Abordagem familiar na Atenção Primária à Saúde com famílias em situação de violência: percepção de preceptores de Residência em Medicina de Família e Comunidade

Abstract

Violence presents itself as a serious public health problem. It is a frequent phenomenon with an impact on the physical, psychological and social life of people, families and communities. Among the types of violence, intrafamily violence is highly prevalent. It is a systemic phenomenon, in which all family members are involved. In Primary Health Care (PHC), families in situations of violence are often assisted by professionals from the Family Health Strategy. However, there is an absence or little space in medical education to address the topic. The aim of this study was to understand the perspective of Family and Community Doctors (FCD), tutors of Residency Programs in FCD, on the Family Orientation in contexts of intrafamily violence in PHC. This is a descriptive and exploratory qualitative approach study. Interviews were conducted with 15 preceptors. Potentialities and challenges were identified for the daily practice of the Family Orientation with families in situations of violence, in PHC. As potential, the following stand out: the strengthening of the professional and family bond; expansion of therapeutic resources and effectiveness of interventions; favoring comprehensive care; articulation of the intersectoral network; promoting reflection and family self-care. Among the challenges were reported: failures in medical training and lack of experience; the silenced violence and the fear of approaching situations of intrafamily violence; lack of specific guidelines for PHC health professionals; poor working conditions, difficulties in articulating the intersectoral network, and not valuing management on the importance of the approach. The importance of the Family Orientation was highlighted by the interviewees, especially in the approach to intrafamily violence. However, there are many challenges for its application in practice. Efforts and guidelines are needed so that FCDs and other professionals working in PHC can be valued and trained in order to carry out the family approach and the approach to intra-family violence in a systematic and daily manner, considering the high prevalence and severity of this phenomenon.