Violence against children in Brazilian scenery

Antonio Jakeulmo Nunes Magda Coeli Vitorino Sales About the authors

Abstract

Violence is a social and public health phenomenon, with greater exacerbation when it affects children, causing an impact on child development and a catastrophic impact on the behavior of an adult life. The purpose of this article is to characterizing by the scientific evidence child abuse on the brasilian scene. There was used the integrative literature review and, as a source of research, the databases Lilacs and Scielo from August 2013. Among the six identified publications showed negligence as the main type of violence, five discoursed that Male gender is the most affected gender and ten stated that the perpetrator is always a family member. Also in this heart, it becomes clear that the parents are the greatest perpetrators of violence against children, especially the mother as the most frequent aggressors. The results demonstrate the need to identify early all types of violence, especially the neglect, recognizing that there is no significant distinction of violence between the genders and sharing the family environment as the most conducive environment for the growth of violent events.

Domestic violence; Child bad-treatment; Protect children and adolescents; Violence; Child

Introduction

Violence can be considered as the use of physical force or power, threatened or actual, against oneself, against another person, or against a group or community, that either results in/or has any chance of resulting in injury, death, psychological harm, developmental disability or deprivation11. World Health Organization (WHO). World report on violence and health. Geneva: WHO; 2002..

More than any other type of violence committed against children is not justified because the peculiar conditions of development of these citizens put them in extreme dependence of parents, family members, caregivers, public authorities and society. In 2011, the System for Notifiable Diseases Information System (SINAN), recorded 39.281 visits in the range of <1 to 19 years old, which represent 40% of the total of 98.115 attendances computed by the system that year22. Waiselfisz JJ. Mapa da violência 2012. Crianças e Adolescentes do Brasil. São Paulo: Instituto Sangari; 2012.. The increase in the number of cases of child abuse according to the World and Brazilian epidemiological data show increasingly, it is necessary to demand control actions, through preventive measures for the social sectors involved, as well as health workers, community councils and others.

The problem arrogate political relevance and visibility of the society, especially from the 1990s, with the implementation of the Children and Adolescents, through Law 8069, which aims to “ensure children and adolescents, promoting health and disease prevention, making it mandatory identification and denunciation of violence”33. Brasil. Presidência da República. Lei n. 8.069, de 13 de julho de 1990. Dispõe sobre o Estatuto da Criança e do Adolescente e dá outras providências. Diário Oficial da União 1990; 16 Jul.. As a result, the state now has legal instruments of protection in situations of violence in childhood and adolescence, making mandatory notification even in cases of suspicion.

The World Health Organization (WHO)44. World Health Organization (WHO). Preventing child maltreatment: a guide to taking action and generating evidence. Geneva: WHO; 2006. classifies violence against children in four types: physical, sexual, emotional or psychological harm and neglect, which can result in physical, psychological damage; damage to the growth, development and maturation of children.

The violence, childish, translates into a strong stressor compared to normal growth and development process and should be considered in its entirety, for its full recognition, in order to implement effective measures for its resolution. Thus, this study aims to characterizing, through scientific evidences, the child abuse on the national scene.

Methodology

Seeking to answer the main question: What are the characteristics to child abuse on the national scene? Held a Integrative Review (RI), which brings significant benefits to the strengthening of Evidence-Based Practice (EBP)55. Mendes KDS, Silveira RCCP, Galvão CM. Revisão Integrativa: Método de Pesquisa para a Incorporação de Evidências na Saúde e na Enfermagem. Texto Contexto Enferm 2008; 17(4):758-764..

Selection of items occurred from the definition of the inclusion criteria used for the satisfaction of the sample, these criteria: articles which referred to the issue addressed and/or thematic counterparts in full publications in Portuguese and time frame between 2008 and 2012. As exclusion criteria it was decided not to use incomplete texts, articles in foreign language and items that were not available in full online.

The next task was to carry out the search of the sample sources indexed in the database SciELO (Scientific Electronic Library Online) and Lilacs (Latin American and Caribbean Literature in Health Sciences), using the following descriptors: child abuse children, child advocacy and adolescent violence and domestic violence during the August 2013 period, according to the requirement of the steps as shown in Figure 1.

Figure 1
Database searched and articles selected.

Data were analyzed and organized by data collection instrument validated by Ursi66. Ursi ES. Prevenção de lesões de pele no perioperatório: revisão integrativa da literatura [dissertação]. Ribeirão Preto: Universidade de São Paulo; 2005. and later tabulated in the following variables: author/year design/ level of evidence and results.

The results and discussions were presented in order of the questions that make up the data collection instrument. To assist in selecting the best possible evidence, we propose a hierarchy of evidence, according to the study design, which is one of the items to be discussed at this stage77. Stetler CB, Morsi D, Rucki S, Broughton S, Corrigan B, Fitzgerald J, Giuliano K, Havener P, Sheridan EA. Utilization-focused integrative reviews in a nursing service. Appl Nurs Res 1998; 11(4):195-206..

This study was registered in the Coordination of Research and Graduate of UNINOVAFAPI University Center.

Results and discussion

From the tracking process performed initially there was identified 1.571 articles, all potentially eligible by quickly reading the title, objective(s) and year of publication. Of these, only 12 articles were analyzed in full from close reading. For a better understanding of the nature of each paper, it proposes a distribution that aims sheds worked by each analyzed manuscript. This distribution can be seen in Chart 1.

Chart 1
Distribution of the studies according to the title of articles, authors, publication year, home study and public journal (2008-2012).

It was observed that the place of higher demand for the studies when it comes to abuse against children was the Reporting Systems (33,3%), followed by hospitals (25%). As for the year, there was a predominance of studies published in 2012 (33,3%), followed by the year 2009 (25%).

The type of research more publication was the quantitative type, including descriptive and exploratory nature. Of all articles, only one was kind of an experience report, reducing the confidence level of this study.

Considering the visibility and wealth of the analyzed articles sought to expose the level of evidence of each sample selected in order to give credence to the study. The distribution can be seen in Chart 2.

Chart 2
Distribution of studies according to the results, design and level of evidence (2008-2012).

When evaluating the core idea of each article, there was a predominance of three categories, which are: predominant type of violence against children; Profile genre hit by violence; and the type of offender, described in Chart 3. Regarding the type of violence, it observed the predominance of negligence (50%), followed by physical violence (33,3%), psychological violence (8,3%) and sexual violence (8,3%).

Chart 3
Quantitative distribution regarding Type, Gender and Offender Violence against Children.

As regards to gender, it is possible to observe the preponderance of males (41,7%) compared to females (25%), noting that some studies have established percentage for each gender, taking into account a type of violence alone. Regarding the type of offender, it was possible to identify the prevalence of aggression perpetrated by a member of the family group (75%). Two studies (16,7%), did not describe the aggressor and only one study (8,3% of cases) said the source of the offender as non-family, described this study as others - and any individual who hold indirect relationship with the victims without any degree of kinship.

The bias given to the discussion of violence against children in this study will be presented emphatically, scaled on the following perspective: violence the greatest impact on children, sexual gender in which there was a higher prevalence in the analyzed articles and where of violent action, or seek to quantify the degree of relationship / kinship aggressor.

Predominant types of violence against children

Negligence is a violence difficult to define because it involves cultural, social and economic aspects of each family or social group, it is what it claims Zambon et al.88. Zambon MP, Jacintho ACA, Medeiro MM, Guglielminetti R, Marmo DB. Violência doméstica contra crianças e adolescentes: um desafio. Rev Assoc Med Bras 2012; 58(4):465-464.. Neglect represents the most frequent form of abuse against children88. Zambon MP, Jacintho ACA, Medeiro MM, Guglielminetti R, Marmo DB. Violência doméstica contra crianças e adolescentes: um desafio. Rev Assoc Med Bras 2012; 58(4):465-464.

9. Faleiros JM, Matias ASA, Bazon MR. Violência contra crianças na cidade de Ribeirão Preto, São Paulo, Brasil: a prevalência dos maus-tratos calculada com base em informações do setor educacional. Cad Saude Publica 2009; 25(2):337-348.

10. Pfeiffer L, Rosário NA, Cat MNL. Violência contra crianças e adolescentes: proposta de classificação dos níveis de gravidade. Rev Paul Pediatr 2011; 29(4):477-482.

11. Assis SG, Avanci JQ, Pesce RP, Pires TO, Gomes DL. Notificações de violência doméstica, sexual e outras violências contra crianças no Brasil. Cien Saude Colet 2012; 17(9):2305-2317.
-1212. Apostólico MR, Nóbrega CR, Guedes RN, Fonseca RMGS, Egry EY. Características da violência contra a criança em uma capital brasileira. Rev Latino-Am Enfermagem 2012; 20(2):266-273..

According Faleiros et al.99. Faleiros JM, Matias ASA, Bazon MR. Violência contra crianças na cidade de Ribeirão Preto, São Paulo, Brasil: a prevalência dos maus-tratos calculada com base em informações do setor educacional. Cad Saude Publica 2009; 25(2):337-348. is noteworthy that maternal deprivation is a major stressor that directly affects child development show that negligence victims of individuals or any other type of violence in the first decade of life have, in most cases, deviations conduct in which are mainly based on transgression of social rules.

Another point also important in this arsenal, concerns the age group of abused children which was observed in the Apostólico et al.1212. Apostólico MR, Nóbrega CR, Guedes RN, Fonseca RMGS, Egry EY. Características da violência contra a criança em uma capital brasileira. Rev Latino-Am Enfermagem 2012; 20(2):266-273. study, dominance aggression in children under five years, and this number may be greater the younger the child, complete Assis et al.1111. Assis SG, Avanci JQ, Pesce RP, Pires TO, Gomes DL. Notificações de violência doméstica, sexual e outras violências contra crianças no Brasil. Cien Saude Colet 2012; 17(9):2305-2317..

So it is understandable that the younger the age, the greater the vulnerability and the risk of violence, because the dependence on the performance of basic survival activities is given entirely by the caregiver, requiring inherent abilities to care for what can become a stressor who demand care.

It is worth emphasizing, according Granville-Garcia et al.1818. Granville-Garcia AF, Silva MJ F, Menezes VA. Maus-Tratos a Crianças e Adolescentes: Um Estudo em São Bento do Una, PE, Brasil. Pesq Bras Odontoped Clin Integr 2008; 8(3):301-307., that neglect has high prevalence in various locations and has been described in the literature as worrisome, since this type of abuse, although not inspire the same degree of anger the other is about 40% of the recorded fatalities.

This makes it possible to suggest the great social impact of other types of violence against children, such as physical and sexual violence, which affects the express way in society and can be seen with great fanfare, since there are several by political public directed to these cases.

In contrast the ideology of dominance of neglect as the most common type of bad-treatment in children, other authors in the literature indicate physical harm as the most common category of bad-treatment1414. Mascarenhas MDM, Malta DC, Silva MMA, Lima CM, Carvalho MGO, Oliveira VLA. Violência contra a criança: revelando o perfil dos atendimentos em serviços de emergência, Brasil, 2006 e 2007. Cad Saude Publica 2010; 26(2):347-357.,1616. Gawryszewski VP, Valencich DMO, Carnevalle CV, Marcopito LF. Maus-tratos contra a criança e o adolescente no Estado de São Paulo, 2009. Rev Assoc Med Bras 2012; 58(6):659-665.,1717. Garbin CS, Rovida TAS, Joaquim RC, Paula AM, Guimarães e Queiroz APD. Violência denunciada: ocorrências de maus tratos contra crianças e adolescentes registradas em uma unidade policial. Rev Bras Enferm 2011; 64(4):665-670.,1919. Carvalho ACR, Barros SG, Alves AC, Gurgel CA. Maus-tratos: estudo através da perspectiva da delegacia de proteção à criança e ao adolescente em Salvador, Bahia. Cien Saude Colet 2009; 14(2):539-546. and in some cases stand out the beating/physical strength, concludes Mascarenhas et al.1414. Mascarenhas MDM, Malta DC, Silva MMA, Lima CM, Carvalho MGO, Oliveira VLA. Violência contra a criança: revelando o perfil dos atendimentos em serviços de emergência, Brasil, 2006 e 2007. Cad Saude Publica 2010; 26(2):347-357..

Physical violence as a form of education, from the perspective of the caregiver / aggressor, presents explanations about the act of hitting or beating motivated by social difficulties, difficulties in daily family relations and child care, emotional imbalance and guilt of child for the problems.

According Gawryszewski et al.1616. Gawryszewski VP, Valencich DMO, Carnevalle CV, Marcopito LF. Maus-tratos contra a criança e o adolescente no Estado de São Paulo, 2009. Rev Assoc Med Bras 2012; 58(6):659-665., because it is a widely discussed problem in society in general, physical abuse tend to occupy the first place among the forms of violence in studies conducted in the emergency units facing these cases, probably be more serious and require health care, a fact that depending on the circumstances cannot be omitted.

Taking as relevant local looking to record the occurrence of violence, police stations stand out as the first place to be searched, while health services are forgotten, that because the victims or who the leads, do not consider the health sector as competent to deal with such problem.

In another design, according the studies analyzed in relation to the type of violence, is viewed from scarce in the literature psychological aggression as the predominant type of bad-treatment of children, being virtually ignored in hospitals, was what said Moura et al.1515. Moura ATMS, Moraes CL, Reichenheim ME. Detecção de maus-tratos contra a criança: oportunidades perdidas em serviços de emergência na cidade do Rio de Janeiro, Brasil. Cad Saude Publica 2008; 24(12):2926-2936..

The cultural and social scene where there is psychological violence must be regarded as relevant as its recognition depends substantially on the context in which it is inserted. Often, the detection of the source of the event can be hampered by the omission of the cases, since the psychological violence leaves no marks so expressive initially.

Finally, in regard to the prevalence of violence it was possible, distantly, find studies showing sexual violence as the most common type, but points out that children are not prepared physical, cognitive, emotional or socially to face a sexual violence. A sexually abusive relationship is a power relationship between the adult victim and the child who is victimized88. Zambon MP, Jacintho ACA, Medeiro MM, Guglielminetti R, Marmo DB. Violência doméstica contra crianças e adolescentes: um desafio. Rev Assoc Med Bras 2012; 58(4):465-464..

However, to establish a reliable quantitative on the prevalence of violence, it is necessary to take into account the occurrences of profile that can vary depending on the source or place searched.

Most prevalent sexual gender from the perspective of child abuse

Just as important to quantify the form of violence that affects children, it is to differentiate which gender is most affected by bad-treatment, since the conduct of the action by the professionals responsible for the care of ill-treated children should be done in a particular way, respecting the individuality of each case.

With that in most studies you can see the prevalence of males as the gender most affected by violence99. Faleiros JM, Matias ASA, Bazon MR. Violência contra crianças na cidade de Ribeirão Preto, São Paulo, Brasil: a prevalência dos maus-tratos calculada com base em informações do setor educacional. Cad Saude Publica 2009; 25(2):337-348.,1111. Assis SG, Avanci JQ, Pesce RP, Pires TO, Gomes DL. Notificações de violência doméstica, sexual e outras violências contra crianças no Brasil. Cien Saude Colet 2012; 17(9):2305-2317.,1414. Mascarenhas MDM, Malta DC, Silva MMA, Lima CM, Carvalho MGO, Oliveira VLA. Violência contra a criança: revelando o perfil dos atendimentos em serviços de emergência, Brasil, 2006 e 2007. Cad Saude Publica 2010; 26(2):347-357.,1515. Moura ATMS, Moraes CL, Reichenheim ME. Detecção de maus-tratos contra a criança: oportunidades perdidas em serviços de emergência na cidade do Rio de Janeiro, Brasil. Cad Saude Publica 2008; 24(12):2926-2936. establishing forms of aggression different as to gender, and “lack of parental control” was significantly more frequent in boys. On the other hand, according Faleiros et al.99. Faleiros JM, Matias ASA, Bazon MR. Violência contra crianças na cidade de Ribeirão Preto, São Paulo, Brasil: a prevalência dos maus-tratos calculada com base em informações do setor educacional. Cad Saude Publica 2009; 25(2):337-348., girls more vivenciariam the two other forms of negligence: the “physical abandonment” and “emotional”.

A point that justifies the above statement, as reported by Mascarenhas et al.1414. Mascarenhas MDM, Malta DC, Silva MMA, Lima CM, Carvalho MGO, Oliveira VLA. Violência contra a criança: revelando o perfil dos atendimentos em serviços de emergência, Brasil, 2006 e 2007. Cad Saude Publica 2010; 26(2):347-357., is that given by the different behaviors of each gender and cultural factors that determine greater freedom to the children and, in turn, greater vigilance on the girls.

In this respect, the higher incidence of aggression among boys may be related to one of the great male symbols in the world today, the weapons, which materialize the power to submit the other to their wishes and interests, power of life and death through objects that are introduced early in a boy’s life in the form of toys, and become part of the male universe.

To characterize the prevalent gender, says Assis et al.1111. Assis SG, Avanci JQ, Pesce RP, Pires TO, Gomes DL. Notificações de violência doméstica, sexual e outras violências contra crianças no Brasil. Cien Saude Colet 2012; 17(9):2305-2317., you must also include the type of perpetrated violence, whereas sexual violence tends to be directed more often against girls and physical violence and neglect more commonly seen in boys, according to the notification children between 1-9 years old.

For another view, will women’s subordinate status in society seen since childhood, as well as the ideology of an alleged female frailty concept that women are weak, submissive, passive; averse man, strong, manly, rational concepts translated into just decades that need solution as to social values, compared to cases of violence, causing the female is regarded as the greatest prevalence of sex between aggression1616. Gawryszewski VP, Valencich DMO, Carnevalle CV, Marcopito LF. Maus-tratos contra a criança e o adolescente no Estado de São Paulo, 2009. Rev Assoc Med Bras 2012; 58(6):659-665.,1717. Garbin CS, Rovida TAS, Joaquim RC, Paula AM, Guimarães e Queiroz APD. Violência denunciada: ocorrências de maus tratos contra crianças e adolescentes registradas em uma unidade policial. Rev Bras Enferm 2011; 64(4):665-670..

Continuing the growing idea of the prevalence of the female is given a close relationship to the prevalence of physical abuse in male children in relation to other types of abuse, indicating no specific age range for the occurrence of these events, is the says Carvalho et al.1919. Carvalho ACR, Barros SG, Alves AC, Gurgel CA. Maus-tratos: estudo através da perspectiva da delegacia de proteção à criança e ao adolescente em Salvador, Bahia. Cien Saude Colet 2009; 14(2):539-546., the interface of relations between the maltreatment of children and aspects of violence between genders.

As much as is noted prevalence of males in this category, you can see that some studies do not clearly stating the prevalence of which focuses violence according to gender, making only a brief comparative typology in relationship / gender as mentioned earlier, the male gender affected more by physical abuse, and the psychological and neglect and violence the women suffered the most sexual violence 1010. Pfeiffer L, Rosário NA, Cat MNL. Violência contra crianças e adolescentes: proposta de classificação dos níveis de gravidade. Rev Paul Pediatr 2011; 29(4):477-482.,1212. Apostólico MR, Nóbrega CR, Guedes RN, Fonseca RMGS, Egry EY. Características da violência contra a criança em uma capital brasileira. Rev Latino-Am Enfermagem 2012; 20(2):266-273..

Description of the aggressor concerning the grade of relationship/kinship

In this category, nine (75%) of 12 analyzed articles reported that the offender is always one of the family members. Only one study (8,3%) showed the source is external aggression, as classified in this study and two other studies have described this category.

According to Mascarenhas et al.1414. Mascarenhas MDM, Malta DC, Silva MMA, Lima CM, Carvalho MGO, Oliveira VLA. Violência contra a criança: revelando o perfil dos atendimentos em serviços de emergência, Brasil, 2006 e 2007. Cad Saude Publica 2010; 26(2):347-357., the home environment is the place where much of the violent events taking place, which is a favorable environment for the occurrence of attacks and abuses against children, especially girls. For stay longer in their homes, children end up being more often abused these sites.

Interestingly, through this problem, that any family member can become, under certain circumstances, a victim or perpetrator of violence. However, children, because they are more susceptible, helpless and dependent family as well as society, are the main victims of such violence, referring increasingly a gender perspective on this reality.

In this relationship, as quoted Moura et al.1515. Moura ATMS, Moraes CL, Reichenheim ME. Detecção de maus-tratos contra a criança: oportunidades perdidas em serviços de emergência na cidade do Rio de Janeiro, Brasil. Cad Saude Publica 2008; 24(12):2926-2936., it is important to note that the mother was considered as the main aggressor when violence committed - the psychological and corporal punishment, followed by neglect.

In a very detailed way, there was the following representation as to the aggressors: the main authors of the aggression were responsible for the victims themselves - mother and father1010. Pfeiffer L, Rosário NA, Cat MNL. Violência contra crianças e adolescentes: proposta de classificação dos níveis de gravidade. Rev Paul Pediatr 2011; 29(4):477-482.

11. Assis SG, Avanci JQ, Pesce RP, Pires TO, Gomes DL. Notificações de violência doméstica, sexual e outras violências contra crianças no Brasil. Cien Saude Colet 2012; 17(9):2305-2317.

12. Apostólico MR, Nóbrega CR, Guedes RN, Fonseca RMGS, Egry EY. Características da violência contra a criança em uma capital brasileira. Rev Latino-Am Enfermagem 2012; 20(2):266-273.
-1313. Martins CBG, Mello Jorge MHP. Desfecho dos casos de violência contra crianças e adolescentes no poder judiciário. Acta Pau Enferm 2009; 22(6):800-807.,1616. Gawryszewski VP, Valencich DMO, Carnevalle CV, Marcopito LF. Maus-tratos contra a criança e o adolescente no Estado de São Paulo, 2009. Rev Assoc Med Bras 2012; 58(6):659-665., followed by step-parents - or acquaintances, included other family members, and according Gawryszewski et al.1616. Gawryszewski VP, Valencich DMO, Carnevalle CV, Marcopito LF. Maus-tratos contra a criança e o adolescente no Estado de São Paulo, 2009. Rev Assoc Med Bras 2012; 58(6):659-665., this distribution showed differences in relation to gender, which demonstrated the high proportion of mothers as perpetrators of assault against male children. Although these interface cases of sexual violence, stepfather or mother’s partner took first place, followed by his father, grandfather, uncle and others with whom the victim kept ties of dependence, affection and cohabitation, concludes Pfeiffer et al.1010. Pfeiffer L, Rosário NA, Cat MNL. Violência contra crianças e adolescentes: proposta de classificação dos níveis de gravidade. Rev Paul Pediatr 2011; 29(4):477-482..

Another issue which pointed out the mother as the main aggressor can be explained by the fact that she is closer physically child, is taking responsibility for the emotional and educational care of children, is ensuring its survival, since most of the time when the couple is separated, it is to her that the child remains, and this proximity is a risk factor for the development of violence1919. Carvalho ACR, Barros SG, Alves AC, Gurgel CA. Maus-tratos: estudo através da perspectiva da delegacia de proteção à criança e ao adolescente em Salvador, Bahia. Cien Saude Colet 2009; 14(2):539-546.. However, several situations are described by their mothers as environmental factors to trigger the violent act, such as the cry of child or any action taken by it which has no control angering the caregiver.

All this configuration of violence goes against the idea that home is a safe place, which serves as a source of growth for children. The effects of violence can arise in the short or long term regarding the biopsychosocial aspects of abused children, which hinders their development in the social environment, reflecting the diminished ability to think and act and tackle difficult situations imposed on them, so living with stressful times throughout their life, since the violent event will be marked in their memory independent of age occurs.

Contributing once more to this study, Zambon et al.88. Zambon MP, Jacintho ACA, Medeiro MM, Guglielminetti R, Marmo DB. Violência doméstica contra crianças e adolescentes: um desafio. Rev Assoc Med Bras 2012; 58(4):465-464. states that a difficulty that can be observed in relation to violence when committed by family, is the child’s own fear to report the incident, fearing future punishments; through the difficult diagnosis and notification to the lack of standardized and effective devices for the proper conduct of these cases by the health system.

In another look not so far on child violence, according to Carvalho et al.1919. Carvalho ACR, Barros SG, Alves AC, Gurgel CA. Maus-tratos: estudo através da perspectiva da delegacia de proteção à criança e ao adolescente em Salvador, Bahia. Cien Saude Colet 2009; 14(2):539-546., the attackers, mostly had an indirect relationship with the victims, and the profile of these offenders are males presenting an average of 31,55 years age.

Therefore, it is also necessary to stress the importance for the recognition of non-family violence, because usually social relations open with the other members of a community can foster the emergence of these episodes, since the trusts are given to neighbors, friends or anyone else without any parental bond. So cases of violence mostly when extra-familiar, are committed by someone the child knows and trusts considered by both as a friend of the family.

However, violence against children and adolescents can be understood as a serious form of disrespect for fundamental rights, which is treated as a natural fact or as just a particular way parents deal with their children, becoming regarded as a serious problem the responsibility of both the State, civil society and particularly their own families.

Conclusion

Therefore, it becomes evident that parents are the main perpetrators of violence against children, especially among those of a younger age than or equal to 5 years old, especially the mother as the greatest aggressor. Regarding the type of harm, neglect emerges as the main form of harm, establishing itself as a serious social problem despite not having visibility expressed between the company and specific public policies to combat it. The distinction of violence was not significant when analyzed from the perspective of the victim’s sex, noting only that there is a marked predominance of physical violence and neglect in males and sexual violence in females.

So once made this recognition tripod of child abuse is necessary for health professionals, with emphasis on the nurse, set goals in order to intervene to rescue the family values and community involved in the violent context, with measures health education and continuously, the socialization of the actors involved and the stimulus for the development of social coping violence policies.

References

  • 1
    World Health Organization (WHO). World report on violence and health Geneva: WHO; 2002.
  • 2
    Waiselfisz JJ. Mapa da violência 2012. Crianças e Adolescentes do Brasil São Paulo: Instituto Sangari; 2012.
  • 3
    Brasil. Presidência da República. Lei n. 8.069, de 13 de julho de 1990. Dispõe sobre o Estatuto da Criança e do Adolescente e dá outras providências. Diário Oficial da União 1990; 16 Jul.
  • 4
    World Health Organization (WHO). Preventing child maltreatment: a guide to taking action and generating evidence. Geneva: WHO; 2006.
  • 5
    Mendes KDS, Silveira RCCP, Galvão CM. Revisão Integrativa: Método de Pesquisa para a Incorporação de Evidências na Saúde e na Enfermagem. Texto Contexto Enferm 2008; 17(4):758-764.
  • 6
    Ursi ES. Prevenção de lesões de pele no perioperatório: revisão integrativa da literatura [dissertação]. Ribeirão Preto: Universidade de São Paulo; 2005.
  • 7
    Stetler CB, Morsi D, Rucki S, Broughton S, Corrigan B, Fitzgerald J, Giuliano K, Havener P, Sheridan EA. Utilization-focused integrative reviews in a nursing service. Appl Nurs Res 1998; 11(4):195-206.
  • 8
    Zambon MP, Jacintho ACA, Medeiro MM, Guglielminetti R, Marmo DB. Violência doméstica contra crianças e adolescentes: um desafio. Rev Assoc Med Bras 2012; 58(4):465-464.
  • 9
    Faleiros JM, Matias ASA, Bazon MR. Violência contra crianças na cidade de Ribeirão Preto, São Paulo, Brasil: a prevalência dos maus-tratos calculada com base em informações do setor educacional. Cad Saude Publica 2009; 25(2):337-348.
  • 10
    Pfeiffer L, Rosário NA, Cat MNL. Violência contra crianças e adolescentes: proposta de classificação dos níveis de gravidade. Rev Paul Pediatr 2011; 29(4):477-482.
  • 11
    Assis SG, Avanci JQ, Pesce RP, Pires TO, Gomes DL. Notificações de violência doméstica, sexual e outras violências contra crianças no Brasil. Cien Saude Colet 2012; 17(9):2305-2317.
  • 12
    Apostólico MR, Nóbrega CR, Guedes RN, Fonseca RMGS, Egry EY. Características da violência contra a criança em uma capital brasileira. Rev Latino-Am Enfermagem 2012; 20(2):266-273.
  • 13
    Martins CBG, Mello Jorge MHP. Desfecho dos casos de violência contra crianças e adolescentes no poder judiciário. Acta Pau Enferm 2009; 22(6):800-807.
  • 14
    Mascarenhas MDM, Malta DC, Silva MMA, Lima CM, Carvalho MGO, Oliveira VLA. Violência contra a criança: revelando o perfil dos atendimentos em serviços de emergência, Brasil, 2006 e 2007. Cad Saude Publica 2010; 26(2):347-357.
  • 15
    Moura ATMS, Moraes CL, Reichenheim ME. Detecção de maus-tratos contra a criança: oportunidades perdidas em serviços de emergência na cidade do Rio de Janeiro, Brasil. Cad Saude Publica 2008; 24(12):2926-2936.
  • 16
    Gawryszewski VP, Valencich DMO, Carnevalle CV, Marcopito LF. Maus-tratos contra a criança e o adolescente no Estado de São Paulo, 2009. Rev Assoc Med Bras 2012; 58(6):659-665.
  • 17
    Garbin CS, Rovida TAS, Joaquim RC, Paula AM, Guimarães e Queiroz APD. Violência denunciada: ocorrências de maus tratos contra crianças e adolescentes registradas em uma unidade policial. Rev Bras Enferm 2011; 64(4):665-670.
  • 18
    Granville-Garcia AF, Silva MJ F, Menezes VA. Maus-Tratos a Crianças e Adolescentes: Um Estudo em São Bento do Una, PE, Brasil. Pesq Bras Odontoped Clin Integr 2008; 8(3):301-307.
  • 19
    Carvalho ACR, Barros SG, Alves AC, Gurgel CA. Maus-tratos: estudo através da perspectiva da delegacia de proteção à criança e ao adolescente em Salvador, Bahia. Cien Saude Colet 2009; 14(2):539-546.

Publication Dates

  • Publication in this collection
    Mar 2016

History

  • Received
    06 July 2014
  • Reviewed
    10 July 2015
  • Accepted
    12 July 2015
ABRASCO - Associação Brasileira de Saúde Coletiva Rio de Janeiro - RJ - Brazil
E-mail: revscol@fiocruz.br