Violence against children and adolescents and the pandemic – Context and possibilities for education professionals

Abstract

Objective

to understand the education professionals' perception about violence against children and adolescents in the COVID-19 pandemic context.

Method

a research study with a qualitative approach, anchored in the Complex Paradigm, carried out with seven education professionals between September and October 2020. Data collection took place through semi-structured interviews carried out on a free virtual platform, and the data were thematically analyzed.

Results

Two final themes emerged: “Violence and the pandemic” and “(Non)perception of action possibilities”. Violence against children and adolescents is seen as a multidimensional phenomenon by the participants. Due to the specificities that occur more frequently in families, the life changes imposed by the pandemic, especially distancing from the school, can lead to an increase in the number of cases and to greater difficulty identifying violence against this population. The impacts on children's and adolescents' mental health during this period were reinforced.

Conclusion and implications for the practice

despite the understanding of greater exposure to violence during the pandemic, the professionals were unable to propose coping strategies. New studies on the subject matter with different actors involved are needed, as well as intersectoral articulation to face the phenomenon.

Keywords:
Adolescent; COVID-19; Child; Social Isolation; Violence

Resumo

Objetivo

compreender as percepções de profissionais da educação sobre as violências contra crianças e adolescentes em contexto de pandemia pela Covid-19.

Método

pesquisa com abordagem qualitativa, ancorada no Paradigma Complexo, realizada com sete profissionais da educação entre setembro e outubro de 2020. A coleta de dados se deu por entrevistas semiestruturadas realizadas em plataforma virtual gratuita, sendo os dados analisados tematicamente.

Resultados

emergiram dois temas finais “Violência e pandemia” e “(Não) percepção de possibilidades de atuação”. A violência contra crianças e adolescentes é vislumbrada como fenômeno multidimensional pelos participantes. Pelas especificidades de maior ocorrência nas famílias, as alterações da vida impostas pela pandemia, em especial, o afastamento escolar, podem implicar no aumento de casos e maior dificuldade para identificação de violências contra essa população. Os impactos à saúde mental de crianças e adolescentes nesse período foi reforçado.

Conclusão e implicações para a prática

apesar da compreensão de maior exposição às violências durante a pandemia, os profissionais não conseguiram propor estratégias para enfrentamento. Novos estudos sobre o tema com diferentes atores envolvidos, e articulação intersetorial para enfrentamento do fenômeno, são necessários.

Palavras-chave:
Adolescente; COVID-19; Criança; Isolamento Social; Violência

Resumen

Objetivo

comprender las percepciones de los profesionales de la educación sobre la violencia contra niños y adolescentes en el contexto de pandemia por Covid-19.

Método

investigación con enfoque cualitativo, anclada en el Paradigma Complejo, realizada con siete profesionales de la educación entre septiembre y octubre de 2020. La recolección de datos se llevó a cabo a través de entrevistas semiestructuradas realizadas en una plataforma virtual libre, y los datos fueron analizados temáticamente.

Resultados

Surgieron dos temas finales “Violencia y pandemia” y “(No) percepción de posibilidades de actuación”. La violencia contra niños y adolescentes es vista por los participantes como un fenómeno multidimensional. Debido a las especificidades que ocurren con mayor frecuencia en las familias, los cambios en la vida que impone la pandemia, especialmente el alejamiento de las escuelas, pueden conllevar un aumento de casos y una mayor dificultad para identificar la violencia contra esta población. Se reforzaron los impactos en la salud mental de niños y adolescentes durante este período.

Conclusión e implicaciones para la práctica

a pesar de comprender que se manifiesta una mayor exposición a la violencia durante la pandemia, los profesionales no pudieron proponer estrategias de afrontamiento. Se advierte la necesidad de contar con nuevos estudios sobre el tema, que incluyan a los diferentes actores involucrados, con articulación intersectorial para enfrentar el fenómeno.

Palabras clave:
Adolescente; COVID-19; Niño; Aislamiento Social; Violencia

INTRODUCTION

Violence is understood as the intentional use of force or physical power, real or threatening, against a person, group or community, which results in or has a great possibility of resulting in injury, death, psychological damage, deprivation or alteration in development¹. Due to the specificities of the phenomenon, it affects more severely some groups that are considered vulnerable, such as children and adolescents. In Brazil, accidents and violence appear as the leading cause of mortality in children over one year old and adolescents. In addition, violence commonly occurs in a space of trust, responsibility or power relationships – the household or intrafamily space, used as synonyms in this study².

In 2014, the World Health Organization (WHO) issued a report with systematized data from 133 countries, corresponding to 6.1 billion people, representing 88% of the world's population. This report indicated that approximately one out of four adults reported having suffered physical violence as children; 36% reported having suffered psychological violence as children; and 20% of the women and 5-10% of the men report having suffered sexual violence as children³. Violence against children and adolescents, due to the specificity of the growth and development phase in which it occurs, leads to brain alterations that increase the risk of mental, physical and behavioral problems in adulthood. It is also important to emphasize that being a victim of violence as a child can increase the risk of this person becoming a victim or perpetrator of other forms of violence in adolescence and adulthood^3,4.

The health emergency caused by the Coronavirus Disease 2019 (COVID-19), characterized as a pandemic by the WHO in early 2020, imposed social distancing between people as one of the main measures to contain spread of the disease⁵. In this sense, schools were closed exerting psychosocial impacts on the children's and adolescents' health. The school occupies a place in the lives of children and adolescents beyond the educational sphere, especially for those in social vulnerability. This population meets its nutritional and protective needs in this space, even considering that the main institution identifying situations of violence is the school^6,7.

Thus, this study sought to answer the following questions: How do education professionals perceive situations of violence against children and adolescents during the pandemic? What elements are found in this phenomenon? The Brazilian literature is incipient in the analysis of these issues by health, especially from the perspective of professionals directly involved in the care of children and adolescents^8,9.

To approach this object, the study was based on the Complex Paradigm, aiming to understand the meaning of phenomena characterized by their instability, nonlinearity and impossibility of being described in a number of finite steps and time space. The distinct elements of this phenomenon remain in constant interaction, from which unknown properties can arise. Such elements coexist with uncertainty and change, to the extent that the interconnected or intertwined parties maintain links capable of generating additional information in the same process of action; therefore, there is always the possibility of emergence of the new, of the unforeseen. At the same time, contradictory elements can occur that do not dilute, living in an articulated way in the phenomenon and constituting one of its principles: the dialogical¹⁰.

Thus, the objective of this study was to understand the perceptions of education professionals about violence against children and adolescents in the context of the COVID-19 pandemic.

METHOD

A research study with a qualitative approach, understood as that destined to the study of social relationships; allows recognizing the perspectives of the participants, directly involved in a given phenomenon, and respect for their singularities and diversities¹¹. It was anchored in the Complex Paradigm, directed by the notions of understanding and contextualization. The first allows apprehending the meanings of the phenomena, in their articulations with other events and objects, in a dynamic construction of bundles of relationships. The second reflects a multidimensional perspective in the analysis of the phenomenon, in order to discover how things weave together¹⁰.

The study was carried out in a medium-sized municipality, a technological pole in the center of the state of São Paulo. It has 221,950 inhabitants according to the 2010 census, with an estimated population of 249,415 inhabitants for 2018. The specific field was a district with approximately 80,000 inhabitants. A school in this district was selected, characterized as a group exposed to high social vulnerability for an urban sector, being classified as category 5 (five) according to the 2010 São Paulo Social Vulnerability Index (Índice Paulista de Vulnerabilidade Social, IPVS)¹². The school in question was inaugurated in 2016, having a built area of 4,008 m² and 12 classrooms, as well as laboratory and computer rooms and reading center, among other spaces. The school serves students from the first grades of elementary school to the last years of high school, with a total of 18 classes in both shifts and 578 regular enrollments.

The study participants were education professionals who had contact with elementary and high school students and had access to the Internet, maintaining the consent criterion through the Free and Informed Consent Form (FICF).

Such teachers were invited online (WhatsApp), according to the suggestion and availability of contacts by the school board, and collection was also carried out via this virtual platform. In total, 15 professionals were invited to participate in the research; of these, 7 agreed to participate. The FICF was included in the free online Google Forms platform, to be read by the potential participant after initial contact by the researcher using WhatsApp and expression of interest by the professional. In this initial contact, the risks and benefits, especially of the virtual environment, and the strategies and care by the researchers to minimize these risks were explained by means of a text message. It was reported how the data collection process would be, and the information to be collected by the instruments in the FICF was detailed. At the end of the FICF, the participants could agree or disagree to participate in the research by clicking on the corresponding link for their consent or not. A copy of the FICF was forwarded to the participants to the e-mail address provided, reinforcing the importance of keeping this copy.

Semi-structured interviews were used as data collection instruments. To characterize the participants, a questionnaire was used via Google Forms. The semi-structured interview started from certain basic questions, following a script that guides a conversation with a defined purpose, presenting no obstacle and not having the means to predict all the conditions or situations of the field work¹³. The following triggering questions were used: What do you understand by violence against children and adolescents? How do you think these cases are in this period of distancing from the school? What do you think can be done as an intervention on this subject matter, both now and after the pandemic?

The interviews were conducted in September and October 2020, with a mean duration of 25 minutes. They were recorded in a mobile audio recording application and transcribed in full. The files were saved in digital media, under the custody and responsibility of the researcher responsible for five years, not being kept in cloud files; and any and all identifications were deleted, such as names. The professionals were identified in the order of the dates of the interviews with the initial “P” to represent professionals (“P1, P2, P3...”) in order to ensure the participants' anonymity.

In this study, it was decided to seek code saturation; this was defined when no additional elements appear to answer the study question and these elements were understood¹⁴. This saturation occurred in the sixth interview; another interview was conducted for complementing the data.

The participants' characterization was presented by means of descriptive statistics. The data were analyzed through the reflexive thematic analysis proposed by Clarke and Braun¹⁵. This is an analysis with inductive logic, from the data, considered a reflective, creative, subjective and deliberative process. It brings up a systematic and rigorous approach to coding and creation of themes, at the same time fluid and recursive. We followed these stages: (I) familiarization with the data: after transcribing the interviews; (II) coding; (III) search by themes; (IV) review of themes; (V) definition and naming of themes; and (VI) final writing. The concepts of understanding and contextualization led the process of data collection and analysis¹⁰.

The research project was approved by CEP-UFSCar under the CAAE number 09272919.4.0000.5504, opinion No. 3,215,561, dated March 22^nd, 2019, respecting the criteria set forth in Resolutions No. 466/2012 and No. 510/2016 of the National Health Council.

RESULTS

The study participants were seven teachers in the fields of mathematics, geography, letters, chemistry, history and physical education. Of these, the majority were aged between 31 and 40 years old (n=3, 42.8%). Four of the teachers had up to 6 years of training (57.15%) and the rest had more than 12 years of study. The working time of most of the teachers in the school is up to one year (n=4, 57.15%), with the others having worked for up to four years. Six participants stated that the theme of violence was addressed during their own training, and three participated in a course or lecture on the subject matter during their professional performance (n=42, 86%).

From the statements, two final themes entitled “Violence and the pandemic” and “(Non)perception of action possibilities” emerged.

Violence and the pandemic

Violence was reported by the teachers with a broad perspective, which can occur in different manifestations, including related to absences by the State:

[...] I don't know if you're specifically talking about physical or psychological violence, but in both cases in my opinion it's a crime, regardless of the degree you know, I believe you have other things to treat, if dealing with a child or a teenager that doesn't involve any kind of violence, then for me the person who perpetrates violence against a child or teenager is committing a crime in fact [...] (P6)

[...] violence against children and adolescents is unacceptable, it's obvious that we know there are several aspects of violence, from physical to verbal and also non-assistance by the State in my view is characterized as violence... for example when the State acts in bad faith, and doesn't meet the commitments established by law, ... the lack of school supplies, the lack of security around the school, the lack of structure [...] (P7)

The teachers highlighted that intrafamily violence against children and adolescents has always occurred but that, due to the pandemic, other elements overlapped with those already existing – such as social isolation, longer contact time, family difficulties and parental conflicts:

[...] if they're structured families, which have a relationship of affection, warmth and respect, possibly the situation of violence has not increased, but as we know that in reality doesn't work in this way it can be that cases of violence during the pandemic may have increased, not only in relation to children, but also in relation to couples, husband-and-wife quarrels that may have caused domestic violence, even have caused some death or some additional harm, how can I say it. More severe, so to speak [...] (P1)

[...] I'm sure that this has even doubled, most of them are in a situation of vulnerability and already lived ... in this environment of conflicts, added to this situation of the pandemic, lack of work, vices, in short, this has certainly doubled (P4).

You're going to be in the house all this time, I think the kid got bored, and then logically, the unemployed parents in dire straits with their child at home all the time asking for things that the father and mother can't give them, if the child was at school, was somewhere else, if they didn't have the pandemic, this would be so much, because these needs that the child goes through inside the house they make up with the friends they have at school, right?, with the peers and so on [...] (P2)

Some statements end up reinforcing the blaming of children and adolescents for the violence suffered, as the last case mentioned. A repeated question was occurrence of violence at home, therefore with greater exposure at this time, and distancing from school ended up intensifying the situation:

[...] mainly because we have many students with parents who are alcoholics, it's drug users, right?, so I think it was like a pressure cooker about to explode all the time, right?, because everyone, a lot of people indoors sometimes in small houses, with people sometimes drinking, using drugs, everyone together all the time, so I think it's been increasing. We saw cases of students in hunger situations so I think this must have also influenced a lot, you know? [...] (P6)

[...] I think that for sure the children who are in such vulnerability situations were much more exposed to this type of violence on the part of those who take care of them, right? [...]. There are children who were more abandoned than they already are and these cases must be so, not increased, but in children who have already suffered aggressions they must have been assaulted even more, right?, because they're indoors, only with the father, without anyone seeing, who's going to know [...] (P3)

In this sense, the teachers highlighted the school institution as the only space for identification and intervention in situations of violence involving children, adolescents and their families due to daily life:

[...] it gives you splurges in various ways within the school, where it's the space if it's not the second, the student's first home is the school, right? [...]. It can happen because sometimes the only means of a responsible contact, of someone who can forward the situation to an institution responsible for these situations is the school, right? [...] (P2)

[...] if children and adolescents report any case of violence where the school can intervene, contact the guardianship council and pass on the situation that is happening it's more feasible to develop some type of intervention. But at that specific time we're not having much contact with children, with teenagers it gets quite complicated to intervene in some way [...] (P1)

[...] because unfortunately in the school we're so the only contact of the State with this type of child, right?; if we see that the child is with some bruise, or that something strange happened, or that the student speaks to someone it's through the school that we can trigger this, right?, the guardianship council, it's the military police and keep a little eye on the student, right? [...] (P3)

(Non)perception of action possibilities

Despite highlighting the school as the only space for timely identification of situations of violence against children and adolescents, the teachers did not perceive possibilities for action during the pandemic. Even before this health emergency, there were specific actions with commitment of some people:

[...] now that we're not having much contact with children and adolescents I find it a little difficult to develop some kind of intervention to avoid cases of violence, which may not only be physical but also psychological and moral, right? [...] (P1)

[...] there's a specific group within the school which is responsible for this sector, and then informs the authorities, so I believe it's become easier, actually less difficult, because it's never easy, dealing with violence is never easy, but there's the issue of you suddenly getting involved in the teacher's role remembering that the teacher has there another 50 minutes with 35 to 40 students inside a classroom, and as much as the teacher has support for the work they're there alone, so on my part at least, there's always been a lot of insecurity about it... so much so that I don't commit [...] (P2)

The interviewees highlighted the importance of the social protection network against children and adolescents to be more articulated, with a special look by the Guardianship Council:

[...] I think the guardianship council now more than ever has to be closer to these families, I think much more than us like that at this time... after the pandemic it's to make the resumption of what we already did before, which is to observe these students, always trying to find out if something different is happening at home, you know, and work on these topics in the school, although it's something very difficult to do lately, right? [...] (P6)

One of the main elements present in this difficulty to face situations of violence is physical and affective distancing from the school. The teachers reported that the difficulty of many students accessing the Internet reinforces this distancing:

[...] so I believe that there's also the situation while now in remote class, and there's the student who doesn't answer, there's the student who doesn't have the device, I have a female student where the mother took the device from her [...] (P2)

[...] there, a periphery school, it was very difficult for us to be able to keep in touch with the children, and I don't know if the school managed to reach 100% of the children, to know what is happening, how their life is, it was all very complicated [...] (P3)

[...] in the private school it works because everyone has state-of-the-art computers and Internet, and for us from the State, does it work? Do you know how many students I have? I've got almost a thousand, you know how many of them attend the telework with me? If I tell you it's a 20-student thing, it's too much! [...] (P4)

The teachers also stated the difficulty thinking about remote actions to deal with sensitive topics, such as cases of violence:

[...] but so, the intervention policies, they need to be built in the long run, and they need dialog, they need meetings, and I think it's hard to do them online; I'm not saying that we need to hire someone for this, I think the teacher-mediator and even ourselves, the teachers, can walk in this direction and build up something for the next year and for the next few years, because this pandemic will leave sequelae, emotional sequelae, whether in the adolescents, or in the adults [...] (P7)

In this respect, they highlighted the impacts on the children's and adolescents' mental health by the pandemic, still vulnerable by violence and other absences, which were exacerbated. They reinforced the importance of post-pandemic care and welcoming:

[...] they lost that part of their day, lost that part of their life I would say, because it's more than seven months that this context was taken from their lives and there was no preparation for it; they need the school environment to socialize [...] (P7)

[...] by understanding how this student will resume from this pandemic, most of them don't even know where they are [...] (P2)

[...] so I think having a welcome like that, having contact with psychologists with everyone because sometimes the students don't even feel very comfortable to open up with the teachers, right?, in this case it would have to be professional help so, to collect them after they have stayed so long in quarantine [...] (P3)

DISCUSSION

Violence against children and adolescents is presented in a multidimensional way, produced and reproduced by various elements that articulate themselves for the emergence of this phenomenon. In addition to the complexity intrinsic to the phenomenon, the elements found in the pandemic overlap. Essentially, the need for physical distancing and home/family isolation as the main element to face spread of the virus needs to be considered from a dialogical perspective. For children and adolescents in situations of violence, this measure can enhance occurrence of these events, in addition to maintaining those that are not more prone to such violence¹⁰. Education professionals reinforced this polydimensional view towards the phenomenon, despite the difficulties in devising strategies to achieve it.

The context in which this new phenomenon emerges, that of violence against children and adolescents, is weaved by the changes in daily life imposed by the pandemic¹⁰. The literature states that violence against vulnerable groups, especially children, adolescents and women, is higher on weekends, holidays, vacation seasons and natural disasters¹⁶. This fact is related to the greater interaction of this population with their family members, usually the perpetrators of violence, as well as to distancing from their possible support network; children and adolescents through the vulnerable development process can be even more exposed. In this context, it is emphasized that children and adolescents who need to live with families that are dealing with additional stressors, such as in the pandemic – financial problems, unemployment, increased substance use, higher domestic workload – are more vulnerable to violence^17,18. The participants of our study reiterated these findings.

Furthermore, previous epidemics such as those caused by the Ebola virus in West Africa, cholera and Zika virus have led to higher rates of domestic violence. In addition to the phenomenon of social distancing, it is worth emphasizing the reduction of funding for specialized public health services, as well as reduced access to the health services by these populations due to changes in the care priorities¹⁹. The digital media has been reinforcing these aspects, including greater difficulties identifying cases of intrafamily violence, which was already a challenge to social protection services before the pandemic^16,19.

The participants reiterated a polysemic look at violence, including bringing up the absences of the State as a conditioning and determining element of these phenomena. A study conducted with families involved in violence against children and adolescents corroborated these findings, also impressing certain historicity to the reproduction of violent acts. Public policies and reductionist, fragmented and compensatory practices need to be gradually replaced by expanded and integrally based views²⁰. A literature review on strategies to combat violence against children, adolescents and women in the context of social isolation due to COVID-19 brought up that social protection services should be classified as essential, even ensuring safe face-to-face care in the impossibility of virtual care⁸.

In this sense, Law No. 14,022 was promulgated in Brazil on July 7^th, 2020, providing for measures to combat domestic and family violence against vulnerable populations, including children and adolescents, during the COVID-19 pandemic²¹. This legislation reiterates and guarantees the continuity of processes and measures for these populations; the record of the occurrence of these situations by electronic means or telephone; and the maintenance of virtual services, which do not exclude the obligation by the public authorities to maintain face-to-face care²¹. In this way, it is sought to overcome the greater vulnerability of children and adolescents to violence imposed by social isolation, especially by the distancing from schools and health units.

Despite the verification of higher occurrence of violence against children and adolescents in the pandemic, underreporting is also more frequently found. A Brazilian study developed in Rio Grande do Sul analyzed the rates of reports of violence against children and adolescents from 2015 to 2020, as well as changes in trends due to the health crisis caused by COVID-19. This study showed a 54% reduction in the number notifications in 2020 when compared to the same period in 2019. The authors recommended the planning of strategic intersectoral actions to allow for the identification of suspected cases and timely intervention to guarantee the rights of children and adolescents in adverse times⁹.

Another study conducted in Florida, United States, cross-sectionally examined and estimated data on the distribution of child abuse reports in March and April 2020, the first two months during which schools were closed in the state. The authors noted that, despite the expectation that the financial, mental and physical stress related to COVID-19 could result in more cases of maltreatment, the number of notifications was 27% lower than expected for these two months⁷. In this sense, these data corroborate the teachers' statements, in which they unveiled the school as the main and, in some territories, the only space for identifying situations of violence.

As an important context for human development, the school occupies a privileged place for the construction and exercise of autonomy and identity by children and adolescents beyond the families⁶. Children and adolescents who are vulnerable to violence were separated from a valuable resource for protection and coping with this phenomenon; a study reinforced that, when schools are closed, cases of child abuse are more likely to remain unidentified and/or unreported⁷. The care network for children, adolescents and their families in situations of violence was already weakened before the pandemic. A study developed with primary health care professionals in a large Brazilian municipality showed that the network built has reduced intersectoral links, with low density (little support) and homogeneous, leading to fragmented care, based on the biomedical model²².

As pointed out by some statements, schools have joined remote education, but it is there that another dialogic resides¹⁰ – most Brazilian families do not have technological resources or Internet network for this. An Australian study pointed out that, even though violence against children and adolescents occurs in all groups in society during the pandemic, children from disadvantaged socioeconomic groups are more representative in the statistics²³. At this time, accessing this population is more difficult due to insufficient electronic equipment, limited network connection or the existence of younger children requiring attention and insufficient number of adults to provide support²³. In addition, the unsecured and secure spaces of Brazilian households need to be considered⁸.

Considering this distancing from school, a number of studies have contributed strategies and possibilities to identify and cope with violence against children and adolescents^7,8,24. One of them, corroborating data from this study, is that basic social protection is considered a priority service, with extended functioning and greater possibilities of accessing families that are in a situation of vulnerability²³. Unfortunately, this action is still a challenge in Brazil. A study recommended that school districts could coordinate virtual verifications among professionals trained to recognize signs of violence in vulnerable children or adolescents⁷; in the case of Internet limitation, there could be intersectoral articulation for visits concerning the health conditions.

In this context, the participants cited the Guardianship Council, which is a constitutional body responsible for guaranteeing the rights of children and adolescents in Brazil. A study brought up the importance of maintaining the work of the Tutelary Councils with face-to-face, telephone or digital appointments during the pandemic¹⁶. Strategic preventive actions, such as mass dissemination of media for community violence, in addition to easy and free access, are recommended⁷.

The impact on the children's and adolescents' mental health imposed by the pandemic and possible cases of violence to which they are exposed has been mentioned in several studies. A theoretical study reflected on the implications of the pandemic on the mental health of adolescents²⁵. It brought up that this population experiences environments that are not sustainable for healthy development, and that it is urgent to devise and implement interprofessional actions promoting mental health for this population; and, also, that studies are needed that glimpse the Brazilian reality²⁵. Another study with a narrative literature review brought up that one of the main consequences of the pandemic will be the implication of the mental health of children, adolescents and their families by the various factors – economic recession, mournings and conflicts. The authors recommended focusing on populations with greater social vulnerability, including without access to the Internet, in addition to children and adolescents with chronic diseases, who already went through adverse experiences or mental distress, and immigrants/refugees²⁵.

FINAL CONSIDERATIONS AND IMPLICATIONS FOR THE PRACTICE

The results allowed understanding that violence against children and adolescents is seen as a multidimensional phenomenon by the participants. Due to the specificities of greater occurrence in families, the life changes imposed by the pandemic, especially social distancing, can imply an increase in the number of cases and greater difficulty identifying violence against this population. Distancing from school, including due to the difficulty of remote access to children and adolescents by the teachers, was understood as the main element for greater vulnerability to violence. The impacts on the children's and adolescents' mental health from possible conflicting and/or violent experiences were reinforced; interprofessional and intersectoral care needs to envision this challenge and propose actions in the short- and medium-term.

This study had limitations; the first refers to data collection that worked only with the audios, making it difficult to analyze non-verbal communication. Another limitation was the use of code saturation, since such data could be deepened with other techniques to achieve saturation of meanings. These limitations can be envisioned by new studies in the area that are especially necessary in the Brazilian context, aimed at actors such as families, managers and professionals from other social protection sectors.

Despite the limitations, this study has important implications for the nursing and health practice, namely: (1) elaboration of support and intersectoral strategic actions focused on the school, since it is a device that has been in contact with children and adolescents, including to support visits respecting sanitary conditions for those in which remote contact is not possible; (2) permanent education for health professionals, as well as for education and social assistance professionals on suspected signs of violence against children and adolescents in pandemic times; (3) elaboration of intersectoral action protocols in these cases; (4) elaboration of a standard-question on home safety for children and adolescents; (5) mass dissemination in channels of reports on violence against children and adolescents to the community; and (6) development of actions promoting mental health to children, adolescents, families and communities in pandemic times.

• FINANCIAL SUPPORT

  National Council for Scientific and Technological Development. Research Assistance – Universal Notice No. 28/2018. Research project: Prevention of violence in intimate relationships between adolescents: Analysis of an intervention. Coordination: Diene Monique Carlos, Process No. 434214/2018-3. Research Support Foundation of the State of São Paulo. Scientific Initiation Scholarship granted to Ana Paula França de Oliveira, Process 2018/23296-6. Coordination for the Improvement of Higher Level Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, CAPES) – Brazil. Master's Scholarship granted to Marina Soares de Souza, Funding Code 001.

REFERÊNCIAS

• ¹
  World Health Organization, Violence Prevention Alliance. Definition and typology of violence [Internet]. Geneva: WHO; 2014 [citado 2020 maio 28]. Disponível em: http://www.who.int/violenceprevention/approach/definition/en/index.html
  » http://www.who.int/violenceprevention/approach/definition/en/index.html
• ²
  Ministério da Saúde (BR). Vigilância de violência doméstica, sexual e/ou outras violências: Viva/Sinan Brasil, 2011 [Internet]. Brasília: Ministério da Saúde; 2013. (Boletim Epidemiológico) [citado 2020 jul 20]. Disponível em: https://antigo.saude.gov.br/images/pdf/2014/junho/11/BE-2013-44--9----VIVA-SINAN.pdf
  » https://antigo.saude.gov.br/images/pdf/2014/junho/11/BE-2013-44--9----VIVA-SINAN.pdf
• ³
  World Health Organization. Global status report on violence prevention 2014 [Internet]. Geneva: WHO; 2014 [citado 2020 maio 28]. Disponível em: https://www.who.int/violence_injury_prevention/violence/status_report/2014/en/
  » https://www.who.int/violence_injury_prevention/violence/status_report/2014/en/
• ⁴
  Katz LF, Stettler N, Gurtovenko K. Traumatic stress symptoms in children exposed to intimate partner violence: the role of parent emotion socialization and children‟s emotion regulation abilities. Soc Dev. 2016;25(1):47-65. http://dx.doi.org/10.1111/sode.12151
  » http://dx.doi.org/10.1111/sode.12151
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Edited by

ASSOCIATED EDITOR

SCIENTIFIC EDITOR

Publication Dates

• Publication in this collection
  27 Oct 2021
• Date of issue
  2022

History

• Received
  18 June 2021
• Accepted
  15 Sept 2021