PROFILE OF NOTIFICATIONS OF VIOLENCE AGAINST CHILDREN AND ADOLESCENTS PERFIL DAS NOTIFICAÇÕES DE VIOLÊNCIA CONTRA CRIANÇAS E ADOLESCENTES PERFIL DE NOTIFICACIONES DE VIOLENCIA CONTRA NIÑOS Y ADOLESCENTES

Objective: to analyze the profile of notifications of violence perpetrated against children and adolescents. Method: this is a quantitative, descriptive, exploratory, retrospective study, from 2014 to 2015, with 85 cases of violence perpetrated against children and adolescents. Data from the Notifiable Diseases Information System was used. Epidemiological profiles were analyzed using descriptive statistics. Results: it was found that violence was prevalent in children aged ten to 14 years (36.47%), brown (90.59%), female (83.53%), with elementary school (60, 60%) and that 98.82% did not have any disability or disorder. It turns out that the most common type of violence was psychological / moral (43.66%) and the prevalent means of aggression was the threat (51.92%) practiced in the residence (75.29%) of the victim by friends / (47.06%) were male (91.76%). Conclusion: there was an increase in the number of cases of violence against brown children and adolescents, female and with elementary education, and the most common type of violence was psychological / moral violence through threats practiced by friends/ acquaintances at the victim's residence. Descriptors: Adolescent; Child; Domestic Violence; Child Abuse; Aggression; Nursing.

Violence has been an issue increasingly on the agenda in the discussions and concerns of Brazilian society. It is pointed out that, despite the knowledge that violence is not an exclusively contemporary phenomenon, what is perceived is that the political and social visibility of this issue has a recent character, referring only to the last 50 years.¹ Due to this occurrence, there are several types, which can be characterized as violence against children, women, the elderly and intra-family and can also be defined as to the nature of their action as physical, sexual, psychological, torture, human trafficking, child labor, neglect and abandonment, among others.² It is reported that intra-family violence is any action or omission that damages the well-being, physical or psychological integrity or freedom and the right to the full development of another family member. It is added that it can be committed inside or outside the home by any member of the family, including people who take on a parental role, even if they do not have blood ties, and in relation to power to the other.³ Through the experience of violence experienced in the family of origin, the life of the individual is impacted not only in his affective relationships, as a model of loving relationship, but also in other contexts, legitimizing violence as a conflict resolution strategy in the most diverse situations. In recent years, the importance of looking at the subject from what he received from previous generations has become evident, understanding the repercussion of issues against children and adolescents, which is a complex task. 4 Therefore, the occurrence of violence against children and adolescents is a challenge for public health, as it causes physical and emotional impacts throughout the life of the victim of violence, 5-6 since violence affects children more than adolescents, due to the vulnerability of the victims, unable to defend themselves, and the emotional and physical damage caused to them. 7 Currently, violence against children and adolescents has ceased to be treated as a natural fact or as "just" a particular way for parents to deal with their children, to be treated as a serious problem to be tackled both by the State, as well as by civil society and by the families themselves. 8 In 1990, Federal Law 8,069 / 90 created the Statute for Children and Adolescents (SCA) in order to provide greater coverage and formalization of the right to protection and comprehensive care for the population of this age group. Thus, SCA presents, in detail, the fundamental rights of this public; everyone's duty to prevent the occurrence or violation of these rights; the service policy and the institutions responsible for the actions; protection measures; referrals in case of the practice of the infraction, by children and adolescents, as well as parents in case of negligence. 9 In 2013, 188,728 cases were notified by the Information System for Notifiable Diseases (SINAN / MS), of which 104 without information about sex were excluded, totaling 188,624 valid notifications for analysis. Of these, 29,784 cases were registered among children aged zero to nine years, with 50,634 cases occurring among adolescents aged ten to 19 years. The highest proportions of reported cases were identified among children, adolescents and young adults. 10 In the period from 2010 to 2016, there were 5,971 cases of violence in the age group <1 year to 19 years, in SINAN, in Maranhão, representing 46.6% in cases of violence registered in the period. 11 It is understood that the underreporting of these cases is a serious problem, despite advances in legislation and the creation of bodies that fight the various types of violence in children and adolescents, and underreporting hinders the enforcement of the law and contributes to keeping children vulnerable to these mistreatments. 12 It shows the inefficiency of the various sectors in attending to such an event, leaving vulnerable individuals at the mercy who, many times, will not have support or protection and will still be deprived of a possible recovery from the damages suffered. 13 In this way, the notification of cases of violence against children and adolescents stands out as an opportunity for early intervention that aims to break with situations of violence in the future lives of these individuals, minimizing the negative repercussions of this act. It is added that the information produced by the notification also favors the visibility of the phenomenon, a fact that is essential for the planning of preventive actions and for the evaluation of the implemented measures. 14 It is detailed that, despite the social, scientific, legal and cultural advances, children and adolescents remain vulnerable to violence, especially the groups affected by social inequalities perpetuated historically, which determine low education, exploitation at work, pregnancy child abuse and sexual exploitation, among many other. 15 In this context, violence against children and adolescents can trigger stressors in the development of these individuals. It is, therefore, essential to carry out the construction of the profile of vulnerable individuals, expanding the epidemiological knowledge of this event in the municipality, so that the public power can subsidize prevention, care and protection measures for victims or people in situations of violence. 15 • To analyze the profile of notifications of violence perpetrated against children and adolescents. This is a quantitative, descriptive, exploratory, retrospective study. The municipality of Caxias, located in the State of Maranhão, Northeast Brazil, was chosen as the study scenario.
The study population was composed of the reported cases of violence perpetrated against children and adolescents in the municipality of Caxias in the period from 2014 to 2015. The cases notified in the municipality were included and the cases notified more than once were excluded to avoid duplication of notification, forms that did not present year of notification and whose identifications of the individuals were unreadable.
Secondary data from the Notifiable Diseases Information System (SINAN) and made available by the Epidemiological Surveillance of Caxias (MA), Brazil, were used. The interpersonal / selfinflicted violence form has independent or explanatory variables composed of epidemiological and health indicators contained in the notification forms, such as: demographic (gender, race / skin color; education; marital status / marital status; occupation; if you have any type of disability / disorder; place of occurrence; other times (repeated violence); other sexual violence; bond / degree of kinship with the assaulted victim; sex of the probable perpetrator of the assault; suspected use of alcohol and referral to sectors.
Epidemiological profiles were analyzed using descriptive statistics using Epi Info software, version 7.2.1.0, for programming and storing data, performing a descriptive analysis based on absolute and relative frequencies for sociodemographic and other variables. The research project of this study was submitted to the Research Ethics Committee, being approved with the opinion number: 3,693,773.
In the period from 2014 to 2015, 85 cases of violence against children and adolescents were reported at SINAN, in the city of Caxias (MA).
In the evaluation of the sociodemographic characteristics of children and adolescents victims of violence, it was evident in table 1. In this study, the update of data on violence perpetrated against children and adolescents in the city of Caxias, Maranhão, is presented, dimensioning the panorama of this condition as a public health problem. It is emphasized, in this research, that the profile of the victims, mostly, is female, aged ten to 14 years old, brown race and that they did not have any disability or disorder.
There is the female sex, with regard to the most prevalent type of sex in the study, and this finding corroborates studies developed in the area. In an analytical study carried out in Minas Gerais, it stood out with 1,481 reports of violence perpetrated in children and adolescents, most of whom were women (66.7%) and, after the enactment of Law No. 13,010, there was a significant difference in frequency of notifications considering the sexes, with a decrease of 7% in females and an increase of 27.2% in males. 16 It is indicated by an epidemiological analysis of violence against children and adolescents in Brazil that, in most cases, the victims of violence were female, with 43,034 occurrences (74.2%), and only 14,996 (25.8 %) were male, 14,16 corroborating the data in Caxias (MA).
Other studies in the literature confirm, due to the prevalence of the age group of ten to 14 years old, brown race and without disabilities or disorders. 5,18 In a cross-sectional study carried out in Bahia, the age groups of the victims were found, demonstrating a greater involvement of children between 11 and 18 years old, with 74.4% of cases in total, with children from zero to five years old being the least reached, with 9.2% of frequencies; 65 (37.8%) were brown; 63 (36.6%) were black and 75 (43.6%) had not completed elementary school; of the total, only 22 (12.8%) had some type of disability or disorder and seven of these (31.8%) had mental disabilities, but in 11 (50%), this information was not in the records. 19,20 It is shown, with regard to the type of violence, by research, that psychological and physical were the most frequent, since these acts were repeated and were practiced by male friends or acquaintances, corroborating studies in the literature.  It was found, in a research carried DISCUSSION https://periodicos.ufpe.br/revistas/revistaenfermagem/index out through 498 notifications of violence perpetrated against children and adolescents, over a period of three years, in Ribeirão Preto (SP), focused on the most recurrent types of violence referred to, that these were those of physical nature (59.2%). Subsequently, psychological violence (38.6%), sexual violence (36.7%) and negligence (19.7%) were registered. The opposition between sex and age of the victims was shown to be a predominance of sexual violence against girls, since, for all forms of aggression, the victim's own home was the place of the highest occurrence of violence (75.5%), being that, among the aggressors, the male sex predominated, especially in situations where the violence was of a sexual nature. 11, In this study, at least two limitations should be considered: first, the use of secondary data, in which it is possible to fail to complete and / or incomplete information in the notification forms, which directly interfere with the disclosure of information; second, the data cannot be generalized to all children and adolescents who are victims of violence in the municipality, since the notifications are made only in health services and many do not seek these services.
In short, there was an increase in the number of cases of violence perpetrated against children and adolescents, being prevalent in brown, female children, with elementary education and without disabilities or disorders. It turns out that the most common type of violence was psychological / moral violence through threats and being practiced by friends or acquaintances, with repetition of cases of violence, most of the time, at the victim's residence.
The data points out specific characteristics of the group of children and adolescents most vulnerable to being a victim of violence. In this way, it is noted the relevance of studies that make it possible to know the profile of the victims so that they can serve as a subsidy for planning prevention actions in the most vulnerable population. The importance of the obligation to notify cases in view of the need for this information is highlighted, however, information from health information systems, through notifications of violence, still does not provide a reliable overview of violence against children and adolescents in the municipality. Thus, it is necessary to conduct direct research in order to analyze the real magnitude of this phenomenon.