Representações sociais das enfermeiras e médicas da atenção primária à saúde acerca da violência de gênero contra as mulheres

Abstract

Introduction: The object of the study was the social representations of nurses and physicians regarding gender-based violence against women and its implications for the care of these women in the context of Primary Health Care. Objectives: To identify the contents and meanings that structure and organize the social representations about gender-based violence against women among nurses and physicians working in Primary Health Care; To characterize the strategies used by nurses and physicians in caring for women experiencing situations of gender-based violence; To discuss the implications of these social representations for care in the context of Primary Health Care for women experiencing gender-based violence; To propose strategies based on the social representations of nurses and physicians that contribute to improving care for women experiencing such violence. Methodology: This is a descriptive and exploratory study grounded in the Theory of Social Representations by Serge Moscovici, adopting both structural and processual approaches. A total of 100 professionals participated, including 50 nurses and 50 physicians working in Family Health Clinics in programmatic area 4.0 of the municipality of Rio de Janeiro. Data collection was conducted through a socioeconomic and demographic questionnaire, the Free Word Association Test, and semi-structured interviews. Questionnaire data were analyzed using simple frequency in Excel, while data from the test and interviews were processed through matrix analysis and descending hierarchical classification using the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEq). The research was approved by the Ethics Committee of the Anna Nery School of Nursing, the São Francisco de Assis Health Care Institute, and the Municipal Health Secretariat, under opinion no. 6.142.502. Results: The majority of participants were between 25 and 34 years old, self-identified as white, Catholic, married with children, and held postgraduate degrees. Nurses predominantly worked 40 hours per week, while physicians worked either 20 or 40 hours. In the structural approach, machismo, prejudice, and justice emerged as the central core. Among nurses, an affective and evaluative positive dimension regarding their work emerged, considered rewarding, although also recognized as exhausting and stressful. The understanding of violence against women was associated with family experiences, and care was influenced by personal experiences. Among physicians, a positive evaluation of their work was also identified. Gender-based violence was anchored in intimate partner domestic violence, and the care provided was considered adequate despite difficulties, being guided by strategies built from their experiences. The triangulation of methods allowed the identification of representational fields for each group, highlighting their ways of understanding and acting in relation to the phenomenon. Based on the results, an interactive educational card was developed to support professional practice. Final considerations: It is therefore argued that violence against women is neither linear nor homogeneous and is part of the daily lives of nurses and physicians. Addressing this situation requires integrated strategies, continuous training, strengthening of support networks, public policies, and actions aimed at combating the structural roots of gender inequalities.