Social support network of family members of abused children and adolescents: Perspectives and possibilities.

AIMS AND OBJECTIVES: To analyse the network of care and social support from the perspectives of family members of children and adolescents who have been abused. BACKGROUND: The theoretical-methodological background of the ecological model for understanding violence and the Paradigm of Complexity provide a broad perspective of violence. The paradigm considers all aspects that constitute a phenomenon as well as particular features. DESIGN: Qualitative research based on the Paradigm of Complexity, developed by Edgar Morin, the primary philosopher. We have adhered to the COREQ Checklist guidelines for qualitative research. METHODS: Data were collected through Minimal Maps of Personal Social Networks, and semi-structured interviews were held with 15 families who were assisted by a nongovernmental organisation in a Brazilian city. The notions of comprehension and contextualisation guided the data analysis. RESULTS: Two categories emerged from the data analyses: "Social isolation" and "Affective relationships needs." The maps revealed a weakened and limited network with low-density, homogeneous bonds and few significant bonds. Therefore, the network provided predominantly instrumental and material social support with few important effective relationships. The participants disclosed some strategies to empower their lives. CONCLUSIONS: We conclude that it is urgent to develop strategies in a broad manner to promote family empowerment, especially on education and employment dimension, and to construct supportive and respectful relationships between services and families as well. RELEVANCE TO CLINICAL PRACTICE: The present study contributes to international clinical nursing, especially in low- and middle-income countries, by discussing (a) looking at and caring for family members of children and adolescents who have been abused in a contextualised manner; (b) family empowerment, which enables them to have access to healthier environments and to educational/employment opportunities; and (c) broad comprehension of health care among the family members, which provides perspectives not only for looking at violence but also for strengthening supportive social relationships.

The care network of the families involved in violence against children and adolescents: the Primary Health Care perspective.

AIMS AND OBJECTIVES: To contribute the understanding of the network care provided to families involved in family violence against children and adolescents (FVACA), from the Primary Health Care (PHC) perspective. BACKGROUND: Children and adolescents figure among the main victims of violence around the world, which occurs predominantly in the family context. PHC-guided network care has emerged as a new process that contrasts with traditional approaches, which rely on fragmented, punctual and compensatory actions and produce simplified and segmented interventions in response to complex phenomena like violence. The Paradigm of Complexity interacts with the network care approach and, by articulating the multiple dimensions of the research phenomenon, contributes to its understanding. DESIGN: Qualitative research, based on the Paradigm of Complexity. METHODS: Data were collected through minimal maps of the external institutional social network, focus groups and semi-structured interviews held with 41 PHC professionals in Brazil. The notions of comprehension and contextualisation as well as dialogical, recursive and holographic principles from complexity theory guided the data analysis. RESULTS: The two thematic categories that emerged revealed reduced institutional networks, with low-density and homogeneous bonds, which resulted in fragmented care in all stages of the care process. CONCLUSIONS: Although the network organisation of care for the families involved in FVACA is fundamental, the construction of these networks still represents a great challenge, as it requires the joint work of a multiprofessional team. RELEVANCE TO CLINICAL PRACTICE: For nursing to respond to the contemporary care demands in a contemplative and pertinent manner, a perspective and a reference framework need to be developed, leading to broader and more contextualised actions, with a multidimensional approach to the families and communities of which child and adolescent victims of violence are a part.

Domestic violence against children and adolescents: social support network perspectives. / Violência doméstica contra crianças e adolescentes: olhares sobre a rede de apoio.

OBJECTIVE: To identify and analyze the social support network of families involved in violence against children and adolescents, from the perspective of health professionals and families in a municipality of the state of São Paulo, Brazil. METHODS: This was a qualitative strategic social study, anchored in the paradigm of complexity. Data were collected from 41 health professionals and 15 families using institutional or personal network maps, and semi-structured interviews. Analysis was conducted by organizing the data, constructing theoretical frameworks, and categorizing resulting information. RESULTS: The category "weaving the network" was unveiled, with family experiences and professionals focused on a logic of fragmentation of care. FINAL CONSIDERATIONS: The creation and implementation of public policy are urgently needed to address the needs of this population, by empowering families and communities and developing research that respects the multidimensional nature of the phenomenon.

Coping with domestic violence against children and adolescents from the perspective of primary care nurses. / Enfrentamento da violência doméstica contra crianças e adolescentes na perspectiva de enfermeiros da atenção básica.

OBJECTIVE: To analyse the actions reported by primary care nurses in the fight against domestic violence against children and adolescents. METHODS: Qualitative research conducted at five family health centres in the state of São Paulo, Brazil. Data were collected in the second half of 2013 through semi-structured. RESULTS: Two thematic cores emerged: "Public policies identified by the nurses" and "Nurses' actions regarding violence permeated by fear and conflicts". The nurses were familiar with public policies, but they were unable to put them into practice; they were unprepared to identify and cope with the violence; they did not participate in training courses; they were afraid to report the detected cases of violence. CONCLUSION: The main limitations to the practical work of nurses are work burden, lack of security, and the dynamics of work that is not articulated with the protection network, which causes the underreporting of cases of domestic violence.

Minimum Map of Social Institutional Network: a multidimensional strategy for research in Nursing.

OBJECTIVE: To analyze the use of methodological strategies in qualitative research - Minimum Maps of Social Institutional Network, as proposed to understand the phenomena in the multidimensional perspective. METHOD: Methodological theoretical essay in which we aimed to reflect on the use of innovative methodological strategies in nursing research, supported in Complex Paradigm fundamentals. RESULTS: The minimum map of Social Institutional External Network aims to identify institutional linkages and gaps for the intervention work of the surveyed institutions. The use of these maps provided important advances in know-how qualitative research in Health and Nursing. CONCLUSIONS: In this perspective, the use of minimum Social Intitutional Network maps can be stimulated and enhanced to meet the current demands of the contemporary world, particularly for its flexibility in adapting to various research subjects; breadth and depth of discussion; and possibilities with health services. OBJETIVO: Analisar o uso de estratégias metodológicas em pesquisas qualitativas - Mapa mínimo da Rede Social Institucional, como proposta para compreender os fenômenos na perspectiva multidimensional. MÉTODO: Ensaio teórico metodológico em que buscou-se refletir sobre o uso de estratégias metodológicas inovadoras de pesquisa na enfermagem, sustentada nos fundamentos do Pensamento Complexo. RESULTADOS: O mapa mínimo da Rede Social Institucional Externa tem o objetivo de identificar os vínculos institucionais e lacunas para o trabalho de intervenção das instituições pesquisadas. O uso destes mapas proporcionou avanços importantes no saber-fazer pesquisa qualitativa em Saúde e Enfermagem. CONCLUSÃO: Nessa perspectiva, o uso de mapas mínimos da Rede Social Institucional pode ser estimulado e potencializado para responder às atuais demandas da contemporaneidade, em especial pela sua flexibilidade na adequação a diversos objetos de pesquisa; amplitude e profundidade de discussão; e possibilidades de articulação com a prática dos serviços.

[Social support from the perspective of adolescent victims of domestic violence]. / O apoio social sob a ótica de adolescents vítimas de violência doméstica.

OBJECTIVE: Assess the understanding of adolescents regarding the social support received in situations of domestic violence. METHOD: A qualitative study with data collection carried out through focus groups with 17 adolescent victims of domestic violence, institutionally welcomed in Campinas-SP, and through semi-structured interviews with seven of these adolescents. Information was analyzed by content analysis, thematic modality. RESULTS: Observing the thematic categories it was found that social support for the subjects came from the extended family, the community, the Guardianship Council, the interpersonal relationships established at the user embracement institution and from the religiosity/spirituality. CONCLUSION: The mentioned sources of support deserve to be enhanced and expanded. With the current complexity of the morbidity and mortality profiles, especially in children and adolescents, the (re)signification and the (re)construction of health actions is imperative.

[Influences of intra-family relationships on the behavior of children attending public nursery schools in Alfenas]. / Influências das relações intrafamiliares no comportamento de crianças que frequentam creches públicas de alfenas.

In recent years, social organizations and families have changed leading to an increase in the nursery school demand by the population. Our aim was to understand the influences of intra-family relationships on the behavior of children ages 0-3 years old who attend nursery schools through the experiences of their child care providers. A qualitative research, using Phenomenological Approach, in which 12 child care providers of sir municipal nursery schools were interviewed. As categories: Reproduction of behaviors learned in the family atmosphere; Integration family-nursery school as a facilitator of the work carried out by the child care providers; Lack of hygienic care offered by the family. Future studies could promote improvements in the actions of caregivers towards the children's needs, leading to a better quality of life for the children and helping to develop their full potential.

[Protective factors for preventing the use of drugs in the families of a Colombia locality]. / Factores protectores de las familias para prevenir el consumo de drogas en un municipio de Colombia.

The aim of this study was to analyze the protective factors that prevent drug use in the families of children who attend Community Homes of Family Well-being in a small Colombian locality. This was a quantitative, descriptive, transversal study, with 256 families constituting the sample. Data were collected through a self-applied questionnaire throughout March and April 2007. Protective factors found included demonstrations of affection toward the children, playing with them and talking to them about things they like, open communication, decision making as a couple, flexibility of the nursing process, and establishment of rules. However, some risk factors were also found, such as consumption of legal drugs such as cigarettes and alcohol, and in a low percentage, consumption of illicit drugs. A high percentage of families consider that drug use must be prevented in the first years of life, by the parents. The protective factors found require reinforcement as they are not very strong, and the risk factors must be controlled to turn them into protective factors.

Violence in intimate relationships from the point of view of adolescents: perspectives of the Complexity Paradigm.

OBJECTIVE: To analyze adolescents' perceptions about intimate violence from the perspective of the Complexity Paradigm. METHOD: A qualitative approach configured as strategic social study. The study participants were adolescents between 15 and 18 years old, attending high school in two public schools in a city in the interior of São Paulo State, Brazil. Data collection was performed through a focus group and a semi-structured interview as a complement. Data analysis was based on the dialogical, organizational and holographic principles of the Complex Paradigm. RESULTS: The study included 39 adolescents (14 males and 25 females). Through the emerging categories, it was noticed that intimate violence occurs through dialogical affection-jealousy/control by a naturalization of violent acts which permeates gender, cultural and social issues, and by technology as preponderant for intimate violence among adolescents, denoting new forms of control and coercion. CONCLUSION: The study introduces aspects present in intimate violence among adolescents, presenting them in an articulate and interdependent way. These aspects constitute a relevant contribution to the actions of health professionals.

"I don´t have it, I didn´t have it": experiences of families involved in violence against children and adolescents.

OBJECTIVES: to characterize and analyze the experiences of families involved in domestic violence against children and adolescents, based on the Paradigm of Complexity. METHODS: qualitative research, in which data of 15 families was collected through documentary research, open interviews and field diary. The data were analyzed through thematic analysis. RESULTS: two categories "I don't have it" and "I didn't have it" emerged, revealing the historicity that marks the violence experienced in the present. They include social vulnerability, maternal burden, associated with urban violence to which families are exposed. At the same time, stories of violence by the intimate partner, as well as intergenerational violence and drug abuse have impacted the current moment. Final Considerations: nursing can contribute to attribute new meaning to violent stories woven by families, as well as to the interdisciplinary construction of perspectives and interventions that consider the multiple violence and adversities to which such a population is exposed.

Protection network in the assistance to children, adolescents and their families in situation of violence.

OBJECTIVE: To understand the performance of the protection network for children, adolescents, and their families in situations of intrafamily violence, from the perspective of professionals of the Specialized Reference Center for Social Assistance. METHOD: A qualitative study conducted with five Specialized Reference Center for Social Assistance professionals in a Pernambucan municipality. Data collection was conducted from October 2017 to January 2018 by means of a semi-structured interview, with data analyzed by the thematic content technique. RESULTS: The professionals know how the protection network works, but they see the deductive logic of the team; the lack of material resources; the difficulty of articulation; and the logistics of care flow as limiting factors for maintaining effective care. CONCLUSION: The performance of the protection network must be able to ensure the rights of children, adolescents, and their families in situations of violence, through articulated and integrated care, aiming at changing attitudes and breaking the cycle of violence.

Inter-sectoral network to face violence against children and adolescents in a rural context.

OBJECTIVE: To analyze the Primary Health Care inter-sectoral network in a rural context to face domestic violence against children and adolescents. METHOD: A qualitative research study, with the Paradigm of Complexity as theoretical and methodological framework. Eighteen health professionals from two rural Family Health Units in a municipality in the state of São Paulo were the participants. Data was collected through minimum maps of the institutional network and focus groups in May and June 2019. Data was analyzed through thematic analysis. RESULTS: Two categories emerged, entitled "It's not nonexistent, but it's complicated" and "We're always on the firing line". The existence of a weakened network; assistance based on biomedical bias; and care fragmentation were characteristics present in the care provided to the families. FINAL CONSIDERATIONS: The absence of network care was evident, with isolation and overload of the Primary Health Care unit that is enhanced by the characteristics of rurality.

Representations of eating and of a nutrition program among female caregivers of children under 5 years old in Tizimin, Yucatan, Mexico.

This study was carried out between January and April 2008 with 14 caregivers of children younger than 5 years residing in Tizimín city, Mexico. It aimed to understand the social representations of eating and the Programa Oportunidades [Opportunity Program] held by caregivers taking into account their social and cultural context. This qualitative investigation with an ethnographic approach was based on participant observation and semi-structured interviews. Two empirical categories emerged: 1) feeding and 2) an aid. The first refers to the caregivers' representation of eating patterns of children younger than 5 years and the second reveals that the program is considered an aid, which favors and helps caregivers to meet part of their needs. The study achieved the proposed objectives since it enabled us to understand caregivers in the complex task of feeding these children and also to propose strategies in several spheres to improve infant nutrition.

[The institutional violence in day-care and pre-schools according to mothers' view]. / A violência institucional em creches e pré-escolas sob a ótica das mães.

The objective of this research is to know the institutional violence in the day-care centers and preschools by the mothers' view. It was elaborated with two approaches:quantitative and qualitative. The researcher through interview and observation made the collection of primary data, and the qualitative data werw collected by recorded interview, being made the content analysis. The results show that 23,9%of the mothers affirm that violence exists against the child; the proportion of children that didn't suffer violence in the day-care center can be considered statistically significant, when cmpared with those already suffered, independently of the time of frequency in the day-care center (p= 0,95);the mothers say they don't know the cause of the institutional violence; the physical violence appears with larger incidence; it is more frequent the mother to try to know the cause of theviolence, and the minus, to denounce to Guardian Council. It's compatible to the parents the child's protection and they need to know the ways of protecting them of the infantile violence.

Prevalence of school violence and use of alcohol and other drugs in adolescents.

OBJECTIVE: to analyze the school violence suffered and practiced and its association with the use of alcohol and other drugs in adolescents between 12 and 18 years old. METHOD: the study sample consisted of 643 adolescents enrolled in six schools, who answered two self-administered questionnaires: "Global School-based Student Health Survey" and "Violence in School". Statistical analysis was performed using the chi-square test and the degree of association between the variables was analyzed using the prevalence ratio. RESULTS: the prevalence of school violence suffered and practiced was 62.2% and 51.9%, respectively. About 44.6% of the aggressors said they did not want to change their behavior. There was an expressive prevalence of alcohol use (16.5%), tobacco (15.7%) and illicit drugs (6.8%), and drunkenness (12.6%). There was a significant association between the violence suffered and the age group of 12 to 14 years old (p=0.001); (p=0.011) and education level in elementary school (p<0.001). In mothers with less than eight years of studies, the association was significant for the violence practiced (p=0.002). CONCLUSION: the study contributes to the aspects involved in school violence, which can subsidize actions and policies in this area.

Drugs use by six to seven-year-old children from an elementary school in Celaya, Guanajuato, México.

This study aimed to identify the use of drugs by six to seven-year-old students from an elementary school in Celaya, Gto., Mexico. It is a cross-sectional exploratory study with non-probabilistic sample. Thirty-nine students, both genders, were interviewed, and the use of drugs was identified, not only among students, but also among people close to them. The whole sample (100%) was 7 years old, 61.5% female, 77% reported their mothers smoked, and 25% she consumed alcohol; 24.3% reported their father smoked, and 48.6% he consumed alcohol; 30.6% of the scholars had already consumed alcohol once (beer), 8.1% had tried cigarettes, but not other drugs.

School as a "protective factor" against drugs: perceptions of adolescents and teachers.

This study aims to discover and describe protective factors regarding the use of drugs, according to teachers and students, aged 14 to 15 years, from a Public Secondary School in Santiago de Querétaro, Mexico. This is a descriptive and exploratory study. Data collection was carried out through semi-structure interview and non-participative observation with ten students and five teachers. Three themes resulted from data analysis: school and school's environment: the school does not provide a healthy environment; use of drugs: perceived by both the students and teachers in the institution itself; prevention programs: there are health promotion and prevention programs available at the school. According to the students' and teachers' perceptions, the school represents a risk factor.

Intrafamily violence and justice.

This study aimed to analyze the structural, developmental and functional dimensions of families in situations of violence, under judicial intervention in the city of São Paulo, SP, Brazil. The theoretical reference utilized was centered on the perspective of the ecological context of human development. A qualitative methodology was adopted. Data collection was constituted in the analysis of the judicial lawsuits, census maps, semi-structured interviews, free observation and photographs produced by the subjects. Data analysis was inspired by dialectic hermeneutics. "I did not have" and "In the streets" were empirical categories emerging from the subjects' statements, evidencing situations of insecurity and despair, the insertion in perverted relations, established in the universe of drug dealing, exploitation, violation of rights and economic privations. Families showed changes from one historical moment to another, under distinct variables and with a specific complexity, regarding their capacity of discovering, maintaining or altering their development in the environment.

Perceptions of adolescents students on the consumption of drugs: a case study in Lima, Peru.

The consumption of drugs has increased worldwide and has become a public health problem, affecting particularly adolescents. This study aimed to identify the opinions of adolescent students on the use of drugs and drug users, in a school in Lima, Peru. It is a descriptive and cross-sectional study with a questionnaire self-applied to 386 students. Data collected comprised students' personal data, their perception on the risk of drugs consumption, motivations, information on preventive interventions, drugs availability, opinion regarding drug users and their family, and social acceptance. Male gender was predominant. Most of the participants were unfavorable regarding risk perception and consumption motives, though, they were favorable towards information. We have a relevant role in explaining behaviors and also in implementing appropriate and efficient preventive and treatment programs.

[Health care to children and adolescents sheltered in Ribeirão Preto, SP]. / Assistência em saúde às crianças e adolescentes abrigados em Ribeirão Preto, SP.

This article aims to describe the health care offered to children and adolescents sheltered at the Care Center for Child and Adolescent Victims, in Ribeirão Preto-SP, Brazil. The study is descriptive and exploratory. Data were collected through semistructured interview, non-structured observation and document analysis. The points we examined were the human resource and physical space structure and the care delivered by the shelter and by the referral health unit. We observed many deficiencies, whose solutions not only depend on the shelter, but on an articulation with other sectors, seeking a quality health care that contemplates the needs of children and adolescents in their integrality.