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Campos RT, Martiniano LVM, Lirio AKS, Souza KEDA, Rose N, Dias JMM, Cardoso ACA, Farhat SC, Silva CA. Nonsexual violence against children and adolescents: a study in a Latin American tertiary and university hospital. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2022; 40:e2021101. [PMID: 35544904 PMCID: PMC9095060 DOI: 10.1590/1984-0462/2022/40/2021101in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/08/2021] [Indexed: 12/03/2022]
Abstract
OBJECTIVE The objective of this study was to assess interpersonal nonsexual violence against children and adolescents in a tertiary university hospital. METHODS A cross-sectional study was performed in 240 patients under nonsexual violence situation for 15 consecutive years. Data analyses included demographic data, hospital referral site, type and author of nonsexual violence, legal referral, laboratorial and imaging examinations, and outcomes. RESULTS Nonsexual violence situation was diagnosed in 240 (0.1%) of 295,993 patients for 15 years: 148 (61.7%) in children and 92 (38.3%) in adolescents. Out of 240, the most frequent types of violence were negligence in 156 (65.0%), physical 62 (25.8%), psychological/emotional aggression 52 (21.7%), Munchausen by proxy syndrome 4 (1.7%), and bullying/cyberbullying in 3 (1.3%). Out of 123, the most common pediatric chronic conditions were chronic kidney disease 24 (19.5%), human immunodeficiency virus 14 (11.4%), prematurity 9 (7.3%), cerebral palsy 8 (6.5%), and asthma 8 (6.5%). Further comparison between children versus adolescent under nonsexual violence situation revealed significant difference between the hospital referral sites. The frequency of patients under violence referred from outpatient clinics was significantly reduced in children versus adolescents (27.7 vs. 62%), whereas emergency department was higher in the former group (57.4 vs. 25.0%; p<0.001). All types of violence situations and pediatric chronic conditions were similar in both groups (p>0.05). CONCLUSIONS Nonsexual violence against our pediatric population was rarely diagnosed in a tertiary hospital, mainly negligence, physical, and psychological/emotional aggression. Approximately two-thirds of violence diagnosis occurred in children, referred mainly by the emergency department. In contrast, approximately one-third of violence diagnosis occurred in adolescents, referred mostly by outpatient clinics.
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Affiliation(s)
| | | | | | | | - Natalia Rose
- Universidade de São Paulo, São Paulo, SP, Brazil
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Moreira LR, Paludo SDS. A Violência Mora ao Lado? Violência Familiar e Comunitária entre Adolescentes. PSICOLOGIA: TEORIA E PESQUISA 2022. [DOI: 10.1590/0102.3772e38314.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Resumo Para descrever a ocorrência de situações de violência contra adolescentes na família e na comunidade, foi conduzido estudo transversal em escolas públicas de municípios do Brasil. O Questionário da Juventude Brasileira Versão Fase II foi utilizado. Participaram 2.860 adolescentes, sendo 58,5% do sexo feminino. Cerca de um terço dos participantes sofreram violência física na família. Na comunidade, 32,7% dos adolescentes reportaram ter sofrido situações de violência psicológica. Situações de violência física ocorreram mais entre meninos, em participantes de 15 a 19 anos e nos que experimentaram álcool ou drogas ilícitas. Considera-se como importante que ações preventivas contra violência de naturezas distintas sejam contínuas e abrangentes, incluam diferentes subgrupos e garantam o suporte necessário.
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Nunes LS, Silva-Oliveira F, Mattos FF, Maia FBF, Ferreira EFE, Zarzar PMPDA. Prevalence of recognition and reporting of child physical abuse by dental surgeons and associated factors. CIENCIA & SAUDE COLETIVA 2021; 26:5013-5022. [PMID: 34787194 DOI: 10.1590/1413-812320212611.3.02442020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 02/24/2020] [Indexed: 11/21/2022] Open
Abstract
Studies evaluating the factors associated with under reporting and with the recognition and reporting of child physical abuse are scarce and highly necessary. This study aimed to assess the prevalence of recognition and reporting of child physical abuse (CPA) by Brazilian dentistsin primary care and associated factors. A cross-sectional study was carried out with a representative sample of dentistsfrom the Family Health Strategy in Belo Horizonte. A self-administered questionnaire validated to Brazilian Portuguesewas used for data collection. Statistical analysis included univariate and multiple analyses through Poisson regression. A total of 181dentists participated in the study. Among them, 73 (40.3%) had already recognized some cases of CPA, but only 11 (6.1%) ended up reporting. Dentists with six to 19 years of experience as a municipal worker presented 2.38 times [PR = 2.38 (95%CI: 1.29-4.41)] more probability to recognize cases of CPA than the ones with less than six years. Having a graduate degree with a major in childcare [PR = 4.50 (95%CI: 1.08-18.68)] was associated with a larger number of reports. The employment duration as municipal worker was positively associated with the recognition of CPA cases and the prevalence of reporting was low.
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Affiliation(s)
- Laís Soares Nunes
- Departamento de Saúde Bucal da Criança e do Adolescente, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-90 Belo Horizonte MG Brasil.
| | - Fernando Silva-Oliveira
- Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Flávio Freitas Mattos
- Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Fernanda Bartolomeo Freire Maia
- Departamento de Saúde Bucal da Criança e do Adolescente, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-90 Belo Horizonte MG Brasil.
| | | | - Patrícia Maria Pereira de Araújo Zarzar
- Departamento de Saúde Bucal da Criança e do Adolescente, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-90 Belo Horizonte MG Brasil.
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Silva-Oliveira F, Ferreira RC, Alencar GP, Ferreira EF, Zarzar PM. Reporting of child physical abuse by a group of Brazilian primary care health professionals and associated factors. CHILD ABUSE & NEGLECT 2020; 107:104571. [PMID: 32619866 DOI: 10.1016/j.chiabu.2020.104571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/15/2020] [Accepted: 05/28/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND Evidences points to the importance of health professionals to recognize child abuse, but also to a high frequency of underreporting, even in countries where reporting is mandatory, like Brazil. OBJECTIVE To evaluate the frequency of non-reporting behavior of child physical abuse (CPA) among Brazilian primary care health professionals who recognized some cases in their careers and associated factors with reporting. METHODS Cross-sectional study conducted with a representative sample of dentists, nurses, family physicians, and pediatricians from the Family Health Strategy network in the city of Belo Horizonte, Brazil. A validated self-administered questionnaire for use in Brazil was applied in-person to professionals in 2014 and 2015. Pearson's chi-squared test (p < 0.05) and a binary logistic regression model was used. RESULTS A total of 715 professionals participated (response rate: 98.89%), 414 (57.3%) recognized cases, of which 171 (41.3%) reported. Reporting was associated with the type of profession, as pediatricians reported cases more than dentists [OR = 6.05 (95% CI: 1.24-29.50)], with the willingness to become involved [OR = 2.01 (95% CI: 1.02-3.97)] and knowledge regarding where to report cases [OR = 2.68 (95% CI: 1.25-5.74)]. Confidentiality was the barrier associated with a lower probability of reporting CPA cases [OR = 0.22 (95% CI: 0.08-0.66)]. CONCLUSIONS There is a high frequency of non-reporting behavior. Pediatricians reported more CPA cases, followed by family doctors and nurses. Dentists were those who reported fewer cases. Reporting was also associated with a willingness to be involved in detecting/reporting abuse and knowing where to report CPA.
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Affiliation(s)
- Fernando Silva-Oliveira
- Ph D in Public Health at the Faculty of Dentistry of the Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627 Campus Pampulha, CEP: 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Raquel Conceição Ferreira
- Department of Social and Preventive Dentistry of the Faculty of Dentistry of the Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627 Campus Pampulha, CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Gizelton Pereira Alencar
- Department of Epidemiology of the School of Public Health of the Universidade de São Paulo, Avenida Dr. Arnaldo, 715, Sala 213, CEP 01246-904, São Paulo, São Paulo, Brazil.
| | - Efigênia Ferreira Ferreira
- Titular Professor of the Department of Social and Preventive Dentistry of the Faculty of Dentistry of the Universidade Federal de Minas Gerais. Av. Antonio Carlos, 6627 Campus Pampulha, CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Patrícia Maria Zarzar
- Department of Pediatric Dentistry and Orthodontics of the Faculty of Dentistry of the Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627 Campus Pampulha, CEP: 31270-901, Belo Horizonte, Minas Gerais, Brazil.
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Silva-Oliveira F, Andrade CI, Guimarães MO, Ferreira RC, Ferreira EF, Zarzar PM. Recognition of child physical abuse by a group of Brazilian primary care health professionals. Int J Paediatr Dent 2019; 29:624-634. [PMID: 31071237 DOI: 10.1111/ipd.12506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/16/2019] [Accepted: 05/02/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Child maltreatment is a complex social and public health problem. AIM To evaluate the frequency of the recognition by Brazilian health professionals in primary care of child physical abuse (CPA) and associated factors. DESIGN A representative cross-sectional study was conducted with dentists, nurses, family physicians, and pediatricians who participated in the network of the Family Health Strategy in the city of Belo Horizonte, Brazil. Data collection involved in the administration of a questionnaire validated for use in Brazil. Data were collected from 181 dentists, 235 nurses, 203 family physicians, and 96 pediatricians. RESULTS Among the 715 health professionals, 499 (69.8%) had some type of postgraduate degree and 414 (57.9%) recognized suspected or proved cases of CPA. The recognition was associated with occupation, as pediatricians recognized 14.11-fold [OR = 14.11 (95% CI: 3.73 to 53.43)] more cases of CPA compared with dentists. The recognition was also associated with a longer period of time working in the city [OR = 2.79 (95% CI: 1.24 to 6.29)]. CONCLUSION The recognition of cases was positively associated with the longer working time in the municipal network and with pediatricians. The dentist was the category that was least associated with the recognition of CPA.
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Affiliation(s)
| | | | | | - Raquel Conceição Ferreira
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Efigênia Ferreira Ferreira
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Patrícia Maria Zarzar
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Associated factors of companion animal neglect in the family environment in Pinhais, Brazil. Prev Vet Med 2018; 157:19-25. [DOI: 10.1016/j.prevetmed.2018.05.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 05/20/2018] [Accepted: 05/27/2018] [Indexed: 11/18/2022]
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Apostólico MR, Egry EY, Fornari LF, Gessner R. Accuracy of nursing diagnoses for identifying domestic violence against children. Rev Esc Enferm USP 2018; 51:e03290. [DOI: 10.1590/s1980-220x2017019103290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 09/09/2017] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective Identify nursing diagnoses involving a hypothetical situation of domestic violence against a child and the respective degrees of accuracy. Method An exploratory, evaluative, case study was conducted using a quantitative and qualitative approach, with data collected using an online instrument from 26 nurses working in the Municipal Health Network, between June and August 2010, in Curitiba, and also during the first half of 2014 in São Paulo. Both of these cities are in Brazil. Nursing diagnoses and interventions from the International Classification of Nursing Practices in Collective Health were provided, and accuracy was verified using the Nursing Diagnosis Accuracy Scale. Results Thirty-nine nursing diagnoses were identified, 27 of which were common to both cities. Of these, 15 were scored at the null level of accuracy, 11 at high accuracy and 1 at medium accuracy. Conclusion The difficulty the nurses had in defining diagnoses may be associated with the fact that nursing care generally focuses on clinical problems, and signs expressing situations of domestic violence against children go unnoticed. The results demonstrated the difficulty of participants in selecting the appropriate nursing diagnosis for the case in question.
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Dos Santos TMB, Pitangui ACR, Bendo CB, Paiva SM, Cardoso MD, de Melo JPR, da Silva LMP. Factors associated with the type of violence perpetrated against adolescents in the state of Pernambuco, Brazil. CHILD ABUSE & NEGLECT 2017; 67:216-227. [PMID: 28282595 DOI: 10.1016/j.chiabu.2017.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 12/20/2016] [Accepted: 02/03/2017] [Indexed: 06/06/2023]
Abstract
To analyze the factors associated with the types of violence against adolescents reported in Pernambuco, Brazil, from 2009 to 2012. Prevalence study conducted through an electronic database from the Violence Surveillance Official System in a population of 5259 adolescents (aged 10-19 years). Poisson regression was used, with significance level at 5%. There was a significant increase of 204% in the number of violence reports, and the number of reporting units increased by 92.6%. When separately evaluated, physical violence was the most prevalent type, accounting for 44.7% of the reports. Taking as independent variables the age range of 15-19 years, female, having no disability, and public roads as place of occurrence, the positively and independently associated factors were: male gender (OR 1.5, 95% CI 1.4-1.6) with physical violence; having deficiency (OR 1.7, 95% CI 1.5-2.0) with psychological violence; age range of 10-14 years (PR 2.4, 95% CI 2.2-2.6) with sexual assault; and male (OR 3.9, 95% CI 2.0-7.5), having disabilities (PR 4.6, 95% CI 2.7-9.7), and occurrence in residence (PR 2.8, 95% CI 1.3-6.1) with neglect. Age between 10 to 14 years was associated with the occurrence of sexual assault; male with the occurrence of physical violence and neglect; having disabilities with psychological violence and neglect; and occurrence in the residence was associated with neglect.
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Affiliation(s)
| | | | | | - Saul Martins Paiva
- Federal University of Minas Gerais, Dentistry School, Belo Horizonte, MG, Brazil
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Wirtz AL, Alvarez C, Guedes AC, Brumana L, Modvar C, Glass N. Violence against children in Latin America and Caribbean countries: a comprehensive review of national health sector efforts in prevention and response. BMC Public Health 2016; 16:1006. [PMID: 27659869 PMCID: PMC5034460 DOI: 10.1186/s12889-016-3562-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/19/2016] [Indexed: 12/02/2022] Open
Abstract
Background Violence against children (VAC) remains a global problem. The health sector has an opportunity and responsibility to be part of the multi-sector collaboration to prevent and respond to VAC. This review aimed to assess the health sector’s response to VAC among Latin American & Caribbean (LAC) countries, particularly as it relates to physical violence, sexual violence, and neglect. Method National protocols for the identification and provision of health care to child survivors of violence, abuse and neglect were solicited in partnership with UNICEF and PAHO/WHO country offices within the LAC region. A parallel systematic review was undertaken in January 2015 to review studies published in the last 10 years that describe the regional health sector response to VAC. Results We obtained health sectors guidelines/protocols related to VAC from 22 of 43 (51 %) countries and reviewed 97 published articles/reports that met the review inclusion criteria. Country protocols were presented in Spanish (n = 12), Portuguese (n = 1), and English (n = 9). Thematic areas of country protocols included: 1) identifying signs and symptoms of VAC, 2) providing patient-centered care to the victim, and 3) immediate treatment of injuries related to VAC. The systematic review revealed that health professionals are often unaware of national protocols and lack training, resources, and support to respond to cases of VAC. Further, there is limited coordination between health and social protection services. Conclusions VAC remains an international, public health priority. Health professionals are well-positioned to identify, treat and refer cases of VAC to appropriate institutions and community-based partners. However, poor protocol dissemination and training, limited infrastructure, and inadequate human resources challenge adherence to VAC guidelines. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3562-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea L Wirtz
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | - Carmen Alvarez
- Community Public Health Nursing, Johns Hopkins School of Nursing, Baltimore, USA
| | - Alessandra C Guedes
- Family, Gender and Life Course Department, Pan American Health Organization/World Health Organization, Regional Office for the Americas, Washington, DC, USA
| | - Luisa Brumana
- UNICEF Latin America and Caribbean Regional Office, Panama, Panama
| | - Cecilie Modvar
- UNICEF Latin America and Caribbean Regional Office, Panama, Panama
| | - Nancy Glass
- Community Public Health Nursing, Johns Hopkins School of Nursing, Baltimore, USA
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Gonçalves CFG, Silva LMPD, Pitangui ACR, Silva CCD, Santana MVD. NETWORK ACTION FOR THE CARE OF ADOLESCENT VICTIMS OF VIOLENCE: CHALLENGES AND POSSIBILITIES. TEXTO & CONTEXTO ENFERMAGEM 2015. [DOI: 10.1590/0104-0707201500004580014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to investigate the perception of health care service managers about the network action for the care of adolescent victims of violence. A qualitative, exploratory, descriptive study conducted from May to July of 2013. The subjects were 15 managers of a hospital that is a referral center for cases of violence in the Brazilian State of Pernambuco. Data were collected through semi-structured interviews and explored using content analysis. The results indicate that social work plays an aggregating and interconnecting role as required by the network action. The health care network is appreciated, but regarded as providing insufficient actions, with lack of standardization of care and service flow. We conclude that the subjects show a positive perception of the role of the studied service, but they point out a lack of specific technical standards in the health care sector aimed at high quality care for adolescents.
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