Driving Factors and Actions Taken by Women to Confront Violence: Qualitative Research Based on Art

Abstract

This qualitative study based on art aimed to analyze the critical path of women in coping with situations of violence in the city of Santa Maria/Rio Grande do Sul, Brazil, in these women’s perspective. It has as settings the Women’s Police Station (DEAM) and the institutional care service for women in situations of violence, named Casa Abrigo (Shelter House). The “talking map” creativity and sensitivity technique was used in conjunction with the in-depth interview to analyze the critical path of 12 women in situations of violence. The driving factors of the critical path of women in coping with situations of violence were related to their knowledge about the DEAM’s assistance, their perceptions about the experience of different types of violence, the fact that they can no longer stand the violence and that they worry about their children, as well as the support of their family, of the ex-husband’s or ex-partner’s relatives, and of their female friends. The decisions executed and actions taken by the women included reporting the aggressor, requesting a restraining order, seeking help from the guardianship council and family members, getting back together with the aggressor, and leaving home. There is a need to strengthen the decision-making process of women in situations of violence to break the silence and the situation of violence. For this purpose, it is urgent to broaden the information for and knowledge of women about where and how to seek help, through access to clear and precise information in all places that compose the assistance network for these women.

Keywords

violence violence against women abused women critical path qualitative research Brazil

Introduction

Violence against women is considered a serious public health problem and a violation of human rights (García-Moreno et al., 2015). It presents high prevalence, and one in three women in the world has been exposed to physical or sexual violence at some point in their lives (World Health Organization [WHO], 2013). It is mainly perpetrated by their current or former partners (Basar & Demirci, 2018; Chowdhury et al., 2018; De Barros et al., 2016; Navarro-Mantas et al., 2018; Saffari et al., 2017). Violence against women has its sources in gender, an integral element of social relations based on gender differences, and gives meaning to the power relations established between men and women (Scott, 1995), which legitimize violence against them.

There is evidence that violence against women impacts their health and well-being. These impacts include medical or behavioral and psychiatric problems (Barnawi, 2017), such as depression (Barchi et al., 2018; Damra & Abujilban, 2018; De Barros et al., 2016; Kachaeva & Shport, 2017; Kotan et al., 2017), conversion disorder, and other somatoform disorders (Kotan et al., 2017), in addition to anxiety, low self-esteem, post-traumatic stress disorder, drug abuse (Kachaeva & Shport, 2017), and risk of suicide (Barchi et al., 2018; Kavak et al., 2018). Furthermore, women who experience violence are more likely to have low birth-weight children, are twice as likely to have an abortion, 1.5 times more likely to get HIV infection, and 2.3 times more likely to use alcohol (WHO, 2013). Evidence also indicates that violence against women has resulted in lower well-being and suffering for their children (Barnawi, 2017; Bui et al., 2018).

Despite these impacts, there are reasons that lead women in situations of violence to remain in the relationship with the aggressor. Among these reasons, there is the naturalization of violence (Fanslow & Robinson, 2010; Frías, 2013), shame (Dutra et al., 2013; Fanslow & Robinson, 2010; Frías, 2013), fear of retaliation from the aggressor (Fanslow & Robinson, 2010; Frías, 2013; Meneghel et al., 2013), financial dependency (Presser et al., 2008), belief about the importance of the partner in child rearing (Dutra et al., 2013; Frías, 2013), loving the partner and believing that he will review his behavior regarding the perpetration of violence (Dutra et al., 2013). However, when women decide to break this cycle of violence, they desire to resume their plans, to have their rights to life, freedom, peace, and safety guaranteed (Vieira et al., 2012).

With this decision, the critical path begins, a set of actions implemented by women when seeking support in their social networks and in the services, breaking the silence and making the situation public. Thus, this is the theoretical framework of support for this investigation. This path presents elements that relate to the women’s perceptions, their actions, and decisions in the search for coping with the situation of violence. The path also presents elements related to the social responses found regarding the family and community context as well as the institutional one (Sagot, 2000; Shrader & Sagot, 2000). Therefore, this study aims to analyze the critical path of women in coping with the situations of violence in the city of Santa Maria/Rio Grande do Sul, Brazil, through the perspective of these women.

Theoretical Framework

The critical path comprises a sequence of decisions and actions taken by women in situations of violence to confront that violence. This process occurs more than once to the same woman, and it is constituted by determining factors and actions performed by the women, as well as by the responses of providers and services (Sagot, 2000; Shrader & Sagot, 2000).

The critical route is a process based on the decisions, actions, and reactions of women in situations of violence, along with the responses found during the search for a solution to the situation. The beginning of the path can be considered as breaking the silence, that is, when women in such situations decide to expose their situations to someone outside the immediate scope of the family (Sagot, 2000; Shrader & Sagot, 2000).

From this concept, it is assumed that there are several factors that drive or inhibit a woman to seek help, such as information, awareness, their perceptions and attitudes, resources available, previous experiences, situation assessment, and support or obstacles found. Thus, the path describes the decisions made and actions taken by women, as well as the responses found both at the family and community context as well as at the institutional context. Regarding the institutional area, the response factors are related to access, availability and quality of services, representations, attitudes and behaviors of service providers and of the community in general (Sagot, 2000; Shrader & Sagot, 2000).

The factors mentioned above are correlated and act on the subjectivity of the women, strengthening or weakening them in the decision-making to initiate and continue the search for help to solve and cope with the situation of violence, which makes the path a complex and nonlinear process, involving advances and setbacks. Thus, it can be understood that there is more than one critical path, as women go through multiple ways of coping with the situation of violence until they reach a solution (Sagot, 2000; Shrader & Sagot, 2000).

Method

Design, Location, and Period

Qualitative research based on art is mediated by the use of artistic production as a way of access to the human experience (McNiff, 2007, 2009), especially when the object of study is a sensitive subject (Fraga, 2016). It was developed in the city of Santa Maria/Rio Grande do Sul, Brazil, in the period from August to December 2017. It had as settings the Women’s Police Station (DEAM) and the institutional assistance service for women in situations of violence called Casa Abrigo (Shelter House).

The DEAM is a specialized unit of the Civil Police to assist women in situations of violence. Its actions focus on prevention, verification, investigation, and legal adjustment of situations of violence perpetrated against women (Brasília, 2010). The Shelter Houses, in turn, are places that offer safe housing and protection, in a temporary and secretive manner, to women at imminent risk of life due to domestic violence, whether or not accompanied by their children (Brasília, 2011).

Sample and Participants

A total of 11 women in situations of violence participated in the study. The inclusion criteria were age between 18 and 59 and having accessed a service in the municipality due to the situation of violence.

General Outline of the Study

The following figure synthetizes the steps for the execution of the study (Figure 1).

Figure 1.

General outline of the study.

Data Collection

For the data collection, the “talking map” creativity and sensitivity technique, developed with women in situations of violence, was used, coupled with the in-depth interview. This technique allows the visualization of the spatial and social dimension of the participants’ experience through the graphic design of the places where people circulate (Ferreira & Pereira, 2013; Gauthier et al., 1998; Groleau & Cabral, 2009; McNiff, 2004). It associates technical-scientific knowledge, art, creativity, and sensibility in a simple and recreational manner (Ferreira & Pereira, 2013). Five moments were employed for its application, described below.

Moment 1: cordially receiving the participants and forwarding to a reserved place set up for the research. At the DEAM, this moment occurred after they had registered the police report, and at the Shelter House, it was scheduled and held at the place where the participants were living. In this way, the physical environment for the development of the research sought to ensure the participant’s comfort and well-being, as well as the ethical principles, such as privacy, for the dialogue with the researcher. When dealing with a sensitive topic such as violence against women, ensuring an appropriate environment was fundamental to the research, so that the woman felt welcomed, respected in her individuality, and could talk freely about the situation experienced.

After this initial contact, the researcher presented the research objectives, methodological procedures, and ethical considerations by reading and explaining the Informed Consent Form (ICF). The women who agreed to participate in the study signed the form in two copies, one staying with the participant and the other with the researcher.

Moment 2: Explanation about the creativity and sensitivity technique. Then, the material needed for its development was provided (paper sheets, craft paper, crayons, markers, and ballpoint pens).

Moment 3: Production of the “talking map” by the participants. The women were invited to represent through drawings or words the path taken, as well as the people and resources (institutions, services, organizations, neighborhoods) they had sought to cope with the situation of violence. That way, women were able to highlight in the artistic production the places and people that were or are part of the journey of their experience (Cabral & De Moraes, 2015), describing their relationships with the social environment, with people, or with institutions (Ferreira & Pereira, 2013). By handling the materials available for the development of the artistic production, the participants were immersed in their recent and latent memories (Cabral & Neves, 2016).

In the moment of production of the talking map, the researcher sought not to interrupt the participants, letting them produce it freely. The participants drew their home, the institutions in which they sought help, such as the DEAM, the Shelter House, and relatives’ houses, as well as the people who supported them, such as siblings, parents, female friends, and children.

Moment 4: The participants were invited to talk about their production. This moment can be considered one of the most delicate, because during the presentation of the production, the women were reliving the situation of violence, which triggered their feelings, and which were sometimes expressed through crying. In these cases, the researcher tried to calm the women, offered a glass of water, and asked them about the continuity of the activity. Still during the presentation, some women were remembering elements that they could add to the artistic production, which they did. It should be noted that none of the women who ended up crying wanted to interrupt their participation in the research.

Moment 5: It involved the in-depth interview, in which the woman was encouraged to talk openly about the subject through questions related to the critical path theoretical framework, contemplating the discussion generated by the talking map. This moment was guided by the following generating question: Which people and resources have you been seeking to cope with the situations of violence?

In the present study, the talking map allowed the women to remember the path taken from the occurrence of the situation of violence to seeking help to cope with it, as well as the people who supported them. Through the construction of the artistic production in a free manner, a favorable space for dialogue and interaction between the women and the researcher was constituted, which was essential for the women’s verbal narratives.

The “talking map” creativity and sensitivity technique allowed the development of the in-depth interview. It is relevant to note that the development of just one interview would not make it possible to achieve the results of this study, because the art mobilizes the memories of the women. As they were representing the path taken, they were remembering events and people that perhaps in the interview they would not have mentioned.

Data Analysis

The data were systematized and analyzed through content analysis (Minayo, 2014), which was developed in three phases. These phases were concomitant with the field stage, which allowed the conclusion of data collection when the internal logic of the object of study was understood (Minayo, 2017). The phases of the data analysis are described below.

Data organization and pre-analysis: literal transcription of the interviews in a text editor, composing the research corpus for in-depth analysis. Afterward, the recordings were listened to, and the text was skimmed, which comprised the first contact with the empirical material, making the initial impressions emerge. The empirical data were imported into the MAXqda software, version 2018. The sequence of detailed readings was performed, whereby the excerpts of the participants’ speeches were systematized into categories established based on the critical path theoretical framework. The focus of this analysis was the driving factors and decisions/actions taken.

Investigation of the material: clipping common information present in the transcribed material that had been codified at the end of the previous phase. The cores of meaning were enumerated, referring to words, phrases, and expressions that give meaning to the content of the material and support the analytical categories. Finally, the cores of meaning were grouped for the constitution of two categories.

Treatment of results obtained and interpretation: proposition of inferences and interpretations about the results according to the objective of the study.

Ethical Considerations

To guarantee anonymity, the participants were identified through the letter W for Women, followed by the ordinal number according to the sequence of participation in the research (e.g., W1, W2, . . . W11). The field stage was recorded (audio) with the consent of the women, with an average duration of 40 minutes. The Institution’s Human Research Ethics Committee approved the study, and the recommendations of Resolution No. 466/2012, which regulates research on human beings in Brazil (2012), were met.

Results

Regarding the participants, ages ranged from 21 to 56 years (average = 35.54). The skin color information was self-declared, being mostly white (n = 8), followed by brown (n = 3). All of them had children. As for the profession/occupation, two women were cleaners (n = 2) and two were unemployed (n = 2), and the others were housewife, pensioner, manicurist, recyclable materials collector, administrative assistant, cleaning assistant, and surgical technologist. Regarding their education, complete high school prevailed (n = 5), which means 12 years of study, followed by incomplete elementary school (n = 3), incomplete high school (n = 1), complete elementary school (n = 1), and Technical Course (n = 1). Concerning the situation of violence, the women disclosed the marital status, the aggressor, and the type of violence (Table 1).

Table 1.

Alphanumeric Representation of Participants, Age, Marital Status, Relationship With the Aggressor, and Type of Violence.

Participant	Age	Marital Status	Aggressor	Type of Violence
W1	53	Separated	Ex-partner	Physical, psychological, and moral violence
W2	52	Has a partner	Current partner	Physical, psychological, moral, and patrimonial violence
W3	41	Separated	Ex-husband	Physical, psychological, and moral violence
W4	28	Separated	Ex-husband	Physical and psychological violence
W5	42	Has a partner	Current partner	Psychological, moral, and patrimonial violence
W6	35	Has a partner	Current partner	Physical, psychological, and moral violence
W7	22	Has a partner	Current partner	Physical, psychological, and moral violence
W8	26	Separated	Ex-husband	Physical, psychological, moral, and patrimonial violence
W9	35	Separated	Ex-husband	Psychological and moral violence
W10	36	Separated	Ex-husband	Physical, psychological, moral, and patrimonial violence
W11	21	Separated	Ex-husband	Physical, psychological, moral, and patrimonial violence

From the cores of meaning, the categories were configured based on the dimensions of the critical path theoretical framework (Sagot, 2000; Shrader & Sagot, 2000). They are represented in the explanatory scheme below, which includes the driving factors, the decisions made, and the actions taken, which are the dimensions that this study contemplated (Figure 2).

Figure 2.

Scheme of the process of analysis of the driving factors, decisions made, and actions taken of the critical path applied to the study.

Driving Factors of the Critical Path of Women in Situations of Violence

In this category, the driving factors of the critical path of the women in situations of violence emerged in their speech. They were related to the awareness of the women about the assistance of the DEAM, to the women’s perceptions regarding the experience of different types of violence, to the fact that they could no longer tolerate the violence and that they worried about their children, as well as to the support from their family members, from the ex-partner’s or ex-husband’s relatives and from female friends (Table 2).

Table 2.

Illustrations of the Statements That Presented Thematic Convergence With the Driving Factors of the Critical Path and Alphanumeric Representation of the Participants.

Information and awareness

. . . through studies we see that at the police station [DEAM] there’s this assistance, of safety and protection. (W3)
. . . I already knew how it worked here [DEAM], by hearing about it. (W7)

Perceptions and attitudes

. . . I couldn’t take it anymore [violence]. (W10)
. . . I don’t deserve this [violence]. There comes a point that we have to stop suffering, because I suffered a lot from it. (W7)
. . . I didn’t want to accept what was happening, didn’t want to open my eyes. I was blind, thinking that it [violence] was a temporary thing, that it would change, get better with time. (W5)
I can’t give this example to my son. . . . living with him [partner] knowing that he uses drugs, and yet I accept him at home, it’s going to be a huge example to my thirteen-year-old son, who is entering adolescence. (W4)

Previous experiences

. . . started hitting me, hitting me. Threw me on the mud, hurt me a lot, arms, stomach. (W1)
Yesterday morning he threatened me with a handgun. . . . said that if I didn’t stay with him he would set fire to the house with me and the kids [children] inside. (W4)
He would drink, come home and break everything. . . . things started to disappear from my house . . . my situation was horrible, I had no water, no electricity . . . the neighbors lent me water, and sometimes helped me getting food for the kids. . . . because the little I could get, he would steal . . . he was selling everything I had in my house. (W5)
There were some things [the aggressions] like him covering my mouth, pushing me. Then it was starting to get rougher. He got to the extreme last night, tried to strangle me. I thought I was going to die in front of my daughters . . . (W7)
. . . I couldn’t live, I didn’t have a job, I couldn’t do anything. Only inside the house . . . I was depressed, I didn’t believe in myself anymore, found myself ugly. He ruined me. (W8)
Called me a whore . . . he called me every offensive thing you can think of. That I went out to cheat on him, that I’m no good . . . a lot of offenses. (W9)
He set fire to my stuff, tore up my clothes . . . said that other men would only use me . . . that another man wouldn’t accept me with my kid . . . I want to work, he doesn’t let me. (W11)

Support from close people

. . . my girlfriends. (W3)
I’m more likely to talk to my sister. My sister knows everything . . . my grandmother is not blood-related to me, but I count on her a lot. (W4)
This was my ground for me to get here [drawing the sister and mother]. (W7)
. . . my son is my friend to talk to. (W9)
. . . his mother is in my favor. She went to the courthouse with me to tell me that she’s on my side. (W10)

Decisions Made and Actions Taken

In this category, the decisions made and actions taken on the critical path for coping with situations of violence emerged in the participants’ speech. Such actions included the report against the aggressor, the request for a restraining order, seeking help from the Guardianship Council and from family members, getting back together with the aggressor and leaving home (Table 3).

Table 3.

Illustrations of the Statements That Presented Thematic Convergence With the Decisions Made and Actions Taken on the Critical Path and Alphanumeric Representation of the Participants.

Decisions made and actions taken

When he hit me, I crawled out and called the police [State Police]. (W1)
I filed a police report again. . . . (W3)
I filed the report and requested the restraining order . . . he went to work, I packed my bags. I called my father and he went to pick me up. (W8)
[After registering the police report] I went to my son’s and stayed many days there. (W2)
My mom still gets a bit distrusting . . . it’s quite complicated because she knows the whole story and she thinks that the bad one in the story is me, that I’m the one who is no good. (W8)
. . . talking here, talking there, we decided to continue together, because of [name of the couple’s daughter], since she is really attached to her father. (W4)
I ended up going back, I asked to get back together with him hoping that something would get better, believing that wouldn’t happen anymore . . . and it did. (W6)

Discussion

One of the driving factors of the path of the women in situations of violence was their awareness about the assistance provided at the DEAM, as shown in the narratives of the participants W3 and W7, which indicate the relation between previous knowledge and decision-making. This may be related to women’s understanding that violence is a problem whose scope is restricted to the police and security sector, as well as to the greater dissemination of the assistance of specialized police stations in the Brazilian media. Studies performed in Peru (Cripe et al., 2015) and in Bangladesh (Parvin et al., 2016) have shown that many women do not seek help due to the absence of information about the legal resources available (Parvin et al., 2016) to help them protect themselves and their children (Cripe et al., 2015). This indicates the need for information about services to be made available, so that women can access different sectors such as health, justice, and social assistance.

In this study, the moment at which the women decided to start the trajectory of facing the situation of violence occurred for several reasons, such as no longer enduring experiencing such a situation, realizing that the relationship with their husband and/or partner is permeated by violence, worrying about their children, and previously experiencing various types of violence simultaneously. These were the women’s experiences that influenced the beginning of the path taken to cope with the situation of violence.

In accordance with these findings, studies have shown that women made the decision to seek help at referral centers in two Brazilian municipalities when the aggressions worsened, because the situation had become intolerable (Albuquerque Netto et al., 2015; Baragatti et al., 2018), or because an extreme situation had occurred, such as attempted suicide of their children (Baragatti et al., 2018). These facts were fundamental for them to begin the trajectory of coping with the situation, added to the need to realize that they are experiencing it (Dutra et al., 2013; Meneghel et al., 2011), because they do not always see themselves as the object of violence (Virkki, 2015), or do not recognize that violence is a problem in the relationship with the partner (Cripe et al., 2015).

In the face of these aspects, we understand that, to begin the trajectory, women need to recognize that the situation of violence is a serious problem and affects their rights as human beings. It is important to note that this process is complex, as many women have lived with violence in the family context since they were children, when the father assaulted the mother, for example, and, thus, they naturalized this situation in the relationship established with the current abuser. In this regard, a study pointed out that the acceptance of violence represented the main reason why women did not seek help (Parvin et al., 2016).

Although women suffer from the various types of violence, many of them only begin the trajectory of confrontation when violence intensifies in terms of frequency and severity, losing the status of something natural (Frías & Agoff, 2015). In addition, severe physical violence increases the probability of women reporting violence and seeking help in comparison with women who are not severely beaten (Parvin et al., 2016).

Another driving factor of the women’s trajectory was the fact that violence also began to affect their children, converging with results of other studies (Ellsberg et al., 2001; Presser et al., 2008). When women have children, the probability of seeking help to cope with the situation increases (Parvin et al., 2016) due to the concern about them (Ellsberg et al., 2001; Fanslow & Robinson, 2010).

In this study, the previous experiences of women were related to the experience of physical, patrimonial, psychological, and moral violence. There was a predominance of women who experienced physical, psychological, and moral violence (n = 4); followed by women who experienced physical, psychological, moral, and patrimonial violence (n = 4); physical and psychological violence (n = 2); psychological, moral, and patrimonial violence (n = 1); and psychological and moral violence (n = 1). Based on that, it is possible to infer that the aggressor, in general, perpetrates different forms of violence simultaneously. In national and international studies (Basar & Demirci, 2018; Fernández-González et al., 2017; Kotan et al., 2017; Saffari et al., 2017; Santos et al., 2017), physical and psychological violence are the most prevalent. In addition, the partner and ex-partner are mainly responsible for such violence (Araújo et al., 2017; Basar & Demirci, 2018; Chowdhury et al., 2018; De Barros et al., 2016; Navarro-Mantas et al., 2018; Saffari et al., 2017). These facts can be confirmed by the present investigation, in which the abusers were the partner (n = 7), followed by the ex-partner (n = 4).

Because the situation happens at a domestic (private) level, there is a common sense that “no one should poke their nose into a husband-and-wife fight,” which conveys the idea that the woman could solve the situation on her own. In this respect, many women tend to remain alone and vulnerable until an acute episode of violence occurs, from which they can start seeking help in institutions or get shelter through family or friends (Albuquerque Netto et al., 2017). They are motivated by the search for protection for themselves and their children (Vieira et al., 2015) and do so within their social network to break the situation of violence.

Along these lines, the support of people close to the women was a factor that drove them to seek help in coping with violence. This shows the need for professionals who assist these women to recognize in their social networks who could be a source of support, so that they can be contacted and prepared to provide such support. In this study, the family members of the woman (mother, sister, grandmother, and son), relatives of the ex-husband/ex-partner (mother), and female friends stood out. Such actors were also mentioned in other investigations as a source of support for women to start seeking help (Barrett & St. Pierre, 2011; Dutra et al., 2013; Fanslow & Robinson, 2010; Frías, 2013; Fugate et al., 2005; Meneghel et al., 2011; Moe, 2007; Montero et al., 2015; Santi et al., 2010; R. A. Silva et al., 2012).

These are the members of the women’s social network whose bond is stronger, and consequently are mostly sought by women searching for help (Vieira et al., 2015). A study has found that the main support received by women in coping with violence was from their offspring, followed by the support of their mother, female friends, and sisters, and women considered them to be the most significant (Baragatti et al., 2018). Such support from family and friends tends to empower and encourage women, prompting them to break the cycle of violence (Cripe et al., 2015; Gomes et al., 2015). However, the social isolation resulting from the violent relationship with the partner can impose obstacles, which restricts the number of people to be sought, and consequently impairs the trajectory of facing violence. It means that isolation and a weakened social network can hinder the beginning of the path.

In contrast, studies indicate that some family members encourage women to stay in the violent relationship or claim they do not want to be involved in the situation (Cripe et al., 2015). In addition, they often do not recognize the situations reported by women as violent or even underestimate those (Baragatti et al., 2018). Thus, it is clear that while a family can be the point of support, it can also be detrimental to coping with violence. Therefore, it is essential that the professional can identify the sources of support that the woman needs, recognizing which member of their family or social support network will be one of these sources.

Regarding the actions taken, the women reported that they filed the police report against the aggressor and requested a restraining order. The women’s information and previous knowledge both direct the search for help mostly in police services. Another action was seeking help from family members, who are their closest support network to leave home, although they often find no support and solidarity to cope with the situation. When there is a threat to the children, help is also sought at the Guardianship Council. Finally, regarding the action of maintaining the relationship, some women returned to live with the aggressor.

Seeking help from the police (Baragatti et al., 2018; Ellsberg et al., 2001; Fanslow & Robinson, 2010; Frías, 2013; Moe, 2007; Montero et al., 2012; R. A. Silva et al., 2012), filing a complaint and a request for a restraining order (Baragatti et al., 2018; Meneghel et al., 2011, 2013; Moe, 2007; Montero et al., 2015; Presser et al., 2008; R. A. Silva et al., 2012; Vieira et al., 2015), as well as seeking help in social assistance services (Baragatti et al., 2018; Moe, 2007; Vieira et al., 2015), are reported. These are decisions and actions taken by women in investigations developed in Nicaragua (Ellsberg et al., 2001), New Zealand (Fanslow & Robinson, 2010), Mexico (Frías, 2013), the United States (Moe, 2007), Spain (Montero et al., 2012), and in Brazil in different states such as Recife (R. A. Silva et al., 2012), São Paulo (Baragatti et al., 2018), and Rio Grande do Sul (Meneghel et al., 2011, 2013; Presser et al., 2008; Vieira et al., 2015). This shows the worldwide extent of the situation of violence and, especially, that the women’s trajectory can be generalized, because the data found are convergent.

The search for help in the family is recurrent in investigations (Barrett & St. Pierre, 2011; Dutra et al., 2013; Fanslow & Robinson, 2010; Frías, 2013; Meneghel et al., 2011; Montero et al., 2012, 2015; Santi et al., 2010; R. A. Silva et al., 2012); however, often, women do not find empathy and solidarity (Meneghel et al., 2011). The parents often believe that the woman is wrong and make her return to live with the aggressor, an attitude based on hierarchical sexual patterns, where the woman is sometimes considered deserving of violence (Santi et al., 2010). In addition, there is an intrafamily transmission of social values and norms that determine women’s submission and the naturalization of violence (Frías & Agoff, 2015).

Seeking help is an action that can take years to be executed, given the factors already mentioned that lead women to stay in the relationship with the abuser. A study from Turkey points out that, out of 163 women who suffered violence by their partner, only 10.4% asked for help from a person or institution (Kotan et al., 2017), which reinforces the difficulty women experience in starting the path.

Such difficulty can make women return to live with the abuser, having as excuses the attachment of the children to their father and the hope that violence will not happen again. Other issues include believing in the change of behavior of the aggressor (E. B. Silva et al., 2013), lack of financial resources, threats from the aggressor, and feelings of guilt and loneliness (Moe, 2007). There are also women who claim that they love the abuser (Moe, 2007; R. A. Silva et al., 2012) and that they wish for the well-being of their family and children (Fanslow & Robinson, 2010; R. A. Silva et al., 2012). In face of these situations, women should be informed that, at any time, they can review their decision and look for positive answers in any of the services that compose the protection network for women in situations of violence, without the fear of being judged by professionals who are there to meet their demands for health, safety, justice, and social assistance.

The limitation of the present research is related to the inclusion of only two services at which the women sought help, and through which they were contacted. The study was completed with a small sample group, so for the results to be generalized, these issues must be taken into account.

Conclusion

We understand that the main trigger for women to seek help lies in the need to recognize that they are in an abusive and violent relationship. This implies the possibility of developing educational programs or actions in school institutions starting in childhood, for girls and boys to denaturalize violence in the domestic sphere. Thus, the actions would focus on the prevention of new situations of violence.

For the strengthening of the decision-making process of women in situations of violence, they are going to need support to break the silence and the cycle. To this end, it is urgent to broaden women’s information and awareness about where and how to seek help, through access to clear and accurate information in all places that compose the assistance network for these women.

Whereas in the school environment, actions can be a public policy of prevention, within the services of justice, security, social assistance, and health, the process of women’s empowerment can become part of the daily clinical practice and of public policies with a view to the integrality of assistance to health and gender.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Jaqueline Arboit

Stela Maris de Mello Padoin

Author Biographies

Jaqueline Arboit, PhD in Nursing, is a substitute teacher in the Nursing Department at the Federal University of Santa Maria, Brazil. She develops studies on the theme of violence against women from the perspective of the intersectoral assistance network.

Stela Maris de Mello Padoin, postdoctorate in nursing, is an associate professor—Level 3 in the Nursing Department at the Federal University of Santa Maria, Brazil. She develops studies on gender-based violence from the perspective of immigrant, refugee, and academic women and of professionals of the intersectoral assistance network.

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