Violência entre adolescentes por armas de fogo e armas brancas - morbimortalidade, necessidades básicas e assistência hospitalar

Abstract

The purpose of this study was to investigate the rates of morbidity and mortality from injuries caused by firearms and sharp objects among adolescents aged 10 to 19 years in Campo Grande county, Mato Grosso do Sul state, Brazil, in the period of 2009-2010. Different methodologies were applied to the object investigated. As a first step, a cross-sectional study was conducted with secondary data to analyze sociodemographic and clinical aspects and costs incurred by hospitalizing adolescent patients in emergency services accredited by the Brazilian Unified Health Care System (SUS) in Campo Grande. This was followed by an epidemiological analysis of mortality among male adolescents aged 15-19, taking into account the county’s urban areas and the index of urban life quality (IULQ). The third part of the investigation, which involved a qualitative approach to analyzing the life trajectory of a female adolescent assaulted with a sharp object, drew on Horta’s Theory of Basic Human Needs (1979) and on Social Determinants of Health in order to elucidate aspects contributing to victimization and influencing post-victimization prospects of life and health. Finally, Nursing Diagnoses described by the North American Nursing Diagnosis Association (NANDA) were identified through desk research conducted under a descriptive approach, in which nursing records, clinical evolution, and discharge conditions were the elements of investigation. A total of 35 male adolescents died as a consequence of assault by firearm, with a positive association between geographic location of death and worse indicators of education, income, and housing. Most hospitalized victims were male, who had longer hospital stays and more severe injuries than females. The rate of assault with sharp objects was higher among females, with injuries on the face and upper limbs. Basic human needs identified in the economic, social, and affective settings contributed to the event, implying a life trajectory marked by vulnerability. Seventeen nursing diagnoses were identified, with priority assigned to those related to biological conditions, given the clinical impairment of the hospitalized victims. This study revealed that violence and its consequences are still viewed neutrally by society, as if the ensuing deaths and injuries were not part of its life context. This view has roots in a lack of political and social integration, as well as in poor acknowledgment by civil society of the magnitude of this problem, which has a profound impact on the economy, age pyramid, quality of health resources, and access to healthcare services, since victims in this age group do not currently gain access to these services through primary care facilities, but by way of high complexity services and rehabilitation centers.