Print version ISSN 0104-0707
Texto contexto - enferm. vol.21 no.1 Florianópolis Jan./Mar. 2012
Joana Iabrudi CarinhanhaI; Lucia Helena Garcia PennaII
IMaster in Nursing. Professor, Faculdade
de Enfermagem (FENF), Universidade do Estado do Rio de Janeiro (UERJ). RN, Psychiatry
Institute, Universidade Federal do Rio de Janeiro. E-mail: firstname.lastname@example.org
IIPh.D in Women's and Children's Health. Adjunct Professor, Department of Maternal-Child Health, FENF/UERJ. E-mail: email@example.com
Considering that female adolescents living in shelters may have a different view regarding the meaning of violence and the effect it has on their lives, in this study, we aimed at understanding violence from the perspective of these youths. This qualitative study was performed using semi-structured interviews with 11 female adolescents embraced by a municipal shelter in Rio de Janeiro. Their statements were subjected to content analysis (thematic), which revealed the violence they experienced in their usual environments: family, community, and the shelter. The adolescents have a precise and rather concrete understanding of violence, pertinent to their experience. They face difficulties to realize the complexity of the phenomenon, basically referring to the community and intrafamily violence tangible to them. The results point to the need for more investments to engage in discussions regarding the process of vulnerability and disaffiliation that these adolescents experience in life, their roots and effects.
Descriptors: Violence. Violence against women. Adolescent, institutionalized. Adolescent health.
Violence is characterized as a mobilizing and fascinating theme due to its complexity and polysemy, but also because of its devastating consequences. Thinking about violence from the perspective of adolescents is a strenuous task that researchers have been addressing. Our efforts in this study regarded the dimension of the violence experienced by the female adolescents embraced in shelters.
Institutionalization in adolescence is a reality for many unprivileged families, which is a reflection of the historical socioeconomic inequality in Brazil, and it represents a current relevant study dimension. Moving away from family living raises concerns regarding the negative effects on the development of the adolescents' emotional structure and the consequent construction of life projects.
Historically, in Brazil, the excluded adolescence was institutionalized based on a practice focused on the repression of deviation, characterized as discriminatory and stigmatizing.1 It is a response to a demand of society itself, which, by producing so much poverty and social inequity, leads children and adolescents towards the experience of explicit and silent violence both within and outside their families.
Since the implementation of the Estatuto da Criança e Adolescente - Children's and Adolescents' Statute,2 the shelter is a means of protection that should be structured for the temporary housing of adolescents experiencing a situation of psychosocial vulnerability. Nevertheless, difficulties exist, because the stigma of these youths is so rooted in our culture that even the shelter staff resists to change this image and the authoritarian attitude against the poor youths, ignoring their needs and points of view.1
These subjects are young individuals separated from their families, whose social ties are frayed - which assigns them a trajectory of exclusion and violence, driving them towards a differentiated form of seeing and being in the world, with their own social/relationship norms, and making it more difficult to address the health issue, and, even more difficult to promote their health.3-4 Therefore, every day they experience collective violence, which comprises their way of seeing and being in the world, and is characterized by being committed by larger groups of individuals or the State5 - an invisible violence rooted on the forms of social, political, and economical organization. The vulnerability of physical and mental health problems, thus, determined the need for special and specific attention for adolescents.
The National Survey of Children and Adolescents in Shelters reported 36,929 sheltered children and adolescents in the country. Data from the 7th census of sheltered children and adolescents, in the State of Rio de Janeiro, showed that among 2,658 children and adolescents who are currently sheltered, most are girls in the age range between 13 and 15 years (22.54%).6 Furthermore, negligence and abandonment by parents or guardians, and homelessness are still the main causal factors for sheltering, and they reflect the social inequities and the inability of the State to guarantee the human and citizen rights of these youngsters.1,6-7
In this context, violence against adolescence deserves more highlight and investment, considering its smaller lethality and greater invisibility, in order to make it more apparent and passible of preventive interventions.8
Brazil is a patriarchal society, and, as such, the gender issues that imply a different cultural construction of men's and women's roles in society assign differences in the manifestations and repercussions of violence among female and male adolescents. A study about the understanding that the shelter staff have regarding the [violence experienced by the sheltered adolescents revealed that gender violence is seen as a critical and concerning issue, as they verified the marking reproduction of the naturalized subjection of girls to boys within the shelter units, that is, without the girls perceiving they were suffering violence.9
Therefore, we understand there are specificities regarding the violence experienced by adolescents living in shelters, particularly due to the gender asymmetry and being institutionalized (away from family living), which makes these conditions relevant in face of the government's recommendations about the care for adolescents exposed to violence, as well as their right to family living.10-11
Considering that these youths may have a different view regarding the meaning of violence and the effect it has on their lives, in this study, we aimed at understanding violence from the perspective of female adolescents living in shelters.
This exploratory study used a qualitative approach in the attempt to understand the meanings, subjectivities, values, feelings, experiences, opinions, attitudes and motivations comprised in the statements of adolescents living in shelters and involved in the violence problem to which they are exposed.
Seeking the view of those who experience violence, in a context of high vulnerability - the sheltering situation, we highlight the female adolescents admitted at the temporary housing (a temporary shelter of the Rio de Janeiro municipal social care network for adolescents - SMAS/RJ). We emphasize that, in general, the sheltered female adolescents are in this situation because they do not have solid family/social ties, which eventually results in their leaving home to live in a shelter or on the streets. Surviving on the streets, on the other hand, also implies vulnerability, thus encouraging them to seek or be referenced to shelters.
In order to interview these adolescents, a first contact was made with the team working at the studied shelter, then with the youths themselves, with the purpose of explaining about the study and its goals, advantages and risks. Twelve sheltered female adolescents were then invited to participate in the study. Eleven of them became the social subjects of this study - one refused to participate - and all authorized their participation by signing the Free and Informed Consent Form, which was also ratified and signed by the board of the shelter (legal guardians of the adolescents at the time). It should be noted that the study was approved under protocol number 203/07 with the Research Ethics Committee of the Municipal Department of Health and Civil Defense, in compliance with all the ethical principles of human research.
Data were collected through semi-structured interviews, using a script. The statements were digitally recorded and later transcribed and subjected to Content Analysis, which groups the main themes present in the statements into analytical categories.12 The categories that emerged in this process were: General characterization of violence; Violence experienced in the family environment; Violence experienced in the community; and Violence experienced in the shelter.
The subjects' age ranged between 13 and 17 years, and they had a low educational level, with most being behind in school. One adolescent reported never being in school, because she was not registered (she did not have a birth certificate), and the other, despite being in the third grade, was unable to read or write. On the other hand, most of them see education as a perspective of a future, particularly as the path to build a better life. Regarding their experience of living on the streets, opposite to what we had supposed, only three adolescents had been in this situation, although all of them had run away from home. The others, however, sought the house of closed ones or some form of service (child protection agency, fire department) for shelter.
RESULTS AND DISCUSSION
General characterization of violence
Violence was discussed among the adolescents, based on their life experiences, which permitted to understand the manifestations and facets of the violence that pervades their everyday lives, whether they are visible or silent.
In general, the adolescents were able to clearly identify the nature of the existing violent acts:5 physical (hitting), psychological (treating bad) and sexual (sexual abuse), specifying crimes (killing and stealing). Nevertheless, opposite to what we had expected, more than half of the interviewed adolescents found it difficult to assume they were exposed to violence. No [there were no situations in which I felt assaulted] [...] buy my brother always hit me [...] (A5, 13 years old).
Their difficulty to recognize the violence they experienced is perhaps related to the fact that is was perpetrated by those who should have protected and given affection, notably, the family. It is understood they need to hide, cover this occurrence, because of the constraint that is caused if revealed. Violence is understood as something greater or more serious, different from the common events of their everyday life, hence the difficulty to realize the situation of violence - either as victim or aggressor. In this sense, it could mean that violence is so trivialized and naturalized that it is no longer recognized as such.
The naturalization of violence refers to an unjust social order that installs an atmosphere of acceptance towards violence, considering it as a negotiation device. Juvenile violence is anchored on experiencing systematic violent events at home or in the community, thus conditioning the child or adolescent to considering violence as an acceptable way to solve conflicts.5 The issue can also be addressed from the women's perspective, based on the premise that violence against women is socially legitimated, such that many men do not realize they perpetrate violence and many women do not perceive themselves as victims of violence, based on the belief of men's right of possession over women, and women's duty of obedience to men.13
The interviewed adolescents illustrated several situations in which they did not perceive the violence present in the surrounding environments, which characterized a naturalization of violence, mainly in the family environment. Many situations of intrafamily violence are not seen as violence, but mostly as an educational measure. In other words, in our culture, getting a spanking from your parents is part of parental education, a part of family living. However, we consider that using violence to discipline children involves, among other factors, the difficulty to condemn physical punishment as violence, whatever its form or intensity, as well as the harms of a vicious cycle in which the child, early in life, learns that it is normal, or even desirable, to be spanked by your parents, because they are doing it for your own good.14 Furthermore, corporal punishment is a form of oppression and coercion, and, as any form of aggression, is unjustifiable.
The adolescents also accept coercion as an educational measure when practiced by the shelter staff: like in the case that he [professional from the shelter] wants my well being! If he is arguing with me today, it's because tomorrow he wants to see that I became a decent person, a good person, a person who is working, studying, being someone in life, a mother, or a father, he wants us to leave here well! (A11, 15 years old).
We should, herein, emphasize the attitude of the professional that could be on the verge of establishing discipline as punishment, characterizing a silent violence that effects the mental health of the adolescents under their care. It can be considered that parents often lack the necessary conditions to evaluate the effects of a violent disciplinary method in order to avoid a punitive attitude, but the caregiver at the shelter must be prepared to promote discipline by supporting the adolescents, so they develop self-control and self-esteem to deal with situations without the need to assume certain behaviors only to avoid punishment.
We observe an ambiguity in the adolescents' perception of what is the limit of an acceptable corrective measure and what denotes violence. This confusion becomes clearer in the following statement: if spanking was right, then today in this world there wouldn't be any drug dealers, no corrupt people [...] Lula (the president at the time) would not be this way! Because if I were his mother, I would give him a good beating to make him better! Because he lies too much! [laughter] (A11, 15 years old).
In this aspect, the adolescents assume that the corporal punishment that parents commit as an educational means does not solve the problem; in fact, it only worsens the situation because it deteriorates into aggressive reactions, opposing the acceptance of this method. Outside the family environment, the adolescents recognize that violent attitudes produce violent reactions, so, the person who likes to hit, gets hit too! So, I hit others because he [brother] hit me (A5, 13 years old). Nevertheless, what marked the adolescents' statements and attitudes observed in the shelter was that, because of the expansion of their acceptance towards aggression as a parental educational measure to other situations and relationship domains, they learn to accept violence as a normal or appropriate answer to problems.
The violence experienced within the family
Most situations that the adolescents identify as violence point to the family environment. This fact characterizes intrafamily violence, which originates in unstructured contexts where adolescents grow and develop, learning a violent way of being in the world. It refers to a trajectory of invisibility that tends towards dissafiliation.15 The path (or its loss) begins to be outlined based on the compromised paternal references: adoptive parents due to the abandonment by biological parents, stepparents, deceased and/or unknown parents. My father, I don't remember, I don't know if he's dead or alive [...]. I think my father has already died! (A5, 13 years old).
We found that the adolescents' family structure was compromised mainly due to the members' involvement with drugs and/or crime. It is interesting that this family context of drugs and crime involved only the male relatives of the interviewed adolescents, though it is not surprising, considering that men are not only the main victims but also the perpetrators of violence in general, as confirmed by the rates of morbimortality by violence. This is rooted on the historical construction of gender, in which masculinity presupposes attitudes of aggressiveness and an imposition of power, which can result in violent behaviors.
This broken family composition generates hostility and uncountable conflicts that portray the manifestations of intrafamily violence, such as: negligence and deprivation, evident verbal conflicts, physical aggressions and sexual abuse. Because my mom doesn't get to the point of hitting me. She says: 'Oh! Take this pest away!'. She's called me those names: 'you b......'. She really put me down, she humiliated me a lot! (A10, 17 years old).
Negligence appears in the form of moving away from family living, either because they are away from home or because they are abandoned by the family while at the shelter. Deprivation refers to the underprivileged financial conditions. We understand it consists of psychological violence,16 because it sends a culturally specific message of rejection based on the abandonment by the family and the State, indicating the need for intervention, according to article 98 of Children's and Adolescents' Statute.2
Opposed to what one could think, particularly because the subjects are exclusively women from popular classes of a patriarchal society, only one adolescent revealed having been sexually abused by her brother, which was experienced as physical and psychological violence: my oldest brother, he did it to me, like, by force! My brother, forced me! I was really small, he threw me on the bed and forced me! I was a virgin! It bled a lot! I had to use a vaginal paste! It really hurt! It was horrible! (A10, 17 years old).
Sexual violence in childhood, in general, is perpetrated by people the child trusts, which results in severe physical and psychological effects, because of the circumstances of fear, threat, and seduction that are involved.17 It represents an inadmissible violation of human rights and consists of one of the oldest manifestations of gender violence. In other words, it is rooted on the ideology of men's rights over that of women regarding sex, reflecting a way of exerting their historically and culturally legitimated power. Furthermore, it is a growing worldwide historical issue that requires the incorporation of sensitivity, solicitude, patience and preoccupation in the everyday practice of nurses, based on the sharing of values and emotions.18
Besides this facet of gender violence, two adolescents revealed experiencing pregnancy as violence, either because it was unplanned and unwanted, or because of the rejection from the partner, or yet because of seeing abortion as a solution, but not as the result of sexual abuse. These situations refer to issues regarding early and violent sexual initiation, making them hostages of the events on the streets, as well as their not knowing their own body, disengaging sex from desire and pleasure and putting them at the risk of being infected with STD or getting pregnant.19
Therefore, pregnancy in adolescence, for the present study subjects, can be understood as an aggression to their body and psychoaffective structure, as they do not receive the support they need in order to understand the physiology of their body and sexuality, nor a safe maternity with a responsible partner. In addition, there is the abortion issue, which, despite appearing to be an attitude of autonomy, in this context, it is actually a reflection of their lack of control over their body and life, indicating the lack of access to information to make a critical decision, including the roots and repercussions of this behavior.
Despite their recognizing the pregnancy experience as violence, because of many social, ethical, moral and religious factors, in the case of sheltered adolescents, another study found they actually wanted this experience, considered it satisfactory or salvaging from the moment they found support in the shelter.13,19
The violence experienced in the community
Community violence invades the lives of the studied youths, and is responsible for the occurrence of aggressions, loss of close ones, leaving home, eventually, due to the difficult and directly or indirectly cruel situations they experience. These refer to homicides, thefts, criminal conflicts and events committed by felons/drug dealers, sometimes the police, or, yet, by themselves.
These situations illustrate the violent life of large cities - as the case of Rio de Janeiro, with its intense social and economical inequality caused by the capitalist mode of production, which stirs social tensions. The World Health Organization recognizes that certain community environments favor violence more than others, e.g. poverty zones, urban zones with high criminality rates or with poor institutional support, as is the case of the communities where the interviewed adolescents are from.5
These adolescents are experiencing the tough and perverse ordination imposed by criminal organization, which use virility to solve conflicts, punishing violators with violence, often deadly.20 It refers to the manifestation of post-modern machismo that is "exteriorizes through exhibitionism, vainglory, through the pleasure of domination, and the imposition of cruelty per se".21:25 He [drug dealer] hit us... he came there, and made me and L.. [brother] say we did it [the robbery]... and to give shocks on L.! That wire there... it can take a part out of you... they get you wet and put the wire here like this... (A2, 16 years old).
On the other hand, we found there was naturalization of this type of violence according to the statement of one adolescent regarding the community context in which she lived: he [drug boss] considers me a daughter, a niece, because he really likes my mother. He said: 'if something happens to D.... and her mother dies or if she gets sick... you'll have to deal with me!' [...] So, I can do whatever I want in the favela (slum), and I won't be told at, I won't get spanked, I won't get shot, I won't get nothing! (A3, 14 years old).
We verified the violent social reality that is home for the adolescents, where the State cannot made definitive interventions with its laws and norms, thus the order of criminal organizations (traffic) prevails, which, despite the violence, organizes the community, and offers some support and protection to those who respect it. Therefore, in this environment, this organization obtains the support from the community and their form of keeping order gains legitimacy. In other words, it is more than dealing with the lack left be the State. In fact, it mainly refers to a broader social order that produces a culture of peripheralization, in which violence is the mark that legitimates the functioning of this class, teaching the community, adolescents in particular, to live and react through violence.
Both situations refer to the experiences of the urban community violence that invades the lives of these young sheltered women, restricting or impeding their movement, leaving indelible marks. This impossibility of community living was referred to as 'exile' - a form of violence against the adolescents, which is understood as their non-belonging to the context where they were born and established their closest relationships.22 Therefore, the contexts of the development of sociability, which is essential for the adolescents' human experience, acquire new outlines, marked by vulnerability/disaffiliation,15 restricting their opportunities and driving them towards paths that are usually harmful favorable.
We also found they perceived the influence of their peers to their accepting violence as a form of answering the everyday situations, such as the encouragement to use drugs, commit felonies, react with aggressiveness, or even maintain relationships with persons of bad character. We understand that peers are important in adolescence in order to establish personal relationships, nonetheless, there is an association with young transgressors, although it is not clear if having delinquent friends comes before or after being a delinquent adolescent.5
The main influence reported by four adolescents refers to the use of psychoactive substances also interfering in their decision to go home, because it would favor their contact with the groups in their community that encourage drug use, and make it difficult for them to resist the offer of those substances. Many classmates and neighbor friends are on crack. That's what I mean! I have a weak mind! I really go and do it! If people invite me, I go! [...] if I stay on the hill, it will be something that will draw my attention... you go, and see you walk by, again and again ... until the point you stop to buy some! (A9, 15 years old).
Herein, we notice that the adolescents recognize the harms of being involved with drugs and, at the same time, their effort to keep away from this context, as a form of self-preservation, even though it may mean moving away from family living. This indicated the movement of these adolescents towards a change in the reality they experience.
Looking deeper into this issue brings us to a reflection about the power of the traffic organization to persuade youths to consume, sell or become involved in other drug-related activities ("watcher", "warner", "messenger"). This situation points to one of the causal nexus between drugs and violence: the perverse, perhaps uncritical exchange of the offer/promise of financial gains in the illegal drug market, the anesthesia from the reality they live in and the fun involved in being in a situation that is even more oppressive, either because of the devaluing of life among those involved in drug dealing, or because of the organic repercussions of the use, or, yet, because of the stigmatization of the users. Another aspect that should be highlighted is the fact that these adolescents are curious about the possibilities they can experience in the world and anxious to be recognized and approved in their group.
The adolescents also revealed they are concerned about establishing community relationships that harmed them directly, or encouraged them towards attitudes considered wrong, such as stealing and having aggressive reactions. A study about the vulnerability of children and adolescents living on the streets states that "just as in any group, on the streets, the child is submitted to the expected pattern of behavior, for instance, using drugs and being involved in illicit activities",15:472 thus the participation in groups characterizes a strategy to survive on the streets, considering, most of all, the violence in this environment.
When the family is unable to provide a social environment to their children and adolescents, as is the case of the subjects' broken families, the group makes them 'someone', subjects of something, even if that something is violence; the group provides them with the necessary conditions to defend their social space through force, threats, and fear. Thus, although they realize there is violence in these relationships, the subjects are driven to accept their peers' rules so they do not surrender to an invisible existence.
A bit broader perception about community violence emerges in the statements of two adolescents regarding the prejudice that is created from the stigma of class and/or race, demonstrating a more critical awareness of the society and their life standards: they say I'm full of ways... but it's not ways, hygiene is necessary! We already are black and poor, and now without hygiene too?! No way, right?! (A9, 15 years old).
The reference to racial prejudice is well founded. The black population currently accounts for 70% of the poorest population in the country, as opposed to their 15% participation in the richest group, which comprises 10% of the population.23 Furthermore, data show that there are more black poor children and adolescents than their white peers or even adults, regardless of the color of their skin. Therefore, besides the stigma of being a juvenile delinquent and poor, one more is added, skin color: black.
The violence experienced at the shelter
Most of the interviewed adolescents highlighted the shelter is a place of embracement and opportunities, emphasizing the several positive aspects of living there. However, some referred that the institution where they are is not able to provide an environment that helps them assign a new meaning to their traumatic experiences, which led them to the sheltering situation. In fact, during the development of the study, it was observed that the adolescents dealt with an array of difficulties and impasses involved in handling the sheltered adolescents, who are often impulsive, disrespectful, self-sufficient, aggressive, and have no limits.
Experiencing violence in the shelter, according to the interviewed adolescents, is associated with the violent relationships, mostly between the adolescents and the staff, but also between themselves.
The adolescents identified several situations of disrespect and negligence by the staff. The disrespect of the professionals appear mainly in the form of power abuse and by calling the police to solve conflicts at the shelter, which is a reflection of their difficulty to deal with the adolescents they are caring for, particularly in the sense of establishing limits. Besides the psychological violence that results from these attitudes, emphasis should be given to the criminalization of the adolescents implied by their calling the police, which reaffirms their stigma of delinquents for the society and the adolescents themselves: some of them [sheltered adolescents] are taken to the police station when they fight! (A9, 15 years old).
The adolescents follow the line of the disrespect practiced by the staff at the shelter: the talks are aggressive, denoting ignorance, discrimination, humiliation and prejudice, and remount the aforementioned stigmatization process.1
On the other hand, it is necessary to weigh the adolescents' statements without devaluing them. The adolescents themselves report their violent relationships with the staff, and it is also noticeable they have a behavior that is provocative and intimidating, often disrespectful, which appears to constantly test the other's limit. In addition, one must consider the working conditions of the referred professionals: the lack of internal and external human and material resources (support network), the reduced or lack of a democratic and collective management environment, the immobilizing norms and routines of the institution, the aggressiveness and arbitrariness of the youths, the lack of preparation to deal with these adolescents and their cruel realities, eventually create an environment that is propitious to hostility, one in which the staff feels disrespected, devalued, frustrated and powerless, thus compromising the quality of the care they provide.9,24
Consistent with the findings, the negligence of the shelter staff is reported by the adolescents mainly as a lack of attention to their needs/demands. They refer to their need of professional listening, care, education and work - all of which are rights legitimated by the Children's and Adolescents' Statute, which should be granted by the shelter.2
One cannot consider the possibility of car to cope with violence if the healthcare professional assumes an oppressive attitude. A previous study shows the effort of the shelter caregivers in developing educational interventions aiming at coping with violence, while also identifying some situations of a traditional education that attempts to fit the adolescent within the ruling standards from an authoritarian view of correcting any deviation.9
Care must be taken so that the shelter does not become, for the adolescents, another context with conditions that can affect their development and establish a trajectory that propitiates violent behaviors. Thus, it is desired that the professionals at the shelter (as well as those from other services involved) engage in dialogues with the adolescents to provide the conditions for them to become the central subjects of their lives by other means rather than violence.
The adolescents' understanding about violence is timely and quite concrete, considering their experience, and they show difficulties to realize the connections, the complexity of the phenomenon. It is idealized that violence is unjustifiable, but that is consists of their way of seeing and being in the world, and, in practice it becomes the means to solve problems. Thus, it is considered to be necessary to maintain order.
The gender approach about the particularities of the violence to which the adolescents were exposed on the streets, refers to the historical passivity and acceptance of the violent situations built on relationships in which one holds the power and the other is forced to obey this fate. They learn, mainly at home, by seeing the aggressive relationships between their mothers and partners, their brothers assuming their virility by becoming involved in drug dealing and/or crime, and by being assaulted by fathers and stepfathers. Therefore, they appear more as victims than as aggressors, suffer more aggressions from men than from women, notably within the family environment, get involved in prostitution, suffer sexual abuse, experience pregnancy as a form of violence, and tolerate violent relationships as a manifestation of affection.
The underprivileged economical and, notably, affective conditions comprise the family context of the interviewed adolescents, weakening the ties and breaking the structure of what should be a support network for the young women, for their development as humans and citizens. This weakness - and breakage, in some cases - of the family ties leads to disaffiliation, which can account for the significant number of adolescents that decide to leave home, consisting of one more violent event in their lives. There is a need to reinforce the investment in family support that promotes a greater cohesion among its participants, developing tolerance, affectivity, and dialogue in the relationships, in addition to promoting more human and decent ways of living.
Although they exclusively refer to the community and family violence that are tangible to them, we realized they also associate with broader social factors such as social and economical inequality based on the capitalist mode of production. This unfair order generates the poverty in which they are included, opposite the wealth they observe in the streets where they walk; social norms that reinforce the coercive and abusive police force over citizens, treating them as criminals; the difficult accessibility to education, generating low educational levels.
Their families are unable to provide a solid/effective affiliation, and so is the State. It appears all that is left is their association with groups whose attitudes and system resemble the violent and perverse pattern they learned, and which helps maintain their accepting attitude towards violence. Their inclusion in groups that leads them to antisocial behaviors, thus, appears to be the path they choose to establish some form of affiliation, however, some are able to realize the harm caused by those relationships, and point to the possibility of coping with their own mechanisms and/or being assisted though care that includes dialoguing.
We must take advantage from the opportunity of working with adolescents living in shelters to engage in discussions about the process of vulnerability/disaffiliation they experience in life, their roots and effects, seeking, together, new ways of living, increasing their self-esteem and their potential of changing the reality. Of course this cannot be separated from the changes in public policies regarding adolescent care, which presupposes that the change in the mindset of society and professionals about these adolescents, to whom very little is offered.
1. Leite LC. Meninos de rua: a infância excluída no Brasil. 5ª ed. São Paulo (SP): Atual; 2009. [ Links ]
2. Brasil. Lei nº 8.069, de 13 de julho de 1990. Dispõe sobre o Estatuto da Criança e do Adolescente. Diário Oficial [da] República Federativa do Brasil, 16 jul 1990. p. 13563. [ Links ]
3. Carinhanha JI, Leite, LC, Penna LHG. "Minha arma é a mão": a violência como forma de resistência. In: Leite LC; Leite MED; Botelho AP, organizadoras. Juventude, desafiliação e violência. Rio de Janeiro (RJ): Contra Capa; 2008. [ Links ]
4. Nogueira LA, Bellini LM. Sexualidade e violência, o que é isso para jovens que vivem na rua? Texto Contexto Enferm. 2006 Out-Dez; 15(4):610-06. [ Links ]
5. Organização Panamericana de la Salud. Informe Mundial sobre la violência y la salud. Washington (DC): OPS; 2003. [ Links ]
6. Ministério Público do Estado do Rio de Janeiro (RJ) [página na Internet]. MPRJ divulga censo estadual indicando a redução de quase 30% do número de crianças e adolescentes em acolhimento. Rio de Janeiro (RJ): MPRJ; 2011 [atualizado 2011 Set 30; acesso 2011 Out 20]. Disponível em: http://www.mp.rj.gov.br/portal/page/portal/Internet/Imprensa/Em_Destaque/Noticia?caid=293&iditem=14936097 [ Links ]
7. Oliveira AAP, Ribeiro MO. O cuidar da criança de/na rua na perspectiva dos graduandos de enfermagem. Texto Contexto Enferm. 2006 Abr-Jun; 15(2):246-53. [ Links ]
8. Taquette sr, organizador. Violência contra a mulher adolescente/jovem. Rio de Janeiro: EdUERJ; 2007. [ Links ]
9. Penna LHG, Carinhanha JI, Leite LC. The educative practice of professional caregivers at shelters: coping with violence lived by female adolescents. Rev Latino-am Enfermagem. 2009 Dez; 17(6):981-7. [ Links ]
10. Ministério da Saúde (BR), Secretaria de Atenção à Saúde. Prevenção e tratamento dos agravos resultantes da violência sexual contra mulheres e adolescentes: norma técnica. Brasília (DF): MS; 2005. [ Links ]
11. Ministério do Desenvolvimento Social e Combate à Fome (BR), Secretaria Especial dos Direitos Humanos, Conselho Nacional dos Direitos da Criança e do Adolescente, Conselho Nacional de Assistência Social. Plano nacional de promoção, proteção e defesa do direito de crianças e adolescentes à convivência familiar e comunitária. Brasília (DF): MDSCF; 2006. [ Links ]
12. Bardin L. Análise de conteúdo. Lisboa (PT): Edições 70; 2000. [ Links ]
13. Lauriano AG. Relação da violência na gestação e o processo de abortamento: uma perspectiva da gestante [dissertação]. Rio de Janeiro (RJ): Universidade do Estado de Rio de Janeiro. Programa de Pós-graduação em Enfermagem; 2009. [ Links ]
14. Donoso MTV, Ricas J. Parent's perspective on child rearing and corporal punishment. Rev Saúde Pública. 2009 Fev; 43(1):78-84. [ Links ]
15. Gontijo DT, Medeiros M. Crianças e adolescentes em situação de rua: contribuições para a compreensão dos processos de vulnerabilidade e desfiliação social. Ciênc Saúde Colet. 2009 Abr; 14(2):467-75. [ Links ]
16. Avanci JQ, Assis SG, Santos NC, Oliveira RVC. Escala de violência psicológica contra adolescentes. Rev Saúde Pública. 2005 Out; 39(5):702-8. [ Links ]
17. Drezett J. Violência sexual como problema de saúde pública. In: Taquette SR, organizador. Violência contra a mulher adolescente/jovem. Rio de Janeiro (RJ): EdUERJ; 2007. p. 81-9. [ Links ]
18. Morais SCRV, Monteiro CFS, Rocha SS. O cuidar em enfermagem à mulher vítima de violência sexual. Texto Contexto Enferm. 2010 Jan-Mar; 19(1):155-60. [ Links ]
19. Gontijo DT, Medeiros M. "Tava morta e revivi": significado de maternidade para adolescentes com experiência de vida nas ruas. Cad Saúde Pública. 2008 Fev; 24(2):469-72. [ Links ]
20. Castro LR, Correa J (org.). Mostrando a real: um retrato da juventude pobre no Rio de Janeiro. Rio de Janeiro (RJ): NAU/FAPERJ; 2005. [ Links ]
21. Minayo MCS. Laços perigosos entre machismo e violência. Ciênc Saúde Coletiva. 2005 Jan-Mar; 10(1):18-34. [ Links ]
22. Santos JEF, Bastos ACS. Pertencimento e "desterro" nas trajetórias de adolescentes da favela de Novos Alagados, Salvador, Bahia. In: Castro LR, Correa J, organizadoras. Mostrando a real: um retrato da juventude pobre no Rio de Janeiro. Rio de Janeiro (RJ): NAU/FAPERJ; 2005. p. 253-77. [ Links ]
23. Assis SG, Deslandes SF, Santos NC. Violência na adolescência - sementes e frutos de uma sociedade desigual. In: Ministério da Saúde (BR), Secretaria de Vigilância em Saúde. Impacto da violência na saúde dos brasileiros. Brasília (DF): MS; 2005. p. 79-115. [ Links ]
24. Bastos FG, Silva MN. Violência institucional contra a mulher adolescente e jovem: da inadequação ao acolhimento. In: Taquette SR, organizador. Violência contra a mulher adolescente/jovem. Rio de Janeiro (RJ): EdUERJ, 2007. p. 123-32. [ Links ]
Correspondence: Received: 16 February 2011
Joana Iabrudi Carinhanha
Rua Pires de Almeida, 66/301
22240-150 - Laranjeiras, Rio de Janeiro, RJ, Brasil
Approved: November 7, 2011
Received: 16 February 2011