Factors interfering with reporting sexual violence against children and adolescents: integrative review
DOI:
https://doi.org/10.12957/reuerj.2025.85873Keywords:
Pediatric Nursing, Child Health, Child Abuse, Child Abuse, Sexual, Mandatory ReportingAbstract
Objective: to describe factors interfering with health professionals reporting sexual violence against children and adolescents. Method: an integrative review conducted in the Medline, LILACS, CINAHL, Web of Science and Scopus databases and portals, including primary studies published in the last ten years. The data were extracted by two researchers and integrated by means of thematic grouping. Results: eighteen articles were included after the search and selection process. Factors related to cultural, economic and social issues of the families and victims were made evident, hindering case identification and reporting. The existence of protocols, institutional flows, work process organization, the subjects' belief systems and lack of knowledge were also obstacles. Conclusion: based on the identification of factors related to the families, victims, work process, beliefs and knowledge, the need for accountability of professionals and institutions alike regarding educational and organizational processes that can guarantee assistance and the patients' rights in dealing with this problem is highlighted.
References
1. Veloso MMX, Magalhães CMC, Cabral IR. Identification and reporting of violence against children and adolescents: limits and possibilities of action of health professionals. Mudanças - Psicologia da Saúde. 2017 [cited 2024 Dec 10]; 25(1):1-8. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-869141.
2. Anunciação LL, Carvalho RC de, Santos JEF, Morais AC, Almeida VRS, Souza SL. Violência contra crianças e adolescentes: intervenções multiprofissionais da Atenção Primária à Saúde na escola. Saúde debate. 2022 [cited 2024 Dec 10]; 46(spe3):201–12. DOI: https://doi.org/10.1590/0103-11042022E315.
3. Ministério da Saúde (Br). Guia de Vigilância em Saúde. 5a ed. Brasília: Ministério da Saúde; 2022 [cited 2023 Sep 10]. Available from: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/vigilancia/guia-de-vigilancia-em-saude-5a-edicao-revisada-e-atualizada-2022/view.
4. Brasil. Lei nº 13.257, de 8 de março de 2016. Dispõe sobre as políticas públicas para a primeira infância e altera a Lei nº 8.069, de 13 de julho de 1990 (Estatuto da Criança e do Adolescente). Brasília: Diário Oficial da União. 2016 [cited 2023 Dec 17]. Available from: https://www.planalto.gov.br/ccivil_03/_ato2015-2018/2016/lei/l13257.htm.
5. Ministério da Saúde (Br). Portaria nº 104, de 25 de janeiro de 2011. Define as terminologias adotadas em legislação nacional. Brasília: Ministério da Saúde. 2011 [cited 2023 Oct 14]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt0104_25_01_2011.html.
6. Muniz BAA, Dantas ALM, Santana MM. Notificação de violência infantojuvenil: percepção dos profissionais da Atenção Primária à Saúde. Trab educ saúde. 2022 [cited 2024 Dec 12]; 20:e00620196. DOI: https://doi.org/10.1590/1981-7746-ojs620.
7. Ministério da Saúde (BR). Linha de cuidado para a atenção integral à saúde de crianças, adolescentes e suas famílias em situação de violências: orientação para gestores e profissionais de saúde. Brasília: Ministério da Saúde, 2014 [cited 2023 Oct 20]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/linha_cuidado_atencao_integral_saude.pdf.
8. Brasil. Lei nº 14.344, de 24 de maio de 2022, Cria mecanismos para a prevenção e o enfrentamento da violência doméstica e familiar contra a criança e o adolescente. Brasília: Diário Oficial da União. 2022 [cited 2023 Sep 01]. Available from: https://www.planalto.gov.br/ccivil_03/_ato2019-2022/2022/lei/l14344.htm.
9. Lima AM, Cavalcante DP, Silva PR, Prazeres PG, Ohara ECC, Gregorio Neto J. A promoção da saúde pelo enfermeiro diante da violência sexual infantil intrafamiliar. Int. J. Health Manag. Rev. 2021 [cited 2023 Oct 14]; 7(1):1-13. Available from: https://ijhmreview.org/ijhmreview/article/view/252.
10. Cabral MVA, Araújo JAC, Sousa AM, Reis PB, Bitencourt EB, Costa RAS, et al. Analysis of general aspects and steps of the integrative literature review for health professionals. Braz. J. Implantol. Health Sci. 2023 [cited 2023 Sep 01]; 5(4):1459-69. DOI: http://dx.doi.org/10.36557/2674-8169.2023v5n4p2-1459-1469.
11. Conselho Nacional dos Direitos da Criança e do Adolescente (BR). Plano Nacional de Enfrentamento da Violência Sexual contra Crianças e Adolescentes. 2013 [cited 2023 Sep 16]. Available from: https://site.mppr.mp.br/sites/hotsites/arquivos_restritos/files/migrados/File/publi/sedh/08_2013_pnevsca.pdf.
12. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 [cited 2024 Dec 10]; 372:n71. DOI: https://doi.org/10.1136/bmj.n71.
13. Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z. JBI Manual for Evidence Synthesis. JBI; 2024 [cited 2024 Dec 10]. DOI: https://doi.org/10.46658/JBIMES-24-01.
14. Moola S, Tufanaru C, Sears K, Currie MJ, Qureshi R, Mu P, et al. Systematic reviews of etiology and risk. JBI Manual for Evidence Synthesis. 2020 [cited 2023 Oct 16]. DOI: https://synthesismanual.jbi.global.
15. Ben Natan M, Faour C, Naamhah S, Grinberg K, Klein-Kremer A. Factors affecting medical and nursing staff reporting of child abuse. Int. Nurs. Rev. 2012 [cited 16 Oct 2023]; 59(3):331–7. DOI: http://dx.doi.org/10.1111/j.1466-7657.2012.00988.x.
16. Ashoor L, Alnasir F, Grant N. Children Abuse: Factors Affecting Case Reporting by Physicians. Bahrain Medical Bulletin. 2012 [cited 2023 Nov 27]; 34(3):1-8. Available from: https://www.bahrainmedicalbulletin.com/september_2012/Child-Abuse.pdf.
17. Ortega EG, Baz BO, Sanchez FLS. Professionals’ criteria for detecting and reporting child sexual abuse. Span J Psychol. 2012 [cited 2023 Nov 27]; 15(3):1325-38. DOI: https://doi.org/10.5209/rev_SJOP.2012.v15.n3.39418.
18. Herendeen PA, Blevins R, Anson E, Smith J. Barriers to and consequences of mandated reporting of child abuse by nurse practitioners. J Pediatr Health Care. 2013 [cited 2023 Oct 16]; 28(1):e1-7. DOI: http://dx.doi.org/10.1016/j.pedhc.2013.06.004.
19. Lynne EG, Gifford EJ, Evans KE, Rosch JB. Barriers to reporting child maltreatment: do emergency medical services professionals fully understand their role as mandatory reporters? N.C. Med. J. 2015 [cited 2023 Oct 16]; 76(2):13-8. DOI: https://pubmed.ncbi.nlm.nih.gov/25621471/.
20. Talsma M, Boström BK, Östberg AL. Facing suspected child abuse--what keeps Swedish general practitioners from reporting to child protective services? Scand. J. Prim. Health Care. 2015 [cited 2023 Nov 2023]; 33(1):21-6. DOI: https://doi.org/10.3109/02813432.2015.1001941.
21. Al-Saif DM, Al-Eissa M, Saleheen H, Al-Mutlaq H, Everson MD, Almuneef MA. Professionals’ attitude toward reporting child sexual abuse in Saudi Arabia. J Child Sex Abus. 2018 [cited 2023 Nov 15]; 22(1):22-37. DOI: https://dx.doi.org/10.1080/10538712.2017.1360429.
22. Egry EY, Apostolico MR, Morais TCP. Reporting child violence, health care flows and work process of primary health care professionals. Ciênc. Saúde Colet. 2018 [cited 2023 Nov 20]; 23(1):83-92. DOI: http://dx.doi.org/10.1590/1413-81232018231.22062017.
23. Silva PA, Lunardi VL, Meucci RD, Algeri S, Silva MP, Franciscatto FP. (In)visibility of notifications of violence against children and adolescents registered in a municipality in southern Brazil. Invest. Educ. Enferm. 2019 [cited 2023 Nov 14]; 37(2):e11. DOI: https://doi.org/10.17533/udea.iee.v37n2e11.
24. Maul KM, Naeem R, Rahim Khan U, Mian AI, Yousafzai AK, Brown N. Child abuse in Pakistan: a qualitative study of knowledge, attitudes and practice amongst health professionals. Child Abuse and Neglect. 2019 [cited 2023 Nov 23]; 88:51-7. DOI: https://doi.org/10.1016/j.chiabu.2018.10.008.
25. Chan ACY, Cheng WL, Lin YN, Ma KW, Mark CY, Yan LC, et al. Knowledge and perceptions of child protection and mandatory reporting: a survey of nurses in Hong Kong. Compr Child Adolesc Nurs. 2019 [cited 2023 Nov 2023]; 43(1):48-64. DOI: http://dx.doi.org/10.1080/24694193.2018.1561763.
26. Elarousy W, Abed S. Barriers that inhibit reporting suspected cases of child abuse and neglect among nurses in a public hospital, Jeddah, Saudi Arabia. East Mediterr Health J. 2019 [cited 2023 Dec 01]; 25(6):413-21. DOI: http://dx.doi.org/10.26719/emhj.18.055.
27. Rolovic JS, Stevanovic N. Perceived skill and willingness to address child sexual abuse: assessing Serbian and Montenegrin pediatricians. J Child Sex Abus. 2020 [cited 2023 Dec 02]; 29(1):112-28. DOI: https://doi.org/10.1080/10538712.2019.1697781.
28. Conceição MIG, Costa LF, Penso MA, Williams LCA. Abuso sexual infantil masculino: sintomas, notificação e denúncia no restabelecimento da proteção. Psicol. Clín. 2020 [cited 2023 Dec 02]; 32(1):101-21. Available from: https://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S0103-56652020000100006.
29. Mkonyi E, Mwakawanga DL, Rosser BRS, Bonilla ZE, Lukumay GG, Mohammed I, et al. The management of childhood sexual abuse by midwifery, nursing and medical providers in Tanzania. Child Abuse and Neglect. 2021 [cited 2023 Nov 14]; 121:e105268. DOI: https://doi.org/10.1016/j.chiabu.2021.105268.
30. Nihan K, Makda A, Salat H, Khursheed M, Fayyaz J, Khan UR. Assessment of knowledge, attitude, and practice of child abuse amongst health care professionals working in tertiary care hospitals of Karachi, Pakistan. J Family Med Prim Care. 2021 [cited 2023 Dec 14]; 10(3):1364-8. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1691_20.
31. Batista MKB, Gomes WS, Villacorta JAM. Sexual abuse against children: building coping strategies in Primary Health Care in a municipality in the metropolitan region of Recife. Saúde debate. 2022 [cited 2023 Nov 29]; 46(spe5):208-20. DOI: http://dx.doi.org/10.1590/0103-11042022E517.
32. Nunes SHB. Violência Sexual Contra Crianças e Adolescentes. JusbrasiL. 2021 [cited 2023 Dec 12]. Avaliable from: https://www.jusbrasil.com.br/artigos/violencia-sexual-contra-criancas-e-adolescentes/1347471880?_gl=1*jyvv57*_ga*MTcxNzM2NTAwNS4xNjg2NTI1MTUw*_ga_QCSXBQ8XPZ*MTY5ODkzOTkxNy4yMS4xLjE2OTg5Mzk5NDIuMzUuMC4w.
33. Jain S, Jain H. Mandatory reporting of sexual offences in indian legislation: an ethical dilemma for medical professionals. Natl Med J India. 2018 [cited 2023 Nov 15]; 31(2)125-6. DOI: http://dx.doi.org/10.4103/0970-258X.253159.
34. Matthews B. Taxonomy of duties to report child sexual abuse: legal developments offer new ways to facilitate disclosure. Child Abuse and Neglect. 2019 [cited 2023 Dec 12]; 88:337-47. DOI: https://doi.org/10.1016/j.chiabu.2018.12.003.
35. Santos LF, Costa MM, Javae ACRS, Mutti CF, Pacheco LR. Factors that interfere with the confrontation of child violence by guardianship counselors. Saúde debate. 2019 [cited 2023 Dec 14]; 43(20):137-49. DOI: https://doi.org/10.1590/0103-1104201912010.
36. Pinto SB. Panorama da violência contra crianças a partir da vigência do marco legal da primeira infância (lei nº 13,257/2016). ICHS. 2023 [cited 12023 Dec 20]; 10(1):479-492. DOI: https://doi.org/10.17564/2316-3801.2023v10n1p479-492.
37. Bonfante AAB, Polli L, von Hohendorff J. Reações de mães de meninos vítimas de violência sexual diante da revelação. Psicol. Estud. 2023 [cited 2024 Sep 10]; 28:e53140. DOI: https://doi.org/10.4025/psicolestud.v28i0.53140.
38. Marra MM, Costa LF. Between revelation and first care: family and sexual abuse. Avances en Psicología Latinoamericana. 2018 [cited 2023 Dec 20]; 36(3):459-75. DOI: https://doi.org/10.12804/revistas.urosario.edu.co/apl/a.3564.
39. Schaefer LS, Brunnet AE, Lobo BOM, Carvalho JCN, Kristensen CH. Psychological and behavioral indicators in the forensic assessment of child sexual abuse. Trends in Psychol. 2018 [cited 2023 Nov 11]; 26(3):1467-82. DOI: https://doi.org/10.9788/TP2018.3-12Pt.
40. Setti SM, Trindade AA, Hohendorff, JV. Atuação da estratégia saúde da família em casos de violência sexual contra crianças e adolescentes. Estud. pesqui. psicol. 2022 [cited 2024 Dec 12]; 22:(1):105-24. DOI: https://doi.org/10.12957/epp.2022.66482.
41. Sousa CMS, Mascarenhas MDM, Lima PVC, Rodrigues MTP. Incompletude do preenchimento das notificações compulsórias de violência - Brasil, 2011-2014. Cad saúde colet. 2020 [cited 2024 Dec 10]; 28(4):477–87. DOI: https://doi.org/10.1590/1414-462X202028040139.
42. Silva CA, Carlos DM, Roque EMST, Salzedas PL, Ferriani MGC. Percepção dos (as) profissionais da rede protetiva às crianças e adolescentes vítimas de violência sexual. ICHS. 2023 [cited 2023 Nov 20]; 10(1):428-40. DOI: https://doi.org/10.17564/2316-3801.2023v10n1p428-440.
43. Platt VB, Coelho EBS, Bolsoni C, Höfelmann DA. Completitud, consistencia y no duplicación de registros de violencia sexual infantil en el Sistema de Información de Enfermedades de Declaración Obligatoria en Santa Catarina, Brasil, 2009-2019. Epidemiol. Serv. Saúde. 2022 [cited 2023 Dec 02]; 31(2):e2021441. DOI: http://dx.doi.org/10.1590/s2237-96222022000100012.
44. Melo F, Roberto NTS, Cavalcante JHA, Soares ACO. Assistência de enfermagem à criança vítima de abuso sexual no serviço de saúde do Brasil. Ciências Biológicas e de Saúde Unit. 2019 [cited 2023 Nov 05]; 5(3):49. Avaliable from: https://periodicos.grupotiradentes.com/cdgsaude/article/view/6167/3673.
45. Aguiar BA, Dantas ALM, Santana MM. Notification of child and adolescent violence: perception of Primary Health Care professional. Trab. Educ. saúde. 2022 [cited 2023 Dec 02]; 20:e00620196. DOI: https://dx.doi.org/10.1590/1981-7746-ojs620.
46. Nunes MCA, Morais NA. Professional practices to support sexual assault victims: a review of national literature. Psicol. cienc. prof. 2021 [cited 2023 Dec 02]; 41:e227527. DOI: https://doi.org/10.1590/1982-3703003227527.
47. Ribeiro FMA, Fernandes FECV, Melo RA. Rede de proteção a crianças e adolescentes em situação de violência na visão dos profissionais. Rev. baiana enferm. 2021 [cited 2023 Dec 02]; 35:e42099. DOI: https://doi.org/10.18471/rbe.v35.42099.
48. Aguiar LS, Alves BFD, Miziara CSMG, Miziara ID. Interpretation of medical findings in suspected cases of sexual abuse of youngers then 18: analysis of 13,870 reports. Persp Med Legal Pericia Med. 2020 [cited 2023 Dec 05]; 5(2)48-55. DOI: https://dx.doi.org/10.47005/050201.
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