Conhecimento e atuação dos profissionais da atenção básica de saúde de Feira de Santana-BA frente à violência contra crianças e adolescentes

Abstract

The violence against children and adolescents is a complex phenomenon that reaches all the social classes, etnias, religions and cultures, bringing consequences to the development, that become necessary measures of intervention of all the sectors of the society, between which the Sector Health. The objective of this study was to analyse the technical knowledge in the theme, as well as the attitude of the health professionals of Basic Care (Family Health Program-PSF and Health Basic Unit-UBS), up against children and adolescents victimization for the physical and sexual abuse, in Feira of Santana-BA, 2008. It is an epidemiologic study of cross cutting with random sampling, stratified by groups in a stage. The sample was 582 professionals, with 13,0% of losses. Descriptive analyses and bivarieds were carried out between independent and dependent variables, using the Reason of Prevalence (RP) and respective intervals of confidence (IC) like measure of association and the qui-square of Pearson, for the statistical signification. The dependent variables were identification and notification of cases and the independent ones were the sociodemographics characteristics (age group, sex and children); characteristics of the professionals activity (time and place of service, professional category) and qualification. The results pointed to 88,9% of professionals of the female sex; 62,8% integrants of the PSF and the Community Health Agents (ACS) totalized 57,0%. As for the knowledge on the subject, the most pointed signs and symptoms were aggressiveness, sadness, isolation, bruises and injuries in genital; the principal aggressors for the violence were the father and stepfather (around 80,0%); more than 60,0 % reported knowledge on proceedings of notification to the competent authorities, being the Advice To tutor was the most mentioned (57,6%). Only 27,9% of the professionals received information in the theme. On notification or suspicion of cases, 39,7% claimed, principally through information of third ones (37,3 %); the principal place of the violence was the residence (52,3%), being the most mentioned sexual abuse (53,5%), principally in the ages of 6-9 years and 10-13 years and in the female sex (67,9%). The co-occurrence between the physical and sexual violences was reported by 51,4%, being the father, stepfather and mother the principal aggressors. Among the identified cases, 56,9 % reported the notification, though only 17,8% has been carried out by the professional himself; the main denunciators were a health professional and the mother; the Advice To tutor (45,2%) and the Police Station (33,6%) were the places most looked for. For the identification of cases, statistically significant associations were observed with the variables of the female sex, presence of children, time of service of 6-10 years; status professional of doctors and nurses and to have qualification. It is believed that the sensitization and qualification are essential conditions to enlarge the technical condition, responsability and professional attitude up against violence, as for the identification and notification of cases, independent of the area of acting, which contributes to that children and adolescents could grow and develop in the safe, worthy and healthy form.