Prevalence and factors associated with recurrent violence in a southeastern Brazilian state: Cross-sectional study

Violence is a serious public health problem and its repetitive character points to a chronic phenomenon and its insertion in the daily lives of victims. To identify the frequency of repeat violence reported in adults in a Brazilian state and its association with the characteristics of the victim, the aggressor, and the aggression. This is an epidemiological cross-sectional study conducted with data from the notifications of violence recorded in the Notifiable Diseases Information System in Espírito Santo, Brazil from 2011 to 2018. Bivariate analysis was performed using Pearson Chi-Squared test and the multivariate Poisson regression, using a widely used hierarchical model, with the victim's characteristics in the first level and the aggressor's characteristics and the occurrence in the second level. In the multivariate analysis, the variables that obtained P  < .2 in the bivariate analysis were included in the model, keeping those with P  < .05. Data were expressed by prevalence ratio (PR), with confidence intervals of 95%. During the period, 9933 cases of violence were registered in the adult population, referring to 1061 notifications of male adults and 8872 notifications of female adults. The prevalence of repeat violence was 56.7% (95% CI: 56.0 - 57.5). It was more prevalent among women (PR: 1.73; 95% CI: 1.63 - 1.83), in the age groups over 40 years (PR: 1.12; 95% CI: 1.08 - 1.16), black and mixed-race ( P : 1.04; 95% CI: 1.01 - 1.07), and with a partner ( P : 1.09; 95% CI: 1.05 - 1.12). Victims with disabilities or disorders suffered 34% more from this problem (95% CI: 1.29 - 1.38) and lived in urban or peri-urban areas (PR: 1.16; 95% CI: 1.10 - 1.23). As for the aggressors, they were under 25 years of age (PR: 1.06; 95% CI: 1.02 - 1.11), of both sexes (PR: 1.32; 95% CI: 1.06 - 1.64), and were the victim's intimate partner (PR: 3.91; 95% CI: 3.25 - 4.71). The aggressions had only 1 perpetrator (PR: 1.17; 95% CI: 1.07 - 1.28) and occurred in the residence (PR: 1.33; 95% CI: 1.26 - 1.41). Repeat violence showed high frequency among notifications and was associated with characteristics of the victim, aggressor, and event. The results point to a phenomenon present in the daily life of communities that is potentially capable of negatively impacting the different areas of the subjects lives. Studies on the subject are important to understand the phenomenon and implement strategic actions to confront it.

The Institutionalisation of Brazilian Older Abused Adults: A Qualitative Study among Victims and Formal Carers

Abuse against elders is acknowledged as a severe and pervasive problem in society. If support services are not tailored to the victims' knowledge or perceived needs, the intervention is likely to be unsuccessful. This study aimed to explore the experience of institutionalisation of abused older people from the perspective of the victims and their formal carers in a Brazilian social shelter. A qualitative descriptive study was performed with 18 participants, including formal carers and older abused persons admitted to a long-term care institution in the south of Brazil. Qualitative thematic analysis was used to analyse the transcripts of semi-structured qualitative interviews. Three themes were identified: (1) personal, relational, and social bonds: broken or weakened; (2) denial of the violence suffered; and (3) from imposed protection to compassionate care. Our findings provide insights for effective prevention and intervention measures in elder abuse. From a socio-ecological standpoint, vulnerability and abuse might be averted at the community and societal levels (e.g., education and awareness of elder abuse) by creating a minimum standard for the care of older individuals (e.g., law or economic incentives). Further study is needed to facilitate recognition and raise awareness among individuals in need and those offering assistance and support.