O fenômeno da violência na percepção dos gerentes dos centros de Saúde da Família de Sobral - CE

Abstract

Violence is part of health service agendas in many ways, either as an expression of health needs or as barriers to the access, in this context the Family Health Strategy plays an important role. Based on this assumption, the objective was to analyze the perception of the managers of the Family Health Strategy teams regarding the phenomenon of violence. An exploratory-descriptive study with a quantitative and qualitative approach was developed. Held in Sobral, were considered as locus and research participants all Family Health Centers and their managers (N = 35). The study was conducted in 2018 and 2019 and the collection was based on the application of a questionnaire and 2 focus groups. The data collected in the first stage (questionnaire) were tabulated in the EpiInfo program and presented in tables and graphs format, adding to the descriptive statistical analysis. In the second stage (focus groups), the data were coded and organized according to the Collective Subject Discourse (CSD) analysis technique. The research was approved by the Scientific Committee of the Sobral Health Secretariat with protocol opinion No. 0064/2019 and by the UVA Research Ethics Committee, with Opinion No. 3,377,966, and CAAE No. 18385513.5.0000.5053. Therefore, in accordance with the principles of the Resolution No. 466/12. The results reveal that 22 (62.86%) of the managers work inside the city and the other 13 (37.14%) in the districts of Sobral. Most managers are nurses (N = 27; 79.41%), have been working in primary care from six months to one year (N = 27; 77.14%), have been manager for more than one year (N = 22; 62.85%) as well as have specialization (N = 26; 76%). Just over half of the managers (N = 18; 51.43%) experienced Permanent Education or other qualifications related to violence, indicating in the discourse of managers the need for more qualifications for better effectiveness in dealing with people / families victims of violence. The most frequent types of violence include neglect/abandonment and physical violence (N = 24; 68.57%); according to the CSD, these were more directed to women, the elderly and children. Other situations mentioned were death threats (N = 9; 25.7%) and homicide attempts (N = 10; 28.5%) suffered by users of the Family Health Care Centers. The existence of territorial conflicts (N = 15; 43%) was indicated as an important factor that directly affects the actions developed, as they cause insecurity and make the work process difficult. Managers report that they feel 'more or less safe' on the way home to work, as well as in the workplace itself. Attendance to demands arising from situations of violence were recurrent from activities directed to individual and multiprofessional care (N = 35; 100%), such as home visits (N = 32; 91.43%). And for this, the intrasectoral and intersectoral partnerships were highlighted, where the majority activates the mental health services (N = 29; 82.86%), the services of the municipal social assistance network (N = 26; 74, 28%) and public schools (N = 23; 65.71%). Based on the data presented, it is necessary to incorporate violence (its determinants, care and outcomes) into the primary care agenda in order to ensure a systematic and accurate approach to this phenomenon.