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Kurbatfinski S, Letourneau N, Luis MA, Conlin J, Holton M, Biletsky R, Hanrieder R, Hansen J, Barber B. The Evaluation of a Domestic Abuse Response Team Program in an Emergency Department. JOURNAL OF FAMILY VIOLENCE 2023:1-14. [PMID: 37358976 PMCID: PMC10144875 DOI: 10.1007/s10896-023-00562-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 06/28/2023]
Abstract
Purpose Domestic abuse (e.g., family violence) occurs globally and increases the risk for lifelong adverse health outcomes for all members involved. Although victims of domestic abuse often refrain from seeking support due to various reasons (e.g., fear), health centers such as emergency departments (EDs) can serve as outlets for assistance. The Domestic Abuse Response Team (DART) is a program working collaboratively with a regional hospital center in Alberta, Canada, uniquely providing immediate, expert, and patient-oriented services (e.g., safety plans) to domestic abuse victims within the ED. This study aimed to evaluate the DART program by: (1) using administrative data to characterize ED and DART patient characteristics and (2) examining staff perceptions about DART's operations, effectiveness, challenges, and improvements. Methods A mixed-methods approach was used to collect data from April 1st, 2019 to March 31st, 2020. Quantitative data consisted of descriptive statistics on patient and staff characteristics and qualitative data was collected through two surveys to determine perceptions of the DART program. Results Approximately 60% of ED patients were screened for domestic abuse and 1% were referred to DART, of which 86% were female. All referrals received support within an hour and were provided patient-oriented assistance. Qualitative data revealed that the DART program offers important support to patient victims, increases comfort around dealing with domestic abuse, and decreases ED staff workloads. Conclusions The DART program offers valuable support to domestic abuse victims. Staff reported that DART is effective in providing victims with immediate care and services while also supporting ED staff.
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Affiliation(s)
- Stefan Kurbatfinski
- Owerko Centre, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
- Community Health Sciences, Cumming School of Medicine University of Calgary, Calgary, Canada
| | - Nicole Letourneau
- Owerko Centre, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
- Community Health Sciences, Cumming School of Medicine University of Calgary, Calgary, Canada
| | | | | | | | | | | | | | - Barbara Barber
- Previously with The Outreach Centre, Red Deer, Canada
- Present Address: Sagesse, Alberta, Canada
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Leite FMC, Pinto IBA, Luis MA, Iltchenco JH, Laignier MR, Lopes-Júnior LC. Recurring violence against adolescents: an analysis of notifications. Rev Lat Am Enfermagem 2022; 30:e3682. [PMID: 36197390 PMCID: PMC9647893 DOI: 10.1590/1518-8345.6277.3681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE to identify the frequency of reported cases of recurring violence against adolescents and their association with victim, violence, and aggressor characteristics. METHOD cross-sectional study conducted with notified data on violence against adolescents, produced by Epidemiological Surveillance and registered in the Information System of Diseases and Notification (SINAN), from 2011 to 2018, in the state of Espírito Santo, Brazil. RESULTS the frequency of recurring violence against adolescents was 46.4%. Higher occurrence was observed among girls (PR: 1.26; 95%CI: 1.15 - 1.38) between 10 and 14 years of age (PR: 1.20; 95%CI: 1.13 - 1.28), and people with a disability or disorder (PR: 1.52; 95%CI: 1.42 - 1.62). Psychological violence/neglect was 30% more prevalent in recurrence than self-harm. Most cases occurred at home (PR: 1.56; 95%CI: 1.37 - 1.77). Results showed a 1.11 times higher prevalence of recurring violence perpetrated by aggressors aged 20 years or older and higher evidence in male aggressors (95%CI: 0.97 - 1.17). CONCLUSION recurring violence was associated with victim, aggressor, and event characteristics. Health intersectoriality is crucial to reduce cases of recurring violence. UNLABELLED (1) Frequency of recurring violence against adolescents was 46.4%. (2) Higher recurrence was observed among girls between 10 and 14 years of age. (3) Most cases occurred at home. (4) Recurring violence was associated with victim, aggressor, and event characteristics. (5) Results show 1.11 times > prevalence of recurring violence perpetrated by men ≥ 20 years old.
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Affiliation(s)
| | - Isaura Barros Alves Pinto
- Universidade Federal do Espírito Santo, Departamento de Enfermagem, Centro de Ciências da Saúde, Vitória, ES, Brasil
| | - Mayara Alves Luis
- Universidade Federal do Espírito Santo, Departamento de Enfermagem, Centro de Ciências da Saúde, Vitória, ES, Brasil
| | - José Henrique Iltchenco
- Universidade Federal do Espírito Santo, Departamento de Enfermagem, Centro de Ciências da Saúde, Vitória, ES, Brasil
| | - Mariana Rabello Laignier
- Universidade Federal do Espírito Santo, Departamento de Enfermagem, Centro de Ciências da Saúde, Vitória, ES, Brasil
| | - Luís Carlos Lopes-Júnior
- Universidade Federal do Espírito Santo, Departamento de Enfermagem, Centro de Ciências da Saúde, Vitória, ES, Brasil
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Feitosa SO, Noll M, Mendonça CR, Silveira EA, Esposito Sorpreso IC, Noll PRES. Prevalence of sexual abuse and its association with health-risk behaviors among Brazilian adolescents: A populational study. CHILD ABUSE & NEGLECT 2021; 122:105347. [PMID: 34634524 DOI: 10.1016/j.chiabu.2021.105347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/26/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Analysis of sexual abuse has usually been neglected in research at developing countries despite its everlasting consequences. This study examined the prevalence of sexual abuse among Brazilian adolescents according to data from the National School Health Survey (PeNSE) and analyzed it based on Brazilian regions, sociodemographic aspects, health information, and health-risk behaviors among Brazilian adolescents who reported having experienced sexual abuse previously. PARTICIPANTS AND SETTING The PeNSE data were utilized, and the sample included 102,072 students from all over Brazil, aged between 11 and 19 years. METHODS Data were collected by questionnaires and were analyzed by multivariate analysis using the Poisson regression model. RESULTS The results denoted a relation between sexual abuse, social determinants of health variables (i.e., black, indigenous, and mixed skin color/ethnicity; Brazilian region public school, age between 15 and 18 years, and low education level of the mother), and health-risk behaviors (i.e., early sexual intercourse, having multiple sexual partners, unprotected sexual intercourse, use of tobacco, alcohol, and illicit drugs). CONCLUSION Therefore, reports of sexual abuse are associated with risky behaviors. Given these findings, targeted interventions on sexual abuse are essential for the health of adolescents and the prevention of risky behaviors, and can also facilitate programs to prevent sexual abuse.
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Affiliation(s)
| | - Matias Noll
- Instituto Federal Goiano - Campus Ceres, Brazil; Programa de Pós-graduação Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Brazil; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | | | - Erika Aparecida Silveira
- Programa de Pós-graduação Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Brazil
| | - Isabel Cristina Esposito Sorpreso
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Priscilla Rayanne E Silva Noll
- Instituto Federal Goiano - Campus Ceres, Brazil; Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil.
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Pereira VODM, Pinto IV, Mascarenhas MDM, Shimizu HE, Ramalho WM, Fagg CW. Violence against adolescents: analysis of health sector notifications, Brazil, 2011-2017. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23 Suppl 1:e200004.SUPL.1. [PMID: 32638987 DOI: 10.1590/1980-549720200004.supl.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/09/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Violence experienced in adolescence results in serious damage and suffering to society. This study aims to characterize the profile of violence victims and likely perpetrators of violence against adolescents, as well as to describe the percentage of notifying municipalities according to the federation unit. METHODS Cross-sectional study conducted with data on notification of violence against adolescents from the Information System for Notifiable Diseases, from 2011 to 2017. The chi-square test was used to assess the statistical significance of the differences between the proportions in the comparison between genders. Proportion ratios for the most frequent types of violence were estimated according to selected variables. RESULTS The notifications came from 75.4% of all the Brazilian municipalities. Physical violence predominated among males, aged 15-19 years. Psychological violence was predominant among females, between 10 and 14 years old, when perpetrated repeatedly at home by family aggressors. Sexual violence prevailed among females, aged 10 to 14 years old, in the indigenous, black and yellow races/colors, when perpetrated repeatedly at home. Negligence was more common among males, between 10 and 14 years old, when perpetrated repeatedly by family aggressors. CONCLUSIONS Sexual violence occurred predominantly against females and generated significant negative impacts on mental, physical, sexual and reproductive health. Community violence, perpetrated with sharp objects and firearms, were prominent among males and are important risk factors for male over-mortality. Because the problems are complex, addressing them requires intersectoral actions.
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Affiliation(s)
| | | | | | | | | | - Christopher William Fagg
- Programa de Pós-Graduação em Ciências e Tecnologias em Saúde, Universidade de Brasília, Brasília, DF, Brazil
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Kataguiri LG, Scatena LM, Rodrigues LR, Castro SDS. CHARACTERIZATION OF SEXUAL VIOLENCE IN A STATE FROM THE SOUTHEAST REGION OF BRAZIL. TEXTO & CONTEXTO ENFERMAGEM 2019. [DOI: 10.1590/1980-265x-tce-2018-0183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to verify the association between victims of sexual violence and the sociodemographic aspects related to exposure in the state of Minas Gerais, Brazil. Method: an ecological study, where the database of the Sistema de Informação de Agravos de Notificação, SINAN provided by the Minas Gerais State Health Department was used. Data were analyzed using descriptive statistics, the chi-square test, and Multiple Correspondence Factor Analysis (p≤0.05). Results: stepfathers were the predominant offenders, associated with schooling from 0 to 4th grade, brown-skinned ethnicity, and the residence as place of occurrence. When the offender was the father, there was association with an unknown place of occurrence, followed by the residence, abuse of male children between 0 and 9 years old, and living in municipalities from 200 to 500 thousand inhabitants. Stranger aggressors were associated with white female victims aged 15 years old or over, schooling between 5th grade and higher education, single act of sexual violence, in which physical violence was used and occurrence on public roads. Conclusion: sexual violence affects mainly women and children, the former being attacked on public roads and the latter in their own home environment by a known offender.
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Fornari LF, Sakata-So KN, Egry EY, Fonseca RMGSD. Gender and generation perspectives in the narratives of sexually abused women in childhood. Rev Lat Am Enfermagem 2018; 26:e3078. [PMID: 30517573 PMCID: PMC6280171 DOI: 10.1590/1518-8345.2771.3078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 09/01/2018] [Indexed: 11/30/2022] Open
Abstract
Objective: to analyze the narratives of sexually abused women in childhood, identifying
issues related to gender and generation. Method: descriptive research with a qualitative approach, based on 214 reports
selected from the Brazilian campaign #primeiroassedio
(first harassment), which took place on Twitter social network, collected
from a structured instrument. Thematic content analysis was used. Results: girls were the main victims of sexual abuse. The perpetrators were mostly
male and people they knew. Five categories emerged from the narratives:
Sexual abuse in the aggressors’ discourse; The child as the object of sexual
pleasure; Violated childhood; Victims’ guilty feelings; and Repercussions of
sexual abuse experienced in childhood. Conclusion: sexual abuse often occurs in the family context and, even if sometimes
veiled, the submission of girls’ power in gender relations and of children
in generation relationships is evident. Analyzing sexual abuse under the
categories of gender and generation contributes to an in-depth understanding
of the phenomenon, directing practices more effectively to their coping.
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Santomé LM, Leal SMC, Mancia JR, Gomes AMF. Children hospitalized due to maltreatment in the ICU of a Public Health Service. Rev Bras Enferm 2018; 71:1420-1427. [PMID: 29972543 DOI: 10.1590/0034-7167-2017-0502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 12/06/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to characterize children hospitalized due to violence in a pediatric ICU in 2011; to relate violence and the mechanisms of trauma with death; to know the contextualization of violence, from the records in the medical records. METHOD retrospective cohort, performed in a first aid hospital, Porto Alegre city, in the records of 22 children hospitalized in the ICU due to violence. Quantitative analysis was performed by absolute and relative frequency rates, chi-square and relative risk. RESULTS 54.5% were boys, 81.8% were white and 50% were up to three years old. Physical violence 50% and neglect 36.4%, family of children (77.3%), highlighting the mother (35.3%). Mechanisms of aggression: fall (22.7%), burns (18.2%). Burns were at high risk for death. Discharge to go home after ICU admission (59.1%). CONCLUSION It is considered that the characterization of the cases of violence reflects the complexity of the theme, mainly, in face of the life histories that surround each case of children hospitalized by this aggravation.
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Affiliation(s)
- Letícia Medeiros Santomé
- Universidade Federal de Cências da Saúde de Porto Alegre. Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Joel Rolim Mancia
- Universidade do Vale do Rio dos Sinos. Porto Alegre, Rio Grande do Sul, Brazil
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Sena CAD, Silva MAD, Falbo Neto GH. Incidência de violência sexual em crianças e adolescentes em Recife/Pernambuco no biênio 2012- 2013. CIENCIA & SAUDE COLETIVA 2018; 23:1591-1599. [DOI: 10.1590/1413-81232018235.18662016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 07/15/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo Este estudo objetivou identificar a incidência da violência sexual em crianças e adolescentes em Recife/Pernambuco, no período 2012-2013. Os dados foram obtidos a partir dos registros de exames sexológicos, realizados no ĩnstituto de Medicina Legal do Recife. Identificaram-se 867 registros no período e foi de 328 o total de crianças e adolescentes vitimadas, com incidência de 3,67/10.000 habitantes, na faixa etária de 0 a 18 anos. A maioria das vítimas era do sexo feminino (92,1%), e estava na faixa etária de 10 a 14 anos (59,2%). A violência sexual do tipo conjunção carnal predominou em 2/3 dos casos, sendo uma pessoa conhecida da vítima o agressor mais frequente (57,8%). Foram significantes (p < 0,001) as associações entre o tipo de violência e as variáveis idade e sexo da vítima, e agressor. Os resultados do presente estudo evidenciaram que ainda há notificação deste tipo de violência, que ainda são indicativos de violência sexual tipo conjunção carnal, e que vitimou com maior frequência os adolescentes, além de atos libidinosos diversos com crianças. A elevada frequência de violência sexual contra crianças e adolescentes evidenciada neste estudo amplia a visibilidade desse grave problema de saúde e é indicativa da necessidade de políticas públicas preventivas.
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Delziovo CR, Bolsoni CC, Nazário NO, Coelho EBS. [Characteristics of sexual violence against adolescent and adult women reported by the public health services in Santa Catarina State, Brazil]. CAD SAUDE PUBLICA 2017; 33:e00002716. [PMID: 28724022 DOI: 10.1590/0102-311x00002716] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 09/08/2016] [Indexed: 11/22/2022] Open
Abstract
Sexual violence against women is a form of gender violence and both a severe human rights violation and public health problem. This ecological, descriptive, and temporal series study aims to analyze sexual violence against pre-adolescent, adolescent, and adult females in Santa Catarina State, Brazil, based on data from the Information System for Notifiable Diseases, in order to describe the characteristics of cases of sexual violence perpetrated against women, reported by health professionals from 2008 a 2013. A total of 15,508 cases of violence were reported, including 2,010 cases of sexual violence (12.9%). Cases of violence totaled 950 reports in the 10 to 14 year bracket (47.3%), 450 in the 15 to 19 year bracket (22.4%), and 610 (30.3%) in women 20 years or older (adults). Adolescent females suffered violence by a single aggressor, at home, at night, with vaginal penetration, and with greater tendency to repeated assault and pregnancy as a result. For females 10 to 14 and 15 to 19 years of age, the aggressors were unknown in 32.9% and 33.1% of the reports, respectively. Adult women were sexually assaulted either at home or on public byways, at night or in the early morning hours, by a single aggressor, with vaginal penetration in more than half of the cases, with more physical injuries, and with more subsequent suicide attempts. The information should contribute to awareness-raising of policymakers, health professionals, researchers, and health field professors concerning the importance of reporting violence in order to help develop interventions to prevent such violence against women.
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Affiliation(s)
- Carmem Regina Delziovo
- Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil
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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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Deslandes SF, Vieira LJEDS, Cavalcanti LF, Silva RMD. Atendimento à saúde de crianças e adolescentes em situação de violência sexual, em quatro capitais brasileiras. ACTA ACUST UNITED AC 2016. [DOI: 10.1590/1807-57622015.0405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
O artigo analisa a atenção à saúde de crianças e adolescentes em situação de violência sexual (VS) na rede pública municipal de saúde de quatro capitais brasileiras – Porto Alegre (RS), Belém (PA), Fortaleza (CE) e Campo Grande (MS) –, enfocando a disponibilidade de serviços e a oferta de atendimentos, tais como a anticoncepção de emergência hormonal (AEH), profilaxias para doenças sexualmente transmissíveis (DSTs) e interrupção legal da gravidez (ILG). O método de estudo de casos foi conduzido por entrevistas semiestruturadas, com vinte gestores e técnicos do nível central, representantes das secretarias municipais de saúde, e de análise documental. A atenção é desigual entre as capitais. Considerando-se a alta demanda, há baixa oferta de serviços em três delas. Os atendimentos especializados, como AEH e ILG, encontram resistências dos profissionais e setores religiosos. Destacam-se inovações de dois Centros Integrados de Atenção e de um Centro de Atenção Psicossocial Pós-Trauma.
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Lima JDS, Deslandes SF. Olhar da gestão sobre a implantação da ficha de notificação da violência doméstica, sexual e/outras violências em uma metrópole do Brasil. SAUDE E SOCIEDADE 2015. [DOI: 10.1590/s0104-12902015000200021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O artigo apresenta um estudo exploratório sobre o processo de implantação da ficha de notificação da violência doméstica, sexual e/ou outras violências contra crianças e adolescentes. O campo de estudo foi o município do Rio de Janeiro. Trata-se de uma pesquisa de natureza qualitativa que utilizou as técnicas de entrevista com gestores/técnicos do nível central e de grupo focal com representantes das coordenações de áreas de planejamento. Verificou-se que apesar de a Secretaria Municipal de Saúde do Rio Janeiro ser pioneira na institucionalização da notificação de maus-tratos, a descontinuidade das ações para o enfrentamento da violência ainda é uma realidade. No que tange à notificação, a gestão em saúde nos diferentes níveis hierárquicos ainda enfrenta vários obstáculos relacionados à incorporação permanente do tema da violência na agenda da política pública de saúde, ainda que demarcando o esforço das ações voltadas para a capacitação dos profissionais de saúde e a interlocução e a articulação com a rede intra e intersetorial.
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