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OBJECTIVE: to identify evidence concerning the contribution of health technologies used to prevent and control hemorrhaging in the third stage of labor. METHOD: systematic review with database searches. First, two researchers independently selected the papers and, at a second point in time, held a reconciliation meeting. The Kappa coefficient was used to assess agreement, while the Grading of Recommendations, Assessment, Development and Evaluation was adopted to assess risk of bias and classify level of evidence. RESULTS: in this review, 42 papers were included, 34 of which addressed product technologies, most referred to pharmacological products, while two papers addressed the use of blood transparent plastic bags collector and the contribution of birth spacing and prenatal care. The eight papers addressing process technologies included the active management of the third stage of labor, controlled cord traction, uterine massage, and educational interventions. CONCLUSION: product and process technologies presented high and moderate evidence confirmed in 61.90% of the papers. The levels of evidence confirm the contribution of technologies to prevent and control hemorrhaging. Clinical nurses should provide scientific-based care and develop protocols addressing nursing care actions.

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OBJECTIVE: to analyze the school violence suffered and practiced and its association with the use of alcohol and other drugs in adolescents between 12 and 18 years old. METHOD: the study sample consisted of 643 adolescents enrolled in six schools, who answered two self-administered questionnaires: "Global School-based Student Health Survey" and "Violence in School". Statistical analysis was performed using the chi-square test and the degree of association between the variables was analyzed using the prevalence ratio. RESULTS: the prevalence of school violence suffered and practiced was 62.2% and 51.9%, respectively. About 44.6% of the aggressors said they did not want to change their behavior. There was an expressive prevalence of alcohol use (16.5%), tobacco (15.7%) and illicit drugs (6.8%), and drunkenness (12.6%). There was a significant association between the violence suffered and the age group of 12 to 14 years old (p=0.001); (p=0.011) and education level in elementary school (p<0.001). In mothers with less than eight years of studies, the association was significant for the violence practiced (p=0.002). CONCLUSION: the study contributes to the aspects involved in school violence, which can subsidize actions and policies in this area.

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Objetivo identificar evidências acerca das contribuições das tecnologias de cuidado usadas para prevenção e controle da hemorragia no terceiro estágio do parto. Método revisão sistemática com busca em bases de dados. Dois investigadores selecionaram os textos de forma independente na primeira etapa e, na segunda, em reunião de conciliação. Para avaliação da concordância, aplicou-se o coeficiente Kappa; para avaliação do risco de viés e classificação dos níveis de evidência, adotou-se o Grading of Recommendations, Assessment, Development and Evaluation. Resultados incluíram-se 42 artigos; desses, 34 classificados como tecnologias de produto, sendo a maioria produtos farmacológicos; dois referentes ao uso do saco plástico transparente para a coleta de sangue e contribuição do intervalo de nascimento e dos cuidados pré-natais. Os oito artigos classificados como tecnologias de processo se referiam a manejo ativo do terceiro estágio do parto, tração controlada de cordão, massagem uterina e intervenções educacionais. Conclusão as tecnologias de produto e de processo apresentaram evidência alta e moderada confirmada em 61,90% dos artigos. Os níveis de evidência demonstram contribuições das tecnologias para prevenção e controle da hemorragia. Na prática clínica, o enfermeiro deve oferecer cuidados à mulher fundamentados em evidências científicas e construir protocolos sobre as ações de cuidado da enfermagem.

Objective to identify evidence concerning the contribution of health technologies used to prevent and control hemorrhaging in the third stage of labor. Method systematic review with database searches. First, two researchers independently selected the papers and, at a second point in time, held a reconciliation meeting. The Kappa coefficient was used to assess agreement, while the Grading of Recommendations, Assessment, Development and Evaluation was adopted to assess risk of bias and classify level of evidence. Results in this review, 42 papers were included, 34 of which addressed product technologies, most referred to pharmacological products, while two papers addressed the use of blood transparent plastic bags collector and the contribution of birth spacing and prenatal care. The eight papers addressing process technologies included the active management of the third stage of labor, controlled cord traction, uterine massage, and educational interventions. Conclusion product and process technologies presented high and moderate evidence confirmed in 61.90% of the papers. The levels of evidence confirm the contribution of technologies to prevent and control hemorrhaging. Clinical nurses should provide scientific-based care and develop protocols addressing nursing care actions.

Objetivo identificar las evidencias acerca de las contribuciones de las tecnologías de cuidado usadas para la prevención y el control de la hemorragia en la tercera etapa del parto. Método revisión sistemática con búsqueda en bases de datos. Dos investigadores seleccionaron los textos, de forma independiente, en la primera etapa; y, en la segunda en reunión de conciliación. Para evaluación de la concordancia fue aplicado el coeficiente Kappa; para evaluación del riesgo de sesgo y clasificación de los niveles de evidencia, se adoptó el Grading of Recommendations, Assessment, Development and Evaluation. Resultados fueron incluidos 42 artículos; de estos, 34 fueron clasificados como: tecnologías de producto (siendo la mayoría productos farmacológicos), dos referentes a la contribución del saco plástico transparente recolector de sangre y del intervalo de nacimiento y de los cuidados prenatales. Los ocho artículos clasificados como tecnologías de proceso se referían al manejo activo de la tercera etapa del parto, a la tracción controlada del cordón, al masaje uterino y a intervenciones educacionales. Conclusión las tecnologías de producto y de proceso presentaron evidencia alta y moderada, lo que fue confirmado en 61,90% de los artículos. Los niveles de evidencia demuestran las contribuciones de las tecnologías para la prevención y el control de la hemorragia. En la práctica clínica, el enfermero debe ofrecer cuidados a la mujer fundamentados en evidencias científicas y construir protocolos sobre las acciones de cuidado de la enfermería.

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ABSTRACT Objective: to analyze the school violence suffered and practiced and its association with the use of alcohol and other drugs in adolescents between 12 and 18 years old. Method: the study sample consisted of 643 adolescents enrolled in six schools, who answered two self-administered questionnaires: "Global School-based Student Health Survey" and "Violence in School". Statistical analysis was performed using the chi-square test and the degree of association between the variables was analyzed using the prevalence ratio. Results: the prevalence of school violence suffered and practiced was 62.2% and 51.9%, respectively. About 44.6% of the aggressors said they did not want to change their behavior. There was an expressive prevalence of alcohol use (16.5%), tobacco (15.7%) and illicit drugs (6.8%), and drunkenness (12.6%). There was a significant association between the violence suffered and the age group of 12 to 14 years old (p=0.001); (p=0.011) and education level in elementary school (p<0.001). In mothers with less than eight years of studies, the association was significant for the violence practiced (p=0.002). Conclusion: the study contributes to the aspects involved in school violence, which can subsidize actions and policies in this area.

RESUMO Objetivo: analisar a violência escolar sofrida e praticada e a sua associação com o uso de álcool e outras drogas entre adolescentes com 12 a 18 anos de idade. Método: a amostra do estudo foi composta por 643 adolescentes matriculados em seis escolas, que responderam a dois questionários autoaplicáveis: "Global School-based Student Health Survey" e "Violência na Escola". A análise estatística foi realizada utilizando-se o teste Qui-quadrado e o grau de associação entre as variáveis analisado por meio da razão de prevalência. Resultados: as prevalências de violência escolar sofrida e praticada foram de 62,2% e 51,9%, respectivamente. Cerca de 44,6% dos agressores afirmaram não querer mudar seu comportamento. Houve prevalência expressiva do uso de álcool (16,5%), tabaco (15,7%), drogas ilícitas (6,8%) e de embriaguez (12,6%). Houve associação significativa entre a violência sofrida e a faixa etária de 12 a 14 anos (p=0,001), sexo masculino (p=0,011) e grau de escolaridade em ensino fundamental (p<0,001). Em mães com menos de oito anos de estudo, a associação foi significativa para a violência praticada (p=0,002). Conclusão: o estudo traz contribuições para os aspectos envolvidos na violência escolar, que podem subsidiar ações e políticas nesse âmbito.

RESUMEN Objetivo: analizar la violencia escolar sufrida y practicada y su asociación con el uso de alcohol y otras drogas entre adolescentes de 12 a 18 años de edad. Método: la muestra del estudio fue compuesta por 643 adolescentes matriculados en seis escuelas, que respondieron a dos cuestionarios autoaplicables: "Global School-based Student Health Survey" y "Violencia en la Escuela". El análisis estadístico fue realizado utilizando el test Chi-cuadrado y el grado de asociación entre las variables fue analizado por medio de la razón de prevalencia. Resultados: las prevalencias de violencia escolar sufrida y practicada fueron de 62,2% y 51,9% respectivamente. Alrededor del 44,6% de los agresores afirmaron no querer cambiar su comportamiento. Se observó una prevalencia expresiva del uso de alcohol (16,5%), tabaco (15,7%) y drogas ilícitas (6,8%), y de embriaguez (12,6%). Se observó una asociación significativa entre la violencia sufrida y el grupo de edad de 12 a 14 años (p=0,001); sexo masculino (p=0,011) y grado de escolaridad en enseñanza primaria (p<0,001). En madres con menos de ocho años de estudio, la asociación fue significativa para la violencia practicada (p=0,002). Conclusión: el estudio aporta contribuciones a los aspectos envueltos en la violencia escolar, que pueden subsidiar acciones y políticas en este ámbito.

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OBJECTIVE: To know and analyze the critical path followed by women subjected to intimate partner violence until reaching a Reference Center of a Brazilian city, from the perspective of these women. METHOD: Qualitative research, based on the concept of critical path. Participant observations of the support group of the Reference Center and interviews with ten women in situations of violence who were followed up in this service. RESULTS: the motivating factors for women to seek help were the increase in the severity of the aggressions, the impact of the violence on their children and support from their family. They go to several sectors and services before reaching the Reference Center, such as the police and legal counsel, health and social services. They find little effective responses from the services, and care is indicated as the most relevant response factor to face the situation. CONCLUSION: the assistance is fragmented and dependent on the posture of the professional. The Reference Center is recognized as an important place of support for women. In addition to governmental efforts to maintain the network structured, the permanent education of the working professionals is also fundamental.

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ABSTRACT Objective: To know and analyze the critical path followed by women subjected to intimate partner violence until reaching a Reference Center of a Brazilian city, from the perspective of these women. Method: Qualitative research, based on the concept of critical path. Participant observations of the support group of the Reference Center and interviews with ten women in situations of violence who were followed up in this service. Results: the motivating factors for women to seek help were the increase in the severity of the aggressions, the impact of the violence on their children and support from their family. They go to several sectors and services before reaching the Reference Center, such as the police and legal counsel, health and social services. They find little effective responses from the services, and care is indicated as the most relevant response factor to face the situation. Conclusion: the assistance is fragmented and dependent on the posture of the professional. The Reference Center is recognized as an important place of support for women. In addition to governmental efforts to maintain the network structured, the permanent education of the working professionals is also fundamental.

RESUMO Objetivo: Conhecer e analisar a rota crítica de mulheres em situação de violência, na perspectiva das mesmas, perpetrada por parceiro íntimo até um Centro de Referência de um município brasileiro. Método: Pesquisa qualitativa, ancorada pelo conceito de rota crítica. Foram realizadas observações participantes do grupo de apoio do Centro de Referência e entrevistas com dez mulheres em situação de violência, acompanhadas por esse serviço. Resultados: os fatores motivadores para as mulheres buscarem ajuda foram o aumento da gravidade das agressões, o impacto da violência nos filhos e o apoio familiar. Passando por diversos setores e serviços antes do acesso ao Centro de Referência, tais como policial, jurídico, saúde e social. Tais mulheres encontram pouca resposta efetiva dos serviços, sendo que o acolhimento é apontado como fator de resposta mais relevante para enfrentamento da situação. Conclusão: O atendimento é fragmentado e dependente da postura do profissional que as atende. O Centro de Referência é reconhecido como importante local de apoio pelas mulheres. Além dos esforços governamentais para manter a rede estruturada, é fundamental a educação permanente dos profissionais atuantes.

RESUMEN Objetivo: Conocer y analizar la ruta crítica de mujeres en situación de violencia perpetrada por su pareja hasta un Centro de Referencia de un municipio brasileño, según la perspectiva de las mismas. Método: se trata de una investigación cualitativa, fundamentada bajo el concepto de ruta crítica. Se realizaron observaciones participativas del grupo de apoyo del Centro de Referencia y se entrevistaron diez mujeres en situación de violencia, acompañadas por este servicio. Resultados: los factores motivadores para que las mujeres buscaran ayuda fueron el aumento de la gravedad de las agresiones, el impacto de la violencia en los hijos y el apoyo familiar. Las mujeres pasan por diversos sectores y servicios antes de acceder al Centro de Referencia, tales como el policial, el jurídico, el de salud y el social. Encuentran poca respuesta efectiva de los servicios, siendo que la acogida es el factor de respuesta principal para enfrentar la situación. Conclusión: La atención está dividida y depende de la postura del profesional que las asiste. El Centro de Referencia es reconocido como importante lugar de apoyo para las mujeres. Además de los esfuerzos gubernamentales para mantener la red estructurada, es fundamental educar continuamente a los profesionales actuantes.

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OBJECTIVE: To identify and analyze the social support network of families involved in violence against children and adolescents, from the perspective of health professionals and families in a municipality of the state of São Paulo, Brazil. METHODS: This was a qualitative strategic social study, anchored in the paradigm of complexity. Data were collected from 41 health professionals and 15 families using institutional or personal network maps, and semi-structured interviews. Analysis was conducted by organizing the data, constructing theoretical frameworks, and categorizing resulting information. RESULTS: The category "weaving the network" was unveiled, with family experiences and professionals focused on a logic of fragmentation of care. FINAL CONSIDERATIONS: The creation and implementation of public policy are urgently needed to address the needs of this population, by empowering families and communities and developing research that respects the multidimensional nature of the phenomenon.

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AIMS AND OBJECTIVES: To contribute the understanding of the network care provided to families involved in family violence against children and adolescents (FVACA), from the Primary Health Care (PHC) perspective. BACKGROUND: Children and adolescents figure among the main victims of violence around the world, which occurs predominantly in the family context. PHC-guided network care has emerged as a new process that contrasts with traditional approaches, which rely on fragmented, punctual and compensatory actions and produce simplified and segmented interventions in response to complex phenomena like violence. The Paradigm of Complexity interacts with the network care approach and, by articulating the multiple dimensions of the research phenomenon, contributes to its understanding. DESIGN: Qualitative research, based on the Paradigm of Complexity. METHODS: Data were collected through minimal maps of the external institutional social network, focus groups and semi-structured interviews held with 41 PHC professionals in Brazil. The notions of comprehension and contextualisation as well as dialogical, recursive and holographic principles from complexity theory guided the data analysis. RESULTS: The two thematic categories that emerged revealed reduced institutional networks, with low-density and homogeneous bonds, which resulted in fragmented care in all stages of the care process. CONCLUSIONS: Although the network organisation of care for the families involved in FVACA is fundamental, the construction of these networks still represents a great challenge, as it requires the joint work of a multiprofessional team. RELEVANCE TO CLINICAL PRACTICE: For nursing to respond to the contemporary care demands in a contemplative and pertinent manner, a perspective and a reference framework need to be developed, leading to broader and more contextualised actions, with a multidimensional approach to the families and communities of which child and adolescent victims of violence are a part.

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OBJECTIVE: to analyze the contribution of Portuguese nursing to improving universal health access and coverage by means of the identification of nurses in the health system; evolution of health indicators; and access-promoting systems, in which nurses play a relevant role. METHOD: this was documentary research of publications from national and international organizations on planning and health outcomes. Statistical databases and legislation on health reforms were consulted. RESULTS: nurses represent 30.18% of human resources in the national health service; the systems of access promotion performed by nurses have good levels of efficacy (95.5%) and user satisfaction (99% completely satisfied); in the local care the creation of Community Care Units (185) occurred, and 85.80% of home consultations were performed by nurses. CONCLUSION: political strategies, the National Health Service and strengthening of human resources in healthcare are the main determinants. Nursing is the most numerous professional group in the National Health Service, however numbers remain deficient in primary health care. The improvement of academic qualification and self-regulation of this professional group has allowed for better answers in improving health for the Portuguese.

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Objetivos: Identificar a prevalência de violência no namoro entre adolescentes e discutir a associação entre os comportamentos de violência e as variáveis: idade, sexo e tempo de namoro. Métodos: Estudo transversal epidemiológico. A amostra foi constituída por 1.268 estudantes de ambos os sexos, idades entre 16 e 24 anos, de escolas secundárias de quatro distritos da Região Central de Portugal. Na coleta de dados, foi utilizado um questionário contendo dados sociodemográficos e de comportamentos de vitimização e perpetração de violência no namoro. Resultados: 5,9% do total dos adolescentes referiram envolvimento em situação de violência no namoro. Ambos os sexos relataram uso de violência física. Na violência psicológica, o sexo masculino é o maior perpetrador e vítima. Conclusão: Os resultados apresentaram, em alguns comportamentos, similaridade do padrão de violência entre os sexos, tais como: puxar os cabelos com força; dar uma bofetada; apertar o pescoço; atirar objetos em outra pessoa; dar pontapés e cabeçadas e dar empurrões violentos, indicando, portanto, que mais pesquisas são necessárias para entender que fatores influenciam as diferenças e similaridades desse evento.

Objectives: To identify the prevalence of dating violence among adolescents and discuss the association between the violentbehaviors and the variables: age, gender and length of dating relationship. Methods: Epidemiological cross-sectional study.Sample: 1,268 male and female students, aged 16-24 years, enrolled in Portuguese secondary schools. Data were collectedthrough questionnaires including sociodemographic data and data on dating violence victimization and perpetration behaviors.Results: 5.9% of the adolescents were involved in dating violence situations. Both genders used physical violence. Males werethe greatest perpetrators and victims of psychological violence. Conclusion: A similar pattern of violence was found betweengenders in some behaviors, such as: hair pulling, choking, throwing objects, slapping, kicking, head-banging, and pushing.Therefore, further studies are needed to understand which factors influence the differences and similarities of dating violence.

Objetivos: Identificar la prevalencia de la violencia en el noviazgo entre adolescentes y discutir la relación entre las conductasde violencia y variables independientes: edad, sexo y tiempo de citas. Métodos: Estudio Transversal Epidemiológico. Lamuestra estuvo conformada por 1.268 estudiantes, de ambos sexos, de 16 y 24 años de edad, de escuelas secundarias decuatro distritos de la Región Centro de Portugal. En la recolección de datos, se utilizó un cuestionario que contiene los datossociodemográficos y el comportamiento de la victimización y perpetración de violencia en el noviazgo. Resultados: 5,9% detodos los adolescentes reportaron participación en situaciones de violencia en el noviazgo. Ambos sexos reportaron el uso de laviolencia física. En la violencia psicológica, los chicos son los mayores perpetradores y las víctimas. Conclusion: Los resultadosmuestran, en algunos comportamientos, similitudes del estándar de violencia entre los sexos, como el pelo tirando con fuerza;bofetada; apriete el cuello; lanzar objetos a otra pessoa; patadas y cabezazos cabeza y dar sacudidas violentas, lo que indica,por lo tanto, que se necesita más investigación para entender que factores influyen en las diferencias y similitudes de este evento.

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RESUMO Objetivo Conhecer e analisar as redes de apoio a famílias envolvidas na violência contra crianças e adolescentes pela perspectiva de profissionais da atenção básica à saúde e de familiares em um município do interior do Estado de São Paulo, Brasil. Métodos Pesquisa qualitativa, do tipo social estratégica, delineada pelo Paradigma da Complexidade. A coleta de dados foi realizada com 41 profissionais e 15 familiares por meio de Mapas da Rede Institucional ou Pessoal e entrevistas semiestruturadas. A análise se deu por meio da organização das informações, formação de quadros referenciais e categorização. Resultados Desvelou-se a categoria "Tecendo a rede" com vivências familiares e dos profissionais centradas numa lógica de fragmentação do cuidado. Considerações finais Desvela-se a urgente necessidade da construção e/ou efetivação de políticas públicas direcionadas às famílias com o empoderamento do núcleo familiar e comunitário, bem como da realização de estudos com abordagens que respeitem a multidimensionalidade do fenômeno.

RESUMEN Objetivo Analizar las redes de apoyo a los familiares involucrados en la violencia contra los niños y los adolescentes en el municipio del interior del Estado de São Paulo. Métodos Investigación cualitativa, del tipo social estratégico, delineada por el Paradigma de la Complejidad. La recolección de datos fue realizada con 41 profesionales y 15 familiares a través de Mapas de la Red Institucional o Personal y entrevistas semiestructuradas. El análisis se dio por medio de la organización de las informaciones; Formación de cuadros referenciales y categorización. Resultados Se desveló la categoría "Tejiendo la red", con vivencias familiares y de los profesionales centradas en una lógica de fragmentación del cuidado. Consideraciones finales Se desvela la urgente necesidad de la construcción y/o efectividad de políticas públicas dirigidas a las familias, con el empoderamiento del núcleo familiar y comunitario, así como por la realización de estudios con la multidimensionalidad del fenómeno.

ABSTRACT Objective To identify and analyze the social support network of families involved in violence against children and adolescents, from the perspective of health professionals and families in a municipality of the state of São Paulo, Brazil. Methods This was a qualitative strategic social study, anchored in the paradigm of complexity. Data were collected from 41 health professionals and 15 families using institutional or personal network maps, and semi-structured interviews. Analysis was conducted by organizing the data, constructing theoretical frameworks, and categorizing resulting information. Results The category "weaving the network" was unveiled, with family experiences and professionals focused on a logic of fragmentation of care. Final considerations The creation and implementation of public policy are urgently needed to address the needs of this population, by empowering families and communities and developing research that respects the multidimensional nature of the phenomenon.

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Objective: to analyze the contribution of Portuguese nursing to improving universal health access and coverage by means of the identification of nurses in the health system; evolution of health indicators; and access-promoting systems, in which nurses play a relevant role. Method: this was documentary research of publications fromnational and international organizations on planning and health outcomes. Statistical databases and legislation on health reforms were consulted. Results: nurses represent 30.18% of human resources in the national health service; the systems of access promotion performed by nurses have good levels of efficacy (95.5%) and user satisfaction (99% completely satisfied); in the local care the creation of Community Care Units (185) occurred, and 85.80% of home consultations were performed by nurses. Conclusion: political strategies, the National Health Service and strengthening of human resourcesin healthcareare the main determinants. Nursing is the most numerous professional group in the National Health Service, however numbers remaindeficient in primary health care. The improvement of academic qualification and self-regulation of this professional group has allowed for better answers inimproving health for the Portuguese.

Objetivo: analisar a contribuição da enfermagem portuguesa para a melhoria do acesso e cobertura universal em saúde, através da identificação da distribuição dos enfermeiros no sistema de saúde; evolução de indicadores de saúde; e sistemas de promoção do acesso, em que os enfermeiros têm papel relevante. Método: pesquisa documental das publicações de organizações nacionais e internacionais sobre planejamento e resultados em saúde, consultadas bases de dados estatísticos e legislação sobre as reformas da saúde. Resultados: no serviço nacional de saúde os enfermeiros representam 30,18% dos recursos humanos; nos sistemas de promoção de acesso, realizados por enfermeiros, verificam-se bons níveis de eficácia (95,5%) e satisfação dos utentes (99% totalmente satisfeitos); nos cuidados de proximidade regista-se a criação de Unidades de Cuidados na Comunidade (185) e 85,80% das consultas domiciliárias realizadas por enfermeiros. Conclusões: estratégias políticas, serviço nacional de saúde e reforço dos recursos humanos em saúde são os principais determinantes. A enfermagem é o grupo profissional mais numeroso no serviço nacional de saúde, mas ainda deficitária nos cuidados de saúde primários. O aumento da qualificação acadêmica e autorregulação deste grupo profissional tem permitido melhores respostas ao desafio de melhoria da saúde para os portugueses.

Objetivo: analizar la contribución de la enfermería portuguesa para la mejora del acceso y cobertura universal en salud, mediante la identificación de la distribución de los enfermeros en el sistema de salud, evolución de los indicadores de salud y sistemas de promoción del acceso en los que los enfermeros tienen un papel importante. Método: investigación documental de las publicaciones de organizaciones nacionales e internacionales sobre planificación y resultados en salud, basadas en datos estadísticos y la legislación sobre las reformas de salud. Resultados: en el servicio nacional de salud, los enfermeros representan 30.18% de los recursos humanos; en los sistemas de promoción de acceso realizados por enfermeros, se verifican buenos niveles de eficacia (95.5%) y satisfacción de los usuarios (99% totalmente satisfechos), y los cuidados de proximidad registran la creación de Unidades de Cuidados en la Comunidad (185) y 85.80% de las consultas domiciliarias realizadas por enfermeros. Conclusiones: las estrategias políticas, servicio nacional de salud y refuerzo de los recursos humanos en salud son los principales determinantes. La enfermería es el grupo profesional más numeroso en el servicio nacional de salud, pero es aún deficiente en cuanto a los cuidados primarios de salud. El aumento de la calificación académica y autorregulación de este grupo profesional ha permitido mejores respuestas ante el desafío de mejora de la salud para los portugueses.

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Objective To understand the trajectories that women go through from entering into to leaving relationships involving intimate partner violence (IPV), and identify the stages of the transition process. Method We utilized a constructivist paradigm based on grounded theory. We ensured that the ethical guidelines of the World Health Organization for research on domestic violence were followed. The analysis focused on narratives of 28 women survivors of IPV, obtained from in-depth interviews. Results The results showed that the trajectories experienced by women were marked by gender issues, (self) silencing, hope and suffering, which continued after the end of the IPV. Conclusion The transition process consists of four stages: entry - falls in love and becomes trapped; maintenance - silences own self, consents and remains in the relationship; decides to leave - faces the problems and struggles to be rescued; (re) balance - (re) finds herself with a new life. This (long) process was developed by wanting (and being able to have) self-determination.

RESUMEN

Objective To understand the trajectories that women go through from entering into to leaving relationships involving intimate partner violence (IPV), and identify the stages of the transition process. Method We utilized a constructivist paradigm based on grounded theory. We ensured that the ethical guidelines of the World Health Organization for research on domestic violence were followed. The analysis focused on narratives of 28 women survivors of IPV, obtained from in-depth interviews. Results The results showed that the trajectories experienced by women were marked by gender issues, (self) silencing, hope and suffering, which continued after the end of the IPV. Conclusion The transition process consists of four stages: entry - falls in love and becomes trapped; maintenance - silences own self, consents and remains in the relationship; decides to leave - faces the problems and struggles to be rescued; (re) balance - (re) finds herself with a new life. This (long) process was developed by wanting (and being able to have) self-determination. .

Objetivo Conhecer as trajetórias que as mulheres percorrem desde a entrada até à saída de relações de violência exercida por parceiros íntimos (VPI), e identificar as fases do processo de transição. Método Utilizou-se um paradigma construtivista com recurso à grounded theory. Salvaguardaram-se as orientações éticas da OMS em matéria de investigação sobre violência doméstica. A análise centrou-se em narrativas de 28 mulheres sobreviventes de VPI, obtidas em entrevistas em profundidade. Resultados Referem que as trajetórias percorridas pelas mulheres foram atravessadas por questões de género, (auto)silenciamento, esperança e sofrimento, o que ultrapassou o fim da VPI. Conclusión O processo de transição é constituído por quatro fases: entrada - enamora-se e fica aprisionada; manutenção - auto-silencia-se, consente e permanece na relação; decisão de saída - enfrenta o problema e luta pelo resgate; (re)equilíbrio - (re)encontra-se com uma nova vida. Este (longo) processo foi atravessado por querer (e poder) autodeterminar-se. .

Objetivo Conhecer as trajetórias que as mulheres percorrem desde a entrada até à saída de relações de violência exercida por parceiros íntimos (VPI), e identificar as fases do processo de transição. Método Utilizou-se um paradigma construtivista com recurso à grounded theory. Salvaguardaram-se as orientações éticas da OMS em matéria de investigação sobre violência doméstica. A análise centrou-se em narrativas de 28 mulheres sobreviventes de VPI, obtidas em entrevistas em profundidade. Resultados Referem que as trajetórias percorridas pelas mulheres foram atravessadas por questões de género, (auto)silenciamento, esperança e sofrimento, o que ultrapassou o fim da VPI. Conclusão O processo de transição é constituído por quatro fases: entrada - enamora-se e fica aprisionada; manutenção - auto-silencia-se, consente e permanece na relação; decisão de saída - enfrenta o problema e luta pelo resgate; (re)equilíbrio - (re)encontra-se com uma nova vida. Este (longo) processo foi atravessado por querer (e poder) autodeterminar-se. .

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