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This Special Report aims to outline the development process of the first National Clinical and Policy guidelines on Intimate Partner Violence and Sexual Violence in Trinidad and Tobago and to support the implementation of quality standards for survivors. The study used an implementation science approach to identify key evidence-based practice recommendations from guidance documents on health care for women who are subjected to violence and from relevant national legislation, policy, and practices. The process engaged stakeholders in discussions on the appropriateness, implementation, and use of these recommendations in the context of local health care delivery. Multidisciplinary teams of frontline health workers were consulted in groups in each of the five Regional Health Authorities. Interviews were held with senior government stakeholders responsible for health policy and with representatives of four civil society agencies. Participants provided recommendations to integrate quality standards into routine practice. These were incorporated into the guidelines, which include human rights principles and pathways of care for identifying violence, providing psychosocial and clinical care, safety planning, referrals, care during emergencies, and prevention of intimate partner violence and sexual violence. The guidelines were approved by the Ministry of Health of Trinidad and Tobago on 15 August 2022. Training of trainers has been undertaken to support implementation.

El objetivo de este informe especial es describir el proceso de elaboración de las primeras directrices políticas y clínicas nacionales sobre violencia de pareja y violencia sexual en Trinidad y Tabago, así como brindar apoyo para la aplicación de normas de calidad dirigidas a las personas supervivientes. El estudio utilizó un enfoque de ciencia de implementación para hallar recomendaciones prácticas clave basadas en la evidencia a partir de documentos de orientación sobre atención de salud para mujeres víctimas de violencia, así como de las leyes, políticas y prácticas nacionales pertinentes. El proceso involucró a las partes interesadas en las deliberaciones sobre la idoneidad, la puesta en práctica y el uso de estas recomendaciones en el contexto de la prestación de servicios de salud locales. Se realizaron consultas grupales a equipos multidisciplinarios de trabajadores de salud de primera línea de cada una de las cinco autoridades regionales de salud. Se mantuvieron entrevistas con funcionarios gubernamentales con cargos de responsabilidad en materia de políticas de salud y con representantes de cuatro organizaciones de la sociedad civil. Los participantes proporcionaron recomendaciones para integrar las normas de calidad en la práctica habitual. Estas recomendaciones se incorporaron a las directrices, que incluyen principios de derechos humanos y protocolos asistenciales para detectar la violencia, prestación de atención psicosocial y clínica, diseño de planes de seguridad, derivación de los casos, atención durante emergencias y prevención de la violencia de pareja y la violencia sexual. Las directrices fueron aprobadas por el Ministerio de Salud de Trinidad y Tabago el 15 de agosto del 2022. Se ha llevado a cabo la capacitación de formadores a fin de brindar apoyo para su puesta en práctica.

O objetivo deste relatório especial é resumir o processo de elaboração das primeiras diretrizes clínicas e orientações sobre políticas de âmbito nacional para violência por parceiro íntimo e violência sexual de Trinidad e Tobago, bem como apoiar a implementação de padrões de qualidade para sobreviventes. O estudo utilizou uma abordagem científica de implementação para identificar as principais recomendações de práticas baseadas em evidências, derivadas de documentos de orientação sobre atenção à saúde para mulheres vítimas de violência e de leis, políticas e práticas nacionais pertinentes. O processo envolveu as partes interessadas em discussões sobre adequação, implementação e uso dessas recomendações no contexto da prestação de serviços de saúde em nível local. Em cada uma das cinco autoridades regionais de saúde, equipes multidisciplinares de profissionais de saúde na linha de frente foram consultadas em grupo. Foram entrevistadas partes interessadas da alta administração do governo que eram responsáveis pela política de saúde e representantes de quatro organizações da sociedade civil. Os participantes fizeram recomendações para integrar padrões de qualidade à prática de rotina. Tais recomendações foram incorporadas às diretrizes, que incluem princípios de direitos humanos e percursos assistenciais para identificação de violência, oferta de atenção psicossocial e clínica, planejamento da segurança, encaminhamentos, cuidados durante emergências e prevenção de violência por parceiro íntimo e violência sexual. As diretrizes foram aprovadas pelo Ministério da Saúde de Trinidad e Tobago em 15 de agosto de 2022. Realizou-se capacitação de instrutores para apoiar a implementação.

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OBJECTIVES: Describe the characteristics and changes in the profile of women who sought care after experiencing sexual violence (SV) during the first six months of the COVID-19 pandemic in a Brazilian city. METHODS: This is a cross-sectional retrospective study. Data from emergency care and legal abortion requests of women assisted at the Women's Health Care Center Hospital (School of Medical Sciences, University of Campinas, Brazil) due to SV experienced between March 23 and August 23, 2020 (Quarantine Group, QG), were collected and compared with data from the same period of the previous biennium (Comparison Group, CG). χ2 and Fisher's exact tests were used to compare groups; the significance level was 5%. RESULTS: Data for 236 women were analyzed; 70 women were included in the QG and 166 in the CG. In the QG, there was a restriction in the area of origin of women, with a higher proportion of women who lived in Campinas (P = 0.0007) and a higher frequency of chronic SV (P = 0,035). There were no rapes associated with the use of social media or apps in the QG, but 9.8% of women in the CG experienced rape associated with the use of social media or apps. There were higher rates of domestic violence (P = 0.022) and intimidation through physical force (P = 0.011) in the first two months. CONCLUSION: The COVID-19 quarantine affected the profile of women who sought care after experiencing SV. The quarantine resulted in changes in the area of origin of patients, hindering access to health services and leading to higher rates of chronic and domestic SV, particularly in the first 2 months of the pandemic.

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PURPOSE: To verify clinical validity evidence for the ineffective social support network nursing diagnosis. METHOD: A quantitative, descriptive, cross-sectional study was performed with 98 violence-victimized women treated in two reference centers for violence in the city of Recife, Pernambuco, Brazil. The women were interviewed from August 2021 to June 2022. FINDINGS: The clinical indicators that best predicted the nursing diagnosis were as follows: Frustration with unmet support expectations, negative social interaction, perceived neglect of support demands, feeling of abandonment, low reciprocity, and encouragement of negative behaviors. Etiological factors that showed greater association were excessive demand for support, limited social network, social isolation, the fragility of institutional service networked organizations, and inadequate appreciation of available social support. CONCLUSIONS: The clinical validity evidence for the ineffective social support network nursing diagnosis has been verified. Thus, the validated clinical indicators and etiological factors can accurately diagnose and predict the emergence of this phenomenon in violence-victimized women. IMPLICATIONS FOR NURSING PRACTICE: The results contribute to advancing scientific knowledge in nursing teaching, research, and practice and support the nursing process in violence-victimized women.

OBJETIVO: Verificar evidências de validade clínica para o diagnóstico de enfermagem Rede de Apoio Social Ineficaz. MÉTODO: Estudo quantitativo, descritivo e transversal realizado com 98 mulheres vítimas de violência atendidas em dois centros de referência em violência na cidade do Recife, Pernambuco, Brasil. As mulheres foram entrevistadas no período de agosto de 2021 a junho de 2022. RESULTADOS: Os indicadores clínicos que melhor predisseram o diagnóstico de enfermagem foram: Frustração com Expectativas de Apoio Não Atendidas, Interação Social Negativa, Negligência Percebida nas Demandas de Apoio, Sentimento de Abandono, Baixa Reciprocidade e Incentivo a Comportamentos Negativos. Os fatores etiológicos que apresentaram maior associação foram Demanda Excessiva de Apoio, Rede Social Limitada, Isolamento Social, Fragilidade das Organizações em Rede de Serviços Institucionais e Valorização Inadequada do Apoio Social Disponível. CONCLUSÕES: Foram verificadas evidências de validade clínica para o diagnóstico de enfermagem Rede de Apoio Social Ineficaz. Assim, os indicadores clínicos e fatores etiológicos validados têm a capacidade de diagnosticar e prever com precisão o surgimento deste fenômeno em mulheres vítimas de violência. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: A validação clínica do diagnóstico fundamenta as intervenções de enfermagem direcionadas às mulheres vítimas de violência e à sua rede de apoio social. PALAVRAS­CHAVE: Apoio social; Educação saudável; diagnóstico de enfermagem; rede social; violência contra as mulheres.

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O objetivo desse estudo é traçar o perfil epidemiológico das notificações de violência contra a mulher no estado da Paraíba, no período de 2009 a 2019. Trata-se de um estudo transversal, descritivo, realizado por meio de consulta online ao Sistema de Informação TabNet na seção de Doenças e Agravos de Notificação através do campo violência interpessoal. Como parte dos resultados, identificamos que a violência mais frequente é a física, 45,2%. Foi observado que o maior número de queixas envolve mulheres negras, com 60,11% dos casos; na faixa etária de 20 a 29 anos, 22,71%; com ensino fundamental incompleto, 14,21%. Ademais, 59,2% das situações de violência contra a mulher ocorrem, predominantemente, em locais residenciais. Quanto aos encaminhamentos ao setor de saúde, os achados revelam que, nesse item, em 54,15% dos registros é definido como ignorado. O estudo apontou uma grande fragilidade nos registros de dados sobre violência, tanto pela falta de informações quanto pelo preenchimento inadequado das fichas. Por isso, é crucial reforçar a importância do preenchimento adequado das fichas de notificação compulsória e a qualificação dos profissionais para fornecer evidências precisas sobre o problema e subsidiar a gestão para os enfrentamentos.

This study aims to trace the epidemiological profile of notifications of violence against women in the state of Paraíba from 2009 to 2019. This cross-sectional, descriptive study conducted an online consultation of the TabNet Information System in the Diseases and Notifiable Diseases section through the field of interpersonal violence. As part of the results, we identified that the most frequent form of violence was physical violence (45.2%). We found that the highest number of complaints involved black women, with 60.11% of cases; in the 20-29 age group, 22.71%; and with incomplete primary education, 14.21%. In addition, 59.2% of situations of violence against women occur predominantly in residential areas. As for referrals to the health sector, the findings reveal that 54.15% of the records were defined as ignored. The study pointed to a significant weakness in the recording of data on violence, both due to the lack of information and the inadequate filling out of forms. For this reason, it is crucial to reinforce the importance of correctly filling out compulsory notification forms and training professionals to provide accurate evidence of the problem and support management in dealing with it.

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Like other parts of the world, women and girls in the Commonwealth Caribbean (CC) experience high and escalating rates of physical and sexual violence. The interview presented outlines some factors that underscore the gendered disparities of violence against women in the Caribbean as well as how healthcare responses are not developed for marginalised women and girls. The interview explores the invisibility of women and girls within healthcare and broader national healthcare structures responses through case details analysis of a Barbadian strategic litigation case. The interview calls for transdisciplinary approaches to analysing the effectiveness of the global health system that make space for not just traditional research approaches but also lived experiences 'from below' and input of advocates and activists. Despite Barbados being a signatory to a range of global health initiatives to improve healthcare responses to gender-based violence, the country does not have a formalised, comprehensive national plan to inform prevention and intervention measures. The interview shows the connections between plantocratic patriarchal culture (PPC) and the existing gaps that cause harm to women and girls who experience various types of gendered violence.

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Purpose: The purpose of this study is to bring a multilevel perspective to the discussion of the antecedents of violence against women in higher education settings. Originality/value: This paper was guided by the need indicated in the literature for research on the multiple levels that constitute the context of violence against women, as this is a public health problem, a designation that indicates the urgency with which this pervasive phenomenon should be addressed. The university context is conducive to this type of research, as it includes situations that favor instances of violence. Additionally, it aligns with the United Nations Sustainable Development Goals (SDGs) of Gender Equality and Quality Educations. Design/methodology/approach: This paper follows a qualitative and interpretative approach. This choice was due to the need to know the "how" and "why" elements that are part of violence against women in the university context. As the main source of evidence for the study, we conducted 20 in-depth interviews with women (victims) and men (aggressors), all university students involved in situations of violence. The transcription of the interviews generated 346 quotations, including 41 analysis codes. Findings: After conducting the data coding, we identified that (i) the actions and omissions of the educational institution, (ii) the taste for violence, the perception of self-efficacy and the influence of the aggressors' group of friends, and (iii) the apparent dichotomy between women's vulnerability and women's strength are among the main antecedents of violence against women. The article concludes with possible research questions to combat violence. Among the contribution of the discussions presented in our article, we highlight the importance of adopting a multilevel view so that we can better understand and fight against this violence, the existence of which is not restricted to the university context.

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INTRODUCTION: Non-consented care, a form of obstetric violence involving the lack of informed consent for procedures, is a common but little-understood phenomenon in the global public health arena. The aim of this secondary analysis was to measure the prevalence and assess change over time of non-consented care during childbirth in Mexico in 2016 and 2021, as well as to examine the association of sociodemographic, pregnancy-, and childbirth-factors with this type of violence. METHODS: We measured the prevalence of non-consented care and three of its variations, forced sterilization or contraception, forced cesarean section, and forced consent on paperwork, during childbirth in Mexico for 2016 (N = 24,036) and 2021 (N = 19,322) using data from Mexico's cross-sectional National Survey on the Dynamics of Household Relationships (ENDIREH). Weighted data were stratified by geographical regions. We performed adjusted logistic regression analyses to explore associations. RESULTS: The national prevalence of non-consented care and one of its variations, pressure to get a contraceptive method, increased from 2016 to 2021. A decrease in the prevalence was observed for forced contraception or sterilization without knowledge, forcing women to sign paperwork, and non-consented cesarean sections nationally and in most regions. Women between the ages of 26 and 35 years, married, cohabiting with partner, living in urban settings, who do not identify as Indigenous, and who received prenatal services or gave birth at the Mexican Institute of Social Security (IMSS) facilities experienced a higher prevalence of non-consented care. Being 26 years of age and older, living in a rural setting, experiencing stillbirths in the last five years, having a vaginal delivery, receiving prenatal services at IMSS, or delivering at a private facility were significantly associated with higher odds of reporting non-consented care. CONCLUSION: While a decrease in most of the variations of non-consented care was found, the overall prevalence of non-consented care and, in one of its variations, pressure to get contraceptives, increased at a national and regional level. Our findings suggest the need to enforce current laws and strengthen health systems, paying special attention to the geographical regions and populations that have experienced higher reported cases of this structural problem.

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Domestic violence (DV) is a global prevalent health problem leading to adverse health consequences, yet health systems are often unprepared to address it. This article presents a comparative synthesis of the health system's pre-conditions necessary to enable integration of DV in health services in Brazil, Nepal, Sri Lanka and occupied Palestinian Territories (oPT). A cross-country, comparative analysis was conducted using a health systems readiness framework. Data collection involved multiple data sources, including qualitative interviews with various stakeholders; focus-group discussions with women; structured facility observations; and a survey with providers. Our findings highlight deficiencies in policy and practice that need to be addressed for an effective DV response. Common readiness gaps include unclear and limited guidance on DV, unsupportive leadership coupled with limited training and resources. Most providers felt unprepared, lacked guidance and felt unsupported and unprotected by managers and their health system. While in Brazil most providers felt they should respond to DV cases, many in Sri Lanka preferred not to. Such organizational and service delivery challenges, in turn, also affected how health providers responded to DV cases leaving them not confident, uncertain about their knowledge and unsure about their role. Furthermore, providers' personal beliefs and values on DV and gender norms also impacted their motivation and ability to respond, prompting some to become 'activists' while others were reluctant to intervene and prone to blame women. Our synthesis also pointed to a gap in women's use of health services for DV as they had low trust in providers. Our conceptual framework demonstrates the importance of having clear policies and highlights the need to engage leadership across every level of the system to reframe challenges and strengthen routine practices. Future research should also determine the ways in which women's understanding and needs related to DV help-seeking are addressed.

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BACKGROUND: Violence against women (VAW) severely impacts their physical and mental health. In some cultures, women can normalize certain types of violence if they were linked to home models in childhood and, eventually, do not seek for help in adulthood. We aimed to determine, in Peruvian women, (1) the association between witnessing violence in their family of origin and VAW experienced in adulthood, (2) the extent to which women who have experienced VAW seek some help, and (3) identify VAW prevalence by Peruvian region. METHODS: Cross-sectional study of secondary data obtained from the 2019 National Demographic and Family Health Survey (ENDES). The outcome was VAW (psychological, physical and sexual violence), whereas the exposure was witnessing violence in the home of origin. Help-seeking behavior was a secondary outcome, for which VAW was the exposure. Prevalence ratios (PR) were estimated to assess both associations, unadjusted and adjusted for covariates (aPR). RESULTS: Data from 14,256 women aged 15 to 49 years were analysed. 51.5% reported having experienced VAW and 43.8% witnessed violence in the home of origin during childhood. Witnessing inter-parental violence in childhood was associated with psychological violence aPR = 1.25 (95% CI: 1.17-1.33), physical aPR = 1.52 (95% CI: 1.38-1.67), and sexual aPR = 1.99 (95% CI: 1.57-2.52). Women who have experienced both types of violence (physical and sexual) were more likely to help-seeking (aPR = 1.30, 95% CI: 1.14-1.50) than women suffering only one type of violence. CONCLUSION: Women who reported having witnessed home violence in their childhood are more likely to experience Violence Against Women (VAW) by their current partner. Physical and sexual violence with a current partner was more associated with witnessing inter-parental violence in childhood, and when physical and sexual violence jointly occurred women were more help-seeking. The southern region of Peru is identified as an area of high vulnerability for women. It is crucial to promote educative and community-based programs aimed at the prevention and early recognition of VAW.

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Introdução: O cenário pandêmico trouxe à tona e de forma potencializada alguns indicadores preocupantes acerca da violência domésticacontra a mulher.Dessa maneira, questiona-se: a pandemia de COVID-19 provocou diferença no número de ocorrências de casos de Violência Doméstica?Objetivo:Comparar a ocorrência de casos de violência doméstica contra mulheres em um estado brasileiro nos períodos de 2015 a 2018 e 2019a 2021 segundo dados da Polícia Civil do estado.Metodologia:Trata-se de um estudo documental e descritivo, realizado com dados secundários. As informações foram colhidas através da ouvidoria da Polícia Civil em 11 de março de 2021,a partir dos registros de boletins de ocorrências policiais sobre violência doméstica contra a mulher dos anos de 2015 a 2021.Resultados:Durante os anos de 2015 a 2021 foram registrados um total de 26.671 boletins de ocorrência por violência contra a mulher. De 2015 a 2018,a média mensal foi de 360,1ocorrênciase durante a pandemia, de 2019 a 2021, a média mensal foi de 360,9ocorrências. Notou-se um discreto aumento na quantidade de boletins de ocorrência feito durante a pandemia deCOVID-19, com destaque para 2020, que apresentou média mensal de 387,4ocorrências, período mais recrudescido da pandemia. A principal violência perpetrada foi a lesão corporal dolosa principalmente contra mulheres de 18 a 24 anos, que trabalhavam em casa ou estavam desempregadas.Conclusão:Apesar da falta de diferenças expressivas entre os anos pré e pós-pandemia, a análise reforça a urgência de discutir os fatores subjacentes à violência contra a mulher, especialmente a violência doméstica. Destaca-se a importância de medidas preventivas e de apoio às vítimas para enfrentar esse problema social. É essencial promover políticas visando uma sociedade mais segura e igualitária para todas as mulheres (AU).

Introduction:The pandemic scenario has brought to light, and in a intesified manner, some concerning indicators regarding domestic violence against women. Thus, the question arises: did the COVID-19 pandemic make a difference in the number of domestic violence cases? Objective: To compare the occurrence of domestic violence cases against Brazilian women in the periods from 2015 to 2018 and 2019 to 2021 according to data from the state's Civil Police. Methodology: This is a documentary and descriptive study, conducted with secondary data. The information was collected through the Civil Police ombudsman on March 11, 2021, based on police reports of domestic violence against women from 2015 to 2021. Results: During the year of 2015 to 2021, a total of 26,671 police reports of violence against women were registered. From 2015 to 2018, the monthly average was 360.1 occurrences, and during the pandemic, from 2019 to 2021, the monthly average was 360.9 occurrences. There was a slight increase in the number of police reports during the COVID-19 pandemic, with a peak in 2020, which had a monthly average of 387.4 occurrences, the most intense period of the pandemic. The main violence perpetrated was intentional bodily harm, mainly against women aged 18 to 24, who were either working from home or unemployed. Conclusion: Despite the lack of significant differences between pre and post-pandemic years, the analysis reinforces the urgency of discussing the underlying factors of violence against women, especially domestic violence. The importance of preventive measures and support for victims to address this social problem is emphasized. It is essential to promote policies aimed at a more equal and safer society for all women (AU).

Introducción: El escenario pandémico ha sacado a la luz algunos indicadores preocupantes sobre la violencia doméstica contra las mujeres. Entonces, surge la pregunta: ¿la pandemia de COVID-19 ha provocado una diferencia en el número de ocurrencias de casos de Violencia Doméstica?Objetivo:Comparar la ocurrencia de casos de violencia doméstica contra las mujeres en un estado brasileño en los períodos de 2015 a2018 y de 2019 a 2021 según datos de la Policía Civil del estado. Metodología:Se trata de un estudio documental y descriptivo, realizado con datos secundarios. La información fue recabada a través de la Defensoría del Pueblo de la Policía Civil el 11 de marzo de 2021,a partir de los registros de las denuncias policiales sobre violencia intrafamiliar contra las mujeres de 2015 a 2021.Resultados:De 2015 a 2021 se presentaron un total de 26.671 denuncias policiales por violencia contra las mujeres. De 2015 a 2018, el promedio mensual fue de 360,1 ocurrencias y durante la pandemia, de 2019 a 2021, el promedio mensual fue de 360,9 ocurrencias. Hubo un ligero aumento en el número de denuncias policiales realizadas durante la pandemia de COVID-19, especialmente en 2020, que tuvo un promedio mensual de 387,4 ocurrencias, el período más severo de la pandemia. La principal violencia perpetrada fueron lesiones corporales intencionales, principalmente contra mujeres de 18 a 24 años, que trabajaban en el hogar o estaban desempleadas.Conclusión:A pesar de la falta de diferencias significativas entre los años pre y post pandemia, el análisis refuerza la urgencia de discutir los factores que subyacen a la violencia contra las mujeres, especialmente la violencia doméstica. Se destaca la importancia de las medidas preventivas y de apoyo a las víctimas para hacer frente a esta problemática social. Es esencial promover políticas encaminadas a lograr una sociedad más segura e igualitaria para todas las mujeres (AU).

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O estudo apresentado neste artigo objetivou descrever a produção científica entre 2012 e 2022 sobre o cuidado médico na Atenção Primária à Saúde a mulheres em situação de violência. Trata-se de um estudo bibliométrico e descritivo de abordagem quantitativa, a partir de publicações indexadas na base de dados Web of Science mediante o uso dos descritores "Violence Against Women", "Medical Care", "Primary Health Care". Diante do que foi analisado, é perceptível uma falta de priorização de estratégias de cuidados pelos serviços de saúde, apesar de uma produção científica consideravelmente importante, bem como uma falta de atuação de alguns nichos dos profissionais de saúde. O desenho metodológico permitiu um mapeamento do perfil dos estudos voltados para a temática, assim como a necessidade de estudos sobre intervenções multidisciplinares, em especial o cuidado médico, na Atenção Primária à Saúde, a mulheres em situação de violência.

The study presented in this article aimed to describe the scientific production between 2012 and 2022 on medical care in Primary Health Care for women in situations of violence. This is a bibliometric and descriptive study of quantitative approach, from publications indexed in the Web of Science database through the use of the follow descriptors: "Violence Against Women", "Medical Care", "Primary Health Care". In the light of what has been analyzed, it is visible a lack of prioritisation of care strategies by the health services, despite a considerably important scientific production, as well as a lack of action by certain niches of health professionals. The methodological design made it possible to map out the profile of studies on the subject, as well as the need for studies on multidisciplinary interventions, especially the medical care by health services in Primary Health Care for women in situations of violence.

El estudio presentado en este artículo tuvo como objetivo describir la producción científica entre 2012 y 2022 sobre el cuidado médico en la Atención Primaria de Salud a mujeres en situación de violencia. Se trata de un estudio bibliométrico y descriptivo con enfoque cuantitativo, basado en publicaciones indexadas en la base de datos Web of Science utilizando el descriptores "Violence Against Women", "Medical Care", "Primary Health Care". Frente a lo analizado, es notoria una falta de priorización de las estrategias de atención por parte de los servicios de salud, a pesar de una producción científica considerable y importante, así como de una falta de actuación de determinados nichos de profesionales de la salud. El diseño metodológico permitió mapear el perfil de los estudios acerca del tema, así como la necesidad de estudios sobre intervenciones multidisciplinarias, especialmente el cuidado médico en los servicios de salud de la Atención Primaria de Salud a mujeres en situación de violencia.

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Resumo: Pesquisa participativa cujo produto tecnológico gerado foi um vídeo em formato de animação em processo de registro na Agência Nacional de Cinema ­ ANCINE. Objetivo geral: compreender como profissionais de saúde podem colaborar no enfrentamento à violência contra a mulher. Objetivo específico: desenvolver uma tecnologia social para a prevenção da violência contra a mulher. O trabalho foi aprovado pelo Comitê de Ética em Pesquisa da UFPR (CAAE: 69298023.0.0000.0102 / Número do Parecer: 6.177.307). Metodologia: Pesquisa-ação desenvolvida por meio do Itinerário de Pesquisa de Paulo Freire que compreende três etapas: investigação temática, codificação e descodificação e desvelamento crítico, desenvolvidas por meio de um Círculo de Cultura, no mês de agosto de 2023. Participaram do encontro 16 trabalhadoras de unidades básicas de saúde: seis agentes comunitárias de saúde, sete técnicas de enfermagem e três enfermeiras. Durante a investigação temática emergiram nove temas geradores os que foram codificados e descodificados em três temas: Caracterização da violência; Relação da mulher com a violência; Atuação profissional diante da violência. Resultados: o grupo aponta para a necessidade de capacitação das/os profissionais das equipes de saúde e de outros serviços envolvidos na assistência às mulheres vítimas de violência, especialmente no que se refere ao atendimento individual. O grupo define por construir uma tecnologia social que sirva para divulgar informações relacionadas à violência, o produto deve ter imagens e mensagens leves e não apelativas, que possa ser divulgado em redes sociais alcançando tanto possíveis vítimas quanto trabalhadoras/es que atendam essas vítimas, que reforce a coragem e o apoio da rede para que mulher rompa com o ciclo da violência. Conclusões: O produto tem caráter inovador por ter sido produzido de forma democrática em conjunto com as participantes da pesquisa, garantindo que atenda às necessidades do próprio grupo que o idealizou. A animação poderá ser usada em capacitações profissionais, bem como ser amplamente divulgada enquanto ferramenta de prevenção da violência contra a mulher podendo gerar impactos tanto no nível local quanto de forma mais ampla, a depender do alcance na etapa de divulgação (até o momento o vídeo foi reproduzido mais de mil vezes na plataforma YouTube). Itinerário de Pesquisa de Paulo Freire foi adequado para abordar a violência contra a mulher com a equipe profissional e garante a característica de replicabilidade do trabalho em outros grupos e com outros temas. Apesar de ter sido possível identificar potencialidades e fragilidades para melhorar o atendimento individual às mulheres vítimas de violência, não possível oferecer uma capacitação sobre o tema. Esta pesquisa foi financiada pelo programa CAPES/COFEN, na linha de pesquisa Tecnologia e Inovação para o Cuidar em Saúde e Enfermagem.

Abstract: Participatory research whose technological product generated was a video in animation format in the process of being registered with the National Cinema Agency ­ ANCINE. General objective: understand how health professionals can collaborate in combating violence against women. Specific objective: develop a social technology to prevent violence against women. The work was approved by the UFPR Research Ethics Committee (CAAE: 69298023.0.0000.0102 / Opinion Number: 6.177.307). Methodology: Action research developed through Paulo Freire's Research Itinerary, which comprises three stages: thematic investigation, coding and decoding and critical unveiling, developed through a Culture Circle, in August 2023. 16 participants participated in the meeting workers from basic health units: six community health agents, seven nursing technicians and three nurses. During the thematic investigation, nine generating themes emerged, which were coded and decoded into three themes: Characterization of violence; Women's relationsh ip with violence; Professional action in the face of violence. Results: the group points to the need for training professionals in health teams and other services involved in assisting women victims of violence, especially with regard to individual care. The group defines to build a social technology that serves to disseminate information related to violence, the product must have light and non-appealing images and messages, which can be disseminated on social networks reaching both potential victims and workers who serve these victims, who reinforce the courage and support of the network so that women can break the cycle of violence. Conclusions: The product has an innovative character as it was produced in a democratic way together with the research participants, ensuring that it meets the needs of the group that created it. The animation can be used in professional training, as well as being widely disseminated as a tool for preventing violence against women and can generate impacts both locally and more broadly, depending on the reach in the dissemination stage (so far the video was reproduced more than a thousand times on the YouTube platform). Paulo Freire's Research Itinerary was suitable for addressing violence against women with the professional team and guarantees the replicability of the work in other groups and with other themes. Although it was possible to identify potentialities and weaknesses to improve individual care for women victims of violence, it was not possible to offer training on the topic. This research was funded by the CAPES/COFEN program, in the research line: Technology and Innovation for Health and Nursing Care.

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RESUMEN Introducción: La violencia intrafamiliar se basa en fenómenos con una relación de subordinación, cuyos comportamientos se relacionan con el daño físico, psicológico y sexual, mediante el uso real o simbólico de la fuerza, con el objetivo de dominar la voluntad, mente y cuerpo de la víctima. Objetivo: Determinar los factores sociodemográficos asociados a las mujeres víctimas de violencia intrafamiliar en el Perú durante el año 2021. Material y Métodos: Es estudio observacional, retrospectivo, analítico y transversal, desarrollado mediante las bases secundarias ENDES 2021; se utilizó la información de 21 557 mujeres, la cual fue analizada mediante el software estadístico SPSS versión 27. Se hizo uso de las razones de prevalencia mediante el modelo de regresión de Poisson con varianza robusta. Resultados: Se determinó una prevalencia del 47.7 % de violencia psicológica. El análisis multivariado identificó que las variables asociadas a violencia psicológica fueron el nivel de educación primaria (RPa: 1.10) y la región Lima Metropolitana (RPa: 1.14), respecto a la violencia sexual, el nivel de riqueza pobre (RPa: 2.35) fue la variable asociada, y en cuanto a la violencia física, la edad de 20 a 29 años (RPa: 1.21), nivel de riqueza pobre (RPa: 1.49) y la región costa (RPa: 0.79). Conclusiones: Se identificaron como factores asociados a la violencia psicológica el nivel de instrucción y la región natural, el estado civil fue un factor protector ante la violencia sexual, y las variables de edad y nivel de riqueza fueron asociadas a la violencia física.

ABSTRACT Introduction: Domestic violence is based on phenomena that establish a relationship of subordination, whose behaviors are related to physical, psychological and sexual damage, through the real or symbolic use of force, with the aim of dominating the will, mind and body of the victim. Objective: Determine the sociodemographic factors associated with women victims of domestic violence in Peru during the year 2021. Material and Methods: It is an observational, retrospective, analytical and cross-sectional study, developed through the ENDES 2021 secondary databases, using information from 21,557 women. Said information was analyzed using the SPSS vers.27 statistical software, making use of the prevalence ratios using the Poisson regression model with robust variance. Results: A prevalence of 47.7% of psychological violence was determined. The multivariate analysis identified that the variables associated with psychological violence were the level of primary education (RPa:1.10) and the metropolitan Lima region (RPa:1.14), regarding sexual violence, the level of poor wealth (RPa:2.35) was The associated variable, and with respect to physical violence, were age between 20 and 29 years (RPa:1.21), poor wealth level (RPa:1.495) and the coastal region (RPa:0.79). Conclusions: It was identified that the factors associated with psychological violence were the level of education and the natural region, the marital status was a protective factor against sexual violence, and the variables of age and wealth level were associated with physical violence.

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Considering that reports of violence against women must come after a victim seeks help, the subject matter transcends health-related issues. In Brazil, mobile urgency services (SAMU/SIATE) frequently provide first aid to these women and, to the best of our knowledge, no other research has specifically examined the first reaction given to these women. The present study aimed to analyze SAMU/SIATE assistance to abused women in a cross-sectional study of the assistance to assaulted women provided by SIATE and SAMU Maringá/Norte Novo between 2011 and 2020. Women between 20 and 39 years old, non-pregnant, were the main victims, and 19.52% of them have used drugs of some kind. The (ex) partner figured as the perpetrator in 17.35%, but there was no information about this variable in 73.75% of the records. The Chi-square test shows a mortality rate superior to 70% among the severely traumatized victims. This is the first research work to examine the kind of care that SAMU/SIATE offers, and it identifies several weaknesses in its "modus operandi" that may prevent the results from being applied to larger contexts. In addition, further studies on mobile urgent care services in other provinces are required in order to suggest ways to lessen this epidemic.

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Resumo Objetivo Mapear e sumarizar as principais evidências disponíveis sobre a violência por parceiro íntimo contra a mulher parda e preta durante a pandemia COVID-19. Métodos Trata-se de uma revisão de escopo nas bases de dados National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpa Medica DataBASE, PsycINFO - APA PsycNET e Literatura Latino-Americana e do Caribe em Ciências da Saúde. Os critérios de inclusão foram estudos sobre violência interpessoal contra a mulher parda e preta após o decreto de pandemia COVID-19, perpetrada por parceiro íntimo, publicados a partir de 2020, nos idiomas português, espanhol ou inglês. Excluíram-se editoriais, cartas resposta, retratações e estudos voltados à violência autoprovocada. Foi realizada análise descritiva. Resultados Foram obtidos 26 estudos e após a seleção obteve-se a amostra de oito artigos, publicados entre 2020 e 2022. Os resultados evidenciaram estudos majoritariamente norte-americanos, contudo apontaram para a violência por parceiro íntimo contra a mulher parda e preta como um fenômeno global durante a pandemia. As vítimas apresentavam múltiplas condições de vulnerabilidade e encontraram várias barreiras de acesso aos serviços de saúde e segurança pública, incluindo o racismo. Medidas de prevenção e controle foram escassas e geraram consequências à saúde integral da mulher. Conclusão O fenômeno foi caracterizado como um agravo global durante a pandemia COVID-19. Estratégias de enfrentamento individuais, coletivas e políticas foram criadas pelas vítimas. Políticas públicas de prevenção e controle da violência por parceiro íntimo não foram adequadamente aplicadas em muitos países durante a pandemia.

Resumen Objetivo Mapear y resumir las principales evidencias disponibles sobre la violencia contra mujeres pardas y negras por parte de la pareja íntima durante la pandemia de COVID-19. Métodos Se trata de una revisión de alcance en las bases de datos National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpa Medica DataBASE, PsycINFO - APA PsycNET y Literatura Latinoamericana y del Caribe en Ciencias de la Salud. Los criterios de inclusión fueron estudios sobre violencia interpersonal contra mujeres pardas y negras después del decreto de pandemia de COVID-19, ejercida por su pareja íntima, publicados a partir de 2020, en idioma portugués, español o inglés. Se excluyeron editoriales, cartas de respuesta, retractaciones y estudios sobre violencia autoprovocada. Se realizó análisis descriptivo. Resultados Se obtuvieron 26 estudios y, después de la selección, se obtuvo una muestra de ocho artículos, publicados entre 2020 y 2022. Los resultados evidenciaron estudios mayormente norteamericanos, pero señalaron que la violencia contra mujeres pardas y negras por parte de su pareja íntima fue un fenómeno global durante la pandemia. Las víctimas presentaron múltiples condiciones de vulnerabilidad y encontraron varias barreras de acceso a los servicios de salud y seguridad pública, inclusive racismo. Las medidas de prevención y control fueron escasas y generaron consecuencias en la salud integral de las mujeres. Conclusión El fenómeno fue caracterizado como un agravio global durante la pandemia de COVID-19. Las estrategias de enfrentamiento individuales, colectivas y políticas fueron creadas por las víctimas. Las políticas públicas de prevención y control de la violencia por parte de pareja íntima no fueron aplicadas adecuadamente en muchos países durante la pandemia. Open Science Framework: https://osf.io/bdsf7/

Abstract Objective To map and summarize the main available evidence on intimate partner violence against brown and black women during the COVID-19 pandemic. Methods This is a scoping review carried out in the National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpa Medica DataBASE, PsycINFO - APA PsycNET and Latin American and Caribbean Literature in Health Sciences databases. Studies on interpersonal violence against brown and black women after the COVID-19 pandemic decree, perpetrated by an intimate partner, published from 2020 onwards in Portuguese, Spanish or English, were included. Editorials, response letters, retractions and studies focused on self-inflicted violence were excluded. Descriptive analysis was carried out. Results A total of 26 studies were obtained, and after selection, a sample of eight articles was obtained, published between 2020 and 2022. The results showed mostly North American studies, however, they pointed to intimate partner violence against brown and black women as a global phenomenon during the pandemic. The victims presented multiple conditions of vulnerability and encountered several barriers to accessing health and public safety services, including racism. Prevention and control measures were scarce and had consequences for women's overall health. Conclusion The phenomenon was characterized as a global problem during the COVID-19 pandemic. Individual, collective and political coping strategies were created by the victims. Public policies to prevent and control intimate partner violence were not adequately implemented in many countries during the pandemic. Open Science Framework: https://osf.io/bdsf7/

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Resumo O objetivo deste estudo é avaliar as taxas de homicídios contra mulheres residentes no Brasil, segundo unidades da federação e raça/cor, no período de 2016 a 2020. Trata-se de um estudo ecológico de tendência temporal. Foi realizada análise múltipla adotando-se modelo de regressão para dados longitudinais. No período, ocorreram no Brasil 20.405 homicídios de mulheres e as taxas padronizadas mostraram que as mulheres negras (6,1/100.000) apresentaram as maiores taxas, em comparação às brancas (3,4/100.000). O Brasil apresentou queda de 25,2% de 2016 a 2020. A taxa de homicídio variou de 4,7 mortes por 100 mil mulheres em 2016 para 3,5 em 2020, mas a tendência decrescente e estatisticamente significante foi observada nas taxas de mulheres negras e brancas. As variáveis IDH, taxa de analfabetismo e proporção de causas mal definidas apresentaram uma relação inversa e estatisticamente significante com as taxas de homicídio de mulheres. Nos anos de 2019 e 2020 houve uma diminuição da taxa média de homicídio em relação ao ano de 2016. Apesar do decrescimento na evolução temporal das taxas para negras e brancas, houve diferenças raciais importantes nos homicídios de mulheres, com piores resultados para as mulheres negras.

Abstract This ecological, time-trend study examined rates of homicide against women residing in Brazil, by state and race/colour, from 2016 to 2020, by performing. Multiple analysis by regression model on longitudinal data. During the study period, 20,405 homicides of women were recorded in Brazil. Standardised homicides rates were higher among black women (6.1/100,000) than among white women (3.4/100,000). From 2016 to 2020, rates decreased 25.2%, from 4.7 deaths per 100,000 women in 2016 to 3.5 in 2020, with a statistically significant downward trend among both black and white women. Statistically significant inverse relationships were found between female homicide rates and HDI, illiteracy rate and proportion of ill-defined causes. The average homicide rate decreased in 2019 and 2020, as compared with 2016. Despite the decreasing time trend in homicide rates for both black and white women, they differed substantially by race, with worse outcomes for black women.

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Resumo Este estudo transversal objetivou estimar a prevalência e os fatores associados à violência contra as mulheres rurais e descrever os casos positivos segundo autoria, local e frequência, com dados da Pesquisa Nacional de Saúde (2019). Calcularam-se as prevalências brutas e ajustadas de violência contra as mulheres rurais de todo o Brasil nos últimos 12 meses, segundo perfil demográfico, apoio e saúde por meio da regressão de Poisson. A violência psicológica foi de 18%, a física, de 4,4% e a sexual, de 1,5%. Os principais autores eram pessoas conhecidas, a maior parte dos casos ocorreu na residência e as agressões eram recorrentes. As maiores prevalências: mulheres adultas jovens (24,2%), solteiras e divorciadas (20% cada), com ensino fundamental completo ao superior incompleto (22%),, percepções de saúde muito ruim (34%), ruim (30%) e aquelas com problema de saúde mental (30%). Após o ajuste, permaneceram no modelo as de 30-39 anos e de 40 a 49 anos, casadas, com estado de saúde muito ruim, ruim e regular e com problema de saúde mental. Aponta-se para a alta prevalência de violência contra as mulheres rurais.

Abstract The aim of this cross-sectional study was to estimate the prevalence of violence against women living in rural areas, explore associated factors, and characterize cases of violence according to perpetrator, place of occurrence, and frequency. Based on data from the 2019 National Health Survey, using Poisson's regression we calculated crude and adjusted prevalence ratios for violence committed during the last 12 months against women living in rural areas across Brazil, focusing on the following variables: sociodemographic characteristics, income, social support, and self-reported health status. The prevalence of psychological, physical, and sexual violence was 18%, 4.4%, and 1.5%, respectively. Perpetrators were mainly people known to the victim and violence was mainly committed at home and repeated over time. Prevalence was highest among young women (24.2%), single and divorced women (20% each), women who had complete elementary school till not complete higher education (22% each), women with very poor (34%) and poor (30%) self-perceived health status; and women with a mental health problem (30%). After adjustment, the following variables were retained in the model: women aged 30-39 years and 40-49 years; married women; women with very poor, poor, and fair perceived health; and women diagnosed with a mental health problem.

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Resumo O objetivo é identificar impactos culturais, sociais e de saúde causadas pela violência na parceria íntima (VPI) em mulheres homoafetivas (MOH) e biafetivas (MOB). Estudo de revisão integrativa da literatura que buscou e analisou estudos indexados nas bases de dados PubMed e Lilacs, sendo considerados os idiomas: inglês, português e espanhol. O estudo buscou responder a seguinte pergunta de pesquisa: "Quais impactos a VPI traz para as MOB e MOH?". Foram encontrados 42 estudos e após aplicado os critérios de exclusão, 19 compuseram a amostra final. Os dados foram analisados a partir da metodologia de análise de conteúdo, modalidade análise temática de Bardin (2009). A análise na íntegra dos artigos revelou duas categorias: 1) A violência na parceria íntima e os impactos socioculturais; e 2) A violência na parceira íntima e os impactos na saúde. A vivência de situações de violência na parceria íntima entre mulheres homo e/ou biafetivas afeta suas dimensões socioculturais e de saúde, já que elas estão sob o viés da dupla vulnerabilidade: mulher em relações homo/biafetivas. Existe também invisibilidade do fenômeno nos serviços de saúde já que os profissionais não são formados para abordar as diferentes orientações sexuais entre mulheres e menos ainda as situações de violência advindas dessas relações.

Abstract The aim is to identify cultural, social and health impacts caused by intimate partner violence (IPV) in homoaffective (MOH) and biaffective (MOB) women. This is an integrative literature review that sought and analyzed studies indexed in the PubMed and Lilacs databases, considering the following languages. The study sought to answer the following research question: "What impacts does IPV bring to MOB and MOH?". Forty two studies were found and after applying the exclusion criteria, 19 went into the final sample. Data were analyzed using the content analysis methodology, Bardin's thematic analysis modality (2009). The full analysis of the articles revealed two categories: 1) Intimate partner violence and sociocultural impacts; and 2) Intimate partner violence and health impacts. The experience of situations of violence in intimate partnerships between homo and/or biaffective women affect their sociocultural and health dimensions, since they are under the bias of double vulnerability: women in homo/biaffective relationships. There is also an invisibility of the phenomenon in health services, since professionals are not trained to address the different sexual orientations among women and even less the situations of violence resulting from these relationships.

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ABSTRACT Objective To analyze the association between intimate partner violence during pregnancy (IPVP) and quality of life (QOL). Methods A cross-sectional study was conducted with pregnant women receiving care in Primary Health Care in the municipality of Criciúma, Santa Catarina state, Brazil, in 2022; QOL was assessed in the physical, psychological, social relationship and environmental domains using WHOQOL-Bref instrument; IPVP was evaluated by means of the World Health Organization Violence Against Women; Crude and adjusted linear regression analyses were performed. Results A total of 389 pregnant women were evaluated; IPVP was observed in 13.6% of cases; in the adjusted analysis, IPVP remained associated with physical, psychological and social relationship domains; pregnant women who experienced IPVP had a reduction in their QOL score by 9.77, 11.07 and 8.95 points, respectively, when compared to those who did not experience IPVP. Conclusion IPVP was associated with poorer QOL in the physical, psychological and social relationships domains. Health services equipped to address and prevent violence against pregnant women are essential.

RESUMEN Objetivo Analizar la asociación entre violencia de pareja durante el embarazo (VPE) y calidad de vida (CV). Métodos Estudio transversal con mujeres embarazadas en Atención Primaria de Salud, se evaluó la CV en los dominios físico, psicológico, relaciones sociales y entorno (WHOQOL-Bref); la VPE fue evaluada por la Organización Mundial de la Salud; se realizaron análisis de regresión lineal bruta y ajustada. Resultados Se evaluaron 389 gestantes. La VPE estuvo presente en el 13,6% de las gestantes; en el análisis ajustado, la violencia de género permaneció asociada a aspectos físicos, psicológicos y a las relaciones sociales; las mujeres embarazadas que sufrieron VPE presentaron disminución de 9,77; 11,07 y 8,95 puntos de CV en comparación con quienes no sufrieron VPE. Conclusión La VPE se asocia con una peor calidad de vida en los ámbitos físico, psicológico y de relaciones sociales; los servicios de salud preparados para combatir la violencia son esenciales para prevenir los casos de violencia durante el embarazo.

RESUMO Objetivo Analisar a associação entre violência por parceiro íntimo na gestação (VPIG) e qualidade de vida (QV). Métodos Estudo transversal, com gestantes atendidas na Atenção Primária à Saúde, em Criciúma, Santa Catarina, Brasil, em 2022; avaliou-se a QV quanto aos domínios físico, psicológico, das relações sociais e do meio ambiente (WHOQOL-Bref); a VPIG foi avaliada pela World Health Organization Violence Against Women; foram realizadas análise de regressão linear bruta e ajustada. Resultados Foram avaliadas 389 gestantes; a VPIG esteve presente em 13,6%; na análise ajustada, a VPIG manteve-se associada aos aspectos físico, psicológico e das relações sociais; gestantes que sofreram VPIG tiveram reduzidos 9,77, 11,07 e 8,95 pontos no escore de QV, respectivamente, quando comparadas às que não sofreram VPIG. Conclusão A VPIG esteve associada à pior QV nos domínios físico, psicológico e das relações sociais; serviços de saúde preparados para o enfrentamento e prevenção da violência contra gestantes são essenciais.

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Resumo Este estudo se dedica, através de histórias de vida, a analisar a violência contra as mulheres que vivem em contextos rurais, seu silenciamento e os desafios de rompê-lo. Trata-se de uma pesquisa qualitativa a partir de 20 entrevistas com mulheres rurais em dois municípios do Rio Grande do Sul. Através da Análise de Narrativas chegamos a duas categorias: "Eu sofria calada e certamente toda mulher é assim" - A violência e o silenciamento; e "A gente cuida dela" - Rompendo o silêncio. A primeira, faz referência a opressão do silenciamento e como as mulheres foram afetadas através da violência e do isolamento. A segunda, apresenta os desafios enfrentados pelas mulheres ao romper o silenciamento e sair da relação abusiva, e como, através de suas narrativas, acessamos a histórias de outras mulheres que sofrem violência. As narrativas reforçam que o silenciamento, advindo dos papeis de gênero e do cerceamento de liberdade, contribuiu para a permanência na relação abusiva. A violência teve sustentáculo no contexto rural, no qual as mulheres ficavam ainda mais isoladas, sozinhas e sem apoio, acentuando seus medos, culpa, vergonha, dependência financeira. É fundamental haver um trabalho intersetorial para o enfrentamento a essa problemática com mais informação e assistência às mulheres rurais.

Abstract By way of life stories drawn from 20 interviews of women in two municipalities of Rio Grande do Sul, this qualitative study examined how violence against women living in rural areas is silenced and the challenges involved in breaking that silence. Narrative Analysis arrived at two categories: "I suffered in silence and certainly all women are like that" (Violence silenced) and "We take care of her" (Breaking the silence). The first relates to the oppression of imposed silence and how women were affected by violence and isolation. The second shows the challenges facing women who break the silence and leave abusive relationships and how, through their narratives, to access the stories of other women who suffer violence. The narratives stress that the imposition of silence, which arose from gender roles and constraints on freedom, contributed to their continuing in the abusive relationship. The violence was sustained by the rural setting, where women were even more isolated, alone and unsupported, which heightened their fears, guilt, shame and financial dependence. An inter-sector approach, with more information and care for rural women, is fundamental to addressing this problem.