Quebrando o silêncio: violência familiar e o trabalho clínico de profissionais da saúde

Abstract

Introduction: Among the types of violence that accompany human history, those that occur within the family against children and adolescents stand out. This violence is defined as any physical, sexual, psychological aggression, abandonment or neglect against a developing person, at any stage of life, which may affect their biopsychosocial integrity. In these cases, the performance of the health professional can promote actions capable of breaking or avoiding violent family dynamics. Among the professionals who have faced situations of child and juvenile violations, there is the speech therapist. The close relationship established with the patient and the fact that they remain in a space of privacy, without the presence of those responsible, makes the follow-up of the speech therapist conducive to identifying possible victims. Objective: to describe the prevalence of reports of family violence against children and adolescents by health professionals working in a clinical environment, as well as to analyze the knowledge and performance of the speech therapist in the face of this violence. Method: This dissertation is composed of a collection of two studies presented in the format of scientific articles, presented as follows: Article 1 is characterized as a systematic review of the literature and meta-analysis, which aimed to analyze the prevalence of reports of violence in children and adolescents in the work of health professionals who work in the clinical field. An electronic search of works indexed in six databases was performed: EMBASE, LILACS, LIVIVO, PubMed/Medline, Scopus and Web of Science, in addition to a partial search of the gray literature: Google Scholar, MedRxiv, OpenGrey and ProQuest; Article 2 is configured as a

cross-sectional, descriptive study. A field research was carried out based on the sending of questionnaires to 4,297 speech therapists enrolled in CREFONO-3. The objective was to analyze the knowledge of speech therapists about family violence against children and adolescents and to understand how they act in these cases. Results: Study 1 revealed that approximately one in two health professionals are faced with reports of violence against children and adolescents in their clinical practice, with one in three professionals notifying the cases to Organs competent bodies. The data from study 2 showed that the speech therapist's knowledge about intrafamily violence against children and adolescents is focused on the types of violence, the forms of identification, the notification of cases to the competent bodies, procedures such as the reception and referral of victims to other services, for the relationship between speech-language pathology symptoms and the situation of violence and the professional's unpreparedness to act in cases of violence. On the other hand, the role of the speech therapist, in these situations, occurs through the notification of cases, conversation with family members, referrals and/or contact with other professionals. Final considerations: this dissertation portrayed the importance of breaking the silence around violence, making it known as a social problem and indicating the need to put it under discussion. It is also emphasized the need to carry out more research on this topic, within the scope of Speech-Language Pathology and Audiology, enabling the construction of new scientific knowledge that helps speech-language pathologists to work clinically with victims who arrive for care.