Aguiar Janaina Marques de, d'Oliveira Ana Flávia Pires Lucas, Schraiber Lilia Blima
Faculdade de Medicina, Universidade de São Paulo, São Paulo.
Cad Saude Publica. 2013 Nov;29(11):2287-96. doi: 10.1590/0102-311x00074912.
The current article discusses institutional violence in maternity hospitals from the health workers' perspective, based on data from a study in the city of São Paulo, Brazil. Eighteen health workers from the public and private sectors were interviewed, including obstetricians, nurses, and nurse technicians. A semi-structured interview was used with questions on professional experience and the definition of violence. The analysis revealed that these health workers acknowledged the existence of discriminatory and disrespectful practices against women during prenatal care, childbirth, and the postpartum. Examples of such practices cited by interviewees included the use of pejorative slang as a form of "humor", threats, reprimands, and negligence in the management of pain. Such practices are not generally viewed by health workers as violent, but rather as the exercise of professional authority in what is considered a "difficult" context. The institutional violence is thus trivialized, disguised as purportedly good practice (i.e., "for the patient's own good"), and rendered invisible in the daily routine of care provided by maternity services.
本文基于巴西圣保罗市一项研究的数据,从医护人员的角度探讨了妇产医院中的机构性暴力。采访了来自公共和私营部门的18名医护人员,包括产科医生、护士和护士技术员。采用了半结构化访谈,询问有关职业经历和暴力定义的问题。分析表明,这些医护人员承认在产前护理、分娩和产后存在针对妇女的歧视性和不尊重行为。受访者列举的此类行为包括使用贬义词作为一种“幽默”形式、威胁、斥责以及在疼痛管理方面的疏忽。医护人员通常不认为这些行为是暴力行为,而是将其视为在被认为“困难”的情况下行使专业权威。因此,机构性暴力被轻视,被伪装成所谓的良好做法(即“为了患者自身的利益”),并在产科服务日常护理中变得无形。