Quanto mais me bates, menos gosto de mim – abordagem da violência doméstica em Cuidados de Saúde Primários

Abstract

Introduction: Domestic violence is an epidemic that is present in society across all socio-economic, cultural and educational groups. Family physicians experience difficulty in managing these situations, torn between a passive, supportive attitude and action to empower victims with support in the community. Case description: Fiona, aged 37, came from a deprived socio-economic background and had recent changes in her family. She came to an appointment and revealed that she had recently been a victim of physical abuse by her spouse after weeks of intimidation, emotional, verbal and psychological abuse, and death threats. She called the police for help and was referred to community institutions specialized in managing these situations, but she refused to stay in a shelter with her 7 year-old son. This situation allowed regular contact between the child and his father (the abuser), resulting in a negative influence on the child’s relationship with Fiona. Given the desperate situation of the patient, a follow-up visit was arranged to monitor developments. The perception of increased risk led the healthcare team to build a tertiary prevention plan for domestic violence to be presented to the patient. Enablement of the patient, including providing knowledge of the community support programs available, allowed her to agree to go to live in a shelter with her son. Comment: This case explores the role of the family doctor in the management of domestic violence. A more active approach, aiming to empower victims, promoting their safety, making them aware of their rights, and providing appropriate referral to community resources with specialized help for these situations is required. Integrated effort by the healthcare team is critical for the design of effective guidance to victim