Rev. LatinoAm. Enfermagem vol.14 número6

D isponible e n ca st e lla no/ D isponíve l e m língua por t ugue sa SciELO Br a sil w w w .scie lo.br / r la e

VI OLENCE AGAI NST W OMEN: THEORETI CAL REFLECTI ONS

Let icia Casique Casique1

Ant onia Regina Fer r eir a Fur egat o2

Casique Casique L, Fur egat o ARF. Violence against w om en: t heor et ical r eflect ions. Rev Lat ino- am Enfer m agem

2 0 0 6 n ov em br o- dezem br o; 1 4 ( 6 ) : 9 5 0 - 6 .

Violence appear s in differ ent for m s and cir cum st ances and involves dist inct kinds of violent act s against

childr en, w om en, elder ly and ot her defenseless per sons. This ser ious pr oblem , w hich degr ades w om en’s int egr it y,

is denot ed by t er m s like dom est ic v iolence, gender v iolence and v iolence against w om en. Gender v iolence can

appear as ph y sical, psy ch ological, sex u al, econ om ic v iolen ce, as w ell as v iolen ce at w or k . Violen ce again st

w om en com m it t ed by t heir int im at e par t ner s can be analyzed t hr ough t he Ecological Model, w hich explains t he

close r elat ion bet w een in div idu als an d t h eir en v ir on m en t . Fact or s in f lu en cin g people’s beh av ior t ow ar ds t h is

v iolence should be analy zed w it h a v iew t o est ablishing help pr ogr am s.

DESCRI PTORS: v iolence; m ent al healt h; nur sing; gender ident it y ; w om en

VI OLENCI A CONTRA MUJERES: REFLEXI ONES TEÓRI CAS

La v iolen cia se m an if iest a de dif er en t es f or m as, en dist in t as cir cu n st an cias y con div er sos t ipos de

act os d ir ig id os a n iñ os, m u j er es, an cian os y ot r as p er son as in d ef en sas. Violen cia d om est ica, v iolen cia d e

gener o y v iolencia cont r a m uj er es son t ér m inos ut ilizados par a denom inar est e gr av e pr oblem a que degr ada

la in t egr idad de la m u j er . La v iolen cia de gén er o pu ede m an if est ar se a t r av és de v iolen cia f ísica, v iolen cia

psicológica, v iolencia sex ual, v iolencia económ ica y v iolencia en el t r abaj o. La v iolencia sufr ida por la m uj er

por par t e de su com pañer o ínt im o puede ser analizada a t r av és del Modelo Ecológico que ex plica la est r echa

r elación ent r e el individuo y su ent or no. Se concluyo que es im por t ant e analizar los fact or es que influyen en el

com por t am ient o de las per sonas fr ent e a la v iolencia par a est ablecer pr ogr am as de ay uda.

DESCRI PTORES: v iolen cia; salu d m en t al; en fer m er ía; ident idad de géner o; m uj er es

VI OLÊN CI A CON TRA MULHERES: REFLEXÕES TEÓRI CAS

A v iolên cia m an if est a- se de dif er en t es f or m as, em dist in t as cir cu n st ân cias e com div er sos t ipos de

at os v iolen t os d ir ig id os a cr ian ças, m u lh er es, id osos e ou t r os in d ef esos. Violên cia d om ést ica, v iolên cia d e

gêner o e v iolência cont r a m ulher es são t er m os ut ilizados par a denom inar est e gr av e pr oblem a que degr ada a

int egr idade da m ulher . A violência de gêner o pode m anifest ar - se at r avés de violência física, violência psicológica,

v iolência sex ual, v iolência econôm ica e v iolência no t r abalho. A v iolência sofr ida pela m ulher por par t e de seu

com pan h eir o in t im o pode ser an alisada at r av és do Modelo Ecológico, qu e ex plica a est r eit a r elação en t r e o

indiv íduo e seu ent or no. Concluiu- se que é im por t ant e analisar os fat or es que influem no com por t am ent o das

pessoas fr ent e à v iolência par a se est abelecer pr ogr am as de aj uda.

DESCRI TORES: v iolên cia; saú de m en t al; en fer m agem ; iden t idade de gên er o; m u lh er es

1 _{PhD in Nursing, Facult y m em ber at t he Celaya Facult y of Nursing and Obst et rics/ Universit y of Guanaj uat o- Mexico;} 2 _{Full Professor, e- m ail furegat o@eerp.usp.br.}

THEORETI CAL REFLECTI ONS

T

of con st r ain t an d u sin g p h y sical su p er ior it y on t h e

ot her per son. Violence is m ut ant , as it is influenced

b y v er y d if f er en t t im es, p laces, cir cu m st an ces an d

r ealit ies. Ther e is t oler at ed and condem ned v iolence,

as violence has exist ed on Ear t h as long as m ankind,

assu m in g differ en t , in cr easin gly com plex an d at t h e

sam e t im e m or e fr agm ent ed and ar t iculat ed for m s( 1).

Violence is an ext r em ely diffuse and com plex

phenom enon, w hose definit ion cannot be scient ifically

e x a ct , si n ce i t i s a m a t t e r o f a p p r e ci a t i o n , i t i s

in f lu en ced b y cu lt u r e an d su b m it t ed t o con t in u ou s

r eview t o t he ext ent t hat social values and st andar ds

ev olv e( 2 ).

Th e fem in ist m ov em en t in t h e ear ly secon d

h a l f o f t h e p a s t c e n t u r y s t o o d o u t b e c a u s e i t

denounced cases of v iolence against w om en, cast ing

l i g h t o n a r ea l i t y t h a t , u n t i l t h en , h a d o n l y b een

m ent ioned in t he privat e sphere. Violence in t he hom e

con t ex t con t in u ed w it h ou t an y body doin g or say in g

an y t h i n g . Un t i l t h at t i m e, i t h ad n o t b een o p en l y

m anifest ed and w as suppor t ed by cont em por ar y social

condit ions( 1 ).

Th e s u m m a r y o f d i f f e r e n t i n t e r n a t i o n a l

co n f er en ces h el d i n t h e 2 0t h cen t u r y co n t ai n s t h e

pr oposit ions and definit ions of m inim al hum an r ight s

f o r a l l p e o p l e o n t h e p l a n e t , w h i ch u n d o u b t e d l y

af f ect ed t h e d et ect ion an d in v est ig at ion of g en d er

v iolen ce ag ain st w om en . Th ese con v en t ion s w er e:

Char t er of t he Unit ed Nat ions ( 1945) ; Conv ent ion on

genocide ( 1948) ; I nt er nat ional cov enant on civ il and

p o l i t i ca l r i g h t s ( 1 9 6 6 ) ; I n t er n a t i o n a l co v en a n t o n

e c o n o m i c , s o c i a l a n d c u l t u r a l r i g h t s ( 1 9 6 6 ) ;

I nt ernat ional convent ion on t he elim inat ion of all form s

of r acial d iscr im in at ion ( 1 9 6 5 ) ; Con v en t ion on t h e

e l i m i n a t i o n o f a l l f o r m s o f d i scr i m i n a t i o n a g a i n st

w om en ( 1979) ; Convent ion against Tor t ur e and Ot her

Cr u e l , I n h u m a n o r D e g r a d i n g Tr e a t m e n t o r

Punishm ent ( 1984) ; Conv ent ion on t he r ight s of t he

child ( 1989) ; and t he I nt er - Am er ican Conv ent ion on

t he prevent ion, punishm ent and eradicat ion of violence

a g a i n s t w o m e n - Co n v e n t i o n o f B e l é m d o Pa r á

( 1994)( 3).

Th e s e c o n v e n t i o n s e s t a b l i s h e d l e g a l

f r am ew or k s t o p r ot ect h u m an r ig h t s, w it h p osit iv e

r ep er cu ssion s f or t h e ad v an ced u n d er st an d in g an d

er adicat ion of v iolence against w om en.

Gen der v iolen ce w as in f lu en ced by f em in ist

g r o u p s f r o m West er n co u n t r i es, w h i ch d en o u n ced

p e o p l e w h o d e g r a d e w o m e n ’ s d i g n i t y t h r o u g h

violence( 4). As a result of t he ident ificat ion of violence

against w om en, fem inist gr oups hav e been j oined by

o t h e r a c t o r s , s u c h a s h u m a n r i g h t s d e f e n s e

a sso ci a t i o n s a n d i n t er n a t i o n a l o r g a n i za t i o n s, w h o

analyze and at t em pt t o help decr easing t he pr oblem .

I n or der t o u n der st an d t h e gen der v iolen ce

designat ion, w e need t o t ak e int o account t he social

char act er of t r ait s at t r ibut ed t o m en and w om en. Most

fem ale and m ale t rait s are cult ural const ruct ions. They

ar e pr oduct s of societ y and do not necessar ily der ive

fr om nat ur e( 4).

Gender v iolence is ex er cised by m en against

w om en , in w h ich t h e ag g r essor ’s an d t h e v ict im ’s

gender ar e closely connect ed w it h t he ex planat ion of

t his violence. Thus, it affect s w om en due t o t he sim ple

fact of being w om en, t hat is, it is violence perpet rat ed

by m en t o m aint ain cont r ol and dom inion over w om en.

Men ’ s r o l es a n d b eh a v i o r s a r e co n si d er ed

s o c i a l l y m o r e v a l u a b l e . Fo r e x a m p l e , c r y i n g i s

d i s d a i n e d , v i o l e n t r e s p o n s e s a r e l o o k e d u p o n

p o si t i v el y, an d h o u sew o r k ( al t h o u g h f u n d am en t al )

r em ains alm ost unnot iced t o m en, alt hough j ust ifying

t hat it is car r ied out by w om en( 5).

Th e g e n d e r c a t e g o r y p r e s u p p o s e s t h e

u n d er st an d in g of r elat ion s est ab lish ed b et w een t h e

sexes in societ y, differ ent iat ing bet w een biological and

social sex . Wh ile b iolog ical sex r ef er s t o an at om

ic-ph y siological dif f er en ces bet w een m en an d w om en ,

social sex is r elat ed t o how t hese differ ences behav e

in differ ent societ ies t hr oughout hist or y( 6).

I n all cult ur es acr oss t he w or ld, w om en liv e

in socially u n eq u al con d it ion s t ow ar d s m en . Th ese

i n e q u a l i t i e s a cq u i r e d i f f e r e n t m a n i f e st a t i o n s a n d

m ag n it u d es.

Th e def in it ion of gen der im plies t w o lev els,

t h at is, g en d er as a con st it u t iv e elem en t of social

r elat ion s, based on per cept ible dif f er en ces bet w een

t h e t w o s e x e s ; a n d g e n d e r a s a b a s i c f o r m o f

represent ing power relat ions, in which dom inant act ions

ar e pr esent ed as nat ur al and unquest ionable( 6).

I nt er nat ional concer ns about t he phenom enon

o f v i o l en ce a g a i n st w o m en d em a n d a n a l y ses a n d

st udies about t he issue, as t his v iolence det er ior at es

w om en ’s in d iv id u al an d f am ily h ealt h . Wom en w h o

r esist against an abusiv e r elat ion indefinit ely end up

losin g t h eir in div idu al ( ph y sical an d m en t al) h ealt h ,

Th e U n i t e d N a t i o n s c o n v e n t i o n o n t h e

Er adicat ion of v iolence against w om en, w hich t he UN

Gener al Assem bly adopt ed in 1993, defined v iolence

as any act of gender - based violence t hat pr oduces or

ca n p r o d u ce p h y si ca l , se x u a l o r m e n t a l h a r m o r

su f f er in g in w om en , in clu d in g t h r eat s, coer cion or

ar bit r ar y pr iv at ion of fr eedom in public as w ell as in

pr iv at e life( 7).

FORMS OF VI OLEN CE AGAI N ST W OMEN

Dif f er en t f or m s of g en d er v iolen ce in clu d e

int rafam ily or dom est ic violence and violence at w ork,

m anifest ed t hr ough phy sical, psy chological and social

ag g r ession s.

I nt r afam ily v iolence is a for m m any w om en

a r e su b m i t t e d t o , w h i ch o r i g i n a t e s a m o n g f a m i l y

m em ber s, independent ly of w het her t he aggr essor is

sh ar in g t h e sam e h om e or n ot . Aggr ession s in clu de

v iolat ion, phy sical, psy chological and econom ic abuse

and can som et im es culm inat e in t he abused w om an’s

d e a t h . Ha b i t u a l p sy ch o l o g i ca l , se x u a l o r p h y si ca l

violence occurs am ong affect ively relat ed people, such

as husband and w ife, or adult s against m inor s or aged

people w it hin a fam ily.

Abuse is char act er ized by t he set of conduct s

t hat int ent ionally cause phy sical har m , pain or inj ur y

t o anot her per son( 8). I t includes act s ranging from slaps

t o sev er e inj ur ies t hat can cause deat h.

Violence m anifest s it self physically as w ell as

t h r ou gh all t h ose for m s in w h ich people’s in div idu al

g u a r a n t e e s a r e o p p r e s s e d , m a d e i m p o s s i b l e o r

v iolat ed. Hence, all definit ions agr ee t hat v iolence is

any act against w om en’s dignit y, independent ly of it s

or ig in s.

D o m e s t i c v i o l e n c e , g e n d e r v i o l e n c e a n d

v iolen ce again st w om en ar e t er m s u sed t o n am e a

s e v e r e p r o b l e m( 9 ). I n d o m e s t i c v i o l e n c e , t h e

aggr ession com es fr om t he par t ner or anot her fam ily

m em b er, m ov in g b ey on d h ou se w alls an d af f ect in g

el d er l y, ch i l d r en a n d d i sa b l ed p er so n s. I n g en d er

v iolen ce, t h e ag g r essor s ar e p er son s close t o t h eir

v ict im s, an d ag g r ession s occu r in p r iv at e or p u b lic

sp a ces.

One of t he m ost com m on for m s of v iolence

ag ain st w om en is com m it t ed b y t h eir h u sb an d s or

int im at e par t ner s( 10). The fact is t hat , generally, w om en

ar e em ot ion ally in v olv ed w it h t h eir ag g r essor s an d

econ om ically d ep en d en t on t h em . Th is v iolen ce b y

i n t i m a t e p a r t n e r s o c c u r s i n a l l c o u n t r i e s ,

in d ep en d en t ly of t h e social, econ om ic, r elig iou s or

cu lt u r al gr ou p.

Violence by husbands or int im at e par t ner s is

co m m i t t e d a g a i n st t h e “ w e a k se x ” . Th e se ca se s

in clu de m ish an dled w om en . Th is t y pe of abu se h as

also been fr equent in hom osex ual r elat ions. Thus, a

lar g e m aj or it y of cases of p ar t n er ab u se h as b een

com m it t ed by m en against t heir “ par t ner ”( 11).

Gen der v iolen ce boils dow n t o t h e r esu lt of

m ale dom inat ion and fem ale subor dinat ion r elat ions,

in w hich t he m an int ends t o avoid t he w om an’s escape

because he does not w ant t o divor ce her, keeping her

subj ect t o a subm ission she cannot escape fr om( 4).

B a s e d o n e x p e r t s ’ a f f i r m a t i o n s , w e c a n

su m m ar ize t h at g en d er v iolen ce is con cen t r at ed in

individual aggressions t hat go beyond t he social level,

u n d ou b t ed ly r ef lect in g on e g r ou p ’s d om in at ion an d

an ot h er ’s su bor din at ion .

St u dies h av e em ph asized t h e pr ev alen ce of

t he int r afam ily v iolence phenom enon and associat ed

r isk fact or s. Condit ioning fact or s have been appoint ed

in different levels of analysis, ranging from social and

cult ur al aspect s ( aut hor it ar ian and pat r iar chal v alues,

accept ance of violence as a w ay t o solve differ ences,

et hnic gr oups) , gender ( v aluat ion of v iolence in m ale

r o l e p e r f o r m a n c e , a c c e p t a n c e o f v i o l e n c e a n d

p u n i sh m en t as a w ay t o so l v e co u p l es’ co n f l i ct s) ,

psy chological aspect s ( gr eat er im pulsiv eness, alcohol

and dr ugs use) t o ( par ent s’, v ict im s’ or a m ist r eat ed

couple’s ) childhood ex per iences of v iolence( 12).

Violen ce ag ain st w om en an d g ir ls in clu d es

physical m ist reat m ent , as w ell as sexual, psychological

an d econ om ic abu se. Again , it can be affir m ed t h at

“ g e n d e r - b a se d ” v i o l e n ce d e v e l o p s a s a r e su l t o f

w om en’s subor dinat e condit ion in societ y( 11).

Tw o of t h e m ost com m on for m s of v iolen ce

again st w om en ar e abu se by in t im at e par t n er s an d

f or ced sex u al act iv it y, w h ich occu r in ch ild h ood as

w ell as adolescence or adult life. Abuse by an int im at e

p a r t n e r, a l s o k n o w n a s d o m e s t i c v i o l e n c e ,

m ist r eat m ent or aggr ession against t he w ife, is alm ost

alw ay s accom pan ied by psy ch ological abu se an d, in

m ost cases, by for ced sex ual r elat ions. A m aj or it y of

w o m e n m i s t r e a t e d b y t h e i r p a r t n e r s s u f f e r

aggressions. I n fact , abusive relat ions usually develop

in an at m ospher e of fear and even t er r or.

I n indust r ialized count r ies, for m s of v iolence

ar e not t he sam e for all couples ex per iencing v iolent

1 . A s e v e r e a n d g r o w i n g f o r m o f v i o l e n c e ,

char act er ized by differ ent for m s of abuse, t er r or and

t hr eat s, accom panied by incr easingly possessiv e and

cont r olling behav ior s by t he abuser.

2 . A m o r e m o d e r a t e f o r m o f v i o l e n c e i n t h e

r elat ion sh ip , w h er e con st an t f r u st r at ion an d an g er

occasion ally er u pt in ph y sical aggr ession .

Accor ding t o t he st udy by Casique( 13), gender violence

per pet r at ed by int im at e par t ner s against w om en can

m an if est it self t h r ou g h p h y sical act s, p sy ch olog ical

v iolence, as w ell as social act s inv olv ing t he v iolent

sit uat ions w om en liv e in.

Ph y sical ag g r ession

Th is t y pe of v iolen ce again st w om en is t h e

m ost ev ident and difficult t o hide, as it affect s t heir

phy sical appear ance. Wom en suffer ing som e k ind of

physical aggr ession m ost ly exper ience num er ous act s

of v iolence ov er t im e.

Physical violence is underst ood as any act ion

im ply ing t he use of for ce against w om en of any age

an d in an y cir cu m st an ce, w h ich can m an if est it self

t hrough blows, kicks, pinches, bit es, t hrowing of obj ect s,

pushes, slaps, spankings, st ab wounds, scrat ches, hit s

on t h e h ead , in j u r ies, b u r n s, f r act u r es, ab d om in al

inj uries and any ot her act against t heir physical int egrity,

producing m arks on t heir body or not( 13,14,15).

Psy ch olog ical ag g r ession

Th i s t y p e o f v i o l e n ce i s m o r e d i f f i cu l t t o

det ect , as v ict im s pr esent psy chological scar e, w hich

ar e m or e difficult t o obser v e and pr ov e( 16).

Psy ch olog ical or em ot ion al v iolen ce occu r s

b y r ej ect i n g car esses, t h r eat en i n g t o b eat u p t h e

w om an and her childr en, im peding t he w om an t o w or k,

have friends or go out ; t he par t ner, in t ur n, t ells her

about his am or ous advent ur es and, at t he sam e t im e,

accuses her of hav ing lov er s.

A st udy carried out in Chile ident ified diverse

m anifest at ions of psy chological v iolence, classified as

follow s( 16) :

- Ve r b a l a b u s e : h u m b l i n g , i n s u l t i n g , r i d i c u l i n g ,

hum iliat ing, using m ent al gam es and ironies t o cause

con f u sion

- I n t i m i d a t i o n : s c a r i n g w i t h l o o k s , g e s t u r e s o r

scr eam s; t h r ow in g obj ect s or dest r oy in g pr oper t y

- Th r ea t s: t o h u r t , k i l l , co m m i t su i ci d e, t a k e t h e

childr en w it h him

- I solat ion: abusiv e cont r ol of t he ot her per son’s life

by w at ching ov er her act s and m ov em ent s, list ening

t o her conver sat ion, im peding t hat she m akes fr iends

- Disdain: t r eat ing t he ot her per son as infer ior, m aking

im por t ant decisions w it hout consult ing t he ot her

- Econom ic abuse: abusive financial cont rol, im posing

m o n e t a r y r e w a r d s o r p u n i sh m e n t s, i m p e d i n g t h e

w o m a n f r o m g o i n g o u t t o w o r k a l t h o u g h t h i s i s

n ecessar y f or f am ily m ain t en an ce

I t is im p or t an t t o h ig h lig h t t h at v ict im s of

psy chological v iolence oft en t hink t hat w hat happens

t o t h em is n ot su f f icien t ly sev er e an d im por t an t t o

decide on at t it u des t o im pede t h ese act s, in clu din g

denouncing t hem t o com pet ent or gans. Som e v ict im s

believ e t h at t h ey w ou ld n ot be cr edit w or t h y if t h ey

denounced t heir aggr essor. I n ot her cases, som eone

t he w om an r espect t ells her t hat she should cont inue

in t h is abu siv e r elat ion for t h e good of h er ch ildr en

o r t o g u a r a n t e e t h e r i g h t s a c q u i r e d t h r o u g h

m ar r iag e( 1 6 ).

M a n y w o m e n d o n o t d a r e t a l k i n g o r

denouncing t hat t hey ar e vict im s of m ist r eat m ent , out

of fear of t he aggr essor s’ t hr eat s against t hem selv es

and t heir r elat iv es.

Ma n y i n d i r e ct m a n i f e st a t i o n s o f v i o l e n ce

com pr ise t h e so- called “ dest r u ct iv e act s”, w h ich ar e

f or m s of aggr ession or psy ch ological pr essu r e u sed

b y a m an in a con f lict in g r elat ion sh ip , m ak in g t h e

w om an ’s fr ee cir cu lat ion im possible.

Social ag g r ession

No con sen su al d ef in it ion w as f ou n d am on g

t he m ain aut hor s st udy ing v iolence. How ever, in t his

st udy, socia l v iole n ce was consider ed as any act ion

t hat im pair s w om en, im posed by conduct s or at t it udes

of accept an ce or r ej ect ion w h ich societ y est ablish es

as adequat e in view of t he violence w om en suffer, as

w ell as t h e social con dit ion s in v olv in g t h e sit u at ion

t he v iolence v ict im liv es in.

Th e v iolen ce w om en ar e v ict im s of h as n ot

com e ou t in t o t h e op en , d u e t o t h e f act t h at it is

considered as som et hing nat ural and privat e. Violence

is r ein f or ced by r eligion s an d gov er n m en t s t h r ou gh

st andar ds and codes. This gener at es m yt hs and beliefs

t hat are not alw ays in conform it y w it h current realit y,

a l t h o u g h so ci e t y h a s l e g i t i m a t e d t h e m , a t so m e

m o m e n t , d u e t o n o t a l w a y s v e r y c l e a r l y k n o w n

m ot iv es( 17). Popular m y t hs and beliefs about v iolence

- Violen ce is n at u r al, it h as alw ay s ex ist ed an d w ill

alw ay s ex ist

- Hom e is a pr iv at e space, in w h ich n obody sh ou ld

in t er f er e

- Violence occurs in low social classes, w here povert y

and low educat ion lev els pr ev ail

- Alcohol and v iolence pr ov ok e episodes of v iolence

- Th e ag g r essor is v iolen t in all of h is act ion s an d

in t er per son al r elat ion s

- I f t he v iolent m an show s r egr et or apologizes, t his

w ill allow him t o change his abusiv e behav ior

- Beat ing is a pr oof of lov e “ I spank y ou because I

lov e y ou ”

- Man can neit her cont rol his im pulses nor handle his

p assi on s

- The aggr essor is m ent ally ill

- M i s t r e a t e d w o m e n c a n a b a n d o n t h e i r h o m e s

w henev er t hey w ant t o

- Wom en sh ou ld st ay w it h t h eir par t n er s u n der any

cir cu m st an ce, so t h at t h eir dau gh t er s an d son s can

gr ow up t oget her w it h t heir fat her

- The sit uat ion is going t o change for t he w om an, it is

j ust a m at t er of w ait ing, doing one’s best and being

m or e com p r eh en siv e

- Wom en like t o suffer

- I f t her e is no j ealousy, t her e ex ist s no lov e in t he

co u p l e

- Wom an cannot escape fr om v iolence

Now aday s, w om en incr easingly par t icipat e in

eco n o m i c act i v i t i es. Th ei r i n ser t i o n i n t o t h e l ab o r

m ar k et h as p r ov ok ed social ch an g es in p r od u ct iv e

i n s t i t u t i o n s a n d h o m e s . N e v e r t h e l e s s , j o b

d i s c r i m i n a t i o n c o n t i n u e s , d e v a l u i n g w o m e n a n d

av oid in g t h eir ascen sion . Th u s, t h e f am ily p r ov id er

r o l e i s b e i n g c h a n g e d b y w o m e n ’ s e c o n o m i c

independence, w hich undoubt edly affect s her funct ions

at h om e, a f act m en t r adit ion ally ar e n ot w illin g t o

accep t .

So ci a l cl a ss i s a n i m p o r t a n t f a ct o r i n t h e

p h y sical ag g r ession p h en om en on . Th is m ean s t h at

t h e u n d e r e m p l o y e d cl a ss sh o u l d r e ce i v e sp e ci a l

at t en t i o n i n i n t er v en t i o n st r at eg i es r el at ed t o t h e

pr oblem , con sequ en t ly decr easin g v iolen ce st at ist ics

t hat dir ect ly affect w om en( 18).

CON SEQUEN CES OF VI OLEN CE

Th e v iolen ce pr act iced by in t im at e par t n er s

affect s w om en ’s ph y sical an d em ot ion al h ealt h( 1 0 , 1 5 ).

Som e h ealt h con seq u en ces n eed t o b e m en t ion ed ,

r esult ing fr om violence pr act iced by int im at e par t ner s.

- Ph y sical: ab d om in al or t h or acic in j u r ies, b r u ises,

ed em a s a n d h em a t o m a s, ch r o n i c p a i n sy n d r o m e,

in v alid it y, f ib r om y alg ias, f r act u r es, g ast r oin t est in al

disor der s, headache, abdom inal pain, ir r it able bow el

sy n d r o m e , b u r n s, l a ce r a t i o n s a n d a b r a si o n s, e y e

dam age, r educed physical funct ioning, chr onic fat igue,

abr upt w eight changes.

- Sex u al an d r epr odu ct iv e: gy n ecological disor der s,

p er sist en t v ag in al f low , g en it al b leed in g , in f er t ilit y,

c h r o n i c p e l v i c i n f l a m m a t o r y d i s e a s e , p r e g n a n c y

c o m p l i c a t i o n s , s p o n t a n e o u s a b o r t i o n , s e x u a l

dysfunct ion, sexually t r ansm issible diseases, including

HI V/ AI D S, u n sa f e a b o r t i o n , u n w a n t ed p r eg n a n cy,

delay ed int r aut er ine dev elopm ent , fet al and m at er nal

d eat h .

- Psy ch ol og i cal an d b eh av i or al : al coh ol an d d r u g s

abuse, depr ession, anxiet y, eat ing and sleep disor der s,

feelings of sham e and guilt , phobic disor der s and panic

sy ndr om e, phy sical inact iv it y, low self est eem , post

-t r a u m a -t i c s -t r e s s d i s o r d e r s , s m o k i n g , s u i c i d a l

b e h a v i o r s a n d s e l f - p u n i s h m e n t , u n s a f e s e x u a l

b eh av ior.

Violen ce again st w om en , especially by t h eir

par t ner s, r epr esent s a bur den t o healt h ser v ices due

t o t he cost s it generat es. This violence does not only

cause phy sical and psy chological dam age t o w om en,

bu t also im plies r isk s f or t h eir ch ildr en . Wit n essin g

v iolen ce in sid e t h e f am ily in cr eases p r ob ab ilit ies of

depr ession, anx iet y, behav ioral disor der s and delayed

c o g n i t i v e d e v e l o p m e n t i n c h i l d r e n . Mo r e o v e r, i t

incr eases t he r isk t hat t hey w ill t ur n int o v ict im s of

m ist r eat m en t or f u t u r e aggr essor s t h em selv es.

THE ECOLOGI CAL MODEL

One t heor et ical base t o under st and v iolence

a g a i n s t w o m e n i s t h e Ec o l o g i c a l Mo d e l( 1 9 ). Th i s

p r o p o sa l i s b a sed o n d i f f er en t a u t h o r s’ w o r k a n d

pr oposes “ an in t egr at ed ecological f r am ew or k ” w it h

a view t o st udying and get t ing t o know violence against

w o m en .

Th e ecolog ical m od el st u d ies f act or s act iv e

i n f o u r d i s t i n c t s p h e r e s : i n d i v i d u a l , f a m i l y,

com m unit ar ian and sociocult ur al, as show n in Figur e

1 . This m odel focuses on v iolence in t he int er act ion

a m o n g i t s d i st i n ct l e v e l s. Th e se a r e su p e r p o si n g

det er m inant , but an int er act ion of oper at ing fact or s,

fav or ing v iolence or pr ot ect ing t he indiv idual against

it . These causal fact ors and t heir int eract ions need t o

b e k n o w n i n t h e i r d i st i n ct co n t e x t s a n d cu l t u r a l

en v ir on m en t s. Th is k n ow ledge h elps t o iden t if y t h e

f r a g i l e p o i n t s a n d r o a d s t o a d v a n c e i n v i o l e n c e

pr ev ent ion and specific int er v ent ions( 8).

- The fourt h level is direct ed at general fact ors, relat ed

t o t h e st r u ct u r e of societ y . Th ese fact or s con t r ibu t e

t o cr eat e a clim at e t h at in cit es or in h ibit s v iolen ce,

such as t he possibilit y of obt aining arm s due t o social

and cult ur al st andar ds. These include st andar ds t hat

p r ior it ize p ar en t s’ r ig h t s ov er t h eir ch ild r en ’s w

ell-being, consider suicide as a personal opt ion m ore t han

a s a p r e v e n t a b l e a ct o f v i o l e n ce , r e a f f i r m m e n ’ s

dom inion ov er w om en and boy s, back t he ex cessiv e

use of police force against cit izens or support polit ical

conflict s. This level also includes ot her fact s, such as

sa n i t a r y, eco n o m i c, ed u ca t i v e a n d so ci a l p o l i ci es,

w h i ch co n t r i b u t e t o m a i n t a i n e co n o m i c o r so ci a l

in equ alit ies am on g gr ou ps.

Figur e 1 show s t he super posit ion of differ ent

r i n g s, i l l u st r a t i n g h o w f a ct o r s a t d i f f e r e n t l e v e l s

r ein f or ce or m od if y each ot h er. Th u s, f or ex am p le,

t h e p r o b a b i l i t y t h a t a p e r so n w i t h a n a g g r e ssi v e

p e r s o n a l i t y w i l l a c t v i o l e n t l y i n s i d e a f a m i l y o r

com m u n it y t h at is u sed t o solv in g con f lict s t h r ou gh

v i o l en ce i s h i g h er t h a n i f h e i s i n a m o r e p a ci f i c

en v ir on m en t .

Violence against w om en is incr easingly faced

as an im por t ant public healt h pr oblem . Thus, t her e is

a n u r g e n t n e e d t o e st a b l i sh e a r l y d e t e ct i o n a n d

ef f ect iv e in t er v en t ion pr ogr am s.

Ther e is a w ider offer of v ict im suppor t and

p r o t e ct i o n se r v i ce s, p r o v i d i n g o r i e n t a t i o n s, l e g a l

adv ice, edu cat iv e an d w or k t r ain in g. Som e of t h ese

d e v e l o p a l t e r n a t i v e s e r v i c e s , d i r e c t e d a t t h e

ag g r esso r s, as p h y si cal v i o l en ce ex er t s eco n o m i c,

m or bidit y and m or t alit y r eper cussions in differ ent age

g r ou p s.

CONCLUSI ONS

Violen ce can be pr esen t in all sph er es of a

w om an’s life and can m anifest it self in different form s

and circum st ances t hrough it s evolut ive cycle ( physical

v iolence, psy chological v iolence and social v iolence) .

I t is r einfor ced by r eligions and gover nm ent s t hr ough

st an dar ds an d codes.

Many exper t s analyze violence and all of t hem

ag r ee t h at t h is p h en om en on d et er ior at es w om en ’s

in t egr it y, giv in g r ise t o def icien t h ealt h , f am ily an d

s o c i a l g r o u p d i s o r d e r. A m o n g c o n s e q u e n c e s f o r

w o m e n ’ s h e a l t h , p h y s i c a l a n d p s y c h o l o g i c a l

com p l i cat i on s st an d ou t , w h i ch p r od u ce i m p or t an t

d isab ilit ies in w om en , w it h ou t f or g et t in g ab ou t t h e

5QEKGV[ %QOOWPKV[ 4GNCVKQPU +PFKXKFWCN

Figur e 1 - The Ecological Model t o under st and violence

- Sour ce: OPS/ OMS, 2002

The m ain point in t he m odel is t hat it helps t o

a c k n o w l e d g e a n d d i s t i n g u i s h b e t w e e n c o u n t l e s s

f act or s in f lu en cin g v iolen ce an d, at t h e sam e t im e,

pr ovides a fr am ew or k t o under st and how it s differ ent

elem ent s int eract . The First World Report on Violence

and Healt h t r ies t o under st and t he m ult ifacet ed nat ur e

of v iolence t hr ough t his m odel( 2).

The ecological m odel, classified in four levels,

m ak es it possible t o an aly ze t h e f act or s in f lu en cin g

p e o p l e ’ s b e h a v i o r a n d f a c t o r s i n c r e a s i n g t h e

p r o b a b i l i t i e s o f p e o p l e t u r n i n g i n t o v i c t i m s o r

per pet r at or s of v iolent act s.

- Th e f i r st l ev el i d en t i f i es b i o l o g i cal an d p er so n al

h ist or y f act or s. Traceable dat a in clu de per son al an d

d em o g r ap h i c ch ar act er i st i cs ( ag e, sex , ed u cat i o n ,

incom e) , ant ecedent s of aggr essive or self- devaluat ion

b e h a v i o r s , m e n t a l o r p e r s o n a l i t y d i s o r d e r s a n d

su b st an ce- r elat ed d isor d er s.

- The second lev el includes closer r elat ions, such as

t h ose b et w een cou p les an d p ar t n er s, ot h er f am ily

m em ber s and fr iends. I t has been obser ved t hat t hese

incr ease t he r isk of suffer ing or per pet r at ing v iolent

act s. Having friends w ho com m it or incit e violent act s

can increase t he risk t hat young people w ill suffer or

ex ecu t e t h ese act ion s.

- The t hird level explores t he com m unit y cont ext s where

social relat ions are developed in, such as schools, work

p l aces an d n ei g h b o r h o o d s. At t em p t s ar e m ad e t o

ident ify t he char act er ist ics of t hese env ir onm ent s, as

t hey can increase t he risk of violent act s. The risk can

be influenced by fact or s lik e m obilit y of t he place of

r esid en ce, p op u lat ion d en sit y, h ig h u n em p loy m en t

s o c i a l c o n s e q u e n c e s t h a t s o m e t i m e s m a k e i t

im possible for her t o leav e t his v iolent hom e w her e

h e r i n d i v i d u a l g u a r a n t e e s a r e v i o l a t e d a n d h e r

indiv idualit y is denigr at ed.

As t h is ph en om en on af f ect s people’s h ealt h

and h as r eper cu ssion s for pu blic h ealt h at all lev els

( r eg ion al, n at ion al an d in t er n at ion al) , in t er n at ion al

con f er en ces ar e h eld t o look f or d et er m in an t s an d

f act or s t h at lead t o a b et t er u n d er st an d in g of t h e

v iolen ce p h en om en on , w h ich h it s m an y w om en on

t his planet .

Th e Wor ld Healt h Or gan izat ion r ecom m en ds

t h e Ecological Model t o u n der st an d v iolen ce, h opin g

t o cl ar i f y t h e r el at i o n b et w een l ear n ed b eh av i o r s,

m an’s violent behavior and w om an’s passive behavior.

I t is im por t ant t o analy ze fact or s influencing

p eop le’s b eh av ior t ow ar d s v iolen ce w it h a v iew t o

est ablish in g h elp pr ogr am s.

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