Perception and experiences of children and adolescents submitted to work: an exploratory study

Natália Miranda Monteiro¹, Gutembergue Santos de Sousa², Maria Mônica Machado de Aguiar³, Maria Goreth Silva Ferreira³

¹ Federal University of Amazonas

² Federal University of Mato Grosso

³ University of the State of Pará

ABSTRACT

Aim: to understand the experiences and feelings that the exploitation of child labor generates in children/adolescents served by the Child Labor Eradication Program (PETI, acronym in Portuguese). Method: a qualitative study of participatory exploratory character, based on the creative method, with 20 children and adolescents aged from 7 to 16 years, through the technique of the discourse of the subject. Results: the study identifies the following thematic categories: Structural and emotional need as an indispensable support for its development; Family affectivity as a building element; The family structure of the child/adolescent exploited by the work; The related life experiences of children/adolescents exploited by work; Education as a way to break the cycle of oppression. Discussion: evidence of depression tendencies and suicidal ideation were found in the speeches. Conclusion: the experiences lived interfered in the physical and mental health of the deponents, hampering their process of healthy growth and development.

Descriptors: Child Health; Adolescent Health; Nursing; Social Exploration; Child labor.

INTRODUCTION

Despite the mobilization to eradicate child labor in Brazil and in the world, it is still a major challenge for government and society. According to the United Nations Children's Fund, in 2011, approximately 150 million children between the ages of 5 and 14 worked in developing countries, corresponding to 16% of the total population in this age group⁽¹⁾. The demographic census of the Brazilian Institute of Geography and Statistics (IBGE, acronym in Portuguese) described a scenario that was at least bleak in Brazil in 2010: there were 1,666,750 children between the ages of 5 and 15 working. Of these, 160,100 (9.6%) were children between the ages of 5 and 10, and 1,506,650 (90.4%) were young people aged between 11 and 15⁽²⁾.

Childhood and adolescence are recognized as indispensable phases in the process of growth and development in the life of every human being, and in which character and personality are constructed. They must, therefore, be respected, since the experiences that the child/adolescent lives during this period may interfere with their formation and affect throughout their life⁽³⁾.

It is necessary to reflect on this problem and consider that, when working, children/adolescents assume responsibilities incompatible with their physical and mental development, preventing them from experiencing an important phase in their lives: childhood. The exploitation by work steals their freedom, violates their rights and stains their innocence, imposing on them duties and obligations contrary to those guaranteed by the Federal Constitution, and guaranteed by the Statute of the Child and Adolescent (ECA, acronym in Portuguese), such as: the right to health, education, leisure, professionalization, culture, dignity, respect, freedom, and family and community life⁽⁴⁾.

The exploitation by the work represents a violence against the children/adolescents that can be devastating for their health, causing physical, psychological, cognitive and behavioral damages and affecting the psychological development and intellectual capacity. The signs of this violence can easily be confused with mental disorders, as in the case of behavioral etiology, and with domestic accidents, when it results in physical marks⁽⁵⁾. Thus, nursing needs to be aware of this situation, knowing and perceiving the signs indicative of such violence, as it is necessary to identify risks and the perception of vulnerability during the care provided to children and adolescents in various scenarios.

A very frequent signage in the child/adolescent victimized by violence is low self-esteem. Self-esteem, which begins to develop in childhood, is a decisive factor in the individual's relationship with himself and others. The acquisition of self-esteem by the child is intrinsically related to self-concept, defined as the self-evaluation of the self and results in an attitude of approval or repulsion. It is through self-esteem that the person considers himself capable, successful, meaningful and valuable⁽⁶⁾.

In this sense, it is understood that the children/adolescents who experienced the exploitation of child labor have their self-esteem affected, and it is up to the health team to have the sensitivity to recognize who these children/adolescents are and to carry out interventions with the family and the community in order to avoid the emergence of emotional and psychological damages.

Childhood and adolescence deserve special attention from social policies, as stages of the life cycle that should be aimed primarily at education and biopsychosocial training of individuals. In this sense, the objective of this study is to understand the experiences and feelings that the exploitation of child labor generates in children/adolescents served by the Program for the Eradication of Child Labor (PETI, acronym in Portuguese).

PETI is a program of the Federal Government that seeks to protect children and adolescents under 16 years of age against all forms of work, aiming at a redemption of citizenship and social inclusion of its users, by means of monthly financial assistance, ensuring that such children and adolescents are attending school and attending socio-educational activities⁽⁷⁾.

METHODOLOGY

This is a qualitative, exploratory participatory research, based on the Creative Sensitive Method (MCS, acronym in Portuguese), chosen for using techniques consolidated in research with this approach, agglutinating sensitivity with theoretical discourse, through collective ideas and artistic language⁽⁸⁾.

The dynamics of creativity and sensitivity are the great stage of production of data for analysis. The MSC facilitates the expression of the study participant, providing an environment of listening and the possibility of expressions of affection, solidarity and understanding, avoiding the dichotomy between reason and emotion, promoting awareness of the participants and, thus, revealing their subjectivity in the group space⁽⁸⁾.

The use of this method has demonstrated efficiency and good results in the applicability of pedagogical strategies, favoring the exchange of knowledge in a critical and sensitive way, through forms of expression and sharing of experiences, based on the construction of a new look about reality and about the interweaving of knowledge among those involved⁽⁸⁾.

The participants of the study were a group of 20 children and adolescents aged 7 and 16, assisted by PETI in the municipality of Santarém, Pará, Brazil, during the data collection period, namely: June 2014. The meetings occurred in a classroom of the University of the State of Pará (UEPA), where the dynamics were developed for a period of 40 minutes.

The dynamics of creativity and sensitivity (DCS, acronym in Portuguese) developed in this study was the tree of knowledge, aiming to stimulate the participants in describing what was needed to grow and develop in a healthy way. Such dynamics is characterized by the power of code transformation through the sharing of experiences in the group's space of debate, allowing an active participation of the subject in the search for knowledge, based on the concrete reality of those who experience the phenomenon⁽⁸⁾.

As a starting point for the development of dynamics, the following question was generated: "What does a child need in order to grow, develop and be happy?"

The data were analyzed based on the reference that deals with the discourse analysis in the French current, created by the French philosopher Michel Pêcheux. This technique of analysis aims to analyze the use of language through the contextualization of the discourse produced by the interaction between the subjects through their social interactions and the already established processes of structuralism and linguistics⁽⁹⁾.

After the transcription of the speeches produced during the DCS, the corpus of the research and its necessary delineation were constituted. In the first moment linguistic materiality was conferred to the text, by means of symbols and orthographic resources, aiming at its understanding as close as possible to the enunciation of the children and adolescents. In the second moment the object of study was explained after successive readings and re-reading of the empirical material.

At this stage the language resources adopted by its enunciators were identified to give meaning to their speech and to reveal the meanings of each discourse. This phase requires the use of analytical tools from the field of discourse analysis - the metaphor, periphrastic processes and polysemy - essential to reveal the effects of the said and unsaid sense of study participants⁽⁹⁾.

This study was submitted and evaluated by UEPA's Research Ethics Committee and approved on April 24, 2013 under Opinion 259.967, thus respecting all the ethical principles required by the National Health Council (CNS, acronym in Portuguese).

RESULTS

The dynamics of the tree of knowledge allowed us to unveil the concrete existential situations experienced by children and adolescents in the world of work as a vital phenomenon that were enunciated in the dialogical dialectical process, seeking to rescue in the discourses the signs that indicate the effects of child labor on their self-esteem.

During the application of the DCS, the existential situations that emerged in the group space comprised a set of themes generating debates, bringing elements to be decoded by the group.

At that time, the study participants described what they considered important for children/adolescents to grow and develop in a healthy way, thus raising the first topic generating debate, as follows.

Structural and emotional need as an indispensable support for development

Cr3AcU*: - Well, the child needs to have a home, respect, affection and lots of love! He needs a well-structured home and needs attention and support. Because if he doesn't have all these things that I just mentioned, he will not be a developed human being, a capable human being [...]*

Cr2AcU: - A child needs to feed properly, play with other children, go out with his family and take care of his personal hygiene, because a well-fed child grows up in a healthy way. And through the play with other children he learns to share his feelings, such as friendship and respect [...]

Family affectivity as a building element

In the dialogical enunciations of children/adolescents, other elements stand out, giving to family affective relations demonstrations of affection and the sense of happiness, a feeling that certainly contributes to their emotional well-being, as observed in the following dialogical fragments:

Cr1AcNRM: to feel happy he needs to have the affection of his father and mother.

Cr3BbU: I am happy when my parents give me affection and attention. I get very happy...

Cr1AcNRT: because it is important to have the love of the father, the mother and the family.

Cr9JaU: My problem is that my parents don't always give me attention and sometimes I miss their affection... And this happens a lot in my life. There are days I need to vent, talk my things and they don't realize; they don't give me the opening to talk!

Cr5BBNRM: When someone cares about me I'm happy. Sometimes I think I don't even miss me...

Cr3BbU: When I do what my father and mother taught me, I make them proud...

The family structure of the child/adolescent exploited by work

The dialogical fragments also reveal how the relationships established in the children's family space affect their self-esteem.

Cr1BBNRM: I get sad when Mom hits me.

Cr4AcNRT: the usual problems, [...] fights at home. I can never do anything I want. Sometimes I even think about committing suicide... My life is very hard, only problems.

Cr1AcNRM: there are children who even think of committing suicide; there are some that only do what is commanded; They don't drink water, don't eat, and stay on the street.

Cr2BBNRM: I get sad when my parents tell me off.

Cr4BbU: [...] I wanted my stepfather to be someone else because he fights a lot with my mother; sometimes he leaves home and doesn't eat lunch... (Crying)

The related life experiences of children and adolescents exploited by work

All the emotional content present in the discourses reveals the marks that imprint themselves on their behavior after experiencing exploitation by the work that are evident in the following dialogical fragments:

Cr3AcNRM: I think the work hurts because the children get tired, sad, because they walk all day up and down, and their legs get tired. Children even cry because it is bad to be mistreated. They feel isolated because they have no friends.

Cr2JaU: [...] my parents went out to work and I stayed at home taking care of everything, cleaning, cooking, and washing the dirty clothes. [...] and when I remember that, I get angry.

Cr3AcNRM: I think that when children work, they are even psychologically affected because so much work and slavery can undermine their future.

Education as a way to break the cycle of oppression

In the dialogical fragments that follow, children/adolescents point to education as the foundation of life.

Cr4AcU: the child needs to study to learn to read, write and be someone, to have a good future. So she will be happier!

Cr6AcU: for a child to grow up, it must study and be obedient, because if that child does not know how to read, it will never make its dreams come true; if it studies, it will have a decent profession in life, and will know how to manage things. And by obeying its parents it will live more on earth.

Cr1AcU: It is necessary to study to be someone in life so you don't get heavy work, don't feel worn working under the sun as a machine operator like my stepfather, which is a job where you work hard and receive little. It must be a job that pays well and allows you to live a decent life without exploring you.

DISCUSSION

The child has a need to feel loved and valued, and it is essential that the family environment guarantees security and understanding regarding their attitudes and feelings. Support, love and appreciation are central to the well-being of children and directly influence how they will develop ⁽¹⁰⁾. Nurses are responsible for adequate growth and development in childhood and adolescence, and they are aware of any and all violations of rights that compromise the physical, mental and social well-being of this clientele.

The speeches revealed the need for a healthy environment that has favorable conditions and that allow the development of the full potential of children and adolescents. The material and institutional resources that the child can count on (food, housing, sanitation, health services, kindergartens and pre-schools) are of paramount importance in this process. The general care and time devoted to children, such as attention, and the affection that the mother, the family and the society as a whole dedicate to it are also decisive components for their emotional strengthening^(6,8).

The linguistic polyphony of discourse, expressed through the multiple voices in the dialogue they hold in group space and the exposition of their existential situation, makes the phenomenon of child labor and its repercussions on children's/adolescents' self-esteem have a historical, cultural and social dimension, in which the actors perceive their condition, but are aware of the existence of a better world and with other options that imply less suffering and more guarantee of rights⁽¹¹⁾.

What happens within each human being represents a complex and multifaceted universe; it is a mosaic, made up of innumerable emotions, thoughts, interpretations and values⁽¹²⁾. People's behavior reflects these subjective states fundamental to their differentiation from others around them; they act according to what they think and feel; therefore, it is possible to say that people are their feelings and thoughts.

In their speeches, children and adolescents unveil the emotional content of their life experiences. In their conceptions, in order to be happy it is necessary to feel the affection within the family, to feel the care and attention of the parents and to be with the family, since it constitutes one of the main pillars of the psychic life of people⁽¹⁰⁾.

It is through the family that the first interpersonal relationships are established and that the first representations about their abilities, capacities and feelings are being constructed in relation to themselves and, for that reason, the exchange of affection is of fundamental relevance at that moment. Regardless of their multiple configurations, the most important affective experiences in the subjects' lives occur in the family. In this perspective, self-esteem is considered as one of the most important affective states in the life of the subjects, because it allows resources for this to act in their life; it is a socially acquired attribute⁽¹²⁾.

Affectivity is what results from the combination of feelings and emotions and reflects the way people combine emotional experiences to react to the world and other people; it is like a characteristic trait of each individual. The level of affectivity predisposes the person to react to the experiences lived in one way or another, with apathy or with effervescence, with enthusiasm or reserve⁽¹²⁾.

The children's and adolescents' speeches in this study reveal that, in the family context, their experiences are marked by many feelings, including emotional insecurity, a feeling that is evident when they evoke: "When someone cares about me I am happy, sometimes I think they don't even miss me". This affective deficiency manifested in the discourse of children/adolescents points to the need to feel that they are dear and valuable, especially to their parents, signaling the possibility of the development of an insecure personality.

The psychological factor formed by the beliefs, conscious or unconscious, that people developed in childhood and in other phases of their life is preponderant in the formation of their personality. At some point in their existence, during their social relationships, they need to learn that it is acceptable or appropriate to relate affectively to people. Otherwise, in adult life these individuals can lead to social relationships an exacerbated fear of rejection⁽¹²⁾. If children as children do not receive comfort, support, love, and other abstract but necessary tools, they will end up learning contrary lessons about their value, impacting their psychic formation. Thus parents with their attitudes lead children to see themselves as competent and incompetent⁽¹³⁾.

The children/adolescents also stress the need to have more space to talk about their experiences. Note the concern of the research participants in drawing attention and arousing feelings such as the affection and pride of their parents. Many children suffer when they realize that their feelings are not being considered, especially by their parents⁽¹³⁾.

It is remarkable the need to have professionals qualified and potentially committed to provide better care to children and adolescents, especially those victims of violence^(14,15). Thus, nurses need to develop creative strategies that allow them to identify not only the physical repercussions imprinted on the body of children/adolescents, but also the psychic and emotional marks arising from this social problem, broadening their view of the family as an object of attention and care.

Self-esteem is considered a very complex phenomenon, which is part of the personality constructs and implies in everyday life. For the National Advisory Health Counsel, it is one of the leading markers of mental health, as it may be related to serious mental phenomena such as depression and suicide^(6,13). According to the World Health Organization, suicide has become a global public health problem because it is in many countries among the top three causes of death among individuals aged 15-44 and is the second leading cause of death among individuals aged 10 to 24 years⁽¹²⁾. Suicide in childhood and adolescence is a dramatic and serious event that deconstructs the family as a whole.

The family is the most important social structure in the formation of the children/adolescents. It exerts a great influence on the formation of its members, which is reflected in the construction of character, attitudes, forms of relationships, and in the professional and sentimental life of each member. The influence exerted in the construction of individuals as biopsychosocial beings is potentiated in adolescence, triggering behaviors, desires and dialogical feelings necessary to the interactions among adolescents, the period of adolescence and all the social context that permeates them. Dialogue is the basis of family support, because where there is a space in which several people live together, it is essential that there is good communication between them⁽¹⁶⁾.

It is clear that the exploitation of children/adolescents by work is a practice that arises from a family pattern that is unstructured and which poses risks to the child's health, having the capacity to affect their physical, psychological and social development, depriving them of living fully and reducing their future prospects. Childhood and adolescence are stages of life that should be exclusively dedicated to education, recreation and development. It is not possible to include the work and, mainly, the responsibility for the sustenance of the family in this process, as this fact can cause the development of abnormal regulatory standards in front of the exposure to which this public is submitted⁽¹⁷⁾.

Physical exhaustion manifests in their bodies in the form of pains, especially in the legs, because of the long paths they were forced to make, pointing to a result of the fatiguing routine of hard and heavy work experienced by them. Work exploitation assumes a sense of maltreatment in the discourse of children/adolescents and, as such, comes accompanied by crying, anger and sadness, revealing the marks of the emotional fragility that the work imprints on their lives.

The metaphorical effect used by children/adolescents in comparing themselves with slaves makes it possible to construct meanings of statements based on the relation of exploitation by work/suffering, physical pain and emotional pain. Through this metaphorical effect it is revealed in the discourse of children/adolescents the social dimension of the problematic in which they are victims, in an attempt to define something that for them has no explanation, that is, they are compared to someone who has lived in the past the same situation they live today: "the slave"; someone who worked tirelessly, in unhealthy conditions until exhaustion. This comparison reveals the existential meaning of this vital phenomenon, which is the mark of the oppressor as a host in the oppressed⁽¹⁸⁾.

By anchoring himself in the slave's figure to explain how he feels, the child/adolescent reveals all the oppression that pervades his daily life. The understanding of the phenomenon of oppression leads to the idea that the exploitation of children labor leaves children/adolescents in the shadow of oppression. The phenomenon of oppression installs on the oppressed the vocation of being less and of being worthless, which is based on a relation of exploitation in which the oppressed hardly struggle and do not trust in themselves, for having a magical belief in the invulnerability of the oppressor and thus remain accommodated and adapted, "immersed" in the very machinery of the oppressive structure⁽¹⁴⁾.

In the oppressive web in which the children/adolescents live, other feelings are mobilized, and in their context of life they assume a position of conformity to the hard routine they live. Thus, as if they could do nothing against that situation, they passively accept their condition as workers, and with this, various feelings arise, such as fear and sadness and they often cry and feel lonely.

Oppression is a social problem, and in the context of which the less favored are oppressed, they are obliged to accept what is imposed upon them. In this perspective, the oppressive reality is almost like a mechanism of absorption for those who are affected by it⁽¹⁷⁾. Only when the oppressed become aware of the reasons and their state of oppression and the need to struggle for the conquest of their freedom do they break with this inauthentic view of themselves and the world and cease to feel as if they are almost a "thing." Therefore, they break with the chain of oppression, freeing themselves from the oppressed condition and assuming the place of liberation.

Education is presented as a mediating instrument in this process. Through it, children/adolescents envision the possibility of changing their reality. In this context, education appears in speeches as a necessary condition for people to be someone, to have a profession and thus to fulfill their dreams, acquiring the sense of happiness with the ability to promote a safe way to have a "good future" and have a "profession", a condition that guarantees them a "decent life". Not having a profession for children/adolescents assumes the sense of living exploited by heavy work, physical exhaustion, suffering that has no financial return. For them, only those who have a degree can live far from the exploration. The social practice coined of suffering highlights in the children/adolescents the desire to live positive things⁽¹⁹⁾.

As seen in the discourses of children/adolescents, there are those who desire change, represented by the oppressed, and all those who believe and perceive utopia not as something impossible to realize, but as the "unpublished viable"⁽¹⁸⁾. By visualizing the unpublished viable as a dream, the children/adolescents begin to perceive their liberation as a possible reality to be achieved. Thus, being in the world means engaging in actions, reflections and struggles.

This study intends to contribute to a reflection on the health care policies of children and adolescents that have not been sufficient to avoid violence and to remove them from work, promoting new looks and tendencies to address the issue of health promotion, in the context of their daily lives, allowing a deepening of social, cultural, economic and political issues that involve the whole problematic of the various facets of violence and especially the exploitation of child labor.

CONCLUSIONS

Exploitation through work must be understood as one of the worst forms of violence that can be attributed to children and adolescents and that can lead to disturbances and changes in the perception that these young people have of themselves and others. The children or adolescents who have been exploited by the work show change in the way they see themselves before the world in which they are inserted.

The results suggest that concrete experiences lived by these children/adolescents interfered greatly in their physical and mental health, hampering their process of growth and development, since they influenced their self-concept. The children announced the feelings and emotions that resulted from living in the world of work and how these feelings negatively affected their lives, strongly affecting their self-esteem. The life context of the children/adolescents victims of the exploitation of child labor showed a harsh reality, where the perceptions of losses generated in this process are revealed.

This study presents as a limitation the fact that we have worked only with the public served by the PETI, not showing a picture of the perception of other children and adolescents, victims of work, and who are not assisted by any social program because it is difficult to access them and, in most cases, work in hidden places that are not perceivable to the population.

The study contributes to nursing with the possibility of knowing the experiences of children and adolescents exploited by the work, allowing a better approximation for care and for health promotion actions.

REFERENCES

1. Fundo das Nações Unidas para a Infância (UNICEF). **Child labour. [**Internet]. UNICEF; 2014. [Cited 2017 Mai 30]. Available from: http://nacoesunidas.org/150-milhoes-de-criancas-de-5-a-14-anos-sofrem-com-trabalho-infantil-em-todo-mundo-alerta-unicef/.

2. Ministério do Planejamento, Orçamento e Gestão (MPOG). Instituto Brasileiro de Geografia e Estatística. Pesquisa por amostra de domicílios: PNAD. [internet]. Brasília: MPOG; 2011. [Cited 2015 Aug 10]. Available from: https://biblioteca.ibge.gov.br/visualizacao/livros/liv61566.pdf.

3. Lottman TJ; Zawaly S; Niemiec R. Well-being and well-doing: bringing mindfulness and character strengths to the early childhood classroom and home. In: Positive Psychology Interventions in Practice. Springer International Publishing [internet]. 2017 [cited 2017 Jun 02]; 83-105. Available from: https://link.springer.com/chapter/10.1007/978-3-319-51787-2_6.

4. BRASIL. Estatuto da Criança e do Adolescente, Câmera dos Deputados, Lei no 8.069, de 13 de julho de 1990. DOU de 16/07/1990 -- ECA. Brasília, DF.

5. Santana RP De; Santana JSS. https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/10356/11076. J Nurs UFPE online, Recife. 2014 [cited 2017 Jan 03]; 9(Suppl. 1):431-9. Available from: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/10356/11076.

6. Assis SG, Avanci JQ. Labirinto de espelhos: formação da autoestima na infância e na adolescência. Rio de Janeiro: Editora Fiocruz; 2004.

7. Brasil. PETI: programa do Governo Federal para a erradicação do trabalho infantil. Caixa Econômica Federal. [internet]. [cited 2018 Dec 21]. Available from: http://www.caixa.gov.br/programas-sociais/peti/Paginas/default.aspx.

8. Cabral IE. O método criativo e sensível: alternativa de pesquisar em enfermagem. IN: GAUTHIER,J.H.M. et al. Pesquisa em enfermagem: novas metodologias aplicadas. Rio de Janeiro: Guanabara Koogan; 1999.

9. Gonçalves ATP. Análise de conteúdo, análise do discurso e análise de conversação: estudo preliminar sobre diferenças conceituais e teórico-metodológicas. Administração: Ensino e Pesquisa [internet]. 2016 [cited 2017 Mar 03]; 17(2): 275-300. Availble from: http://search.proquest.com/openview/387d6c772bca8ad93bd05e2a488ba9a3/1?pq-origsite=gscholar&cbl=2034243.

10. Reichert APS; Collet N; Eickmann SH; Lima MC. Child development surveillance: intervention study with nurses of the Family Health Strategy. Rev. Latino-Am. Enfermagem  [Internet]. 2015  Oct [cited  2017  June  08] ;  23(5): 954-962. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-11692015000500954&lng=en.

11. Zeb J. Child labour and its causes of in distract Peshawar. Student Journal of Ayub Medical College [internet]. 2015 [cited 2017 Mar 05]; 1(2): 55-8. Available from: http://sjamc.ayubmed.edu.pk/index.php/sjamc/article/view/16/37.

12. Marteleto L et al. Instability in Parent--Child Coresidence and Adolescent Development in Urban South Africa. Studies in family planning., [internet]. 2016 [cited 2017 Apr 03]; 47(1): 19-38. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1728-4465.2016.00048.x/full.

13. Braga LL; Dell'aglio DD. Suicídio na adolescência: fatores de risco, depressão e gênero. Contextos Clínicos, [Internet]. 2013 [Cited 2015 june 22]; 6(1):2-14. Available from: http://revistas.unisinos.br/index.php/contextosclinicos/article/view/ctc.2013.61.01/1533.

14. Santomé LM; Leal SMC; Mancia JR; Gomes AMF. Children hospitalized due to maltreatment in the ICU of a Public Health Service. Rev. Bras. Enferm.  [Internet]. 2018 [cited 2018 Dec 21]; 71(Suppl 3): 1420-1427. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-71672018000901420&lng=en.  http://dx.doi.org/10.1590/0034-7167-2017-0502.

15. World Health Organization (WHO). Participant manual -- IMAI One-day Orientation on Adolescents Living with HIV Geneva. Geneva: OMS; 2010. [Cited 2015 june 30]. Available from <http://whqlibdoc.who.int/publications/2010/9789241598972_eng.pdf.>

16. Silva IR; Souza FGM; Silva ACO; Nogueira ALA; Barbosa DC; Silva TP. Relacionamentos familiares no discurso de adolescentes escolares: contribuições para a enfermagem. Revista ciência, cuidado e saúde [Internet]. 2012 [Cited 2015 Sept. 10]; 11(1):121-128. Available from: http://www.periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/18868/pdf.

17. Koss KJ et al. Patterns of Adolescent Regulatory Responses During Family Conflict and Mental Health Trajectories. Journal of Research on Adolescence [internet]. 2016 [cited 2017 Jun 08]; 27(1): 229-45. Available from: http://onlinelibrary.wiley.com/doi/10.1111/jora.12269/epdf.

18. Freire P. Pedagogia do Oprimido; São Paulo: Paz e Terra. 50ª Ed; 2011.

19. Pereira W; Ghedin E. A epistemologia de Paulo Freire e suas contribuições para o ensino de ciências no mundo contemporâneo. Revista Areté| Revista Amazônica de Ensino de Ciências [internet]. 2017 [cited 2017 Mar 02]; 3(5): 52-65. Available from: http://periodicos.uea.edu.br/index.php/arete/article/view/373.

Contribuitions:

Natália Miranda Monteiro: preparation of the work; substantial participation in the design or preparation of the manuscript, collection, analysis and interpretation of the data;

Gutembergue Santos de Sousa: critical review of intellectual content; approval of the version submitted.

Maria Mônica Machado de Aguiar: critical review of intellectual content; approval of the version submitted.

Maria Goreth Silva Ferreira: preparation of work; critical review of intellectual content; approval of the version submitted.

All authors participated in the phases of this publication in one or more of the following steps, in according to the recommendations of the International Committee of Medical Journal Editors (ICMJE, 2013): (a) substantial involvement in the planning or preparation of the manuscript or in the collection, analysis or interpretation of data; (b) preparation of the manuscript or conducting critical revision of intellectual content; (c) approval of the version submitted of this manuscript. All authors declare for the appropriate purposes that the responsibilities related to all aspects of the manuscript submitted to OBJN are yours. They ensure that issues related to the accuracy or integrity of any part of the article were properly investigated and resolved. Therefore, they exempt the OBJN of any participation whatsoever in any imbroglios concerning the content under consideration. All authors declare that they have no conflict of interest of financial or personal nature concerning this manuscript which may influence the writing and/or interpretation of the findings. This statement has been digitally signed by all authors as recommended by the ICMJE, whose model is available in http://www.objnursing.uff.br/normas/DUDE_eng_13-06-2013.pdf