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巴西圣保罗针对智障人士的人际暴力:受害者、施害者和转介特征。

Interpersonal violence against people with intellectual disabilities in São Paulo, Brazil: characteristics of victims, perpetrators and referrals.

机构信息

Department of Public Health, Federal University of São Paulo, São Paulo, Brazil.

Department of Nursing, São Paulo State University, Botucatu, Brazil.

出版信息

BMC Public Health. 2024 Jul 5;24(1):1797. doi: 10.1186/s12889-024-19211-4.

Abstract

INTRODUCTION

Interpersonal violence is a phenomenon that can occur with different people and conditions. However, people with intellectual disabilities have increased vulnerability to this problem, with potential risks to their health and well-being. The aim of this study was to identify the sociodemographic characteristics of people with disabilities who have been victims of interpersonal violence, the profile of the perpetrators and the measures taken after the victims have been cared for.

METHODS

This is an exploratory, descriptive, cross-sectional study using the Interpersonal Violence Notification Forms entered into the Brazilian Ministry of Health's Notifiable Diseases Information System. The city of São Paulo was chosen as the setting because it is the largest city in Latin America and has a faster data processing system than other cities. The period covered notifications made between 2016 and 2022. The information was collected between October and November 2023 and a univariate statistical analysis was carried out. Fisher's exact test was used, with a significance level of 5% (α = 0.05).

RESULTS

There were 4,603 notifications against people with intellectual disabilities in the period. The forms of physical violence, neglect/abandonment and psychological/moral violence were more frequent in the 15-19 age group, while sexual violence was more frequent in the 10-14 age group (p < 0.001). The sex most often attacked was female in all the forms investigated (p < 0.001) and the skin colors of the most victimized people were black and/or brown, except in cases of neglect/abandonment (p = 0.058). Most of the victims had little schooling (p = 0.012). The aggressions were committed by one person (p < 0.001), known or related to the victim, such as mother or father, except in cases of sexual violence, where strangers were the main perpetrators (p < 0.001). The sex of the perpetrator was male, except in cases of neglect and/or abandonment (p < 0.001), and the age was between 25 and 29 (p = 0.004). In cases of sexual violence, rape was the most frequent and the procedures carried out were blood collection followed by prophylaxis for Sexually Transmitted Infections (STIs) were the main procedures carried out by health professionals (p = 0.004). The majority of referrals made after receiving care were to the health and social assistance network, with few referrals to bodies such as the human rights reference center, guardianship council and police stations (p < 0.001).

CONCLUSION

People with intellectual disabilities are highly vulnerable to the forms of violence studied, especially children and adolescents, black or brown, with low levels of education. The perpetrators are usually close people, male and older than the victims. The referrals made by health professionals did not prioritize the victim's safety and the guarantee of human rights. Lines of care for the health of victims of violence should be implemented, taking into account special aspects, such as people with intellectual disabilities, whose search for help can be difficult.

摘要

简介

人际暴力是一种可能在不同人和情况下发生的现象。然而,智障人士对此问题的脆弱性增加,对其健康和福祉存在潜在风险。本研究旨在确定遭受人际暴力的残疾人士的社会人口学特征、加害者的特征以及受害者接受护理后的措施。

方法

这是一项探索性、描述性、横断面研究,使用了巴西卫生部可报告疾病信息系统中输入的人际暴力通知表。选择圣保罗市作为研究地点,因为它是拉丁美洲最大的城市,并且拥有比其他城市更快的数据处理系统。研究涵盖了 2016 年至 2022 年期间的通知。信息收集于 2023 年 10 月至 11 月之间,并进行了单变量统计分析。使用 Fisher 精确检验,显著性水平为 5%(α=0.05)。

结果

在研究期间,共有 4603 份针对智障人士的通知。在 15-19 岁年龄组中,身体暴力、忽视/遗弃和心理/道德暴力更为常见,而在 10-14 岁年龄组中,性暴力更为常见(p<0.001)。在所有调查形式中,攻击的性别最常见的是女性(p<0.001),最受迫害的人肤色为黑色和/或棕色,除了忽视/遗弃的情况(p=0.058)。大多数受害者接受的教育程度较低(p=0.012)。攻击是由一个人(p<0.001)实施的,加害者是受害者认识或相关的人,如母亲或父亲,除了性暴力的情况,在这种情况下,陌生人是主要加害者(p<0.001)。加害者的性别为男性,除了忽视和/或遗弃的情况(p<0.001),年龄在 25 至 29 岁之间(p=0.004)。在性暴力的情况下,强奸最为常见,卫生专业人员主要进行的程序是血液采集,随后是性传播感染(STIs)预防(p=0.004)。接受护理后的大多数转介是到卫生和社会援助网络,很少有转介到人权参考中心、监护委员会和警察局等机构(p<0.001)。

结论

智障人士极易受到所研究形式的暴力侵害,尤其是儿童和青少年、黑人和棕色人种、教育程度较低的人。加害者通常是亲近的人,年龄大于受害者,是男性。卫生专业人员的转介并没有优先考虑受害者的安全和人权保障。应实施针对暴力受害者的保健护理措施,要考虑到智障人士等特殊人群,他们寻求帮助可能较为困难。

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