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Exposure to community violence of the agents of the Family Health Strategy and its impact on work practices: a qualitative study

Grant number: 13/09486-3
Support Opportunities:Scholarships in Brazil - Master
Effective date (Start): October 01, 2013
Effective date (End): September 30, 2015
Field of knowledge:Health Sciences - Collective Health - Preventive Medicine
Principal Investigator:Maria Fernanda Tourinho Peres
Grantee:Juliana Feliciano de Almeida
Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil


The overall objective of the project is to qualitatively explore the social representations of community health agents (ACS) and of the manager of Primary Care Health Unit with Family Health Strategy (ESF) about the presence of community violence in the territory where they operate, and to verify whether there is some sort of interference of this phenomenon in relation to their work in an census district of São Paulo (MSP). The aim is also to, specifically, explore whether if the community violence would be weakening the construction of bonds between community health agents and the population served in the perspective of these professionals.The growth of occupational violence in the health sector in many countries has called the attention of bodies like the International Labour Organisation (ILO) which defines in general terms this phenomenon as something that is "made up of incidents in which professionals suffer abuse, threats or attacks in circumstances related to their work, including the on the way to work and back home, and that endanger, implicitly or explicitly, their safety, their welfare and their health".The intense contact of health teams with situations of family and community violence may cause psychological problems and illnesses expressed by physical and emotional exhaustion, feelings of helplessness, anger and fear under the circumstances faced in day to day work. The fear of retaliation, according to reports from professionals, is another hallmark of their work at the ESF.In Brazil, the effects of community violence on the structure, functioning and development of the actions of health services in primary care are presented as a reality to be further explored. The same may be said about the effects of continued exposure to indirect violence (hearing, listening or witnessing domestic violence, deaths in the community related to both the consumption and trafficking of drugs and etc.) or direct violence (suffer direct threats or being personally attacked) suffered by health professionals teams. These issues, in addition, help to think about the challenges that still need to be overcome for effective consolidation of the Family Health Strategy in the national territory.Based on a literature review, it was found that although community violence is an issue addressed as able to influence the sickening processes of the ESF agent and the development of their actions, few studies have taken this phenomenon and its repercussions as the central theme for analysis. To this end, this proposal seeks to qualitatively explore this issue by resorting to some theoretical frameworks, such as "expansion of the criminal world", "bonds" and "social representations". With regard to the collection of information it is intended the adoption of the technique of semi-structured interviews following a previously elaborated script with open and flexible questions - adjusted to the topic of interest of the researcher -, valuing the uniqueness of the respondents' answers.The questions of the script will, in addition, be organized around four axes: 1) general information about the respondent; 2) general characteristics of the work context; 3) perceptions of community violence, definitions, causes and types; and 4) interference of violence in actions developed with the community, families and users and in the establishment of bonds.

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Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
ALMEIDA, Juliana Feliciano de. Exposure to community violence of Health Strategy agents of Family and repercussions on their working practices: a qualitative study. 2015. Master's Dissertation - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.

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