Trevizan Flávia Fernandes, Siqueira Regiane Máximo, Aragão Aílton de Souza, Dos Santos Hugo Henrique, de Oliveira Sabino Fabiano Henrique
Department of Production Engineering, São Paulo State University (UNESP), Av. Eng. Luiz Edmundo Carrijo Coube, 14-01, Bauru 17033-360, SP, Brazil.
Department of Public Health, Federal University of Triangulo Mineiro (UFTM), Uberaba 38025-180, MG, Brazil.
Int J Environ Res Public Health. 2022 Apr 26;19(9):5233. doi: 10.3390/ijerph19095233.
Violence against children and adolescents is a global public health problem. In Brazil, there are challenging boundaries for professionals in the protection network in general and for health professionals in particular. Moreover, among other factors, there is the challenge of referral, due to weaknesses in decision making, given the nature of sexual violence and how it is managed by healthcare services. This study aims to propose a Meta-Analytic framework to support the referral of young victims of sexual violence, considering levels of severity, independent of factors such as how protection systems are structured and managed and the local laws in force. We propose a Meta-Analytic approach, developed using the fundamentals of Delphi and DPSIR (Drivers, Pressures, State, Impact, and Response Model of Intervention), from the perspective of Value-Focused Thinking. The Delphi method was structured in two stages: the first stage aimed to identify and classify typical cases of sexual violence; the second stage used the DPSIR model, with the aim of identifying the decision criteria for typical cases that occur in a given municipality. The main outcomes are: (i) the application of the modified Delphi participatory method within the context of local social policies; (ii) the construction of a value tree based on Value-Focused Thinking; and (iii) the identification and systematization of criteria that most interfere with the evaluation of cases of sexual violence, which can be used for multi-criteria decision making.
暴力侵害儿童和青少年是一个全球性的公共卫生问题。在巴西,对于整个保护网络中的专业人员,尤其是卫生专业人员而言,存在着具有挑战性的界限。此外,除其他因素外,由于性暴力的性质以及医疗服务对其的管理方式,决策存在弱点,转诊也面临挑战。本研究旨在提出一个元分析框架,以支持性暴力年轻受害者的转诊,考虑严重程度级别,而不考虑保护系统的结构和管理方式以及当地现行法律等因素。我们从价值聚焦思维的角度,提出一种利用德尔菲法和DPSIR(驱动因素、压力、状态、影响和干预响应模型)基本原理开发的元分析方法。德尔菲法分两个阶段构建:第一阶段旨在识别和分类性暴力典型案例;第二阶段使用DPSIR模型,目的是确定特定城市中发生的典型案例的决策标准。主要成果包括:(i)在地方社会政策背景下应用改进后的德尔菲参与式方法;(ii)基于价值聚焦思维构建价值树;(iii)识别和系统化最影响性暴力案件评估的标准,可用于多标准决策。