Violence against women in Primary Health Care: Potentialities and limitations to identification.

OBJECTIVE: To determine the potential and limitations of Primary Health Care professionals to identify situations of violence against women. LOCATION: A municipality of Rio Grande do Sul, Brazil. DESIGN: Descriptive and exploratory study with a qualitative approach. PARTICIPANTS: Twenty-one health professionals of three Family Health Strategy units, as well as one Basic Health Unit. The inclusion criterion consisted of being a health worker in these services. The exclusion criterion was to be absent from work by any kind type license during the period of data production. METHOD: The technique used to produce data was individual, semi-structured, interviews in order to collect sociodemographic data and the monitoring by professionals related to the potentials and limitations to identify violence situations. The data collection was suspended based on the saturation criterion. The data were systematized and analyzed by the content analysis technique, according to the analytical categories of health care network and gender. RESULTS: The potential to identify themes were: professional experience, receptive atmosphere, bonding, and listening to the reports of women, children and/or neighbors and observing their behavior; to identify the lesions; prenatal consultations; and home visits. As to the limitations: silence, denial/non-recognition of violence, lack of complaints by women; fear and guilt; flaws and unpreparedness of the health team; and fear due to the presence of aggressor. CONCLUSIONS: It is urgent to recognize the potential of Primary Care and to promote the qualification of professionals in order to identify the situation among visible and invisible complaints, leading to the confrontation of violence.

Motives of abuse of psychoactive substances by women assisted in a Psychosocial Attention Center. / Motivos do abuso de substâncias psicoativas por mulheres assistidas em Centro de Atenção Psicossocial.

OBJECTIVE: To understand the reasons attributed by women to the abuse of psychoactive substances. METHOD: Qualitative approach of phenomenological nature. We interviewed 12 women users of psychoactive substances under treatment at the Center for Psychosocial Care alcohol and drugs in Southern Brazil. The interviews were conducted between may and june 2013. The data were interpreted in light of Alfred Schütz's Social Phenomenology. RESULTS: The abuse of psychoactive substances is motivated by the influence of the people with whom the women have a relationship or with whom they have lived. Still, the losses and the family conflicts experienced were also a trigger for the abuse of psychoactive substances. CONCLUSION: Women's health care needs to meet beyond demands, since they must take into account the life history of these women.

Revealing an HIV diagnosis for children and adolescents: subsidy for the practice of care. / Revelação do diagnóstico de HIV para crianças e adolescentes: subsídios para prática assistencial.

OBJECTIVE: To collectively build a guide for following-up on HIV diagnosis disclosure to children and adolescents in a specialized service. METHOD: Convergent-care research approach with observation triangulation, interview and groups, conducted from May to June 2015 with seven health professionals in a pediatric outpatient clinic for infectious diseases. Thematic content analysis was developed. RESULTS: The discussion of understanding the disclosure, its triggers, actors involved, used strategies, and limits and possibilities listed by the professionals subsidized the construction of a guide to be applied in the stages: analyzing children's questions and curiosities; evaluating their cognitive ability; discussing the reasons to reveal; listing the professionals involved on follow-up process; including family; developing strategies for disclosure. CONCLUSION: This guide may mediate changes in care practice to ensure the child's rights and to make the professionals co-accountable.

Instruments for articulating the network of attention to women in situation of violence: collective construction. / Instrumentos para articulação da rede de atenção às mulheres em situação de violência: construção coletiva.

OBJECTIVE: This paper aims at identifying all the necessary information to build instruments which are designed to facilitate the professional integration of services to women in situation of violence with a view to the establishment of a network of attention. METHOD: Qualitative study, convergent, whose information has been produced from February to August 2015 by 10 group meetings, with 32 participants from the Integrated Working Group to Confront Violence in Santa Maria-RS, located at the Universidade Federal de Santa Maria. Using thematic content analysis. RESULTS: It defined the flow direction; the points to compose the network; what it would take to communicate among services: identification of wife and family, report on the situation and the continuity of care. CONCLUSIONS: There is a need for an institutional formalization of constructed devices. The articulation between the services requires communication, involvement and commitment of the professionals to ensure the continuity of care.

Health care for women in situations of violence: discoordination of network professionals.

OBJECTIVE: To learn the conceptions and actions of health professionals on the care network for women in situations of violence. METHOD: A qualitative, descriptive, exploratory study was conducted between April and July 2015 with the participation of 21 health professionals from four primary health care teams in a city of the central region of the state of Rio Grande do Sul. Data were collected by means of individual semi-structured interviews. Content analysis was used for data systematization. RESULTS: Health professionals recognized the importance of the health care network for coping with the problem of violence against women. However, their conceptions and actions were limited by the discoordination or absence of integration among professionals and services of the care network. CONCLUSION: The conceptions and actions of health professionals contribute to the discoordination among the services. It is necessary to reflect on the daily practices of care for women in situations of violence. OBJETIVO: Conhecer as concepções e ações de profissionais de saúde sobre a rede de atenção às mulheres em situação de violência. MÉTODO: Estudo qualitativo, descritivo e exploratório, realizado no período de abril a julho de 2015. Participaram 21 profissionais de saúde de quatro equipes da Atenção Primária à Saúde em um município da região central do estado do Rio Grande do Sul. A coleta de dados ocorreu mediante entrevistas semiestruturadas e individuais. Para sistematização dos dados, empregou-se a análise de conteúdo. RESULTADOS: Os profissionais de saúde reconheciam a importância da rede de atenção à saúde no enfrentamento da problemática da violência contra as mulheres. Contudo, suas concepções e ações eram limitadas pela desarticulação ou ausência de integração entre os profissionais e serviços da rede de atenção. CONCLUSÃO: As concepções e ações dos profissionais de saúde contribuem para a desarticulação entre os serviços. Faz-se necessário refletir acerca das práticas cotidianas de cuidados direcionados às mulheres em situação de violência.

Women's autonomy in the process of labour and childbirth: integrative literature review. / Autonomia feminina no processo de parto e nascimento: revisão integrativa da literatura.

OBJECTIVE: To identify the available evidence in scientific literature on healthcare practices that interfere with the autonomy of Brazilian women in the labour and delivery process. METHOD: The search for papers was conducted in the databases LILACS, Scopus and PubMed, between 1996 and 2015, according to a guiding question and exclusion criteria, resulting in the selection of 22 papers to compose the analytic body. RESULTS: The main practices that favoured the exercise of women's autonomy were out-of-hospital care practices; care practices of support and comfort; and educational care practices. By contrast, the practices that limited autonomy were authoritarian care practices; standardised or routine care practices; care practices that intensify the painful sensation of childbirth; and impersonal and cold care practice. CONCLUSION: There was an alarming contrast between the daily healthcare routine and ministerial recommendations.

Evaluation of the quality of primary health care for children and adolescents with HIV: PCATool-Brasil. / Avaliação da qualidade da atenção primária à saúde de crianças e adolescentes com HIV: PCATool-Brasil.

OBJECTIVE: Assess the overall score of the Primary Health Care in municipalities where children and adolescents living with HIV reside, according to the PCATool-Brazil instrument, professional version. METHODS: Quantitative study with 527 professionals in 25 municipalities where children and adolescents living with HIV reside. Data collection took place between March and August 2014, by applying PCATool-Brazil instrument, professional version. In the data analysis, we used Pearson's chi-square test, the Mann Whitney test and Poisson regression. All ethical aspects were respected. RESULTS: The overall assessment of the Basic Health Unit (BHU) and the Family Health Strategy's (FHS) service quality was satisfactory (6.80). When BHU and FHS were compared, only the latter showed a high score (7.06). CONCLUSIONS: Despite the satisfactory overall score, the need to expand the FSH coverage, and encourage the promotion of competitive public service examinations and the qualification of these professionals.

["This conversation is professional, [...] I am a painter!": resistence at a construction site]. / "Aqui a conversa é profissional, [...] Eu sou a pintora!": resistência no canteiro de obra.

OBJECTIVE: to be familiar with the work relationships between females and their male colleagues at a construction site in the municipality of Santa Maria, RS. METHOD: Exploratory research, qualitative approach with a female worker of a construction site in August 2012. Oral history as a device for data production. Analysis of French tradition speech as an analytical device. RESULTS: Work relationship with stances of resistance, with major fights against power of male order, pointing to shifts and continuities in the test for new gender behaviors. CONCLUSIONS: The conquest of spaces in paid work is not enough to achieve balance in gender relations; public policies on gender sensitizing contribute to changes in the cultural field by understanding that equal rights and opportunities between men and women are a basic condition for achieving justice, citizenship and development.

[Understanding what is lived by the being-couple in face of the prophylaxis of vertical HIV transmission]. / Compreensão do vivido do ser-casal diante da profilaxia da transmissão vertical do HIV.

OBJECTIVE: To understand the couple's perspective, the experience of prevention care against the vertical transmission of HIV. METHOD: Heidegger's phenomenological research conducted with 14 participants, through interviews from December / 2011 to February / 2012 in a hospital in the countryside of Rio Grande do Sul, Brazil. Analysis performed with Martin Heidegger's framework. RESULTS the being-couple unveiled the sense of fear, initially in the variation of dread when terrified due to the HIV infection discovery, and later in the horror variation when treatment was needed during gestation and finally in the terror variation when considering the chances of viral transmission to their child. CONCLUSIONS: Health care attention that enables the couple to assume a leading role in the prophylaxis of vertical transmission is recommended, which will reflect positively on the health of pregnant women and in reducing neonatal and infant mortality as a result from AIDS.

[Care for women victims of violence: empowering nurses in the pursuit of gender equity]. / Cuidar mulheres em situação de violência: empoderamento da enfermagem em busca de equidade de gênero.

OBJECTIVES: To study the care of women victims of violence provided by nurses in emergency services and to analyse the practices that target the empowerment of women and gender equity. METHODS: A qualitative, descriptive study conducted by means of interviews with 10 nurses of an emergency and obstetrics unit of a university hospital and local emergency service of a city in southern Brazil from January to April 2013. We used thematic content analysis and defined gender as the analytical category. RESULTS: Clinical elements refer to nursing procedures and techniques. Non-clinical elements refer to conversation, listening and orientation to the women and their families. CONCLUSION: Revealing these actions is important to qualify nursing care in relation to the other health professionals and care services for women victims of violence.

Assessment of educational technology in lactation physiology by health students.

OBJECTIVES: to assess the suitability, facilitators, and barriers of using a video clip for teaching lactation physiology to health students. METHODS: a cross-sectional study was conducted with online data collection at a higher education institution, using the Assistive Technology Assessment Instrument and open-ended questions. The sample consisted of 88 students. RESULTS: the video clip was deemed suitable in all attributes. Facilitators identified included attractiveness, musicality, and ease of access. Barriers noted were the music's speed and the necessity for prior knowledge. The video clip achieved adequate scores for interactivity (1.71), purpose (1.77), relevance (1.64), and clarity (1.77). The overall average of the attributes was 1.72. CONCLUSIONS: the video clip can serve as an effective learning strategy to enhance hybrid education, potentially contributing to the promotion and support of breastfeeding. However, some barriers underscore the importance of prior knowledge for a complete understanding of the content.

Lactation physiology video clip: health professionals` assessment in hospital care.

OBJECTIVE: To evaluate the usability of a lactation physiology video clips by healthcare professionals and to identify barriers and facilitators for this usage in hospitals. METHOD: Cross-sectional study juxtaposed with the Knowledge Translation Model. The video clip was evaluated with the System Usability Scale self-applied to 63 health professionals from a university hospital in southern Brazil, from April to September 2022. Spearman's correlation test was used. RESULTS: The usability of the video clip obtained the best imaginable classification with a positive association with longer training time (p=0.038) and motivation for using it (p=0.035). The facilitators went to have institutional capacity building; physical space and moments of guidance for breastfeeding; brevity of the video clip with easy and playful information. Barriers were overcrowding and turnover, limited audiovisual equipment and internet equipment. CONCLUSION: The excellence of the usability of the video clip in the hospital highlights the potential for its application in continuing education with professionals and in health education with users. It is concluded that the longer the training time and the motivation for using technologies in daily care, the better professionals evaluate usability.

[Perception of crack users in relation to use and treatment]. / Percepção dos usuários de crack em relação ao uso e tratamento.

The aim was to know the perception of crack/cocaine users about the use and treatment in a midsize general hospital, located in Rio Grande do Sul. It is a qualitative, descriptive and exploratory research that used semi-structured interviews with eight crack users,from September to October 2010. To analyze the data, we used content analysis from which two semantic categories emerged: drug use and seeking treatment. It was evidenced that drug use initiation in adolescence is related to social access or easy economic access, excessive load on studies and work, stress and not knowing about the possibility of chemical dependency, friends and family members influences, who also influence them on seeking treatment. We conclude that it is necessary to investigate the issue of crack users better and support actions on consume reduction, prevention and education to users.

Vulnerabilities of Venezuelan refugee women: violence and intersectional social relations.

OBJECTIVE: To analyze the vulnerabilities of Venezuelan women considering their experiences of violence in refugee situations. METHOD: Qualitative study, developed with ten (10) Venezuelan refugee women in the southern region of Brazil, through individual in-depth interviews. The theoretical framework of analysis was Vulnerability, Human Rights, and Intersectionality. RESULTS: The greater the intensity of the intersection of social markers present, such as sex, racial, nationality, generation, cultural, bodily, territorial and other relations, the greater the range of vulnerable experiences in the social relations of these women, producing exclusions and violation of rights. CONCLUSION: The situations of vulnerabilities of refugee women are enhanced as more or less social markers intersect in their life experiences and established social relationships, causing impacts that allow the transition from 'vulnerable to violated subjects'. Thus, intersectional relationships were formed, either promoting oppression or producing resilience and resistance.

Reproductive planning and pregnancy of HIV serodiscordant couples: a phenomenological study.

OBJECTIVE: To understand the experience of reproductive planning and pregnancy for HIV serodiscordant couples. METHOD: Qualitative study, with phenomenological approach, theoretical-philosophical-methodological framework of Martin Heidegger. The field stage took place in a reference service in the care for people living with HIV, in southern Brazil. From an intentional sample, a phenomenological interview was conducted with 11 couples between August 2013 and April 2014. The analysis was hermeneutic. RESULTS: It was possible to understand, from the meaning units that: couples accept and overcome the serological discordance together; experiencing pregnancy is difficult; there is an effort to have a normal life; the diagnosis is silenced by prejudice and stigma; comes the couple's relief after the child's negative diagnosis. CONCLUSION: It is necessary to recognize the couple as a unit of care with a view to a non-fragmented care in the field of sexual and reproductive health.

Unveiling family relationships based on the context of domestic violence: a Grounded Theory.

OBJECTIVE: To understand the meanings attributed to family relationships by women who have experienced domestic violence. METHOD: Explanatory study using Symbolic Interactionism and Grounded Theory as references. Data were collected from March to November 2021, through online interviews with 23 women found on the social media application Facebook®. RESULTS: Data analysis allowed the construction of a theoretical model consisting of three processes: "We learned that it was normal to be mistreated": experiencing a context of violence in the family of origin; "I just wanted a family": experiencing partner violence and redefining family relationships in the context of violence. CONCLUSION: The meanings attributed to family relationships are elaborated and modified according to the interpretation, trajectory of confrontation, and interactions of women with other individuals and objects in the social web, over time. When experiencing domestic violence, women give new meaning to their feelings and begin to attribute new values, emotions, and empathy to family relationships, expanding their understanding of their weaknesses and potential.

Inter-sectorial network for assisting women in situations of violence: handicraft work built by the people.

OBJECTIVES: to discuss the meanings attributed by professionals to the construction of the service network for women in situations of violence. METHODS: Convergent Care Research developed with the application of a convergence group with 32 participants from the health, social assistance, or public security sectors, in Santa Maria, Rio Grande do Sul. The data was produced during ten meetings, based on the problematization methodology, and submitted to analysis of thematic content and interpreted with the referential of networks. RESULTS: the construction of the network is an artisanal work carried out by people continuously, permeated by bonds, communication and partnerships between services and knowledge of work processes. Lashings require permanent movement. FINAL CONSIDERATIONS: building a network implies defining intertwining lines; form nodes that create cross-sector connections. There is a need to institutionalize processes through care continuity protocols, associated with an efficient communication system between sectors.

[Adolescents under socio-educational measures: everyday ways of being and possibilities for nursing]. / Adolescente que cumpre medida socioeducativa: modos de ser no cotidiano e possibilidades para enfermagem.

This study aimed to understand the routine of the adolescent-being, who is under semi-liberty socio-educational measures. A phenomenological research was developed in unit of the Socio-Educational Treatment Foundation (Fundação de Atendimento Socioeducativo), in the state of Rio Grande do Sul, Brazil. Interviews were held with nine adolescents, from February to May, 2009. The Heideggerian analysis un-veiled that this socio-educational measure means a prison for them, something bad. They know they are not in the prison system due to their age and re-cognize they have thrown away their adolescence. In the institution, these youngsters go to school to learn something, to get some job. They express themselves through gossip, ambiguity and occupation. The conclusion is that the teenager is-thrown in that which is determined and remain in impersonality. For social reintegration they need the help of the socio-educational system, mediated by interdisciplinary work, and a support network for which the family, community and State are co-responsible.

Intentionality of women's actions in labor: a study in social phenomenology.

OBJECTIVE: to understand the intentionality of women's autonomous actions in labor. METHODS: a study in Alfred Schütz's social phenomenology, developed with 15 puerperal women admitted to a university hospital in southern Brazil. Data were collected through phenomenological interviews and analyzed according to the adopted framework and the comparison with scientific productions. RESULTS: the actions intended to receive physical and emotional support from their companions, from pregnancy, for a peaceful delivery with less pain, fast and without interventions. The intention was to do the right things for the child's well-being and, after delivery, to be painless and active to take care of their children. FINAL CONSIDERATIONS: women's actions have intentionality arising from their knowledge, which is guided by the social relationships established in the world of life.

Content validation to support the monitoring of disclosure of HIV diagnosis in childhood.

OBJECTIVES: to create and validate the content of a guide for monitoring the communication of the HIV diagnosis in childhood. METHODS: methodological study, with a design guided by the Knowledge-to-Action (KTA) Framework, supported by a participatory approach. The guide's content was structured according to the communication elements proposed by Lasswel from review studies. RESULTS: the content was validated by 26 experts from nursing, medicine, psychology and pedagogy, using a Likert-type scale for relevance, clarity and precision. Data collection took place online and achieved a Content Validity Index of 0.94. CONCLUSIONS: the guide can contribute to the practice of professionals who care for children living with HIV, to support the family in communication and to the child's right to know their diagnosis. For further research, it is recommended to create and validate the face of the technology in order to implement it.