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Jornal de Pediatria
On-line version ISSN 1678-4782
BLANK, Danilo. Injury control from the perspective of contextual pediatrics. J. Pediatr. (Rio J.) [online]. 2005, vol.81, n.5, suppl., pp. s123-s136. ISSN 1678-4782. http://dx.doi.org/10.1590/S0021-75572005000700002.
OBJECTIVE: To describe the relationship between injury control and contextual pediatrics. SOURCES OF DATA: Quasi-systematic review of MEDLINE, SciELO and LILACS databases, using combinations of the words contextual, community, injury, accident and violence; and non-systematic review of book chapters and classic articles. SUMMARY OF THE FINDINGS: Safety depends on the interaction of family habits, cultural patterns and surroundings. Contextual pediatrics sees the child, the family, and the community as a continuum; health diagnosis (sequential observation of problems and assets) is one of its cornerstones. Changing intrapersonal factors for injuries requires the use of both passive and active strategies. Family and cultural risk factors for injury: home overcrowding, moving, poverty, and young, illiterate and unemployed parents. The main neighborhood factors: material deprivation and traffic. Cultural factors: illiteracy, unsafe products, lack of mass transportation, handguns, workplaces without safety rules, faulty community organization, lack of communication between social sectors, inadequate legislation, low priority for safety among government actions, lack of economic resources, and low academic commitment with the field of safety. CONCLUSIONS: The pediatrician's roles include strengthening of the longitudinal relationship with families, integrated interdisciplinary work, constructive intervention, partnership with community, counseling on injury risks pertaining to each developmental stage, by using lists with explicit processes and contents, and by handing out written materials. Active advocacy for safety promotion in different environments, besides the clinical setting.
Keywords : Community medicine; wounds and injuries; counseling; health education.