 8,6% respectively, stood out. The results show a clear need for improvement of the clinical selection process as well as new studies that would contribute improving understanding concerning the determinants of the flaws detected.

No período de março a maio de 2004, foram estudados 351 primo doadores de sangue do Centro Regional de Hemoterapia de Ribeirão Preto (CRHRP), objetivando investigar os seguintes itens: adequação do tempo utilizado na triagem clínica; entendimento acerca do processo de auto-exclusão e de suas implicações; compreensão sobre as orientações contidas em material informativo, de modo particular em relação ao conceito de janela imunológica; entendimento do termo de consentimento e suas implicações; e entendimento com relação aos comportamentos de risco para a AIDS e para as hepatites B e C. Os participantes foram entrevistados após o término da doação, com as informações sendo obtidas através da aplicação de um questionário e da busca junto à Central de Processamentos de Dados do CRHRP. As entrevistas foram realizadas em todos os dias da semana e durante o horário de funcionamento do Serviço, das 7:00 as 13:00. Nos dias em que o número de primo doadores ultrapassou a capacidade de aplicação do questionário, a escolha dos participantes foi realizada através de sorteio. As variáveis grau de instrução, número de doadores por dia, tempo médio utilizado na triagem clínica e triador foram determinantes para quantificar e qualificar o entendimento dos doadores com relação ao processo de seleção. Verificou-se que 11,4% dos doadores não recebeu o material informativo, e, dos que o receberam, 21,2% não realizou a leitura. O tempo médio gasto na triagem clínica foi igual ou inferior a 3 minutos em cerca de 42,7% dos casos, com variabilidade de 1,2 a 18,2 minutos. Boa compreensão do termo de consentimento e do conceito de janela imunológica ocorreu em 54,4% e 35,3% dos doadores, respectivamente. Evidenciou-se um nítido contraste de boa compreensão sobre comportamento de risco para AIDS e para hepatites B e C, com valores respectivamente iguais a 81,5% e 8,6%. Os resultados apontam para a necessidade de aprimoramento do processo de triagem clínica, bem com de novas pesquisas que contribuam para melhorar o entendimento acerca dos determinantes das deficiências verificadas. / Three hundred fifty-one first time blood donors at the Centro Regional de Hemoterapia in Ribeirão Preto (CRHRP) were studied from March to May 2004, in an attempt to investigate the following items: adequacy of the time spent in the clinical selection; agreement concerning the self-exclusion process and its implications; understanding information contained in informative material, particularly in relation to the immunologic window; understanding consent form and its implications; and understanding risk behaviors for AIDS and hepatitis B and C. The participants were interviewed just after donation; the information was pooled through a questionnaire and a data search at the Data Processing Center at CRHRP. The interviews were performed every weekday during working time, from 7:00 a.m. to 1:00 p.m. During the days when the number of first time blood donors exceeded allocated time for questionnaire completion, the participants were chosen through a raffle. The variables, educational level, number of donors a day, average time used for clinical selection and selector were determinants to quantify and qualify donors' understanding of the selection process. 11,4% of the donors were found not to have received informative material and among the ones who had, 21,2% had not read it. The average time spent in clinical selection was less or equal to 3 minutes in about 42,7% of the cases, with variability of 1,2 to 18,2 minutes. A clear understanding of the consent form and the immunologic window was found in 54,4% and 35,3% of the donors respectively A clear understanding contrast about risky behavior for AIDS and for types B and C hepatitis, 81,5% and 8,6% respectively, stood out. The results show a clear need for improvement of the clinical selection process as well as new studies that would contribute improving understanding concerning the determinants of the flaws detected.

Inledning: Sjukvården är beroende av frivilliga bloddonatorer. Det behövs alltid fler bloddonatorer då vi med dagens sjukvård kan utföra alltmer avancerad kirurgi samt rädda och hjälpa allt fler sjuka samt skadade, med hjälp av blod från frivilliga donatorer. Syfte: Syftet var att undersöka vilka skäl som anges till att inte donera blod, samt undersöka om viljan att ge blod skiljer sig beroende på kön, ålder och om man har yrkes- eller studieanknytning till sjukvård. Syftet var också att undersöka vilka faktorer potentiella blodgivare anger som motiverande till att donera blod. Metod: Denna uppsats baseras på en kvantitativ tvärsnittsstudie, bestående av en webbenkät som delats av författarnas på det sociala mediet Facebook. Enkäten vände sig till personer som enligt blodcentralens kriterier får donera blod, totalt inkom 90 svar, med ett bortfall på totalt 11 personer. Enkäter analyserades sedan kvantitativt med hjälp av statistikprogrammet SPSS. Resultat: Studien visar att den vanligaste orsaken till att respondenten inte gått och donerat blod är att de tillfrågade har tänkt på det men att det inte blivit av. Det finns ingen skillnad i motivationen att donera blod gällande kön, ålder och om man har yrkes-/studieanknytning till sjukvården. Det som respondenterna uppgett som mest motiverande till att gå och donera blod är att få svar på olika provsvar som till exempel kolesterol och infektionsparametrar. Slutsats: Att försöka göra blodgivningen mer tillgänglig skulle förhoppningsvis kunna öka antalet blodgivare, eftersom en tredjedel av de tillfrågade har tänkt på det, men att det inte blivit av. Att erbjuda bloddonatorerna svar på olika blodprover skulle troligtvis också öka chanserna för att flera personer ska bli återkommande bloddonatorer. / Introduction: Hospitals and general healthcare are dependent on volunteers to donate blood. Due to today’s advanced surgery there is an everlasting need for new and more blood donors. With the aid of donated blood more people in need could receive the appropriate treatment. Aim: The aim was to investigate what reasons would be given for not donating blood, and to investigate whether the will to donate blood may depend on gender, age and whether the subject has a work- or study relation to healthcare. The aim was also to determine the motivating factors to blood donation of future donors. Method: This essay is based on a quantitative cross-sectional study consisting of a web based survey shared by the authors on the social networking service Facebook. The target group of the survey was people who are suitable to donate blood according to the criteria of the blood donation centre. A total of 90 individuals responded to the survey, with a loss of 11 people. The surveys were analyzed quantitatively using the statistical program SPSS. Results: The study indicates that the most common reason to why the respondent has not donated blood is that he or she has thought of donating blood, but that it has simply not yet happened. The motivation of donating blood is not dependent on the person’s gender, age or whether or not the person has a work- or study relation to healthcare. The most motivating factor to donating blood is the opportunity to be informed of test results such as cholesterol levels and infection parameters. Conclusion: Since one third of the respondents have considered donating blood, but that they still have not done so, there would probably be an increase in the numbers of blood donors if blood donating centres were more accessible. To offer the donors the results of various kinds of blood tests would probably motivate more persons to become regular blood donors.

Made available in DSpace on 2014-06-11T19:29:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-08-28Bitstream added on 2014-06-13T20:38:56Z : No. of bitstreams: 1 bossolan_rp_me_botfm.pdf: 430534 bytes, checksum: 621278eaf59ba43e891caf2e11e8b99b (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Uma das preocupações atuais dos serviços de saúde diz respeito aos baixos índices de doação de sangue. Essa constatação levou os hemocentros a desenvolverem programas de conscientização, na mídia e nas escolas, partindo do pressuposto que a formação de cidadãos responsáveis pelo bemestar pessoal e coletivo se inicia na infância. Frente à necessidade de subsídios para elaboração desses programas, este projeto teve como objetivo investigar a concepção que escolares de idades e estágios cognitivos diversos têm sobre doação de sangue, a importância que atribuem ao ato de doar e receber sangue, as informações de que dispõem, quais são suas fontes de informação, assim como fantasias e sentimentos associados à doação e recepção. Para tal, 145 escolares de faixa etária dos 6, 8 e 10 anos de idade foram submetidos a provas de desenvolvimento cognitivo, responderam a uma entrevista individual, semi-estruturada, com questões norteadoras sobre os temas discutidos e tiveram que se posicionar frente a um dilema. Num segundo momento, foi pedido que elaborassem um desenho parà sensibilizar as pessoas a doarem sangue. Os resultados mostraram que, tanto na entrevista como na resolução do dilema e no desenho, a maioria das crianças associou a doação com um ato de ajuda ao outro, parecendo mostrar que, independente do recurso metodológico utilizado, os escolares relacionaram o ato de doar om os valores de generosidade e solidariedade, possivelmente influenciados elos slogans veiculados nas campanhas. Apesar das crianças com maior escolaridade, na fase de desenvolvimento formal, possuir um número significativamente maior de informações, quando comparadas com as maIs ovas, que freqüentavam o pré e a segunda série, o nível de desinformação e... / One of the actual concerns in health servlces is the low number of blood donation. This observation led hemocenters to develop awareness programs in media and at schools, once the formation of citizens responsible for the individual and collective well-being begins in childhood. Due to the necessity of information for the programs' design, the aim of this project was to investigate the idea that students from different cognitive stages and ages have about blood donation, the importance they give to the act of donating and receiving blood, the information they have on the issue and its source, as well as the fantasies and feelings related to it. Thus, 145 students aged 6, 8 and 10 years were submitted to cognitive development tests; answered to an individual sem istructured interview, with question related to the themes discussed previously, and had to solve a dilemma. On a second moment, they were asked to draw a touching picture to motivate people to donate blood. Results showed that in the three situations, interview, dilemma solving and drawing, children associated the donation with an act of helping the other, showing that, independent on the methodological source used, the act of donating was related to generosity and solidarity values, possibly because these are the most frequently used slogans in campaigns. Despite the fact that children with a higher levei of education, in formal development stage, also have a significantly higher levei of information, disinformation and misinformation was high, in the sample as a whole, if compared to the younger ones, who were at pre-primary and second year of primary school. Children from the outskirts public schools were the least informed on the issue. When trying to justify the reason why people do not onate blood, children mentioned emotional conditions, fear of pain or damage... (Complete abstract click electronic access below)

Orientador: Gimol Benzaquen Perosa / Banca: Eliana Goldfarb Cyrino / Banca: Mário Sérgio Vasconcelos / Resumo: Uma das preocupações atuais dos serviços de saúde diz respeito aos baixos índices de doação de sangue. Essa constatação levou os hemocentros a desenvolverem programas de conscientização, na mídia e nas escolas, partindo do pressuposto que a formação de cidadãos responsáveis pelo bemestar pessoal e coletivo se inicia na infância. Frente à necessidade de subsídios para elaboração desses programas, este projeto teve como objetivo investigar a concepção que escolares de idades e estágios cognitivos diversos têm sobre doação de sangue, a importância que atribuem ao ato de doar e receber sangue, as informações de que dispõem, quais são suas fontes de informação, assim como fantasias e sentimentos associados à doação e recepção. Para tal, 145 escolares de faixa etária dos 6, 8 e 10 anos de idade foram submetidos a provas de desenvolvimento cognitivo, responderam a uma entrevista individual, semi-estruturada, com questões norteadoras sobre os temas discutidos e tiveram que se posicionar frente a um dilema. Num segundo momento, foi pedido que elaborassem um desenho parà sensibilizar as pessoas a doarem sangue. Os resultados mostraram que, tanto na entrevista como na resolução do dilema e no desenho, a maioria das crianças associou a doação com um ato de ajuda ao outro, parecendo mostrar que, independente do recurso metodológico utilizado, os escolares relacionaram o ato de doar om os valores de generosidade e solidariedade, possivelmente influenciados elos slogans veiculados nas campanhas. Apesar das crianças com maior escolaridade, na fase de desenvolvimento formal, possuir um número significativamente maior de informações, quando comparadas com as maIs ovas, que freqüentavam o pré e a segunda série, o nível de desinformação e... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: One of the actual concerns in health servlces is the low number of blood donation. This observation led hemocenters to develop awareness programs in media and at schools, once the formation of citizens responsible for the individual and collective well-being begins in childhood. Due to the necessity of information for the programs' design, the aim of this project was to investigate the idea that students from different cognitive stages and ages have about blood donation, the importance they give to the act of donating and receiving blood, the information they have on the issue and its source, as well as the fantasies and feelings related to it. Thus, 145 students aged 6, 8 and 10 years were submitted to cognitive development tests; answered to an individual sem istructured interview, with question related to the themes discussed previously, and had to solve a dilemma. On a second moment, they were asked to draw a touching picture to motivate people to donate blood. Results showed that in the three situations, interview, dilemma solving and drawing, children associated the donation with an act of helping the other, showing that, independent on the methodological source used, the act of donating was related to generosity and solidarity values, possibly because these are the most frequently used slogans in campaigns. Despite the fact that children with a higher levei of education, in formal development stage, also have a significantly higher levei of information, disinformation and misinformation was high, in the sample as a whole, if compared to the younger ones, who were at pre-primary and second year of primary school. Children from the outskirts public schools were the least informed on the issue. When trying to justify the reason why people do not onate blood, children mentioned emotional conditions, fear of pain or damage... (Complete abstract click electronic access below) / Mestre

Like the rest of the western world, the UK faces a significant increase in the prevalence of diseases associated with lifestyle. Smoking rates have reduced, but increasing obesity has contributed to alarming increases in diabetes. Discovery of the correlation between behaviour and poor health has, since the 1970s, resulted in public health policies emphasising behaviour change, and personal responsibility; an emphasis that survived later research which demonstrated social, genetic and psychological determinants on behaviour and health. The latest version of the NHS constitution exhorts us to ‘recognise that you can make a significant contribution to your own, and your family’s, good health and wellbeing, and take personal responsibility for it.’ This thesis seeks to clarify the meaning and extent of personal responsibility for health, and at its core are four papers published in peer-reviewed journals. The first clarifies the concept concluding that it is best understood in a tripartite conception of a moral agent having obligations and being held responsible if he fails to meet them. The following two papers discuss the nature of the obligations, using utilitarian reasoning and arguments from analogy. First, an exploration of the moral obligations for our own health is undertaken via an analysis of the practice of tombstoning, jumping from height into water. I conclude that the obligations are of process rather than outcome, consisting of an epistemic duty to determine the health related consequences of our acts, and a reflective duty to consider these consequences for us and for those who share our lives. Second, following an examination of the moral status of blood donation, I conclude that despite its presentation as a praiseworthy and supererogatory act, it is more properly regarded as a prima facie obligation, supported by arguments from beneficence and justice. The final paper discusses the final part of the tripartite conception of personal responsibility for health: being held responsible. I discuss the nature of blame and extend the tombstoning analogy as a way of testing my own intuitions in response to an imagined adult son who has undertaken this dangerous activity. I argue that the notion of blame is not generally allowed as part of the patient – professional relationship, and yet without considering blame, the concept of personal responsibility for health is incomplete. I conclude that if the epistemic and reflective duties, individually applied, conclude that an obligation is owed, it is owed to those within personal relationships, and holding people responsible for their health-effecting behaviour is also best undertaken within these relationships. I conclude the thesis by considering the implications for professional practice. Inevitably this leads to consideration of the promotion of personal autonomy in health care. A more relational account of autonomy is suggested. Facilitating the epistemic duty so that individuals are better able to understand the risks of their behaviour requires rethinking of the way that health promoting material and information are presented.

Yes / Background: The World Health Organization (WHO) recommends 100% blood should be from voluntary non-remunerated donors (VNRD) yet the majority of blood donations (75%) in Barbados are family/replacement donations. Increasing VNRD is paramount to achieving a safe, reliable blood supply and understanding the population is a strategy suggested by the WHO to inform donor recruitment and education. Objective: To obtain information to devise strategies for a voluntary donor mobilization campaign in Barbados. Methods: Participants in Barbados (n=429) completed a self-administered questionnaire in 2014. The questionnaire comprised 31 questions including demographics (age, sex, highest educational attainment) and blood donation-related knowledge, attitudes and practices. Analysis of variance, t-test and linear regression were used to analyse data. Results: Fifty-three per cent (n=219) of participants had previously donated blood; only 23.9% of these had donated within the past two years and almost half were family/replacement donors only. Knowledge deficits included blood donation requirements, deferral factors and maximum yearly donations. Most participants (79%) were willing to donate with more information. Participants with higher educational attainment and previous donors had higher total knowledge and attitude scores (p<0.01). Single, female, and younger participants were less likely to donate blood (p<0.05). Conclusion: Barbados can likely increase voluntary blood donation rates by addressing knowledge deficits through education campaigns and increasing awareness of the need for donation.

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