Violência institucional no âmbito da saúde reprodutiva : a percepção de mulheres usuárias do SUS, na cidade de Natal/RN

Institutional violence ranges from the most widespread lack of access to the poor quality of services provided. It includes abuses committed by virtue of the unequal power between patients and professionals within institutions. The aim of this study was to analyze the perception of women with regard to this type of violence, in the services offered at a reproductive health facility belonging to the National Health System (SUS) in Natal, Brazil. Interdisciplinary perspective is important, in that it provides interaction and complementarity between various disciplines, favoring, in an integrated way, a thematic approach in research activities, teaching and extension, involving professionals, students and researchers in medicine, social services, psychology, nursing, anthropology and physical therapy. A quantitative/qualitative approach was used, involving a sample of 401 women, as part of a transversal observational study. In the qualitative stage, which consisted of participatory observation and semi-structured interviews, we used an intentional sample of 10 individuals. The data were analyzed using logistic regression techniques, correspondence analysis and categorical thematic content analysis, showing that the 2 questions that investigated directly the perception of institutional violence obtained affirmative response frequencies of 28.2% and 31.8%, respectively. In regard to data collected in a field diary related to participatory observation, the main complaints referred to the health providerpatient relation, translated into dissatisfaction with the interpersonal relationship and with the resolution of the specific demand that required care. From content analysis, we classified 4 categories: Access; Information; Health professionalpatient relation; and Respect/dignity. We identified 6 subcategories: Impossibility of choice; Repressed demand; Communication difficulty; Asymmetric interpersonal relations; Privacy/confidentiality; Disrespect. We concluded, therefore, that the data presented show that in the reproductive health care programs, there are indicators of institutional violence. However, it is difficult to approach this phenomenon, mainly because of the power relations involved in the patient-health care provider interaction, resulting from unawareness that determinate situations violate sexual and reproductive rights. This can be explained by sociostructural questions that reveal marked inequalities, ratified by issues related to violation of the rights of National Health System (SUS) patients

Os anjos podem ferir: um estudo sobre a violência intrafamiliar

This work considers the comprehension of the intrafamiliar violence emphasizing violent mothers relationships with their children. The purpose is to understand the development of these relationships which turn into aggressive behavior of the mothers regarding family education. The research was carried out focusing on two aspects: analysis of the theoretical references and empirical research. The theoretical research was done through a bibliographic survey of subjects related to this study such as: the history of the family, motherhood and children, the intrafamiliar violence practiced by mothers against their children; as well as how those violent relationships emerge from family environment. We point out the Foucault s concept of discipline (FOUCAULT, 1975) and Caldeira s concept of circumscribed body (CALDEIRA, 2000). It was selected a sample of ten women to investigate the relationship between mother and son through a detailed interviews. Five mothers from this sample were denounced to the Tutelary Council and they were set in a so called Denounced Group. Similarly, the other five mothers, who live in the same social and cultural context of the selected families assisted by the Tutelary Council, were set in the Non-Denounced Group. Therefore, we work with representations of the own interviewers about the meaning of the pedagogic socializing discipline in their lives. Our priority was the study of case carried out with the denounced families for physical violence and with the other group in order to develop a comparative analysis of both groups. Such methodological choice is explained by the interest for understanding the violence between mothers and children. It is common to all mothers not to consider aggressive their behavior against their children. We observe that physical punishment is considered a way to discipline children and teenagers, hence that is perceived as necessary to repress, to control, and to adapt them. Thus, it is considered a necessary practice for education. However, the reason that made the community denounced against the mothers of the Denounced Group was due to those did not correspond to an ideal example of what was expected to be a mother (they took drugs, alcohol, and had several sexual partners), that is denounces were not for the physical violence itself. Therefore, those mothers were not denounced because they were not morally able to manage their children s education. The community tolerates the punishment against children, but not the amorality of the women, and they were denounced for disregarding their role as mothers

Histórias do corpo negado: uma reflexão educacional sobre gênero e violência feminina

This research has been implanted on thematic area education, politic and culture, based on line research and cultures practices aducatives histories approaches and literaries. on this situations, be involved around the kind of relations investigating about history cultural perspective, the thematic: woman, violence, body and education in women s daily victims of fisic, sexual and psychological violence. The research period happens end of 20th century beginning of 21th, specially between the 1999 until 2002. The survey shows influence of sexually device above body to reveal the root of violence in kinds of relations, be present in lifehistory of women aggressors the prisoners women and the women who permits aggressions the victims who accuse in the police station of woman. to preserv her privacy, i have been utilized in my register book pseudonym by flowers, to everyone. i have been defended my theory by familyrelations, be constitued in micro powerspaces and learn about sex, under the influence of violence in kinds of relations, creating negative bodywoman. shows bodyconceptions and sexuality by light thinking of the French philosopher Mr. Foucault Michel, in his opinion sexuality is a mechanisms by power, it is present on circular form at the society from all the institutions. I have been run over of Erich Fromm s lover theory. Those are fontain of newspapers, Police Protests, the prisoners women statement and the women who permits aggressions that them accuse aggressors of hers. I also utilize as fontain the Brazilian Penal Coole. At last I have decide about the flowers-women´s history, they have discourse who divulge the really importance of body as privileged by wisdom and truths, it was translated by own subjectivity, learned educations relacions, repetead in family breast and be responsible of the actions at signature in the presence of society. These relacions, were twice think and was problematic, their will be bring seeds of social transformations

Violência ocupacional contra profissionais de saúde em um hospital de urgência. natal/rn, 2009

Descriptive exploratory study, with quantitative approach, with data collected from April to May 2009, aiming to identify the types of occupational violence affecting professionals on the nursing and medical staff in an emergency hospital service in Natal/RN, over the last 12 months; to identify emergency sectors where occupational violence episodes took place; to characterize aggressors on each type of occupational violence; to know the procedures adopted after each violent act targeting nursing and medical staff professionals; and to know the consequences of violence suffered by the nursing and medical staff professionals. The sample consisted of 26 nurses, 95 nursing assistants/technicians and 124 physicians, for a total of 245 professionals. The results showed that 50.61% of the professionals were women, aged 41 to 45 (22.45%), with post-graduate studies (51.43%), married (60.82%); 21.22% had 16 to 20 years of experience in the profession and in emergency practice; working 40 weekly hours (86.12%); and working both the day shift and the night shift (70.21%); 27.35% consider violence to be a part of their profession and the patient s companions as an important risk factor (86.53%); couldn t inform whether there was a specific established procedure for reporting occupational violence (45.71%); 73.06% suffered occupational violence in the 12 months; 70.20% verbal assault, 24.08% moral harassment, 6.12% physical assault, and 3.67% sexual harassment; 66.67% of the patients took part in the physical assault; the companions, in verbal assault (58.14%); and the health staff in moral harassment (69.49%); facing episodes violence, 37.65% of the professionals reported the fact to their co-workers; 57.25% uffered from stress as a consequence; on 4.71% of the episodes the professionals had to be bsent from work, resulting in 75 days of occupational violence-related absence. We conclude here was a high rate of occupational violence in the researched population, with verbal ssault and moral harassment as the most frequent violence types. Because factors related to ccupational violence were very diverse, actions seeking to confront this problem shouldn t be limited to the work environment itself. Education ought to be one of the most effective ctions for avoiding or minimizing these events occurrence

Violência contra a mulher : estudo de caso em uma instituição de ensino

The study research case with a quantitative approach and prospective data, carried out between December 2010 and February 2011 with the aim of identifying the profile of women in the study, to characterize the acts of violence in the type, frequency, location occurrence and aggressor, analyze the steps taken after the occurrence of acts of violence and the main consequences on the victims. The population consisted of 285 workers in a tertiary institution in Rio Grande do Norte. The results showed that 99 (34.74%) have between 51 to 60 years of age, 78 (27.37%) of 41 to 50 and 62 (21.75%) between 20 and 30 years, are considered color white, 162 (56.84%) have completed higher education, 171 (60.00%) and of these 97 (56.73%) reported having some post-graduate degrees, are married, 141 (49.47%) and have from zero to one child, 148 (51.93%) reside in the south of the city of Natal, 146 (51.23%) have a monthly income of three to five minimum wages, 171 (60.00%) and are mostly in the Technical Administrative Sciences 152 (53.33%), 77 (27.02%) reported having experienced violence, 60 (62.50%) episodes of verbal aggression, 26 (27.08%) of bullying , 05 (5.21%) of physical abuse and 05 (5.21%) sexual harassment; 05 (100.00%) assaults were made by the spouse or partner of the victims and co-workers is another profession were responsible for 18 (30.00%) verbal aggression, 15 (57.69%) bullying and 03 (60.00%) sexual harassment, 02 (40.00%) of victims of physical aggression and 18 (30.00 %) of verbal abused only once, 10 (38.46%) of bullying and 02 (40.00%) of sexual harassment experienced four or more times 05 (100.00%) assaults occurred at domestic and work stood out with 36 (60.00%), verbal abuse, 22 (84.62%), moral harassment and 04 (80.00%) sexual harassment, 35 (36.46%) told colleagues work and 31 (32.29%) for family and friends in 75 (78.13%) cases there was no intervention, 07 (7.29) were unable to respond if something had been done and 14 (14.58% ) have been reported intervention of these, 09 (64.29%) were taken by the heads of the victims, 26 (32.10%) did not notify the fact on the ground that no action would be taken, 62 (80.52%) felt stress , 5 (1.76%) of women turned away from work after the episode of violence, accounting for 198 days of absenteeism. It is concluded that there is a high rate of violence against women, even when they have a good socioeconomic status, and in this sense is important to establish bases of new proposals for improving control of cases of health professionals, especially nurses, to approach patients with a more investigative, and that by identifying a case of violence, be instructed about the paths to be followed for notification while providing psychological support to victims.

Os profissionais de saúde diante da violência :mapeando o processo de implantaçãoda notificação na rede básica de saúde em Natal/RN

Violence is a complex and multifarious phenomenon that has convoked the government to think about strategies to face the question. This work is about one of these strategies proposed by brazilian Health Minister: the Individual notification/investigation Card - Domestic Violence, Sexual and/or others Interpersonal Violences . This instrument is a notification protocol which is been implanted in all of the country. This process is in course in Natal/RN. This work is a report of one research realized in five units of basic health care network of Natal/RN concerning this process about the implementation of the violence notification card. The study aims to cartography all the process of card implantation, discussing the used strategies, the drawn course, difficulties and possibilities as well as how the researcher intended to map subjective process involved at health professional acting at violence case and the propose to use the card. Meetings were held at each unit and a daily fieldwork report was used as research instrument. In this investigation it was observed that notifying violence involves a complexity that is not present in other kinds of notification as consequence of the phenomenon characteristic and health workers are invited to act in different perspective that knowledge and instruments of traditional health fieldwork available does not work. It was observed that the notification card, as a possible instrument of intervention, are considered important detectors from process of work at health basic care and health policies. Depending the way the instrument is used, it may incentive different discussions and manners to offer health care or in other way it can reproduce control and vigilance logics. Consequently it is necessary to consider some factors pointed out at this experience, implanting instruments like this, thinking about these limits and possibilities

Sexo não é brincadeira: o sentido de infância para adolescentes inseridas na exploração sexual comercial

The childhood has being highlighted by the great concern about the several contexts in which children are inserted, amongst them, commercial sexual exploitation (CSE). The experience of this violence process brings implications to the person constitution. Thus, this research aimed to understand how commercial sexual exploited adolescents to signify the childhood. Participated of this research four female adolescents that had been assisted by Programa de enfrentamento ao Abuso e Exploração Sexual de Crianças e Adolescentes (Sentinela) , with ages between 12 and 17 years. The corpus was composed by the combination of the semi-structured interview and other procedures, like childish stories, draws and photography. Moreover, we used another instruments to constitute the corpus, like the documental research and we proposed the construction of a life story book of each participant. The corpus was analyzed through the Thematic Content Analysis. Five thematic axes emerged from the participants discourse and theoretical perspective: dynamical of family, scholar process, ludic behavior, conception of childhood and insertion on CSE process. The participants presented a conception about childhood as been a preparation and education phase to ingress in adult life. In other words, while children do not grown up, they go to the school, plays, lives with family, are happy and do not have any responsibilities. Nevertheless, the life experience of these girls was implicated by negligence, sexual abuse, child labor, institutionalization and, evidently, the commercial sexual exploitation. Understanding that the childhood experienced by adolescent, as well as, her insertion on CSECA, constitutes her, while person, we investigated how the interrelation expresses it on participants future perspectives. Their goals are defined based on family constitution and professional improvement, although feelings of disillusion and pessimism had been showed up in some moments. According these results, we pointed to the necessity of the effective proposals that promote real improvement of adolescents life quality, through, in which they could to create alternatives to get over the several risks in which they are exposed, mainly, the CSECA condition

Violência na infância: Londrina (1930-1970)

Based on criminal processes regarding child sexual abuse from the early 1940s to the late 1970s, this article intents to analyze both the conception of innocence and childhood held at that time, and the influence of such on the local judiciary.

Violência doméstica: o que se espera do profissional de saúde?

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo do perfil epidemiológico da violência contra crianças, adolescentes e idosos em registros policiais

Pós-graduação em Odontologia Preventiva e Social - FOA

Avaliação do conhecimento e conduta de médicos e cirurgiões-dentistas sobre maus-tratos e violência contra a criança e o adolescente

Pós-graduação em Ciência Odontólogica - FOA

Violência doméstica contra crianças e adolescentes: sentidos e significados atribuídos por familiares envolvidos com o conselho tutelar

Pós-graduação em Psicologia - FCLAS

Hermenêutica gestáltica do abuso sexual para uma adolescente

Esta pesquisa qualitativa de orientação fenomenológica existencial gestáltica, procura desvelar alguns significados atribuídos ao fenômeno do abuso sexual intrafamiliar, por meio de um estudo de caso em que a informante, dos 9 aos 11 anos, foi vitimizada pelo pai e ainda hoje, no seu campo existencial, é influenciada pela vivência dessa experiência. A violência contra a criança, em suas diversas modalidades, é um problema de saúde pública e de relações interpessoais entre família ou cuidador e a criança. Em se tratando do abuso sexual, em que o agressor é o responsável pelos cuidados primários, geralmente, há negação pela vítima, agressor e a família, e quase sempre, ocorre, envolvendo mais de uma modalidade de violência. Mesmo não havendo um consenso entre os autores, a maioria destaca os efeitos nocivos desses acontecimentos sobre a saúde psíquica, ocupacional, física e desenvolvimental das vítimas. Os dados foram coletados na ONG República de Emaús abrangendo leitura de documentos, relatos informais, observação participante e entrevista com a adolescente, sendo esta última, a principal fonte de apreciação. A análise da entrevista conjugou, na medida do possível, a teoria da interpretação de Ricoeur, alguns conceitos da gestalt-terapia como o de contato, figura-fundo, e nutrição psicológica; e da Terapia Ocupacional, como áreas, componentes e os contextos de desempenho. Da entrevista foram criadas unidades de significação que nortearam as reflexões acerca dos significados do discurso da adolescente. Alguns resultados são: apresentação do peso da vivência do abuso sexual ora como figura ora como fundo; repercussões disfuncionais de auto-contato e contato com o outro; na auto-imagem, auto-estima e em algumas áreas de desempenho: aprendizagem e socialização. O ajustamento criativo pode ser identificado na abertura em revelar a experiência, o que sugere expansão de suas fronteiras de contato. Uma conclusão que o estudo apontou foi sobre a relação da adolescente com o pai que, ainda, destaca-se enquanto uma gestalt aberta.

Violência contra a criança: formação, conhecimento, percepção e atitude de profissionais da saúde e da educação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O tráfico feminino para fins de superexploração sexual: o caso do Pará

No imaginário feminino da Amazônia Paraense, migrar é um sonho, cujo conteúdo onírico faz parte não só de uma estratégia de sobrevivência, como também de uma busca por ressignificação dos lugares/construções/imaginário/ atribuídos ao feminino, na herança cultural sexista, racializada e heteronormativa imposta na e para a região. Muitas sonham viver em um contexto livre da violência; ter uma casa bonita, filhos saudáveis e um marido bondoso; outras sonham ganhar muito dinheiro trabalhando na prostituição, como dançarinas ou qualquer trabalho que possibilite a realizarão daquele ou de outros sonhos. Todas já escutaram estórias de outras bem sucedidas que migraram, e hoje possuem carro, roupas caras e uma casa para morar. Ouvem dizer, que há boas perspectivas em torno dos Grandes Projetos, mas não fazem ideia de como chegar, pois, muitos desses locais são de difícil acesso, como minas e garimpos. Já ouviram dizer que “no estrangeiro” sua exoticidade rende muito dinheiro. Outras, já ouviram estórias ruins de gente que foi escravizada, presa, deportada ou morta. Mas, apostam na sorte e acreditam que o risco vale a pena. Sabem o quanto é difícil sair do país, tirar passaporte, negociar em outra língua, outra moeda, lidar com uma burocracia complexa, exigente e uma legislação rígida e restritiva. Acreditam que se tentassem migrar sozinhas, sem o apoio de alguém com experiência no ramo, provavelmente não conseguiriam. Até que, aparece alguém se dizendo com experiência e com a oferta de providenciar tudo, com um simples toque da varinha de condão...O tráfico de pessoas, especialmente o feminino para fins de superexploração sexual - que inclui mulheres, travestis e transgêneros é uma violação de direitos humanos no contexto da migração. Terceira atividade ilícita mais lucrativa do planeta perde, segundo a Organização das Nações Unidas – ONU, apenas para o tráfico de drogas e o de armas. Possui natureza multifacetada marcada por uma dupla regulação: a capitalista e a identitária, cuja finalidade é sempre o trabalho escravo, incluindo o casamento servil e a prostituição forçada. Seu contexto extrapola a esfera criminal, perpassa por questões culturais e de gênero. Seu enfrentamento reclama o reconhecimento da diversidade democrática, do direito à não discriminação e dos parâmetros de direitos humanos.