As violence has proved to be an important public health issue, it has stimulated scientific production and the development of public policies. The objective of the present article is to understand the care strategies developed by Family Health Program Teams in Diadema to handle domestic violence situations. A qualitative analysis approach of selected cases identified by the teams as "difficult", "typical" and "successful" was adopted. Two Family Health Program teams and different professionals from the intersectoral network were interviewed. Organizing services according to the Family Health Strategy guidelines has shown to be a facilitating factor to develop care strategies to handle domestic violence. Professionals identified different kinds of violence in the assisted families, but the actions of the teams focused mainly on the child abuse related situations. Violence against women in general was not taken into account by the teams, which shows different degrees of "visibility" among the various types of violence. Strategies included actions to promote deeper bonds with the family, cases monitoring and biomedical aspects evaluation, as well as more acute actions such as mandatory hospitalization. The strategies developed alternate from a prescriptive perspectivel to one more centered in the concept of Care, during the interaction with the families and regarding their needs. The community health agents and NASF professionals were the main protagonists in these cases, articulating practical and technical knowledge. Keywords: Domestic Violence; Child Abuse; Violence against Women; Primary Health Care. Tatiana das Neves Fraga Moreira ResumoA violência tem se constituído importante objeto da saúde pública, tanto na produção científica como na elaboração de políticas públicas. O presente artigo tem como objetivo analisar as estratégias de cuidado construídas por equipes de saúde da família frente a situações de violência doméstica. Optou-se por uma abordagem qualitativa feita pela análise de casos traçadores identificados pelas equipes como "difíceis", "típicos" e "bem-sucedidos". Foram entrevistadas duas equipes de saúde da família e profissionais de diferentes serviços da rede intersetorial. Os resultados mostraram que a organização do serviço a partir das diretrizes da Estratégia de Saúde da Família propiciou condições favoráveis para o enfrentamento da violência doméstica. Os profissionais identificaram diferentes tipos de violência nas famílias atendidas, mas as ações das equipes voltaram-se prioritariamente para as situações de maus-tratos contra a criança. A violência contra a mulher em geral não foi tomada como objeto da equipe, demonstrando diferentes graus de "visibilidade" entre as violências. As estratégias incluíram ações de vinculação à família, de monitoramento dos casos e avaliação dos aspectos biomédicos, mas também ações incisivas, como a internação compulsória. As estratégias construídas alternam-se entre uma perspectiva prescritiva e outra centrada na ideia de cuidado, no diálogo com as...

MOREIRA, T.N.F. A construção do cuidado: o atendimento às situações de violência doméstica por equipes de saúde da família/ The foundation of care: Family Health Program Teams dealing with domestic violence situations [dissertation]. São Paulo (BR): Faculdade de Saúde Pública da USP; 2012. Introduction: As violence has proved to be an important public health issue, it has stimulated scientific production and the development of public policies. Studies have unanimously pointed to the need of a multi-professional and intersectoral approach, in accordance to the complexity of the issue. Objective: The objective of the present research is to understand the care strategies developed by Family Health Program Teams in Diadema to handle domestic violence situations towards children and teenagers. Methodology: A qualitative analysis approach of selected cases identified by the teams as "difficult", "typical" and "successful" was adopted. Two Family Health Program teams and different professionals from the intersectoral network were interviewed. Results: Organizing services according to the Family Health Strategy guidelines has shown to be a facilitating factor in identifying cases and in developing broader and more longitudinal care strategies. Professionals identified different kinds of violence in the assisted families, but the actions of the teams focused mainly on the child abuse related situations. Violence against women in general was not taken into account by the teams, which shows different degrees of "visibility" among the various types of violence. Strategies included actions to promote deeper bonds with the family, cases monitoring and biomedical aspects evaluation, as well as more acute actions such as mandatory hospitalization. The strategies developed alternate from a prescriptive model to one more centered in the concept of Care, during the interaction with the families and regarding their needs. The community health agents and NASF professionals were the main protagonists in these cases, articulating practical and technical knowledge. Health care teams articulated the intersectoral network triggering health care, social and education services, the guardianship council and the judiciary system in order to deal with the cases. Relevant differences could be perceived, in the understanding and in the necessary actions for each case, from the various network services, which lead to a certain degree of struggle to deal with the cases. Considerations: This study pointed to a greater need of alignment and proximity between the intersectoral network and the new researches that deal with the relations of gender conception and its influence in the definition of the team's practices.