Violência doméstica contra mulheres e a atuação profissional na atenção primária à saúde: um estudo etnográfico em Matinhos, Paraná, Brasil

Abstract

Domestic violence has multiple repercussions on women's health and raises a challenging agenda for health professionals in Brazilian Unified National Health System (SUS). The aim of this study was to analyze how health professionals treat these women, problematizing the notion of acolhimento (receptiveness or openness to patients). A qualitative ethnographic research approach was used with health professionals from a primary care unit (PHU) in Matinhos, Paraná State, Brazil. The study revealed care that was focused on: (1) biologizing principles, with a focus on physical lesions and medicalization and (2) dialogue, active listening, psychosocial questions, and establishment of ties, especially featuring community health agents in this approach. The limited official local structure for handling domestic violence justifies treatment oriented by the grammar of acolhimento, recommended by the SUS, described in the literature, and verbalized in the PHU, but rarely problematized. This article thus proposed to contribute to this debate, not by establishing prescriptions for action, but by raising questions and mainly highlighting and translating the voices of those who deal with this challenge on a daily basis.

Mulheres em situação de violência: (re) pensando a escuta, vínculo e visita

“…These moments allow them to identify situations of violence even without an open report. 19 The domestic space also provides opportunities for women to discuss their experiences of violence with professionals. 20 This workshop was attended by 25 professionals.…”

Violência contra a mulher: limites e potencialidades da prática assistencial

“…This construction is seen by community health agents. (10) The establishment of the bond and dialogic listening to women in situations of violence is a potential care practice, but there is still much to do to ensure efficient user embracement. (5) Because even with the bond between professionals and service users and the obvious signs of violence, women rarely assume that the injury was caused by their partner.…”

“…This close contact of confidence, added to a training focused on actions of health promotion makes them able to detect and support issues such as violence against women. (10) In this respect, the action suggested is to provide information to women about rights and services available in the community and external to it. (10) Doctors were not listed as members of user embracement because they did not participate of discussions.…”

“…(10) In this respect, the action suggested is to provide information to women about rights and services available in the community and external to it. (10) Doctors were not listed as members of user embracement because they did not participate of discussions. Some studies bring doctors as professionals who support the team in clinical issues of the situation; eventually one or another doctor, for being more sensitive, can address the grievance with a qualified hearing, but this practice is not considered a routine conduct that should be discussed and improved.…”

“…(9) Studies show that women who go to the health units or are visited by professionals from the Family Health teams do not talk about the violence suffered. (3,5,10) One of the possibilities is that women do not report because the attention they receive is almost always about the physical problems, so they do not understand violence as a demand to be met in the unit. (5) Moreover, the lack of privacy in the place of user embracement may also be the reason for women not reporting violence.…”