Temas médico-sociais e a intervenção em saúde: a violência contra mulheres no discurso dos profissionais

Abstract

Estuda-se a violência contra mulheres como alvo dos cuidados em saúde. É parte de pesquisa em serviços públicos em São Paulo, envolvendo prevalência de casos entre usuárias de 15 a 49 anos; estudo de seus prontuários; descrição dos serviços, por sua observação; e entrevistas semiestruturadas com 50 de seus profissionais, acerca da rotina e do ideal de trabalho em saúde, percepções quanto à existência de casos, ofertas assistenciais ou seus obstáculos e representações sobre violência. Analisa-se o conteúdo das narrativas profissionais, usando-se os demais dados para caracterização de seus contextos assistenciais. Reiterando a literatura, violência foi quase sempre tida como problema relevante, mas fora dos escopos das intervenções profissionais. Relataram-se ações isoladas e em caráter pessoal. Medos e impotência profissional foram mencionados, mas nenhum aspecto positivo para eventual intervenção. Os profissionais mostraram parco conhecimento de serviços especializados de referência. Conclui-se que as dificuldades na aceitação de casos de violência deveriam ser trabalhadas em três dimensões: a estreita definição da competência profissional, excluindo a violência como objeto; a indefinição tecnológica do fazer profissional; e a ausência de apoios efetivos em seus serviços.

Violence against women: Perceptions of nursing students' about the focus on the formation

“…7 Regarding the presence of the subject in the curriculum, study shows that health professionals recognize that they did not have classes about VAW during their professional formation, so consider that these cases should remain within the security and justice, not blaming the health area. 21 It follows from the VAW theme should be addressed during the professional formation of nurses as and other health professionals, and also need to be enabled moments of continuing education in health services. This will be reflected in a better technical preparation of professionals in the health care of women in situations of violence, so that this grievance be identified in health services, strengthening the support network in the NHS.…”

Violência contra a mulher: limites e potencialidades da prática assistencial

“…The most appropriate response to the demand would be to establish lightweight technologies in care practice that take into account the inter-relationship and inter-subjectivities with users. (3) The listening and dialogue between professionals and users seeks to identify the demands and alternative solutions that translate into ways of dealing with the situation, which are unique to each condition. (7) The humanized assistance is based on the development of individual therapeutic projects with responsible reference teams, which is recommended by the user embracement as a posture and practice.…”

“…Some studies bring doctors as professionals who support the team in clinical issues of the situation; eventually one or another doctor, for being more sensitive, can address the grievance with a qualified hearing, but this practice is not considered a routine conduct that should be discussed and improved. (3,11) Under Brazilian legislation, the Maria da Penha Law contributed to the increase in recognition of violence and, as a consequence, the notification is conduct in health services. (9) To encourage the adoption of notification services, in the year 2011 it was published an ordinance that defines the compulsory notification of diseases, injuries and events throughout the national territory and establishes the flow, criteria and responsibilities of professionals.…”

“…(9) Studies show that women who go to the health units or are visited by professionals from the Family Health teams do not talk about the violence suffered. (3,5,10) One of the possibilities is that women do not report because the attention they receive is almost always about the physical problems, so they do not understand violence as a demand to be met in the unit. (5) Moreover, the lack of privacy in the place of user embracement may also be the reason for women not reporting violence.…”

“…This perspective is based on a model of health strongly rooted in biology, which hinders the development of a social practice that requires knowledge and technological skills that are not domain of all professionals. (3) Primary Healthcare is one of the health sectors which aims to meet women in situations of violence by recognizing confirmed and suspected cases. These actions included in the Program of Integral Assistance to Women's Health encompass violence along with other demands of women, becoming part of the healthcare practice.…”