The care network of the families involved in violence against children and adolescents: the Primary Health Care perspective

Abstract

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.

Keywords: adolescent; child protection; community care; domestic violence; family care; health promotion; nursing; primary care; public health nursing; qualitative study.