NURSING CARE FOR WOMEN VICTIMS OF DOMESTIC VIOLENCE: ANALYSIS OF THE LIMITATIONS OF THE HEALTH SYSTEM IN PRIMARY CARE

Abstract

Introduction: Domestic violence against women is a public health problem with multifactorial causes and serious consequences. It manifests itself in different ways, such as physical, psychological, moral, sexual, and patrimonial, and is associated with factors such as gender inequality and sexist cultural patterns. Despite the fundamental role of Primary Health Care and nursing in welcoming and caring for women, the system faces structural limitations. Methodology: This study was a systematic review of the literature. To select relevant articles, searches were carried out in the following databases: Virtual Health Library (BVS), SciELO, BDENF, and LILACS. The search was restricted to studies published between 2020 and 2025 (last 5 years), in Portuguese, seeking to contribute to the discussion and analysis of this research. Therefore, the following question was formulated: what are the challenges and limitations of nursing care in Primary Health Care for women victims of domestic violence, and how can the implementation of protocols and guidelines improve this care? Original articles, review studies, observational studies, qualitative studies, systematic reviews, guidelines and documents on public health policies were included. To ensure the relevance of the studies, the following descriptors were used, selected according to DeCS (Health Sciences Descriptors): ‘Nursing Care’, ‘Gender Violence’, ‘Primary Health Care’. The search strategies were formulated in Portuguese and English, using the Boolean operator ‘AND’ to combine the descriptors. These combinations were applied to the titles and abstracts of the selected articles. The search was restricted to review articles, editorials and opinion pieces, in order to focus on the most relevant and academic publications. Figures and tables were prepared to present the data. Results and discussion: the main challenges and limitations of nursing care in Primary Health Care (PHC) for women victims of domestic violence involve the failure to recognize violence as a health problem, medicalization and technicality that reduce suffering to pathologies, exclusion of the sociocultural dimension of violence, lack of knowledge and training of professionals, unqualified listening, absence of protocols and workflows, in addition to difficulties such as lack of time, fear, failures in teamwork and poor intersectoral coordination. The implementation of protocols and guidelines is highlighted as fundamental for the identification, non-judgmental reception and appropriate referral of victims, in line with the principles of the SUS and PHC. Conclusion: nursing care for women victims of domestic violence in PHC is essential, but faces limitations such as the reductionist view of health, lack of protocols, lack of time, insecurity, absence of workflows and weak coordination with the intersectoral network, which compromises the comprehensive and effective response to cases.