Health care for women in situations of violence: discoordination of network professionals

Percepções de Profissionais da Saúde sobre Violência contra as Mulheres

Introdução: A violência contra mulheres é reconhecida como um tema de direitos humanos e de saúde pública, sendo os serviços de saúde fundamentais para identificação e acolhimento dos casos. Este artigo descreve as percepções dos/as profissionais da saúde sobre a violência contra as mulheres. Método: Foram realizadas entrevistas com 26 profissionais que atuam em diferentes serviços numa região do sertão de Pernambuco, analisadas pela técnica de análise de conteúdo. Resultados: Destacaram-se três eixos de análise: compreensão da violência contra as mulheres; conhecimento da rede e das legislações; e atendimento às mulheres em situação de violência. Discussão: Verificou-se que os/as profissionais têm dificuldade em reconhecer tipos de violência, apresentam uma visão preconceituosa em relação à mulher e desconhecem a rede e as legislações pertinentes. Conclusões: É fundamental os/as profissionais terem informações sobre violência, rede de serviços e leis, bem como reconhecerem-se como atores importantes na identificação e no enfrentamento da violência.

Social support networks for women in situation of intimate partner violence

OBJECTIVES

to analyze the possibilities of support that the social support network offers to women in situations of intimate partner violence.

METHODS

qualitative research anchored in Sanicola's social network framework. A total of 21 women attended at a specialized social assistance service in Porto Velho-Rondônia, Brazil, participated in a semi-structured interview.

RESULTS

the analysis of network maps showed that the secondary social support network mobilized had a central character in the lives of women in situations of violence. These women sought the third sector's secondary network, the churches, from which they received emotional-affective and spiritual support.

FINAL CONSIDERATIONS

understanding the social network setting and the type of support offered can contribute to improving care for women and strengthening interpersonal and institutional ties that help in the search for breaking the situation of violence.

Inter-sectorial network for assisting women in situations of violence: handicraft work built by the people

OBJECTIVES

to discuss the meanings attributed by professionals to the construction of the service network for women in situations of violence.

METHODS

Convergent Care Research developed with the application of a convergence group with 32 participants from the health, social assistance, or public security sectors, in Santa Maria, Rio Grande do Sul. The data was produced during ten meetings, based on the problematization methodology, and submitted to analysis of thematic content and interpreted with the referential of networks.

RESULTS

the construction of the network is an artisanal work carried out by people continuously, permeated by bonds, communication and partnerships between services and knowledge of work processes. Lashings require permanent movement.

FINAL CONSIDERATIONS

building a network implies defining intertwining lines; form nodes that create cross-sector connections. There is a need to institutionalize processes through care continuity protocols, associated with an efficient communication system between sectors.

Redes de apoio social às mulheres em situação de violência por parceiro íntimo

RESUMO Objetivos: analisar as possibilidades de suporte que a rede de apoio social oferece às mulheres em situação de violência por parceiro íntimo. Métodos: pesquisa qualitativa, ancorada no referencial de rede social de Sanicola. Participaram 21 mulheres atendidas em um serviço especializado de assistência social de Porto Velho-Rondônia, Brasil, que responderam à entrevista semiestruturada. Resultados: a análise dos mapas de redes mostrou que a rede de apoio social secundária mobilizada teve um caráter central na vida da mulher em situação de violência. Essas mulheres buscaram a rede secundária de terceiro setor, as igrejas, das quais receberam suporte emocional-afetivo e espiritual. Considerações Finais: a compreensão da configuração da rede social e do tipo de apoio ofertado pode contribuir para a melhoria do cuidado à mulher e fortalecimento dos laços interpessoais e institucionais que auxiliam na busca do rompimento da situação de violência.

POWER DEVICES USED BY NURSES TO FIGHT DOMESTIC VIOLENCE AGAINST WOMEN

ABSTRACT Objective to identify the power devices used by nurses to fight domestic violence against women from the perspective of parrhesia. Method qualitative study addressing 20 nursts from 13 Primary Heath Care units located in Rio Grande, South of Brazil. Interviews were held from April to June 2018, and data were treated using NVIVO 11 under the light of the Discursive Textual Analysis and Foucault's philosophical framework. Result two categories emerged from the analysis: (1) knowledge devices and (2) administrative/institutional devices. The first refers to the nurses’ actions, such as sharing information concerning domestic violence against women and the second concerns the health units’ actions to fight violence and referrals to other sectors focused on providing care to women experiencing domestic violence. Conclusion nurses use power devices to support women so they can transform their lives. Nursing can promote social transformations as it is engaged with actions intended to promote health.

Percepção das mulheres em situação de violência sobre o apoio formal: Scoping review

RESUMO Objetivo Examinar e mapear as evidências científicas acerca das percepções das mulheres em situação de violência quanto aos serviços de apoio social formal. Método Scoping Review, conforme Joanna Briggs Institute e a questão norteadora: “Qual a percepção das mulheres em situação de violência ao buscar atendimento profissional nos serviços de apoio?”. Inclusos estudos nacionais, internacionais, primários, abordagens qualitativas, quantitativas, métodos mistos, idiomas inglês, português e espanhol, no espaço temporal de 2014 a 2019. Realizadas buscas em sete bases de dados, encontrados 1557 artigos e selecionados 16 como amostra final. Resultados Os atendimentos evidenciaram a escuta ativa, criação de vínculo e articulação dos serviços. Como também a falta de acolhimento; sentimento de insegurança, medo e humilhação. O processo de capacitação foi estabelecido pelos artigos como ferramenta aos profissionais, na promoção de abordagem direcionada e individualizada. Conclusões e considerações para a prática O acolhimento e vínculo propiciado por alguns serviços de apoio resultou em propostas de mudanças e suscitou nas mulheres reflexão, confiança e busca para saída do ciclo da violência. O contrário gerou afastamento dos serviços e consequente permanência junto ao agressor.

"Women fear the law more than abusers": a study of public trust in health and legal response to violence against women in Santo André, São Paulo State, Brazil

Little is known about how perceptions of government affects women's views of violence against women. This qualitative study examines women's perceptions of violence against women laws and trust in the health and legal sector response in São Paulo State, Brazil. Thirty interviews with female residents of Santo André, 18 years and older, were audio recorded, transcribed, coded, and analyzed for themes using MAXQDA12 software. All women were familiar with at least one federal violence against women law. They expressed widespread lack of trust in the government. They viewed the legal sector as ineffective and felt violence against women laws have little impact, or exacerbate violence. Disdain for the health sector was less prominent than for the legal sector. A generalized lack of trust in government manifests as a lack of confidence in these laws for women seeking support through legal and health sectors. Adoption of legal protections for women is a significant accomplishment. However, health and legal sector violence against women response needs to consider perceptions of government, how violence against women laws are operationalized, and the role of each sector in ensuring women's safety. Violence against women response efforts should include standardized intersectoral procedures including referral to accessible resources and means of screening women who may be at high risk for femicide.

Violência contra as mulheres na prática de enfermeiras da atenção primária à saúde

RESUMO Objetivo compreender como os enfermeiros que atuam na Atenção Primária à Saúde identificam a violência contra as mulheres e descrever a assistência de enfermagem prestada a essas mulheres. Método Estudo descritivo e de abordagem qualitativa, realizado entre agosto de 2018 a fevereiro de 2019 com dez enfermeiras que trabalham na Atenção Primária à Saúde. A coleta de dados foi realizada por meio de entrevista semiestruturada, sendo analisados pela análise temática de conteúdo. Resultados As narrativas revelaram como os colaboradores percebem a violência contra as mulheres e os significados atribuídos pelos mesmos. Emergiram três categorias: Percepção do enfermeiro sobre a violência contra as mulheres; Assistência de enfermagem às mulheres que sofrem violência e; Capacitação para o reconhecimento da violência pela própria mulher e pelo enfermeiro. Conclusões e implicações para a prática A assistência de enfermagem às mulheres em situação de violência ainda é de difícil abordagem no contexto da Atenção Primária à Saúde, o que é agravado pela dificuldade da mulher em revelar a sua própria violência e também do profissional que percebe sua incapacidade para reconhecer as situações que envolvem violência.

Understanding marital violence: a study in grounded theory

Objective:

to understand the phenomenon of marital violence based on the experience of women in judicial process and network professionals.

Method:

a qualitative study, with theoretical-methodological support in grounded theory. Data collection took place in two regional Courts for Peace in the Home in a municipality of the Brazilian Northeast. Interviews were conducted with 38 participants, who composed two sample groups: women in situations of violence and network professionals.

Results:

the understanding of marital violence emerged for the phenomenon “Experiencing marital violence as a progressive and cyclical process, with repercussions for health and implications for social relations”.

Conclusion:

in recognizing marital violence as a recurring problem in the life of women, with implications for their own health and that of their children, the study points to the relevance of coping strategies based on institutional and social support.

Direitos sexuais e reprodutivos de mulheres em situação de violência sexual: o que dizem gestores, profissionais e usuárias dos serviços de referência?1

Resumo Este estudo analisa o acesso à atenção e a garantia dos direitos sexuais e reprodutivos de mulheres em situação de violência sexual, de outubro a novembro de 2016. Participaram do estudo gestores, profissionais e mulheres em situação de violência sexual atendidas no Centro de Referência ao Atendimento à Mulher e na Delegacia de Defesa da Mulher. Na análise, foi utilizado o construcionismo social e organização baseada na análise temática. Emergiram três categorias: (1) barreiras no acesso aos serviços e na consolidação das políticas públicas; (2) violência institucional como obstáculo à assistência da mulher; e (3) avanços, retrocessos e resistências no âmbito da atenção e das políticas públicas direcionadas à mulher em situação de violência sexual. Revelou-se a escassez de recursos humanos e materiais, precariedade estrutural e morosidade dos processos policiais e jurídicos, a fragilidade da rede de atenção, a revitimização nos espaços de atendimento e a criação de leis específicas para a proteção da mulher, apesar da ausência de diálogo acerca das desigualdades de gênero e dos direitos humanos e a escassa participação da mulher nos espaços políticos decisórios.

Violence against women in Primary Health Care: Potentialities and limitations to identification

Objective

To determine the potential and limitations of Primary Health Care professionals to identify situations of violence against women.

Location

A municipality of Rio Grande do Sul, Brazil.

Design

Descriptive and exploratory study with a qualitative approach.

Participants

Twenty-one health professionals of three Family Health Strategy units, as well as one Basic Health Unit. The inclusion criterion consisted of being a health worker in these services. The exclusion criterion was to be absent from work by any kind type license during the period of data production.

Method

The technique used to produce data was individual, semi-structured, interviews in order to collect sociodemographic data and the monitoring by professionals related to the potentials and limitations to identify violence situations. The data collection was suspended based on the saturation criterion. The data were systematized and analyzed by the content analysis technique, according to the analytical categories of health care network and gender.

Results

The potential to identify themes were: professional experience, receptive atmosphere, bonding, and listening to the reports of women, children and/or neighbors and observing their behavior; to identify the lesions; prenatal consultations; and home visits. As to the limitations: silence, denial/non-recognition of violence, lack of complaints by women; fear and guilt; flaws and unpreparedness of the health team; and fear due to the presence of aggressor.

Conclusions

It is urgent to recognize the potential of Primary Care and to promote the qualification of professionals in order to identify the situation among visible and invisible complaints, leading to the confrontation of violence.

Women care in situations of sexual violence: an integrative literature review

Abstract Objective: to identify Brazilian and international scientific evidence about women in situation of sexual violence service by a multidisciplinary health team. Method: an integrative literature review carried out in four databases and in a digital library, with the following inclusion criteria: type of study, language and temporal cut. The final sample consisted of 34 studies. Results: nine categories emerged: service network; teamwork; health professional in the service network; qualification and training; comprehensiveness; protocols; services; access to services and support from managers. They were organized into potentialities, demands and weaknesses, constituting elements necessary for assistance effectiveness by the multidisciplinary team to women in situation of sexual violence. Conclusion an Implications for practice: despite the potential of providing women care in situations of sexual violence, weaknesses stand out as an incipient and inexistent articulation of the intersectoral care network, generating demands for the networks’ construction, articulation and sustainability. In addition, professional qualification and support of managers in the performance of public policies make possible care comprehensiveness, updates and service evidence.

Violence against women: historical trajectory of a care program (Curitiba - 1997-2014)

OBJECTIVE

To analyze the historical trajectory and the contributions of the Programa de Atenção às Mulheres em Situação de Violência (Program of Care to Women Victims of Violence) of Curitiba.

METHOD

Research with documentary and local approach, inspired by the Dimension of Political History, to unveil power relations, political representations, symbols and discourses. Eighty-eight sources were used for the period 1997-2014. The data collection was performed in May 2016 and presented in the timeline modality.

RESULTS

The historical trajectory of the program indicates intersectoral and interinstitutional experience that has been increasing and originating important innovations in care to women based on humanization and from the perspective of comprehensiveness.

FINAL CONSIDERATIONS

Historicizing the Program contributed to the reflection on the construction of practices aimed at confronting violence, the need for intersectoral actions and looks that involve its complexity.