Intimate partner violence among speaking immigrant adult Portuguese women in Canada.

OBJECTIVE: This study was conducted to understand the experiences of intimate partner violence among women from Portuguese-speaking countries living in the Greater Toronto Area. METHOD: A social phenomenological study was conducted with ten Portuguese-speaking women who had experienced intimate partner violence who were selected by community centre leaders. The interviews were transcribed, translated and analysed by categories. RESULTS: The consequences of violence included health problems, effects on children, and negative feelings among the victims. Factors preventing the women from leaving abusive partners included religious beliefs, challenging daily jobs, and the need to take care of their husband. Factors that encouraged them to leave included getting support and calling the police. Some women expressed hope for the future either with their husband. Others, desired divorce or revenge. Their plans to rebuild their lives without their husband included being happy, learning English, and being financially stable. CONCLUSION: Using these findings can implicate in the improvement of care for these women.

Older Brazilian women's experience of psychological domestic violence: a social phenomenological study.

BACKGROUND: Domestic violence is a global public health issue, as it is in Brazil. The psychological violence is one of the most prevalent forms of domestic violence, affecting more women than men. However, many older adults do not consider it as a type of domestic violence. In addiction, psychological violence has received little attention from researchers. So, this study aims to further understand the phenomenon of psychological domestic violence perpetrated by relatives against older adult women (60 years and older). METHODS: A qualitative study was conducted using a social phenomenological approach proposed by Alfred Schütz. In-depth interviews were conducted with 11 older Brazilian women from three different agencies, two in Campina Grande and one in São Bernardo do Campo. Data collection took place between November 2012 and February 2013. We performed data analysis using the key concepts (such as the world of everyday life, natural attitude, intersubjetivity, stock of knowledge, biographical situation, social action, motivation and typification) proposed by Alfred Schutz. RESULTS: Despite the fact that participants reported being psychologically abused, they also referred to being neglected and financially abused. They revealed being threatened, disrespected, neglected, financially abused, forced to do housework, and humiliated. Older women expressed feelings of sadness, anger, grief, and fear, which had negative effects on their health. Attempts by the participants to change their current situations were unsuccessful and resulted in feelings of helplessness. The abuser's behaviour will change, and leaving the abusive situation were two possible outcomes pointed for participants. CONCLUSIONS: A support network is crucial to help changing the behaviour of aggressors and/or to help older adult women leave the abusive situation. Further research is needed to understand the risk factors linked to abuse behaviours, to develop educational programs for the abusers, and to design social support for the victims.

Factors Associated With Elder Abuse According to the Levels of Social Determinants in Brazil.

OBJECTIVE: The aim of this study was to analyze the factors associated with elder abuse according to the levels of social determinants. METHODOLOGY: This is a quantitative and multicentric study, with a cross-sectional cut. It was developed in two teaching hospitals in Paraíba, Brazil, with 323 older adults, from July 2019 to February 2020. Data were collected using the Hwalek-Sengstock Elder Abuse Screening Test and Conflict Tactics Scale-1 and then analyzed using descriptive and inferential statistics. RESULTS: There was a significant association between risk for violence and female gender (p = 0.004), residing with grandchildren (p = 0.025), and having four or more comorbidities (p < 0.00). Physical violence was associated with income (p = 0.048). A positive correlation was observed between the number of comorbidities and the risk for violence score (p < 0.001), psychological violence (p = 0.004), and physical violence (p = 0.005). The probability of presenting a risk to violence increased by 2.08 times for women, 1.03 times for those who were illiterate, and 7.03 times for those with four or more comorbidities. CONCLUSION: The social determinants of health that integrate the macrosystem, such as income and number of comorbidities, correlate with situations of violence.

[Elderly women: revealing their experiences and care needs]. / Mulheres idosas: desvelando suas vivências e necessidades de cuidado.

This qualitative study used a social phenomenology approach to elucidate the experiences, care needs and expectations of the elderly women. Nine elderly women were interviewed between February and May 2011 using a semi-structured questionnaire. The elderly women referred to their physical, mental, and social limitations. They valued ​​the preservation of their autonomy in daily activities and in self-care and considered their families to be a fundamental support. They had expectations of remaining healthy, pursuing leisure activities, and having improved access to healthcare information and treatment. The absence of prospects at this stage of life was related to the loss of significant people and the loss of health. The results of this study reveal important aspects of the experiences of elderly women and encourage further research and improvement in teaching, clinical practice and management policies in relation to the needs of these women.

Elder abuse: a conceptual analysis.

OBJECTIVE: to analyze the concept of elder abuse and identify its respective antecedents, attributes and consequents. METHODS: this is a conceptual analysis according to Walker and Avant's proposition. The search for the concept was mediated by an integrative review in the LILACS, PubMed, CINAHL, Web of Science and BDENF databases. RESULTS: as antecedents, female, family member, low social support and low income or socioeconomic conditions stand out. Attributes were threats and/or intimidation, intentional use of physical force, using resources without authorization, unwanted sexual activity, offering low insufficient amount of nutrients for older adults and not meeting older adults' affective/emotional needs. Consequents were psychological disorders, dependence on aggressors, environment of insecurity and damage/loss of human rights or human dignity. FINAL CONSIDERATIONS: the phenomenon under discussion is broad and multifaceted, suggesting expansion of studies related to the theme in order to explore it in detail.

The relationship of general, physical, and psychological violence with depressive symptoms and cognition in elders (cross-sectional study).

OBJECTIVES: to analyze the relationship of general, physical, and psychological violence with depressive symptoms and cognition in the elderly. METHODS: quantitative, cross-sectional study, carried out with 323 elders from the Brazilian northeast. Data collection used a sociodemographic instrument; the Conflict Tactics Scales Form R; the Geriatric Depression Scale; and the Mini-Mental State Examination. The analysis employed descriptive and inferential statistics. RESULTS: as violence increases, so do the depressive symptoms; the opposite was true when comparing violence with cognitive involvement. There is a correlation between physical and psychological violence and depressive symptoms; more depressive elders are from 1.96 to 3.00 times more likely to be the victims of psychological and physical violence, respectively. CONCLUSIONS: general, physical, and psychological violence is associated with depressive symptoms; those with less cognitive alterations are more vulnerable to abuse. Elders with depressive symptoms are more likely to suffer psychological and physically violence.

Risk of violence and frailty syndrome among older adults treated at a hospital service.

OBJECTIVES: to assess the association between risk of violence and frailty syndrome among hospitalized older adults. METHODS: quantitative, analytical and cross-sectional research, carried out with older adults in two university hospitals. Data collection was performed using the Brazil Old Age Schedule, Hwalek-Sengstock Elder Abuse Screening Test and Edmonton Frail Scale instruments. It was analyzed using descriptive statistics and inferential statistics. RESULTS: risk of violence was higher among women (68.9%), over 70 years old (64.7%), with more than 3 years of study (68.9%), without relationship (67.1%), who do not work (65.1%) and with income above 1 minimum wage (65.2%). There is a significant association between risk of violence and frailty (72.3%; p<0.001) and a positive correlation between the instrument scores (r=0.350; p-value<0.001). CONCLUSIONS: risk of violence was associated with being female and frailty. The study is expected to encourage further discussions related to the theme and nursing practice.

Management of overweight and obesity in children and adolescents by nurses: a mixed-method study.

OBJECTIVE: to analyze the management of overweight and obesity in children and adolescents by nurses of the Family Health Strategy. METHOD: this is a study of convergent parallel mixed methods, developed in Health Centers of a municipality in northeastern Brazil. In the quantitative stage, data were collected from a questionnaire applied to 98 nurses and analyzed by descriptive statistics. For the qualitative stage, semi-structured interviews were conducted with seven nurses, interpreted by inductive thematic analysis. The quantitative and qualitative results were integrated and presented by a joint display. RESULTS: most nurses rarely checked waist circumference (77.6%), dyslipidemia (55.7%), blood glucose (42.3%), and neither evaluated blood pressure (75.3%). In the qualitative results, we identified that there are nurses who did not classify body mass index according to sex and age. As for medical tests, the requests were mainly related to the routine of childcare. Guidance on physical activity and diet were given in a basic way or attributed to other professionals, and referrals to other services or professionals were not followed up. CONCLUSION: it is imperative to train nurses for the management of overweight and obesity in primary care for children and adolescents, with a view to quality of care for the prevention of comorbidities. KEYPOINTS: (1) There are weaknesses in the management of obesity in children and adolescents by nurses. (2) A mixed method was adopted, which is new and has understanding and inference in a single study. (3) The study suggests the development of specific protocols for nurses. (4) The research suggests continuing education actions for nurses. (5) With proper management, it will be possible to reduce this morbidity and comorbidities.

Functioning of the citizen's electronic medical records in the prison system. / Funcionamento do prontuário eletrônico do cidadão no sistema prisional.

This paper aimed to describe the implementation and operation of the e-SUS AB strategy in the Prison Primary Care Teams in Paraíba. A qualitative study was conducted through semi-structured interviews with 21 professionals, doctors, and nurses, from 11 primary care teams in prisons in Paraíba and the health management of the Penitentiary Administration Secretariat. A semi-structured roadmap was adopted for the interviews from the script previously established by the Ministry of Health for the implementation of the e-SUS AB system, which resulted in three thematic categories after being transcribed and analyzed per Bardin's content analysis proposal: the health information system and the prison setting; management actions for the implementation of the e-SUS AB and; skills and competencies of professionals to use the e-SUS AB system. The e-SUS AB was implemented in the prison system with some obstacles concerning the physical and technological structure of the setting, the insufficient professional training, and the lack of skills with information technologies highlighted by the respondents. People feel the need to implement the citizen's electronic medical records to ensure continuity of care for people deprived of liberty.

O artigo teve como objetivo descrever a implantação e funcionamento da estratégia e-SUS AB nas Equipes de Atenção Primária Prisional na Paraíba. Foi realizado estudo de abordagem qualitativa, por meio de entrevistas semiestruturadas, com 21 profissionais, médicos e enfermeiros, de 11 equipes de atenção básica prisionais da Paraíba, além da gerência de saúde da Secretaria de Administração Penitenciária. Para as entrevistas, adotou-se um roteiro semiestruturado, elaborado a partir do roteiro previamente estabelecido pelo Ministério da Saúde para implantação do sistema e-SUS AB. Após transcritas e analisadas segundo a proposta de análise de conteúdo de Bardin, resultaram em três categorias temáticas: o sistema de informação em saúde e o cenário prisional; ações da gestão para implantação do e-SUS AB; e habilidades e competências dos profissionais para manuseio do sistema e-SUS AB. O e-SUS AB foi implantando no sistema prisional com alguns entraves relacionados à estrutura física e tecnológica do cenário, à insuficiência de capacitações profissionais, além da falta de habilidade com tecnologias da informação destacadas pelos entrevistados. As pessoas sentem a necessidade de implantação do prontuário eletrônico do cidadão para garantir a continuidade do cuidado às pessoas privadas de liberdade.

Preservation of forensic traces by Nursing in emergency services: a scoping review. / Preservação de vestígios forenses pela enfermagem nos serviços de emergência: revisão de escopo.

OBJECTIVE: to map the scientific production on the preservation of forensic traces by Nursing professionals working in emergency services. METHOD: a scoping review, with searches for studies carried out in six databases, in the gray literature available in Google Scholar and in the references of the studies selected. For analysis, the data reduction method was adopted. RESULTS: 26 studies were included, organized into five categories: 1) Nursing professionals' knowledge on the preservation of forensic traces; 2) Procedures performed by Nursing to preserve traces in the victim's body; 3) Procedures performed by Nursing to preserve traces in the victim's belongings/objects; 4) Procedures performed by Nursing to document traces; and 5) Actions to maintain the chain of custody performed by Nursing. CONCLUSION: the studies showed situations in which the emergency nurse may act in the preservation of forensic traces present in the victim's body and in objects, as well as in the registration of traces, verifying the role of Nursing to ensure integrity of the chain of custody, especially in situations of aggression, firearm injury, sexual violence, child abuse and assistance to trauma victims.

Assessment tools for elder abuse: scoping review.

OBJECTIVE: to map assessment tools for elder abuse and determine the psychometric properties of each one. METHOD: scoping review developed according to recommendations of the JBI Institute Reviewer's Manual in databases and gray literature. RESULTS: seventeen tools were identified for measuring situations of elder abuse. They were categorized into 1) Tools for assessment of risk for abuse, and 2) Tools for identification of abuse. According to risk for abuse, Vulnerability to Abuse Screening Scale was the most prevalent in the literature, with factorial analysis acceptable through four domains, and good internal reliability (0,74). Therefore, Assessment Tool for Domestic Elder Abuse comprises the assessment of six types of elder abuse; however, the study shows psychometric limitation since the internal structure was not evaluated by validity evidences. CONCLUSION: seventeen tools to determine the occurrence or risk for elder abuse were identified with different psychometric properties. We recommend the use of more than one of the tools identified for an appropriate measurement of elder abuse situations given the complexity of the phenomenon and the lack of a single instrument that contemplates all its consequences and forms of expression.

Violence against children and adolescents: nurse's actions in primary health care.

OBJECTIVES: to analyze the role of nurses in suspected or confirmed cases of violence against children and adolescents in Primary Health Care. METHODS: an analytical research, with a qualitative approach. Thirty nurses participated in the study, and data were collected by means of an individual form and a semi-structured interview. The data received lexicographic analysis by the software IRaMuTeQ (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) organized by Bardin's content analysis. RESULTS: five categories emerged, in which it was possible to consider that the nurses' approach in cases of violence was based on the identification of violence through physical examination during nursing consultations, health promotion actions in the school environment, request for support from the multi-professional team, and transfer of responsibilities. FINAL CONSIDERATIONS: it is inferred that the fragility in the professional training of nurses to address situations of violence against children and adolescents produces deficits in comprehensive care for victims.

Social Representations of nurses on the approach to children and adolescents who are victims of violence.

OBJECTIVE: to analyze social representations from the perspective of the structural aspect about the nurses' approach to children and adolescents who are victims of violence, comparing primary, secondary and tertiary health care services. METHOD: an analytical research study with a qualitative approach under the methodological theoretical framework of the Theory of Social Representations from the Central Core Theory. A total of 76 nurses participated in the study: 30 from primary care, 16 from secondary care and 30 from tertiary care. A semi-structured interview was applied using a pre-defined script and similarity analysis using the Interface of R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software. RESULTS: structurally, the maximum tree revealed the central core in the upper right quadrant, the first peripheral zone in the upper left quadrant; the second peripheral zone in the lower left quadrant; and the silent zone in the lower right quadrant. The ten branches of the maximum tree emerged from the following terms: hit, leave, approach (n), receive, approach (v), remember, tell, spend, pass, caution, mom. CONCLUSION: the social representations on the nurses' approach in primary, secondary and tertiary care health services evidenced common points as for the lack of notification, transfer of responsibilities, weakness in identifying situations of violence and the need for training.

Influence of burnout syndrome on the quality of life of nursing professionals: quantitative study.

OBJECTIVE: To estimate the prevalence and factors associated with the burnout syndrome and quality of life among nursing professionals. METHODS: Cross-sectional, analytical study, developed with 83 professionals in emergency care units in the city of Campina Grande-PB. A questionnaire was used to characterize the sample, the Maslach Burnout Inventory scale and the SF-36. Data was analyzed using descriptive and inferential statistics. RESULTS: Most professionals showed low professional effectiveness (78.3; n=65), average depersonalization (53.0%; n=44) and average emotional exhaustion (55.4%; n=46). There was a statistical difference between the scores of the syndrome and the pain (p=0.03), vitality (p=0.04) and social aspect (p=0.03); significant correlation between the syndrome and vitality (p<0.001), mental health (p=0.01) and general quality of life (p=0.04). CONCLUSION: The burnout syndrome has an influence on the outcome of quality of life of nursing professionals, being more prevalent among professionals with older age, high income and among nurses.

Interventions to prevent elder abuse in the community: a mixed-methods systematic review.

OBJECTIVE: To identify the interventions proposed in the literature aimed at preventing elder abuse among community-residing elders. METHOD: This was a mixed-methods systematic review that followed the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols checklist. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews. We included studies published between January 2004 and December 2019 in the databases: LILACS, IBECS, CUMED, CINAHL, MEDLINE and SciELO. The methodological quality of each study included was performed using the Mixed Methods Appraisal Tool. RESULTS: Seven studies formed the final sample. Two groups emerged after the analyses: the primary level intervention group, which used health education and coexisting elder abuse groups; and the secondary intervention level, focused mostly on the mental health care of victims of elder abuse. CONCLUSION: There is still a shortage of intervention studies to prevent elder abuse. All the studies selected had a positive outcome, and all interventions can be implemented in nursing care practice.

Violence among community elderly and its relationship with the nutritional status and sociodemographic characteristics.

OBJECTIVE: To verify the prevalence of violence among elderly community members and its relationship with nutritional status and sociodemographic characteristics. METHOD: Cross-sectional and analytical study developed with 159 community elderly registered at a Family Health Unit in Recife/Pernambuco between March 2016 and March 2017. The Brazil Old Age Schedule, Conflict Tactics Scales and Mini Nutritional Assessment were used as data collection instruments. Data received descriptive and inferential statistical treatment. RESULTS: Among the elderly classified as with violence, there was a predominance of psychological violence (64.3%), and the majority were at risk for malnutrition (54.3%). There was an association between 'having a partner' and psychological (48.1%; p=0.02) and physical (48.1%; p=0.03) violence. Logistic regression demonstrated that being in a relationship or being malnourished increases the likelihood of suffering psychological violence (OR=2.63; OR=3.67), just as not being working increases the likelihood of physical violence (OR=5.61). CONCLUSION: Violence was negatively related to the nutritional status of elderly community members.

Risk of violence and functional capacity of hospitalized elderly: a cross-sectional study.

OBJECTIVE: To analyze the risk of violence associated to functional capacity and sociodemographic characteristics of hospitalized elderly. METHOD: Quantitative, cross-sectional, multicenter study conducted with elderly receiving care at university hospitals of the municipalities of João Pessoa and Campina Grande, in the state of Paraíba, Brazil. The scales Katz and Hwalek-Sengstock Elder Abuse Screening Test were applied. The data was analyzed through descriptive and inferential statistics using Chi-squared Pearson test, Spearman correlation test, and multiple logistic regression. RESULTS: The participating elderly amounted to 323. The risk of violence was predominant among female elders aged 60 to 70 who are unable to read or write, live with someone, perform no labor activity, and whose income is higher than a minimum wage. Elders who were dependent for basic and instrumental activities presented a 2.11 score (Confidence Interval = 1.22-3.64; p = 0.000) and 1.70 (1.01-2.85; p = 0.044) and a higher risk of violence. CONCLUSION: Elders who depended on other people to perform both complex and basic activities are the most exposed to situations of violence.

Factors associated with the risk of violence against older adult women: a cross-sectional study.

OBJECTIVE: to identify the factors associated with the risk of violence against older adult women. METHOD: this is a quantitative, analytical, and cross-sectional research conducted with 122 older adult females in the city of Recife, state of Pernambuco, Brazil. Data collection was carried out using validated instruments adapted to Brazil. The analysis was performed using descriptive statistics (absolute and relative frequency) and inferential statistics (Pearson's chi- square, Spearman's correlation test, and Multiple Logistic Regression). RESULTS: there was prevalence of a risk of abuse against older adult women under 70 years of age, literate, without a stable relationship, living alone, without any work activity, and who had an income higher than the minimum wage. There is a significant association between the risk of violence among older women with a higher number of chronic health conditions (24; 77.4%), and who are less active in advanced activities (42; 70.0%). A reduction in quality of life and satisfaction with life, and the onset of depressive symptoms, increase the risk of violence. CONCLUSION: multimorbidity, low functional capacity, depressive symptoms, low quality of life and low satisfaction with life, a high number of chronic conditions, depressive symptoms, and functional dependence to perform daily activities can be conditioning factors for the emergence of abuse against older adults.

Factors associated with depressive symptoms and cognition in elderly victims of violence.

OBJECTIVE: To identify, among elderly people victims of violence, factors associated with depressive symptoms and cognitive function. METHOD: This was a cross-sectional study carried out with 56 elderly people classified in situation of violence. To do so it was used the Brazil Old Age Shedule (BOAS), the Conflict Tactics Scales Form R, the Geriatric Depression Scale (GDS) and the Mini-mental State examination (MMSE). RESULTS: Depressive symptoms were more predominant in elderly men, over 70 years old, without partner, illiterate, with no job, receiving up to 1 minimum wage and who lived alone; and the cognitive deficit prevailed in women, over 70 years old, without partner, illiterate, who did not work, receiving up to 1 minimum wage and who lived alone. CONCLUSION: Among the elderly population victim of violence, lack of a partner and cognitive impairment were associated to depressive symptoms; and finding themselves living alone, with no partner and being illiterate were associated to cognitive deficit.

Frailty Syndrome: A Risk Factor Associated With Violence in Older Adults.

OBJECTIVE: The objective of this study was to analyze the association between frailty syndrome as a risk factor associated with violence in older adults. METHOD: A cross-sectional study, carried out with older adults, in an emergency care unit of a northeastern Brazilian city was conducted. Three instruments were used: a form for sample characterization (i.e., demographics) and two more scales, namely, the Edmonton Frail Scale and the Hwalek-Sengstock Elder Abuse Screening Test. The results were analyzed through descriptive and inferential statistics, using chi-square or Fisher's exact tests, Spearman's correlation test, and simple logistic regression. RESULTS: The sample included 146 older adults who were over 70 years old (56.6%), male (56.2%), and at risk of violence (69.86%). Among the categorical variables, there was an association between risk and being of a higher age (80.7%, p < 0.001), unemployed (73.7%, p < 0.05), having more than six children (80.8%, p < 0.05), and frail older adults (88.1%, p < 0.001). There was a correlation (p < 0.05) between the numerical variables of the scales of violence and frailty, with a coefficient of 0.40. The simple logistic regression model showed that frailty syndrome increases the risk of violence among older adults. CONCLUSIONS: It was concluded that frailty is a factor that increases the occurrence of risk of violence and provides information to guide nursing action in the field of forensic sciences.