REVIEW PROTOCOL

Follow-up to women in situations of violence in the covid-19 pandemic: protocol of scoping review

Gabriel Hanjin Pietrangelo Kim1, Marina Laura Fernandes Barbosa da Silva1, Thalita da Silva Ribeiro1, Amábile Giulia Faraoni Cardoso1, Camila Luchese Miluzzi1, Tauani Zampieri Fermino1, Silvia Matumoto1, Angelina Lettiere Viana1

1Universidade de São Paulo, Ribeirão Preto, SP, Brazil

ABSTRACT

Objective: to map evidence from the literature about the follow-up in the attention networks to women in situations of violence during the social isolation of Covid-19. Method: scope review elaborated by the population strategy, concept, and context, without limitations of the types of studies, country, or language. Eight databases will be used in the areas of Health, Law, Social, and Multidisciplinary Sciences, and for the gray literature three repositories. The management of the materials will be done through software to exclude duplicate materials and to select the studies by two reviewers and a third reviewer in case of divergences. For data extraction, a script will be used. The presentation of the results will occur descriptively, establishing categories from the findings. The Preferred Reporting Items checklist for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCR) will be used for the final writing of the review.

Descriptors: Violence Against Women; Delivery of Health Care; User Embracement; COVID-19.

INTRODUCTION

Violence against women (VCM) and its different manifestations constitute a public health problem, highlighting the developments that affect health and living conditions. VCM is still crossed by determinants, which impact the phenomenon and its production and reproduction in society.

Social isolation and greater coexistence of people at home, as well as factors such as stress and restricted access to support services, increase the risk of violence(1). This reinforces the general perception that the strategies to curb the advance of the pandemic have accentuated existing weaknesses, demanding new ways of perceiving and acting to cope with new and known social needs. Although isolation is an effective measure of control of Coronavirus 2019 disease (Covid-19), it can lead to social, psychological, and economic consequences, exacerbating or favoring the triggering of various types of violence(2).

In Brazil, in 2021, a survey conducted by the Datasenado(3) on domestic and family violence against women revealed that 49% of the women interviewed declared that, with the pandemic, aggression became more frequent, and 44% stated that it became more serious.

This strategy isolated women in abusive relationships and far from their support networks, hindering access to services, which contributed to the prevention of violence(4). The set of these elements linked to social isolation impacts care networks for women in a situation of violence(5), damaging the continuity of actions related to coping not only in the health field.

VCM and its manifestations have been investigated by various fields of knowledge and faced by different social movements. Despite the extensive production on the occurrence of VCM, and its impact on women's lives during the pandemic(1-2.4,6-7), there are few productions related to actions for the follow-up of this population in the care network during social isolation(8). A preliminary search in the SCOPUS, PUBMED databases, in the Online Brazilian Journal of Nursing (OBJN), and the Open Science Framework (OSF) platform, it did not identify scope review protocols that explored the follow-up of women in situations of violence in the COVID-19 pandemic. Thus, considering the repercussions of the MVC on the quality of life of this population and the urgent need to develop intersectoral measures to combat this phenomenon through the coping network(6), the relevance of this study is justified by unveiling the follow-up experiences developed in this period, from the perspective of survivors and workers of the attention network.

Therefore, it is necessary to analyze the current evidence on how the follow-up of women in situations of violence has occurred in the specialized and non-specialized care networks in the period of isolation, seeking subsidies for the reorientation of coping actions that aim to be accessible, effective and resolvable. From this one can advance in the understanding of the phenomenon of VCM contextualized to the new reality, observing conceptual changes and gaps in knowledge and continuing the efforts of many women in the search for their rights and a life without violence.

Considering the relevance of the issue pointed out as a public health problem, mobilizations in favor of coping with the VCM become essential, assuming a commitment to the search for measures aimed at ensuring the safety and well-being of these women. The objective of this scope review is to map evidence from the literature on the follow-up of care networks to women in situations of violence during the social isolation of covid-19.

METHOD

The framework for the construction of the scope review protocol was based on the Joanna Briggs Institute (JBI) Manual(9) and is registered in OSF (doi 10.17605/OSF.IO/NBPY5). Scope reviews allow for mapping the main concepts, clarifying research areas, and identifying knowledge gaps, proving to be an appropriate methodology for the investigation of broad topics(9). Therefore, it is considered that the publication of protocols is a way to highlight the methodological rigor with the transparency of the process of conducting the research, which also allows reproducibility and reduction of the risk of bias in the study(10).

Review question

The question was based on the population, concept, and context strategy (PCC) recommended for scope reviews(9). The elements were raised: women (population), violence (concept), and follow-up in the period of the covid-19 pandemic (context). The question that guides this review is: “What is the production of knowledge about the follow-up in the network of attention to women in situations of violence in the period of social isolation of Covid-19?”.

Inclusion and exclusion criteria

Inclusion criteria were: materials involving women aged 18 years or over in situations of violence (by intimate, domestic and/or institutional partner) in the context of the follow-up carried out during the social isolation of the covid-19 pandemic in specialized and non-specialized care networks(11).

The exclusion criteria were: materials involving violence against children, adolescents, cis or transgender men, Lesbian population, Gays, Bi, Trans, queer/Questioning, Intersex, Asexual/Aromantics/Agender, Pan/Poli, Non-binary and plus (LGBTQIAPN+) and/or informal support network (family, friends, etc.) exclusively. Materials not found in full will still be excluded, even after a request to the authors or by the Bibliographic Switching service (COMUT) of the Central Library of Ribeirão Preto of the University of São Paulo (BCRP-USP).

For the population, the term “women” was taken as a gender, built in the sociocultural context(12), which maintains relationships with biological sex, but is not determined by it, it can thus cover a larger population when contemplating cis and transgender women. The age of the population was delimited from the milestone of the marital majority in Brazil (18 years).

Concerning the concept of violence, this covers several forms and manifestations, therefore, it is necessary to define which denominations will be contemplated in this review, aiming to give objectivity and meet the scope that aims to delimit. In general, it deals with gender violence that encompasses all kinds of violence from one gender to another, although historically, this concept is closer to the violence of men against women(13).

Specifically, if the VCM does not involve a limited agent or site, which relates to intimate partner violence committed by aggressors who maintain a close bond with the woman in a situation of violence(14), including straight or homosexual affective relationships, and with domestic and intrafamilial violence, which may involve other populations not identified as women in certain spaces(8,15). All of these are centered on the imbalance of power that favors the naturalization of violence, hindering the confrontation and leading to ways to mitigate the impact of aggressions, be they physical and/or psychological(16).

In addition to these types, institutional violence is present, which shows great potential to cause suffering to women in situations of violence by making them unnecessary through procedures that lead them to revive the situation of violence and/or stigmatization(17). Thus, it is emphasized that the scope of this review involves specific forms of violence that persist in the social reality and that are passed by different determinants, not being immune to the phenomena of the context in which they develop.

In this context, initiatives aimed at facilitating women's care by different networks of attention, developed by different institutional and social movements, have shown important mechanisms of resistance to violence(5). Given this, it is questioned how the follow-up began to occur in specialized and non-specialized networks of care for women in situations of violence(11). Thus, we seek to advance in the fight against this problem, understanding how the pandemic impacted the various services, the conditions in which the follow-up occurred, and the coping strategies adopted(5).

Sources of information

All types of studies will be accepted regardless of the methodological designs. There will be no restriction on the language and/or country of publication. Original studies or literature review studies with qualitative and/or quantitative approaches may be included in the sample. As for gray literature, letters, guidelines, guidelines, and other publications may be selected without preliminary limitation.

Each source will be used given the different characteristics they present, being selected for this review: the databases of the area of Biological SCIENCES PUBMED, Latin American and Caribbean Literature in Health Sciences (LILACS) and Cumulative Index to Nursing and Allied Health Literature (CINAHL); the foundations of the area of SocINDEX Humanities, the HeinOnline database and the multidisciplinary databases PsycINFO, SCOPUS and Web of Science. The selected sources of gray literature were Google Scholar, the Thesis Portal of the Coordination for Improvement of Higher Education Personnel (CAPES) and the Institutional Repository for Information Sharing of the Pan American Health Organization (IRIS/PAHO). The references of the studies selected for full reading will be consulted for additional sources. Authors of interest studies may be contacted to request additional information; if data is missing, even after the attempt to contact, further searches will not be followed.

Search strategy

The refinement of descriptors and keywords was performed from a first search in the MEDLINE (PubMed) and Google Academic databases, referring to the words contained in the titles and abstracts and the indexing terms. Access to databases was made by the Virtual Private Network (VPN) of the University of São Paulo (USP). Also, the tools that correspond to the descriptors in Health Sciences (DeCS) and Medical Subject Headings (MESH) were used to identify the indexing terms that best meet the objectives of the review. This whole process, as well as the structuring of the search strategy, was done with the help of a librarian from BCRP-USP (Figure 1). The indexing terms and other keywords listed were combined from the use of the Boolean AND and OR operators and other signals, according to the search platform. In the search for gray literature, the first 100 links/documents raised on the specified platforms will be included, considering the time and number of reviewer's limitations. The final search will be carried out using the terms identified in the refinement described, which can be modified, if necessary, with documentation for final presentation in the review.

Figure 1 - Search strategy in PubMed. Ribeirão Preto, SP, Brazil, 2023

Data management

The selection process, following the search, will be carried out by two independent reviewers, who will use the inclusion/exclusion criteria. The process of deleting duplicates will be performed by an online reference manager (EndNoteWeb), with the transfer of the resulting documents to an application online for conducting revisions (Rayyan); both available free of charge. The entire selection process will be presented through the flow diagram of Preferred Reporting Items for Systematic Reviews and Meta-analyzes extension for scoring review (PRISMA-SCR)(18).

Selection of studies

The titles and substracts of the materials found will be read thoroughly, excluding those that do not meet the purpose of the review. The other materials will be read in full and selected based on relevance to the guiding question and inclusion/exclusion criteria. In case of differences during the search and/or selection, the consensus between the two reviewers will be sought and, if not possible, a third reviewer will be invited to resolve them.

Data collection

The data of the selected materials will be mapped, identifying the information of interest with the help of an adapted script from the JBI manual(9) (Figure 2). The list of data can be modified as other relevant information is identified, mainly regarding the mapping of gray literature. A spreadsheet prepared with the help of Microsoft Excel software, synthesizing the collection script, was elaborated and tested during the refinement of descriptors/keywords.

Figure 2 - Data extraction script. Ribeirão Preto, SP, Brazil, 2023

Presentation of the data

The extracted data will be analyzed and presented, in a descriptive way, with the narrative summarization of the evidence. It is expected to identify possible advances, setbacks, and gaps in knowledge, regarding the reception of women in situations of violence in the care network, aiming to qualify access and care. Other strategies can be idealized after the steps of this protocol. The final wording of the review will be guided by PRISMA-ScR(18), and any change from this document is recorded and justified.

ACKNOWLEDGMENTS

We appreciate the collaboration of Marcia dos Santos, librarian of the Central Library of Ribeirão Preto, University of São Paulo (BCRP-USP), throughout the refinement of the search strategy. Her knowledge and expertise were essential for the development of this work, and it is important to recognize the efforts she dedicates assisting undergraduate and graduate students in the realization of her research projects.                                                                                                                                                                                

CONFLICT OF INTERESTS

The authors have declared that there is no conflict of interests.

REFERENCES

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Submission: 07-Aug-2023

Approved: 20-May-2024