Violência intrafamiliar contra a criança: intervenção de enfermeiros da estratégia saúde da família

Objetivou analisar a atuação dos enfermeiros da Estratégia Saúde da Família frente à violência intrafamiliar contra a criança, visando identificar ações de prevenção do problema. Pesquisa descritiva e exploratória de cunho qualitativo, cujos dados foram analisados conforme análise de conteúdo. Participaram do estudo 14 enfermeiros da Estratégia de Saúde da Família do município de Mossoró-RN. Dados coletados utilizando-se questionário semiestruturado. As ações de promoção à saúde são atividades educativas desenvolvidas após detecção de casos. O medo de represálias do agente agressor, a sobrecarga de trabalho, a falta de apoio dos gestores e a dificuldade para a materialização da interdisciplinaridade, intersetorialidade e integralidade da atenção foram mencionadas como barreiras ao enfrentamento do problema

Atuação dos enfermeiros da estratégia de saúde da família frente à violência intrafamiliar contra a criança

The family violence against children became visible, in the context of public health, due to the damage and injuries generated in the lives of children and to the growing need of investment in physical and human resources to fill this demand. In this context, it is believed that intervention could prevent such events and are configured as primary strategies to prevent the corollaries generated by the violence. In this perspective, this study aims to analyze the performance of nurses dealing with the Strategy of Family Health viewing to identify actions based on the paradigm of health distribution. This is a descriptive, exploratory and qualitative research. The data were analyzed based on the content analysis about the method proposed by Bardin. The study was conducted in Mossoró-RN and the participants were 14 nurses working for the Family Health Strategy in Health Units of this town. The instrument for data collection was a semi-structured questionnaire, with questions answered by the participants themselves. It was evident to the study that the nurses believe that health education are the main tool for dealing with domestic violence against children, being developed, however, in its positivist and vertical way. The actions used to develop health performed by the team on their daily lives are limited to educational activities and are carried exactly when cases of family violence against children are notified. Barriers to the practice emerged from fear of reprisals from the agressor, overwork, lack of management support and difficulty for the realization of interdisciplinary, intersectorality and comprehensive care.

A violência nossa de cada família: notas sobre a violência intrafamiliar contra a criança

This study, done in a master program, evaluated the thematic regarding the domestic physical violence against children. The data was obtained through the SOS children program from Natal municipality. The used methodology involved either recorded date as well as an interview done with a professional who had been working on the SOS program for more than ten years. The study emphasizes violent situations where children were involved, in particular, beaten by their parents. Our goal was to understand the domestic violence phenomena against children, using as parameter the social context where the families were inserted

Violência intrafamiliar contra a criança: intervenção de enfermeiros da estratégia saúde da família

Objetivou analisar a atuação dos enfermeiros da Estratégia Saúde da Família frente à violência intrafamiliar contra a criança, visando identificar ações de prevenção do problema. Pesquisa descritiva e exploratória de cunho qualitativo, cujos dados foram analisados conforme análise de conteúdo. Participaram do estudo 14 enfermeiros da Estratégia de Saúde da Família do município de Mossoró-RN. Dados coletados utilizando-se questionário semiestruturado. As ações de promoção à saúde são atividades educativas desenvolvidas após detecção de casos. O medo de represálias do agente agressor, a sobrecarga de trabalho, a falta de apoio dos gestores e a dificuldade para a materialização da interdisciplinaridade, intersetorialidade e integralidade da atenção foram mencionadas como barreiras ao enfrentamento do problema

Atuação dos profissionais de saúde no atendimento à criança vítima de violência

This study had the purpose of identifying the health professional performance during the care of children victimized by violence. Its objectives were the evaluation of how health professionals diagnose violence on the hospitalized child during the care process; the identification, according to the experience of each health professional, of the types of violence on the hospitalized child, the child's aggressors and the most frequent1y injured area in the body and the analysis of conducts adopted by health professionals upon the recognition of a violence case on a hospitalized child. The study was of the descriptive-exploratory type, using a quantitative approach, performed on Hospital da Criança Santo Antônio (HCSA) in Boa Vista - RR. The population consisted of 235 health professionals, with data collected from June to August 2006. The results show a clear predominance of the female gender, (76,17%); aged 31 to 35 (26,81%); married (45,96%). As for professional formation, 63,9% were nursing auxiliaries and technicians,16,2% physicians, 14,8% nurses, 3,9% social assistants and 2,1% psychologists; 45,96% had completed middle-level education, 51,06% of which coming from private education establishments and 48,94% from public education institutions.; 97,66 % have specialization or improvement courses on their area; 32,77% among 05 to 09 years of work time; 32,06(10 worked on pediatric infirmaries; 75,74% state they have experience with children victimized by violence; 96,22% consider themselves capable of identifying the types of violence suffered by children; 29,00% consider physical violence the most common kind; 91,57% sought to identify the aggressors; 27,72% consider the mother to be the child's main aggressor, 26,36% the father, and 22,28% the stepfather; 26,55% consider the limbs and pelvic waist to be the body region most affected by violence; 26,91% take the attitude of reporting to the nurse and 20,13% to the social service; 70,79% state that the conducts were performed as a team; 26,25% of the professionals consider that the social assistants helped the most on deciding which conduct to adopt; 76,40% state there was no one opposed to the performing of these conducts; but 23,60% that stated there was no one opposed to the performing of these conducts, 77,08% reveal that the family members were against the conducts taken by the team. We conclude that, the hea1th professionals who were part of the study, apparently are not adequate prepared to diagnose and report the violence on child. The results were more drastic when we related the physicians and the nurses' answers, considering that they give directed assistance to these victims social assistants and psychologists are the ones best prepared to conduct cases of child mistreatment. However, we are conscious of our responsibility with professional education not only in upper grade institution but also on the middle-level. We believe also, that a continued education program can help to improve the professional knowledge and improve the quality of care

Concepções e práticas dos profissionais que atuam na educação infantil diante da violência doméstica contra crianças de zero a cinco anos

El estudio presenta el problema de la violencia doméstica contra los niños de hasta cinco años en el contexto de los centros municipales de Educación Infantil (CMEI) en la ciudad de Natal-RN. Constituye un análisis bajo el enfoque teórico y metodológico de carácter cualitativo, en vista de la totalidad, con la asunción de la violencia doméstica contra los niños en su guía sociales, legales, históricos y culturales con el tema. Tiene como objetivo investigar si los profesionales que trabajan en Educación Infantil son capaces de identificar las posibles situaciones de violencia doméstica contra los niños que están bajo su responsabilidad, e incluso si, en los casos de los casos sospechosos o reales de la identidad de saber que las referencias deben ser adoptadas. La ruta entre el conocimiento y el método establecido implica el análisis conceptual de la infancia, la educación infantil y violencia doméstica contra los niños, además de la realización de grupos focales con los participantes de la encuesta con sus registros en un diario de campo. Perciben a sí mismos para el estudio de las contradicciones en la lucha contra la violencia doméstica contra los niños. Incluso con los conocimientos teóricos sobre el tema, los profesionales no pueden dar referencias adecuadas para proteger a los niños y detener la violencia. Nos encontramos con que las condiciones objetivas del trabajo de los profesionales que trabajan en CMEI, asociados con poco conocimiento sobre el tema, no contribuyen a las referencias. Llegamos a la conclusión de que es necesario la participación de la Secretaría Municipal de Educación, sin olvidar que todas las acciones tienen limitaciones como la violencia doméstica contra los niños también se relaciona con problemas estructurales de la sociabilidad capitalista.

Dos atos confessos aos afetos não-ditos: Um olhar sob as múltiplas experiências femininas a partir da análise dos discursos jurídicos, jornalísticos e orais

Women, subjectiveness, experimentations. This paper walks through gender, sexuality, body and subjectivity, bounding as the focus denaturalize the representations of womanlinessstaff and manliness and the modeled subjectivity by normative discusses that shows the transcendency based on multiplicities of experiences, wishes and life way wattled by men and women from the Caicó City s society in the decades from 1900 to 1945. For this, it was adopted a dialogic methodology inlcluding bibliographic and theorist references as well as sources like articles from Jornal das Moças (Lady s Journal); defloration s crime processes, abortion, infanticide and body lesions; iconographic sources and Caicó citizen memories in the period commented. Based on that sources, this work analyze the discursive construction of feminine through Justice and Jornal das Moças that paved by sanitarian, normalizing and moralizing discourses has spread clichés and stereotypes of womanlinessstaff and manliness, which has resulted by to universalize the experiences feminines in polarities and binary oppositions regarding to manliness, it has delineated them as asexual, irrational, anesthesiaed for pleasure and biologically meant to home activities modeling subjectivities that did not create ways for the singularization processes. This polarities, effects of sexual regulatory practices and gender legitimate the representations of courtship, maternity and honor, that although it has been incorporated not passivant on the building of the poor men and women subjectivity, it did not support itself in view of socio-cultural and economic reality of the poorest society side. Therefore, on this work emerge a plurality of women who has transited past the public sphere, who interlaced amorous informal relationships, who has kept relationships before the marriage, who hás established multiples familiar arrangements and helpful networks, who was single mothers without being considered dishonored women by social groups, who made matrimonial agreements without the rules of a formal civil marriage, who made use of beverageey to provoke the menstruation constituting multiples ways to experiment the life. This subjective feminine experimentations turned it possible to notice that representations concerning about the body, sexuality, date, maternity and honor of this women has constituted itself while molecularies and particulares . It was the affection not commented of the feminine sexuality that turned it possible to analyze the construction of singular subjectivities as a opened process, continuous, active, begetting new lands, life ways and wishes cartographies

Entre o sol e a liberdade impera a violência: formação de redes para a ação a partir da estratégia saúde da família

The research aimed to analyze the feasibility of forming a network of municipal services to prevent and treat child victims of violence from the Basic Health Units in the Family Mossoró / RN. The research is a qualitative approach and was developed in the form of action research. The population was composed of representatives of institutions of the child and primary care professionals. Data were collected through questionnaires, workshops and semi-structured interview. The results were analyzed from data collected through the questionnaire designed to assess the material, lectures, dialogues and assessments with the team and presented in accordance with the findings of the research. The study was approved by the Ethics in Research UFRN with protocol No. 158/2010, CAAE: 0176.0.051.000-10. Situational diagnosis in the participants answered a questionnaire to characterize and then launched the guiding question of the focus group FHS While professional what your perception towards violence against children? It was felt the fear and ignorance on the part of the unit staff on how to prevent and to refer cases of violence against children and adolescents in the area of coverage of the unit and also realized that the professionals felt victims of occupational violence before the violence has reached proportions that the area of the unit. Mind the need to change strategies to work to combat violence, we plan to conduct focus group workshop to complete the questionnaire, training for protection against occupational violence, and meeting with other bodies responsible visor protecting children and adolescents to draw the flowchart of the victims in safety net. The next moment training to fill the notification form professionals were interested in learning and use this tool to combat violence. At the third meeting in Unity, meeting with representatives of the Child Protection Council, the professional unit showed interest in interacting with the agency to expose and combat violence against children and adolescents. Due to difficulties in the physical structure of the unit was not possible to continue the research and planned every moment, and then completed the data collection with interviews with the participating professionals, to assess the meetings. Therefore, it is considered that action research has also achieved its goals because the team was involved in the collective construction of a proposed change in the practices of referral and prevention of violence against children and adolescents. This involvement was favored using the principles Freirian during the course of the study. However, it is assumed that the network was not fully implemented because it is known that it is in a continual process of improvement and must continue evolving with the unit team.

O desejo, o relato e a prática da cidade: de como são produzidos territórios marginais na cidade do príncipe (1880 - 1900)

The theme of this work is the study of marginal territories of the Cidade do Príncipe, sketch in time than today is constituted as the city of Caicó/RN, with the time frame the years 1880 to 1900. Our goal is to investigate the construction of these territories from multiple speech subjects practitioners of the city. Thus, we propose to discover the mapping of the deviation in the city in question, as they were drawn, those who experienced and through which practices. Investigate the construction of these spaces from the speeches, and fill a historiographical gap, allows to find stories sharp, silenced or ignored, abortions and madness in prison, repressed passions and avenged. To meet these spaces the sources are diverse, such as the newspaper O Povo, the Codes of posture, the Reports of Presidents and Heads of Provincial Police and process-crime. Regarding the methodological aspects of research, we decided by discourse analysis, discourse here conceived not only as what is said about someone or something, but as a set of statements circulating at any given time in society, articulating speech, intentions, actions and thought. The city is then considered from their territories, imagined as a space configured in/by the relations power that the dispute, but also as a space for experiences multiple, different feelings, place and non-place, the discipline and mockery, of power and resistance.

Caicó: uma cidade entre a recusa e a sedução

This research has as object of study the city of Caicó, Rio Grande do Norte State, between the middle part of the decade of 1920 and the beginning of 1930. It intended to perceive the projects thought to the city of Caicó as well as the challenges due to the new ideas of modernity that were circulating around the contemporary world. So it consists in an important historical exercise about the relation between history and space in to the extent that itself comes to surface a city deals by diverse angles whose perspectives can be read in several "fragments of memory", such as newspapers, trials-crime, reports, memories, books, etc., those show the tension between the traditional and the modern way of life one. In this way, it´s tried to transform the space, giving it a new reference, inspired in what occurs in the Brazilian big cities and around the world, through the use of the techniques, of the electricity, of the movies, of the press, cars, medicine and so on. At the same time in that is necessary-itself deal with the permanencies such as the old manners and the droughts and theirs "flagellated" people. Therefore, it is in this difficult phase that is tried legitimize the city of Caicó as the "Capital of the Seridó", in the threshold between the refusal and the seduction

Análise de qualidade da atenção à criança na estratégia saúde da família: o óbito infantil evitável como referência

Alma-Ata declaration bring the Primary Attention to the Health (PAH) as first level of health attention for individuals, family and community, which considers infant group as priority. Several initiatives that gave bases to integral attention to the children health formalized in the principles of Unique Health System. Family Health Strategy (FHS) comes to strengthen this attention, instituting new ways of work organization and professional practices that gave impact in their quality indicators. One of them is children mortality, showing decline in their values. Though, studies indicates persistence of avoidable infant deaths. In Natal RN, this reality is also perceptible leading to inquietudes, mainly at the space of services production, it means, which motivated the accomplishment of the present study intending to analyse the way that the organizational and structural processes as long as the professional practices in FHS interfered in the quality of children s health attention who died by avoidable death in the year of 2007 in municipal district of Natal-RN. It treats, therefore, to an exploratory and descriptive survey of cases study type, thar had as primary sources the oficial documents of MH, the family prontuary, pregnant card, child card and testimony obt ined from instrument of research elaborated based in investigation form of infant death by MH, applied to 10 mothers of children who had avoidable death. In analysis it was appealed silmultaneous triangulation of methods and sources, allowing a bigger aproximation from obtained informations. To elucidate the cases, the aspects studied were analyzed to the light of explicative model of Social Determinants of Health. Among individual and family aspects were highlighted the related to age, schooling, family habits and customs and mother s economic condition, besides of pregnancy age, newborn weight and associated diseases, which don t differ from literature about the theme. Reffering to the factors organizational and structural processes and professionals practice, highlihgted, the treatment given by the professionals, the territorialization and adscription of areas, the difficulty of having access to the services or sleepers and the reference and counterreference. But also, the ausence or few greet, the lack of communication, few assiduity and ponctuality by professionals in service, among others. In a general way mothers considers the attendance received in the hospital good and very good , opnions that in the Basic Attention weren t so favorable, in spite of many of predictible actions in this level have been performed in the studied cases. It is observed, therefore, that the social determinants of health has a strong influence in ocurrence of infant deaths, what implicates in a large actuation by Infant Mortality Committee from municipal district. This way, it becomes fundamental the reflection and evaluation about the effectiveness and execution by the processes of vigilance to health in FHUs; the rethink about the social determinants of health in a wide and articulate way to the services quality, to permanent education, to management in service, to the given attention and to the way how it is installed the popular participation and social control. To the professionals it is presented the great challenge to review their daily practice, their values, behaviors and commitment, which ones must be guided by logical of sharing, work in team, humanescence and alterity, not only by the accomplishment of a professional duty

O trabalho docente em psicólogo e o enfrentamento da violência contra crianças e adolescentes: uma experiência teresinense

In this thesis I discuss the role of the psychologist as a university professor and as intellectual from a specific context and also from a specific query. The context is the city of Teresina, capital city of Piauí state, which is peripheral in Brazil s northeast region. The defiance here is to build a critical psychological tradition that will deal with the challenges imposed by the reality of poverty and socio-economic backwardness of the region. The greatest difficulty is the lack of a public institution of learning that carries out instruction, research and extension with commitment to social transformation, and with the production of a psychological knowledge that is able to understand local reality. I take it that the undergraduate course in Psychology at UESPI [State University of Piauí] is the only one in Teresina that can take over such mission. The query is confronting violence against children and adolescents that defies us to ethically and politically commit to solidarity toward fragile human beings in need of adult involvement in order to survive this daily inhumanity. The involvement of psychologists from Teresina in this must result from a social commitment and a technical competence to deal with prevention and therapeutic consideration toward the victims. This dissertation is divided into three parts: the first is a study on the curriculum and the performance of psychologists, which revises the academic output in Brazil and envisages new queries to the theme, such as the role of teaching inside the curriculum, and presents social security (including Medicare) as the privileged field in which Brazilian psychologists perform. The second part contains a study on the concepts of childhood, adolescence and violence, which presents a consideration on the strategies to confront violence against children and adolescents. In the last part I discuss the role of the psychologist as teacher and intellectual in the context undergraduate course in Psychology at UESPI [State University of Piauí] from the commitment to the protection of children and adolescents

O que tenho a ver com isso? aula-vivência sobre violência contra crianças e adolescentes

A violência constitui hoje a principal causa de morte em crianças de 5 a 19 anos, o que tem imposto aos profissionais de saúde um olhar mais atento a estas questões, bem como uma formação que busque compreender este fenômeno sobre os vários prismas que a circunscreve. O objetivo deste artigo é relatar a experiência vivenciada com alunos do curso de Graduação em Enfermagem da Universidade Federal do Rio Grande do Norte numa aula-vivência sobre esta temática. A aula foi baseada numa prática pedagógica de ação reflexiva. Desenvolveu-se a partir da integração dos conteúdos teóricos e práticos, articulando-os com temas sociais, políticos e econômicos. A aula foi dividida em três momentos: um momento de sensibilização; um segundo momento onde foi apresentado e discutido o arcabouço teórico, científico e legal que envolve o tema; e um terceiro, que visou estimular uma reflexão sobre a realidade vivenciada nos serviços de saúde por profissionais que atuam diante de situações de violência. Nos três momentos da aula pudemos proporcionar ao aluno a inquietação e a reflexão necessárias para pensarmos sobre a violência em toda a sua complexidade, pluricausalidade e com toda a carga de preconceito em que esta se encontra envolvida

Coevolução e as práticas isomórficas de gestão: um estudo sobre os processos de mudanças institucionais no Instituto Federal de Educação, Ciência e Tecnologia do RN

The Federal Institution for Education, Science and Technology, in its historical path, has been living different changes. The transformations occurred along the way have been determined by coercive forces from the institutional environment, which has became more and more broad and complex throughout the time, obtaining diverse characteristics and new elements such as non institutional factors1 which started to contribute with the other changes. In this context, this work aims to study the isomorphic practices of the managers in the institutional changes process of the IFRN in 1998 and 2008, as of a theoretical coevolutionary perspective (CHILD; RODRIGUES; LEWIN; CARROL; VOLBERDA, 2003). This theory brings a new point of view for the organization analysis to the organizational studies, since it offers a non deterministic and non linear lection of the evolution process, which means, a coevolution. Thus, the organizations and their institutional and non institutional environment auto evolve, auto organize and auto reproduce. Therefore, the institutional and non institutional factors of the macro environment keep a continuous interdependence relationship with the organizations. For the means of this study, it is important to understand that is impossible to comprehend the object, the isomorphic practices, without considering that the previous institutional changes and its evolutions, its continuations and discontinuations, important in the coevolution process. As such, to call upon the institutional historical track is a fundamental aspect to materialize this study, for the recursive movement is indeed present in the coevolution. Another important point to make this research effective is that it is not possible to abdicate from the hologramatic view2 of this study, which considers the object, the isomorphic practices, part of the whole and this whole is also in the parts, therefore it is impossible to comprehend the object of study outside the context where it belongs. With this, as of the objective previously proposed, it is necessary to describe the characteristics of coevolution of the institutional changes related in 1998 and 2008; analyze the dynamic of the isomorphic mechanisms in its respective institutional change process; and describe the lessons learned which the isomorphic practices left to the IFRN, regarding its benefits and difficulties. All these transformations happened through coercive forces3 of the institutional environment. As of the Nineties, these forces became stronger, the environment became broader and more complex, with the emergency of new environmental factors. This study proposed to study the managing process and its practices, related to the micro environment, although it is required to articulate these actions, the demands and requirements from the macro environment. To make this research effective, semi structured interviews have been conducted with the managers who participated in both institutional change processes. In the results analysis, it has been possible to verify the particularity of each change, the one from 1998 with a strong normative action of the managers against coercive forces from the government for the search of recognition and the institutional legitimation and the one in 2008, which has been characterized by the normative action by managers in agreement with the coercive forces from the government, in favor of the government policy for the technological professional education. However, the results analysis it is possible to notice the evidence of a belonging feeling from the interviewed managers

Hemiparesia congênita e adquirida na criança: interrelação entre presença de crises epilépticas, os achados eletrencefalográficos e de neuroimagem por ressonância nuclear magnética

The purpose of this paper was to study patients with congenital and acquired hemiparesis, their clinical aspects, the presence or not of epileptic seizures, and electroencephalographic (EEG) and Magnetic Resonance Imaging (MRI) findings. We analyzed the interrelation between etiology, the presence and seriousness of epileptic seizures (ES) and the possible causes of refractoriness. This is a prospective study using the clinical diagnosis of a child neurologist, who attested to the presence of unilateral motor lesions. We compared the electroencephalographic findings in patients with or without epileptic seizures, and investigated if among the former, these seizures were controlled or not, their likely etiology and risks of refractoriness. EEG background activity on the lesion and contralateral side was analyzed, in addition to the presence of concomitant epileptiform activity. Encephalon MRIs of all the patients were studied to correlate etiology and the control or not of epileptic seizures. The disorganization of bilateral EEG activity correlated with the difficult-to-control epileptic seizures. Suitably organized background activity contralateral to the lesion is a good prognosis in relation to epileptic seizures. Focal epileptogenic activity does not necessarily predispose to epileptic manifestation. The MRI is more important in determining etiology than in prognosing epileptic seizures. This study used a multidisciplinary approach involving child neurologists, a physical therapist and a neuroradiologist. This meets the criteria of multidisciplinarity of the Postgraduate Program in Health Sciences