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ORIGINAL RESEARCH

 

Domestic violence against women: characterization of cases reported in a town in São Paulo State

 

Ana Clara Borborema BozzoI; Giovanna Canesin Matos II; Lívia Parizi BeraldiIII; Mônica Dilene de SouzaIV

I Nurse by Barão de Mauá University Center. Ribeirão Preto, São Paulo, Brazil. E-mail: kazinha92@hotmail.com
II Nurse by Barão de Mauá University Center. Ribeirão Preto, São Paulo, Brazil. E-mail: c-i-k-a@hotmail.com
III Nurse by Barão de Mauá University Center. Ribeirão Preto, São Paulo, Brazil. E-mail: liviapberaldi@gmail.com
IV Master´s Nurse. Professor of the Nursing Department of the Barão de Mauá University Center. Ribeirão Preto, São Paulo, Brazil. E-mail: souzasanturbano@hotmail.com

DOI: http://dx.doi.org/10.12957/reuerj.2017.11173

 

 


ABSTRACT

Objective: to identify the profile of women victims of domestic violence in the town of Ribeirão Preto. Method: this quantitative documentary study reviewed 5,643 notifications of domestic violence against women, from data in notification records in Brazil's Mandatory Reporting Conditions Information System (SINAN), from January 2009 to June 2013. Results: 2011 was found to be the year with most notifications (1,504 cases; 26.65%); the predominant type of violence was psychological or moral, (4,640 cases; 82.23%); and the aggressor was kin to the victim predominantly as spouse (2,644 cases; 46.85%). Conclusion: the results show the need for preventive measures, educational programs, and a service by qualified professionals to establish early diagnosis, as well as the recording of precise notifications.

Keywords: Violence against women; domestic violence; mandatory reporting; nursing.


 

 

INTRODUCTION

Violence is one of the main causes of morbidity worldwide, presenting several facets that affect the population differently. Thus, it has been considered as a public health problem, including in Brazil1.

The World Health Organization (WHO) defines violence as the "intentional use of physical force or power, real or threatened, against itself, against another person, or against a group or community that results or is likely to result in injury, death, psychological damage, developmental disability or deprivation"2:11. Among all types of violence against women, it is maintained that the practice in the family environment is one of the cruelest and perverse. Identified as a welcoming and comfortable place, the home becomes, in these cases, an environment of continuous danger 3.

In the last two decades, it has been increasingly found that violence, particularly against women, is related to a greater risk for several physical and mental health problems, as well as direct physical trauma, as well as frequent use of the female population health services. In this sense, violence has been recognized by the United Nations (UN) and by some governments as a legitimate human rights problem1.

The notification of violence has a collection the Notification/Investigation Form of Domestic Violence, Sexual and/or other Violence as its instrument. The data collected through this form are processed in the Notification of Injury Information System (SINAN) 2. Notification is an important instrument in the fight against violence and in epidemiological control, besides being mandatory for the health professional, allowing greater visibility of the problem, epidemiological sizing and the creation of public policies aimed at its prevention4.

Nursing care for victims of violence requires planning to promote safety, care, respect, and satisfaction of needs in an individualized way. Reflection on planning should be based on the basic nursing instruments, public health policies and current legislation, fundamental for the protection of victims and prevention of future diseases5.

It is observed that violence against women no longer only involves personal issues and it is now a political and social issue. As a public health problem, it requires the preparation of professionals for their confrontation, articulating preventive and humanized care actions, in the perspective of integral care for women6.

In view of the above, the objective of this study was to identify the profile of women victims of domestic violence in the city of Ribeirão Preto.

 

LITERATURE REVIEW

The problematization of violence against women only began to strengthen in the late 1980s. Through the feminist movement, there were partnerships with the State and the implementation of public policies to deal with this problem. Later, in 1983, the State Councils in São Paulo; in 1984, the National Defense Women's Rights; and in 1986, the Specialized Police Offices for Women (DEAM)1,7 were created.

The compulsory notification of cases of violence against women assisted in public or private health services in the national territory was established by Law 10,778 of November 24, 2003. This law was regulated by Decree-Law Number 5,099 of June 3, 2004, and regulated by the Health Surveillance Secretary of the Ministry of Health through Administrative Rule Number 2,406 of November 5, 2004, which established compulsory notification against women under the Unified Health System2.

In 2006, Law 11.340/2006, also known as the Maria da Penha Law, was adopted as an important historical reference in the fight against violence against women, recognized by the UN as one of the three best laws in the world to combat this type of violence8,9.

At the moment, the denunciation notifications have increased and also the social equipment of service to the women victims of violence has increased. This is possibly a reflection of the changing behavior of women and society in the face of women's rights, the fruit of the feminist movements that for decades have been fighting for the rights of the female population 1.

 

METHODOLOGY

This is a documentary study with a quantitative approach carried out in the Epidemiological Surveillance sector of the Municipal Health Department of the city of Ribeirão Preto, in the interior of the State of São Paulo.

A total of 5643 reports of domestic violence against women, SINAN, were analyzed from January 2009 to June 2013.

The data were collected with the authorization of the Municipal Secretary of Health of the municipality studied and approved by the Research Ethics Committee, in compliance with the regulatory norms for the development of research with human beings, in accordance with Resolution 466/2012 of the National Council of Ministry of Health.

The absolute and percentage frequencies were used for the data treatment: the number of cases occurred; characteristics of victims, regarding age, ethnicity, education level, district; characteristics of aggression; the type of violence committed; means of aggression; the degree of kinship with the aggressor; referral of the person assisted.

 

RESULTS AND DISCUSSION

From the information obtained, it is noticed that the highest number of notifications was in 2011 - 1504 (26.65%). The highlight for 2011 may be related to the greater attention of the municipality to the cases of violence and, as a consequence, a public policy of compulsory notification of cases, as well as the encouragement of policies and campaigns about the need to be attentive to the importance of the complaint.

Regarding the age group, there was a predominance of 30 to 39 years old - 1603 (28.41%), followed by the age group of 20 to 29 years old - 1569 (27.80%). These data, referring to such a restricted universe, are in accordance with the characteristics of the population in general and collaborate with the study carried out in the city of Teresina/PI, in the Emergency Room of Getúlio Vargas Hospital, where 100 women 78% were between 18 and 40 years old. It is noted that the average age is the same as in this study, demonstrating the vulnerability of women between 20 and 40 years old10.

Regarding the educational level, there was a predominance of complete Elementary School - 1077 (19.09%). The predominance of complaints by women may be related to the feminine protection determined by the Maria da Penha Law. According to the survey of the National Council of Justice, carried out by judges and courts specialized in domestic violence against women cases throughout the country, from June 2010 to December 2011, there was 106.7% increase in the number of procedures established under the Maria da Penha Law, ranging from the opening of investigations to the initiation of criminal proceedings and protective measures12.

The data found are similar to the study carried out, in which 446 reports of occurrence registered at the women's police station in Ribeirão Preto/SP were analyzed. Regarding the education level, 166 women had completed Elementary School (37.22%). It is important to emphasize that the analysis of the education item was impaired by the lack of information in the notification forms, most of which were ignored, 2411 (42.73%). It is worth noting that the level of education is a very important factor, both (and especially) in terms of women's health and to broaden the discussion on the subject6. The region with the highest number of reported cases was the Sumarezinho district, with 1423 cases (25.22%), followed by Simioni, with 1366 cases (24.21%).
Violence seems to be not only linked to the poverty, social and cultural inequality. These phenomena are profoundly marked by the prejudice, discrimination, and abuse of power of the aggressor towards the victim due to their peculiarities, which is in a situation of vulnerability in the social relation11.

Regarding the type of violence, it was verified that the psychological/moral violence stood out with 4640 (82.33%) cases, followed by physical violence, with 2792 (49.48%) events. A study carried out in São Paulo and Zona da Mata in Pernambuco confirms the prevalence of psychological violence, 37.6% of cases in São Paulo, 32% in Zona da Mata, followed by physical violence, which occurred only once for 37.9% % of women in São Paulo, and 35.2% in the Zona da Mata de Pernambuco 13.

As for the way of aggression, it was verified that the threat factor was highlighted with 3705 (65.66%) cases, followed by body strength/beating, with 2215 (39.25%) cases. The prevalence in relation to the threat factor was also confirmed in another study in a basic health unit in Porto Alegre/RS, in which of the 251 women studied, 139 (55%) reported having suffered at least one episode of insult, humiliation, intimidation or threats from the partner; a factor followed by 96 (39%) women who suffered from slaps, pushes, punches, kicks, beatings, strangling and the use of firearms14.

The main aggressor was the spouse with 26.44 (46.85%) cases, followed by ex-spouse, with 1100 (19.49%) records. The data obtained are similar to the study carried out in the city of João Pessoa/PB, whose sample consisted of 260 women (130 assaulted and 130 non-assaulted). The main aggressor of the 130 women assaulted was the partner /spouse with 58.5% of the cases, followed by the former partners with 31.5% of the cases15.

This confirms that violence against women is closely associated with the category of domestic and marital violence. In this way, it is understood that it is a private problem with a phenomenon invisible as a social and public health problem.

Regarding the referral of the person assisted to other sectors, most women are referred to the DEAM, in 4546 (80.56%) of the cases. The existence of the DEAM is the construction of an ordering of differentiated values ​​that allow different listening and looking at the male parameter of understanding of violence, that is, these police stations must have delegates and police officers trained women in relation to the specificities that characterize violence against women, as well as the broader understanding of their contexts in which it occurs. In the same way, the service in the DEAM should favor the denunciations, as opposed to the common police stations16.

The recognition of the marital violence suffered by the woman who arrives at the health service is still a challenge for some professionals. It is necessary that they understand domestic violence against women as a multifaceted phenomenon, breaking cultural stereotypes or even pre-judgments that can permeate the care of victims17,18.

It should be noted that completing the notification form does not constitute a daily practice of the health service. The results of a study carried out in the state of São Paulo show that the completion of compulsory notification is not yet fully incorporated into the routines of health services that deal with cases of violence against women in the State of São Paulo17,19.

Thus, it is essential to manage health services that seek to insert routine notification, using strategies of qualification of professionals in service that contemplate the relevance of the notification, its process of completion and flow17. Such records are essential for the study of the phenomenon of violence, contributing to the improvement of managerial and care quality, as well as providing subsidies for teaching, epidemiological research and victim advocacy in criminal cases.

 

CONCLUSION

In this investigation, it was realized that the problem of domestic violence against women is a real and daily fact, faced by a significant number of women. This type of violence constitutes a public health problem due to the high rates of morbidity in the world, which is not only related to social factors, but also to cultural factors.

Thus, it was possible to identify the profile of women victims of domestic violence in the city of Ribeirão Preto, and in 2011 there was the highest number of cases of violence against women aged 30 to 39 years old. The psychological/moral violence was highlighted, in which the threat was the main means of aggression, the spouse being the predominant aggressor. The physical violence came in second place.

The omission of certain information is highlighted among the difficulties faced in this investigation, considered substantial for the analysis. Ignored and blank items, completion of the notification in SINAN, compromise the accuracy, dependability, and reliability of the registry and consequently of the studies that use them as secondary sources.

It is important for health professionals and other professionals involved to be able to respond and identify situations of domestic violence against women, provide support and respect the secrecy and decisions of women in the event, as well as stimulate and promote women's access violence against health services and protection against domestic violence. In this way, health education, compulsory notification, and the accuser's denunciation as the best means of avoiding the emergence of new cases become paramount.

 

REFERENCES

1.Fernandes RAQ, Narchi NZ, organizers. Nursing and Women's Health. In: Penha LHG, Santos NC. Violence against women. Barueri (SP): Manoele; 2007. p. 171-89.

2. Ministry of Health (Br). Prevention and treatment of injuries resulting from sexual violence against women and adolescents: technical standard. [internet site]. Brasília (DF),2012,[cited on September 08, 2016]. Available on: http://bvsms.saude.gov.br/bvs/publicacoes/prevencao_agravo_violencia_sexual_mulheres_3ed.pdf

3.Cavalcanti SV. Domestic violence against women and the performance of the public ministry after the advent of the Maria da Penha Law. [internet site].Belo Horizonte (MG): MPMG Legal; 2008 [cited on September 26, 2016]. 3(2):48-52. Available on: http://aplicacao.mp.mg.gov.br/xmlui/bitstream/handle/123456789/724/11.%20A%20viol%C3%AAnica%20dom%C3%A9stica%20contra%20a%20mulher.pdf?sequence=1

4.Saliba O, Garbin CAS, Garbin AJI, Dossi, AP. The responsibility of the health professional regarding the notification of cases of domestic violence. Rev. Saúde Pública. [Scielo-Scientific Electronic Library Online]. 2007 [cited on September 18, 2016]; 41(3):472-7. Available on: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102007000300021&lng=en&nrm=iso >. ISSN 1518-8787. http://dx.doi.org/10.1590/S0034-89102007000300021

5.Ferraz MIR, Lacerda MR, Labronici LM, Maftum MA, Raimondo ML. Nursing care for victims of domestic violence. Cogitare enferm. [Scielo-Scientific Electronic Library Online]. 2009 [cited on October 6, 2016]; 14(4):755-9. Available on: http://.scielo.br/prc

6.Leoncio KL, Baldo PL, João VM, Biffi RG. The profile of victimized women and their abusers. Rev enferm UERJ. 2008 [cited on September 18, 2016]; 16(3):307-12. Available on: http://www.facenf.uerj.br/v16n3/v16n3a02.pdf

7.Minayo MCS, Souza ER. Is it possible to prevent violence? Reflections from the public health area. Ciênc saúde coletiva. [Scielo-Scientific Electronic Library Online]. 1999 [cited on November 19, 2016]; 4(1):7-23. Available on: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81231999000100002&lng=en&nrm=iso >. ISSN 1413-8123. http://dx.doi.org/10.1590/S1413-81231999000100002

8. Federal government (Br). Law nº 11.340, August 7, 2006. It creates mechanisms to curb domestic and family violence against women. [internet site]. Brasília (DF). [cited on September 08, 2016]. Available on: http://www.planalto.gov.br/ccivil_03/_ato2004-2006/2006/lei/l11340.htm

9. Presidency of the Republic (Br). Secretariat of Policies for Women. Maria da Penha Law: Law 11.340 of August 7, 2006: [internet site]. Brasília (DF). 2012. [cited on November 06, 2016]. Available on: http://www.compromissoeatitude.org.br/wp-content/uploads/2012/08/SPM-publicacao-Lei-Maria-da-Penha-edicao-2012.pdf

10.Monteiro CFS. Violence against women treated in emergency unit: a contribution of nursing. Esc Anna Nery. [Scielo-Scientific Electronic Library Online]. 2006 [cited on August 08, 2016]; 10(2):273-9. Available on: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1414-81452006000200015&lng=en&nrm=iso >. ISSN 1414-8145. http://dx.doi.org/10.1590/S1414-81452006000200015

11.Lourenço Ribeiro DK, Duarte JM, Lino KC, Fonseca MRCC. Characterization of women who suffer domestic violence in the city of São Paulo. Collective Health. 2009 [cited on August 08, 2016]; 6(35):264-8. Available on: http://www.redalyc.org/articulo.oa?id=84212201003.

12.Governo Federal (Br). Special policy office for women. Maria da Penha Law. [internet site]. Brasília (DF). 2013 [cited on August 08, 2016]; Available on: http://www.spm.gov.br/lei-maria-da-penha

13.Schraiber LB, Oliveira AFPL, França-JR I, Diniz S, Portella AP, Ludermir AB, et al. Prevalence of violence against women by her partner in Brazilian regions. Rev Saude Publica. [Scielo-Scientific Electronic Library Online]. 2007 [cited on August 07, 2016]; 41(5):797-807. Available on: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102007000500014&lng=en&nrm=iso >. ISSN 1518-8787. http://dx.doi.org/10.1590/S0034-89102007000500014

14.Kronbauer JFD, Meneghel SN. Profile of gender violence perpetrated by a partner. Rev Saude Publica [Scielo-Scientific Electronic Library Online]. 2005 [cited on August 15, 2016]; 39(5):695-701. Available on: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102005000500001&lng=en&nrm=iso >. ISSN 1518-8787. http://dx.doi.org/10.1590/S0034-89102005000500001

15.Rabelo PM, Caldas Junior AF. Violence against women, family cohesion, and drugs. Rev Saude Publica. [Scielo-Scientific Electronic Library Online]. 2007 [cited on August 15, 2016]; 41(6):970-8. Available on: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102007000600012&lng=en&nrm=iso >. ISSN 1518-8787. http://dx.doi.org/10.1590/S0034-89102007000600012

16.Bandeira LM. Gender violence: the construction of a theoretical and research field. Soc estado. [Scielo-Scientific Electronic Library Online]. 2014 [cited on December 08, 2016]; 29(2):449-69. Available on: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-69922014000200008&lng=en&nrm=iso >. ISSN 0102-6992. http://dx.doi.org/10.1590/S0102-69922014000200008

17.Gomes NP, Bonfim ANA, Barros RD, Silva Filho CC, Diniz NMF. Confronting conjugal violence within the family health strategy. Rev enferm UERJ. 2014 [cited on December 07, 2016]; 22(4):477-81. Available on: http://www.facenf.uerj.br/v22n4/v22n4a07.pdf

18.Souza MH. Completion of compulsory notification in health services serving women who suffer sexual violence. Rev bras epidemiol [Scielo-Scientific Electronic Library Online]. 2015 [cited on December 08, 2016]; 18(1):94-107. Available on: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1415-790X2015000100094&lng=en&nrm=iso >. ISSN 1980-5497. http://dx.doi.org/10.1590/1980-5497201500010008

19.Silva CD, Gomes VLO. Oliveira DC, Amarijo CL. Acosta DF, Mota MS. Representation of domestic violence against women among health professionals: age as an attribute of differentiation. Rev enferm UERJ. 2016 [cited on December 07, 2016]; 24(3):01-6. Available on: http://www.facenf.uerj.br/v24n3/v24n3a01.pdf