Name: Gracielle Karla Pampolim Abreu
Type: PhD thesis
Publication date: 15/09/2020
Advisor:

Namesort descending Role
Franciéle Marabotti Costa Leite Advisor *

Examining board:

Namesort descending Role
FABIANA GONRING XAVIER External Alternate *
Franciéle Marabotti Costa Leite Advisor *
Luciana Carrupt Machado Sogame External Examiner *
Maria Carmen Viana Internal Examiner *
Paulete Maria Ambrosio Maciel External Examiner *
Rita de Cássia Duarte Lima Internal Alternate *
Thiago Nascimento do Prado Internal Examiner *

Summary: Introduction: Elder abuse is a serious public health problem, with a complex and multi-
causal structure, which results in serious physical, psychological and/or social consequences

for all involved. Violence has been gaining visibility in health debate circles, and in 2011 was
included in the list of compulsory notification diseases. Objective: To analyze the reported

cases of elder abuse, in the state of Espirito Santo, from 2011 to 2018. Methods: A cross-
sectional study was conducted, with reported cases of violence against the elderly registered

in the Diseases Information and Notification System - SINAN in Espírito Santo between
2011-2018. The database has undergone extensive qualification before statistical analysis,
which, in turn, was conducted according to the nature of the injury (self-harm/interpersonal);
the type of interpersonal violence (physical/psychological/negligence), and second history of
repetition. The independent variables were composed by the characteristics of the victim, the
aggression, and the aggressor, when applicable. Pearson's chi-square test was used for
bivariate analyzes, and multivariate was performed using Poisson Regression with robust
variance and estimation of the Prevalence Ratio, considering a 95% Confidence Interval and
significance of p <0.05. Results: The prevalence of interpersonal violence was 85.0% (95%
CI: 83.3-86.5) and self-inflicted violence was 15.0% (95% CI: 13.5-16.7), in the analyzes
adjusted, significant differences were found between the outcomes studied and the
characteristics of the victim and the aggression. Regarding interpersonal physical violence,
the results show a high prevalence of this condition (66.3%; 95% CI: 64.2-68.8), which was
associated with being 60 to 69 years old, not having a disability/disorder, present a history of
repetition and live in rural areas for both sexes; in elderly males, physical violence was more
frequent among those without a partner, while intolerance was associated with physical
violence against women. Regarding negligence and psychological violence, the prevalence of
negligence was 18.1% (95% CI: 16.31-20.04), 11.8% were cases of psychological violence
(95% CI: 10.32-13,46). Negligence was more prevalent against the elderly person aged 80
years or older, black, with a partner and disability/disorder, it was more often committed by
the victims' children, of both sexes, in the residence, in an urban area, chronically and without
motivation. Psychological violence was associated with the female sex, it was more
perpetrated by someone of the male sex, after alcohol consumption, motivated by intolerance,
in the urban area, and in a chronic way. And finally, the results of the analysis of repetitive
violence show a prevalence of 50.1% (95% CI: 47.7-52.6), and after adjustments, being 80
years old or older, presenting deficiencies or disorders and having been abused by a partner

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and/or children remained associated with the disease in both sexes. In elderly males, repetitive
violence was most often perpetrated by two or more aggressors and during the day, while
elderly women were frequently assaulted in urban areas. Final Considerations: The
interpersonal nature of elder abuse was the most reported, with the physical typology being
the most prevalent among the types of violence studied, followed by psychological violence
and negligence. Several characteristics of the victim, the aggressor, and the aggression were
associated with the injuries studied, varying according to the type of violence. It is understood
that the knowledge of these factors in their different manifestations can contribute to the
confrontation, monitoring, and prevention of violence against the elderly, because only with
the interruption of the cycle of violence will it be possible to restore dignity and provide a
better quality of life to elderly.

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