ORIGINAL RESEARCH

Coping strategies adopted by women victims of violence

Laís Costa^I; Rayane Gonçalves Lordes^II; Dherik Fraga^III; Nathália Miguel Teixeira Santana^IV; Susana Bubach^V; Franciéle Marabotti Costa Leite^VI

^I Nurse. Federal University of Espírito Santo, Graduate Program in Nursing. Brazil. E-mail: lais.costa87@hotmail.com
^II Nurse. Federal University of Espírito Santo, Graduate Program in Nursing, Brazil. E-mail: rayane_lordes@hotmail.com
^III Master student in Nursing. Federal University of Espírito Santo, Graduate Program in Nursing. Brazil. E-mail: dherik@msn.com
^IV Master in Collective Health. Federal University of Espírito Santo, Graduate Program in Collective Health. Brazil. E-mail: nathalia.miguel@hotmail.com
^V PhD in Epidemiology. Federal University of Espírito Santo, Norte do Espírito Santo University Center. ES, Brazil. E-mail: sbubach@gmail.com
^VI PhD in Epidemiology. Federal University of Espírito Santo, Graduate Program in Nursing, Vitória, ES, Brazil. E-mail: francielemarabotti@gmail.com

DOI: https://doi.org/10.12957/reuerj.2018.19334

ABSTRACT

Objective: to examine the coping strategies adopted by women victims of violence. Method: in this quanti-qualitative, descriptive study of 19 women victims of violence, who attended the Multidisciplinary Support Center in Serra, Espírito Santo, in 2013, semi-structured interview and recording were used to collect socioeconomic and violence data. Content analysis was applied to the testimonies. The study was approved by the research ethics committee. Results: the women were predominantly aged 39 years or less, had completed secondary education, had their own income, a family income of 1 to 2 minimum wages, and were Evangelicals. The themes recovered from their accounts were: combating violence by focusing on the problem (42.1%), combating violence by focusing on emotion (26.3%), combating violence by focusing on emotion and religion (21.1%), and combating violence by focusing on emotion and the problem (10.5%). Conclusion: women in situations of violence experienced different manners of coping with this disorder, by focusing on the problem, emotion and religion.

Descriptors: violence against women; psychological adaptation; women's health; nursing.

INTRODUCTION

Violence is defined as the intentional use of force or power through real threat or aggression against oneself, another person, or against a group or community, which results in or is likely to result in injury, death, psychological harm, development problems or deprivation¹. This phenomenon is determined in the cultural tradition, social organization, economic structures and in power relations, being practiced against female persons, simply because of their condition of woman, causing a relation based on inequality, discrimination, subordination and abuse of power².

Since the 1990s, violence against women has been recognized internationally as a public health problem, when it was no longer treated only as violence between spouses or as a private matter and started to be treated as a public health problem. In the world, one in six women suffers domestic violence, and in 60% of cases of violence is perpetrated by the husband or partner³.

In Brazil, the numbers are of violence against women are alarming; one in every five Brazilian women claim to have suffered some kind of violence by men. A study carried out in Vitória, Espírito Santo, showed that in the last year, about 25% of health service users have experienced psychological violence from the intimate partner, and approximately 10% have been victims of physical aggression⁴. The mortality rate of women victims of aggression has not decreased even after the approval of the Maria da Penha Law in 2007. The mortality rate per 100,000 women (victims of aggression) used to be 5.28 in the period between 2001 and 2006 (before the Law) and was 5.22 in the period between 2007 and 2011⁵.

In the first aggression, women create a positive expectation that they will not suffer violence a second time, and then they do not make a formal complaint in the Women's Police Station⁶. In this sense, the victim of violence uses silence as a survival strategy in the attempt to prevent further episodes of fighting and conflicts in order to preserve the family⁷. However, when the victim finds her situation challenging, mobilization of confrontation efforts take place. This situation involves emotions such as excitement, hope and confidence⁸.

Thus, this article aimed to analyze the coping strategies adopted by women victims of violence to deepen the study of the phenomenon, and in this way, to increase the knowledge of the different paths taken by women in situations of violence, as well as of how to support the implementation of interdisciplinary interventions.

LITERATURE REVIEW

One in five Brazilian women claim to have suffered some form of violence perpetrated by men and at least 6.8 million have been beaten at least once. More than half of the victims do not seek help, and when they do, it is because they considered the situation as urgent, such as threats with firearms and spanking and little more than half of these victims ask for help, and when they do so, this is done by means of another family member or close friend⁹.

Coping with violence represents for them an attempt to exert some control over the environment and events in the attempt to facilitate a better adaptation to the situation⁸. It is worth pointing out that, among the strategies adopted, coping reveals distraction, positive reassessment about oneself, definition of limits, life plans and search for social support, especially when leaving the abusive relationship is not feasible¹⁰.

The experience of violence involves several feelings, often ambiguous and contradictory. Victimized women live with fear, anger, indignation, and surprise before their partners' aggressive reaction¹¹. It is worth noting that most women remain in their relationships because they feel shame, or because of financial dependence on the aggressor, fear of loneliness, worry about providing for their children and sparing them from suffering, hope that violence will stop, and also because they have not family and social support¹².

Besides these factors, women usually remain in violent relationships because they have experienced a family history where there was aggression among parents or people close to them, propitiating the repetition of this model in their own conjugal relationship. This is because they believe in the change of attitude of the husband/partner and/or believe in the inability to live without the husband/partner and without a father for the children^13,14. In this context, women in situations of violence often use coping tools and strategies to deal with the problem.

Coping strategies used by women go through gender issues and socio-cultural contexts that, in a transversal way, permeate the meanings, the attitudes adopted and the forms of expression of violence against women that are directly related to the success or failure of the strategies used. Personal or social networks play an important role in the breakdown of violence¹⁵, because the help that a person receives from these networks, material resources, among other variables, influences how they assess a situation as stressful or not, and the choice that she will use to deal with the situation¹⁶.

METHOD

This is a descriptive study with a quantitative approach carried out at the Multidisciplinary Support Center (MSC) in Serra, Espírito Santo, which assists Family cases, and cases of Domestic and Family Violence against Women. The MSC team consists of four social workers and two psychologists. Qualitative research apprehends the complexity of the phenomenon, bringing to the analysis the subjective and objective aspects of social subjects, according to their worldviews¹⁷.

The participants of the study were 19 women victims of violence referred to the MSC, after opening a report in the Police Department of Assistance to Women in the municipality of Serra, in 2013. The inclusion in the study was random and based on the criterion of data saturation, that is, recidivism of information¹⁸. Sampling based on saturation is a conceptual tool commonly used in qualitative research in different areas in the Health field. It is used to establish the final sample size in studies, ending data collection when new components cease to appear¹⁹.

Women who were in the waiting room, in the order of arrival at the service, were invited to participate in the study. Data were collected at the MSC rooms from November 2012 to July 2013. The inclusion criteria were: women with age above 18 years and who had suffered some type of violence.

Before starting the research, the women were informed about the objectives of the research by reading the Informed Consent Term (ICT). Before accepting it, their signature was requested and then the interviews started. In order to guarantee secrecy of information and anonymity of the participants the statements were codified by the letter I, in the results, referring to the word interviewee, and Arabic numerals, composing the codes I1, I2, I3, I4, according to the sequence in which they were interviewed.

Data were obtained through an interview script with questions of characterization of the participants (age group, educational level, own income, family income, and religion) and an open question about the coping strategies adopted, taking into account the guiding question of the study: When you began to suffer violence, how did you sought to cope this situation? The interview took place in a reserved room, after the working the multidisciplinary team had assisted the women so as not to disturb the flow of the service.

The testimonies were recorded and transcribed verbatim. Treatment of the data occurred by content analysis, composed of three stages: pre-analysis; exploitation of the material and treatment of results; and interpretation ²⁰. The first stage consists of the organization phase, using the method of quick reading; in the second step, data were encoded into the record units; and in the third stage, categorization and classification of the elements was done according to their similarities and differences, and then reunited, according to common characteristics¹⁹. Thus, four categories emerged: confrontation violence with a focus on the problem; Confrontation with violence focused on emotion; Coping with violence focused on emotion and religion; and Coping with violence focused on emotion and the problem.

In the quantitative approach, statistical methods were applied, by presenting the absolute and percentage frequency of socio-demographic variables of the participants (in table) and of the thematic categories.

The research project of this study was sent to the Research Ethics Committee of the Federal University of Espírito Santo (UFES) and was approved under Opinion number 195,469.

RESULTS AND DISCUSSION

The attributes of the women - age group, education level, individual and family income and religion were analyzed, as shown in Table 1.

TABLE 1: General characteristics of the victims of violence participating in the study. Serra, Espírito Santo, 2013.

From the 19 eligible women, it was observed that 15 (79.0%) were aged 39 years or more. A documentary study carried out in Ribeirão Preto also found that the majority of women victims of domestic violence (56.2%) were in the age range between 20 and 39 years²¹. The prevalence of aggression among young women may occur due to cultural patterns: a beautiful body arouses attention and may provoke in some men insecure and violent authoritarian practices, explaining the predominance of the occurrence of aggression²².

As to schooling, nine participants (47.4%) had completed secondary education, contrary to the observed in other studies in which the majority of the victims of violence presented low level of schooling. A study carried out in Florianópolis exemplifies this relationship, as it identified the predominance of complete and incomplete Elementary Education among victims of violence¹⁵. Another research developed in Curitiba also found that 59.7% of women who had suffered all types of violence had incomplete Elementary Education²³.

Most participants (84.2%) claimed to have their own income; nine (47.4%) had monthly family income of up to two minimum wages. Although women have low incomes, having their own income reduces their vulnerability to violence because lack of income, or lack of financial autonomy, can hinder decision-making when it comes to breaking up the violent relationship ²⁴. Thus, income is an important tool in decision-making, to break the cycle of violence.

Regarding religiosity, 12 (63.2%) women said to be evangelical. According to an investigation conducted in Fortaleza, 80% of women victims of domestic violence were Catholic and only 11% declared themselves to be evangelicals²⁵. It is worth noting that for evangelical women there is weakness in denunciations because their right to react before violence is understood as lack of faith in the divine promise of transformation of their husband²⁶.

Women who are beaten often use coping strategies to survive the violent relationship within the family¹⁵. In the present study, when questioned about when they began to suffer violence, how they tried to cope with this situation, the following thematic categories were revealed: 8 (42.1%) were in the category of coping with violence focused on the problem; 5 (26.3%) presented reports in the category of coping with violence focused on emotion; 4 (21.1%) in coping with violence focused on emotion and religion; and 2 (10.5%) sought coping with violence focused on emotion and on the problem.

The model of coping strategies adopted²⁷ involves four main concepts: coping as a process or interaction that occurs between the individual and the environment; its function is to manage the stressful situation, rather than to control and dominate the problem; these processes presuppose how the phenomenon is cognitively perceived, interpreted and represented in the mind of the subject; the confrontation process is a mobilization of efforts, in which subjects undertake cognitive and behavioral efforts to manage the situation, that is, reducing, minimizing or tolerating the internal or external demands arising from their interaction with the environment²⁸.

Coping with violence focused in the problem

In the coping strategy focused in the problem, we perceived that there is an effort to change the situation experienced, changing the existing problem. This strategy aims to face the situation, and it is considered the most useful and directed to reality, with the objective of minimizing and/or eliminating the source of stress that in this case is the violence suffered²⁹. These findings are evidenced in the statements of two interviewees:

Another method adopted by women to try to confront the situation was to react to violence. Research reveals that women's aggressions against their partners are considered mild, such as pushing and slaps, while those of men are more serious and violent³⁰. This information was also revealed in this research:

Women have difficulties in escaping domestic violence. It is only when they realize that all attempts and negotiations are exhausted and that violence can reach an extreme point that they go to confront the problem. The most effective denunciation can be obtained when women understand their vulnerability, the seriousness of the violence, and the benefits and the problems in making that decision¹².

The intention of women to report the violence in a police station is based on the possibility of terminating the relationship with the partner, expressing the non-acceptance of the relationship that represents a problem³¹.

Coping with violence focused on emotion

The focus on emotion reveals strategies with high emotional load resulting from self-defense processes, triggering mechanisms of detachment, escape and avoidance that serve as a shield and avoid the confrontation of the individual with the stressor²⁷.

When focused on emotion, confrontation strategies attempt to replace or regulate the emotional impact of stress on the individual, stemming primarily from defensive processes, causing people to consciously avoid confronting the threatening reality³².

In emotion-focused coping strategies, the person focuses on relieving the emotions associated with the stressful situation, although the problem in itself is not resolved. The women try to prevent their negative emotions from dominating them and making them unable to react to solve their problems. This type of confrontation is also used when a conflict is uncontrollable²⁵.

Coping with violence focused on emotion and religion

As previously pointed out, the emotion-focused confrontation modality is an indicative of the presence of emotional difficulties associated with negative emotions and avoidant behavior, pointing to difficulties in managing the situation³³.

Religious practices and/or religiosity promote another meaning and personal strengthening in the life of the most penalized people, and this can cause greater involvement with their reality and search for solutions to everyday problems³⁴. It is noted that this strategy has a relevant role in coping with violence. Belief in God, optimism and positive thinking influence the increase of adaptive responses to difficult situations, as presented in the participants' reports:

Violence perpetrated by the aggressor is counteracted by the power of prayer²⁶. Certain women say that religion helps in the coping with violence and that through faith they can fight it, since faith will be a strengthening subsidy for reaction and fight against violence³⁵.

Coping focused on emotion and on the problem

New models of confrontation can be learned³⁶, as well as used and rejected. That means that persons can discard the resources they used and replace them with others more effective to cope with their problem. It is noted in the speeches that some participants of the research sought help to minimize the stress and suffering generated by the violence and sought solutions to the problem. They used what is called coping strategies focused on emotion and on the problem, according to the literature ^30,36,37.

Until 1997, I would accept everything. Then, in 1998, I took the first initiative to report him. Then I went back and gave up the report. But now I have decided to continue reporting him, since January 2012. (I19)

A common characteristic among people who practice psychological violence against women is the ability to use children as targets every time they wish to affect the victim³⁷.

I cried, cried, and wept. But I made my decision myself and went to the police, because now he started to threaten the children, not only me, he touched my children and this hurts me. When we were just the two of us, but he started to beat my children, so the story changed. (I18)

The data presented allow us to reflect on the importance of approaching violence against women as a complex phenomenon determined by relational, social, cultural, economic and gender stigma. Health professionals, in individual or collective approaches, should constantly promote debates about ethical issues, about the violation and the promotion of women's rights, allowing the construction of strategies that generate change in the conditions for confrontation, promoting health and citizenship¹⁵ .

The intervention in the structure and human resources in the health area can promote change and coping with violence. The inclusion of this content in the training of health professionals contributes to the development of knowledge and skills, reflective criticism, instrumentalizing professionals for collective and individual care. Furthermore, the reorganization of care services aimed at women victims of violence, coupled with the promotion of intersectoral actions, strengthens support networks and multidisciplinary teams³⁸. In this scenario, health education, compulsory notification, as well as stimulating and promoting the women's access health services and their protection against domestic violence become paramount²¹.

CONCLUSION

Four categories emerged from the analysis of participants' speeches: Coping with violence focused on the problem, Coping with violence focused on emotion, Coping with violence focused on emotion and religion, and Coping with violence focused on emotion and on the problem.

It is perceived that women seek in some way to solve the violence, using as coping strategy the focus on the problem. For them, great effort is required to change the situation experienced. They use the support of family, friends, and public security. Otherwise, they seek internal forces for such confrontation.

Religion is a strategy that deserves attention. The religiosity in the life of women who are battered proved to be of great importance to face this problem. Believing in a superior force increases optimism and positive thinking and influences the responses to stressful situations. Another strategy observed, also adopted by the victims and evidenced in this study, is the use of self-defense, either distancing or escaping the problem.

Violence against women and deprivation from their rights as citizens cannot be considered as normal and need to be unveiled and discussed so as to eliminate this cycle. Public policies are needed to strengthen the existing social support networks.

Finally, the main limitations of this study were the small number of studies discussing ways of coping with violence adopted by women and the small sample studied which prevents the generalization of the results. In this research, only women who sought to break the cycle of violence were studied; thus, the coping strategies listed here refer to this particular group and not the countless victims who are unable to escape domestic violence.

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