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An exploration of 'child voice' and its use in care planning : an ethnographic study with a looked after childBacon, Johanna January 2015 (has links)
This thesis uses an ethnographic study to interrogate the policy discourse of capturing ‘child voice’ specifically in relation to a ‘looked after’ child. In recent years, attempts have been made to involve children who are ‘looked after’ in discussions and decisions about their care arrangements to ensure that their voice is heard. To ensure this happens, children ‘in care’ are asked about their care placement regularly as part of the care planning review process and their views are incorporated into decisions about their care plan. This study focuses on the lived experiences of a seven-year old female child, who I have referred to as ‘Keeva’, who is ‘in care’ under a Kinship Care arrangement. Over a period of a year, I was based in Keeva’s home one afternoon a week to gain insights about her lived experience as a ‘looked after’ child and how she represented herself. I also observed three care planning review meetings to see how her voice was captured by those charged with her care and how she was represented. I relate Keeva’s experience through seven narrative episodes to capture the rich complexity of the social world she inhabits. I explore aspects of her home and family, her interactions with others and her experience of exploring physical spaces both inside and outside the home. I suggest that these experiences underpin her sense of self and how she relates to others. Drawing on the ideas of Bourdieu, I suggest these experiences and her sense of place in the social order write themselves ‘onto her’ through her habitus and dispositions. Using a Foucauldian lens, I problematise the notion of voice as I contest that the child I observed engaged fully in the statutory processes that surround her. I suggest Keeva, a child who is ‘looked after’, will neither have nor feel she has the agentive properties to influence the care planning process. Instead, as her voice is irrevocably bound up in a bureaucratic process that is uncritically accepted as representative of her, she is obscured as a consequence. I also examine the multivocity in representations of Keeva highlighting the competing discourses of safeguarding, child protection and the ’rights-based’ agenda. I conclude that Keeva was not well represented in care planning reviews and had very little influence in decision-making about her care plan. Despite believing the opposite, those charged with her care failed to hear her or take note of what she said. Furthermore, there was an absence of criticality in representations of Keeva allowing Keeva to be constructed by those professionals involved with her care, in an unchallenged way. As a consequence she was silenced and less visible than the process itself.
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Potencialidades e limites no atendimento a pessoas em situação de violência doméstica: a experiência do Município de SuzanoDamasceno, Magna Barboza 06 March 2017 (has links)
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Previous issue date: 2017-03-06 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The present research proposed to hold a debate about domestic violence based on
the experience lived in the Municipal Health Department of the city of Suzano. For
this, the historicity of the organization of the Network of Attention to People in
Situation of Domestic and / or Sexual Violence, was recovered from the place of
management occupied by the researcher, with the objective of analyzing the
potentialities and limits of the care provided by professionals To cases of domestic
violence. We used as a reference the cartographic method, which allowed us to
develop the path in which professionals establish connections in the formation of
microreds, as well as identifying the conceptions that they have of violence as a work
object. In this social cartography through historical documents, semi-structured
interviews, online questionnaire and epidemiological data, forms of narratives were
developed that showed in the entangled existential field the crossings and
transversalities embedded in the everyday of knowing how to do health, the fragilities
contained in the political context of management, and The care practices performed
by health professionals, as well as the points that signal power in the construction of
the policy to combat domestic violence. We find as a result the organization in
network, the bond or bond as a tool of high power, founding aspects that expands
social technology in front of the problematic and propitiate transformation. We also
find feelings of loneliness, recrudescence, that make it impossible to build micro
political networks through conceptions that challenge the creative and paralyzing
bias. It was also possible to find out how the network of care was designed for people
in situations of domestic and / or sexual violence and the paths traveled by
professionals / A presente pesquisa propôs realizar um debate acerca da violência doméstica, tendo
como cenário a experiência vivida na Secretaria Municipal de Saúde da cidade de
Suzano (SP). Para tanto, recuperou-se a historicidade da organização da Rede de
Atenção as Pessoas em Situação de Violência Doméstica e/ou Sexual, a partir do
lugar de gestão ocupado pela pesquisadora, com o objetivo de analisar as
potencialidades e limites do atendimento realizado pelos profissionais de saúde aos
casos de violência doméstica notificados na Saúde. Utilizamos, como referencial, o
método cartográfico, que permitiu desenvolver o percurso no qual os profissionais
estabeleceram conexões na formação de microrredes, bem como identificou-se as
concepções que possuem da violência como objeto de trabalho. Nesta cartografia
social, por meio de documentos históricos, entrevistas semiestruturadas,
questionário online e dados epidemiológicos, configurou-se formas de narrativas que
evidenciaram no emaranhado campo existencial os atravessamentos e
transversalidades embutidos no cotidiano de saber fazer saúde, as fragilidades
contidas no contexto político de gestão e as práticas de cuidado executadas pelos
profissionais de saúde, bem como os pontos que sinalizam potência na construção
da política de enfrentamento à violência doméstica. Encontramos como resultado a
organização em rede, o vínculo como uma ferramenta de alta potência, aspectos
fundantes que expandem tecnologias sociais frente à problemática e propiciam
transformação. Também encontramos sentimentos de solidão e recrudescimento,
que impossibilitam a construção de microrredes políticas por meio de concepções
que interpelam o viés criativo e paralisador. Também foi possível averiguar como se
desenhou a rede de atenção às pessoas em situação de violência doméstica e/ou
sexual e os caminhos percorridos pelos profissionais
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Projetos de cuidado em Fisioterapia / Healthcare projects in physiotherapyLarissa de Siqueira Fernandes 29 April 2011 (has links)
Conselho Nacional de Desenvolvimento Científico e Tecnológico / As práticas de cuidado em fisioterapia, em muitas situações, resgatam a função do fisioterapeuta de executor de técnicas que lhe era atribuída nos primórdios da profissão. Ao exercer essa função meramente técnica, muitas vezes deixando-se
substituir pelo equipamento nas suas ações, o profissional compromete o estabelecimento do vínculo terapeuta-paciente, contribuindo para o esvaziamento do encontro em saúde. Nessas situações, predomina o êxito técnico (a eficiência na realização do procedimento) sobre o sucesso prático (os benefícios trazidos para vida das pessoas). Para que o sucesso prático seja atingido, é fundamental que haja o questionamento sobre o que sonham as pessoas, profissionais e pacientes, para as suas vidas e para a saúde, quais são suas perspectivas e projetos de vida, seus projetos de felicidade. Nesse sentido, é imprescindível considerar, também, os projetos de felicidade dos profissionais da saúde enquanto sujeitos desse encontro. Afinal, é a partir deles que o profissional elabora o seu projeto de cuidado para cada paciente. Assim, esse trabalho buscou compreender os elementos que configuram a construção de projetos de cuidado em fisioterapia a partir da reflexão dos próprios fisioterapeutas. Para tanto, utilizou-se a metodologia qualitativa de pesquisa por meio de entrevistas semi-estruturadas para que fossem produzidas narrativas da história de vida do trabalho. Os discursos foram analisados integralmente e a categorização foi
feita em três sub-temas: exercício profissional, relação com os pacientes e reflexões. Foi possível perceber que muitos dos arranjos de trabalho estabelecidos visam coibir o vínculo profissional-paciente, transformando-o em valor de troca e mercantilizando a relação terapêutica. Expropriada do vínculo, a prática se resume à realização de procedimentos independentes de sua finalidade, minando as possibilidades de sucesso prático. Nesse caso, não é a tecnologia que gera o afastamento e a mecanização, mas são as estratégias de mercantilização do cuidado fisioterápico. Essa situação só pode ocorrer por um processo de subordinação do profissional e seu saber, o que está
fortemente associado a condições de trabalho exploratórias. Podemos dizer que a mercantilização do cuidado facilita a restrição sobre as condições de trabalho e também é fruto dela. O problema é que essa restrição é vista pelos profissionais como não definitiva, mas como um caminho para se alcançar reconhecimento na busca pelo exercício liberal da fisioterapia. A intenção desse estudo não foi traçar um plano normativo de conduta para a profissão, mas imaginamos que o equacionamento dessas questões passa necessariamente pelo reconhecimento, pelas inquietações e indignações com o problema. O que se espera, portanto, é facilitar esse processo de
desconforto por meio da proximidade dessas questões trazidas pelas narrativas. / Despite the historical fight to prove themselves as health professionals, in many situations physiotherapy care practices bring to surface the physiotherapist‟s function of a mere executor of practical techniques, which used to be attributed to them at the very beginning of their profession. However, when the practice resumes to a set of techniques and the treatment consist of a routine of mechanical acts, the physiotherapist
compromises the relationship therapist-patient, leading to a tangent out of healthcare principles. The described situation favor the technical success, measured by the efficiency in the execution, with detriment to the overall success of the practical success, measured by the benefits the treatment brings to the health of patients. To achieve practical success, it is fundamental to question what people (both professionals and
patients) dream for their lives, health and what are their life and success projects. In that regard, it is mandatory that healthcare professionals consider their objectives and goals, since they are the starting point for therapeutic plans and each individuals care project. This works investigates deeply the elements that compose the construction of physiotherapy care plans, starting with the reflection of the physiotherapists themselves. A qualitative methodology based semi-structured interviews gathered evidence of life and work of professionals. The answers were analyzed as a whole and three categories
were identified: professional practices, relationship patient doctor and reflections. The answers pointed that the current practices aims to eliminate the relationship professional-patient, transforming the professional in a mere service provider instead of
a care provider. Deprived from the relationship, the practice resumes to a collection of independent procedures and undermining any possibility of practical success. In that
case, it is not the technique that originates the mechanization, but the economics underlying the physiotherapeutic care. This situation can only happen through a process of subordination of the professional and his domain of knowledge, which are strongly
correlated to exploratory and predatory working conditions. The monetary policy underlying the care which facilitates the restriction over the work conditions it is also a result of those working conditions, in a vicious cycle. The problem is that this restriction is viewed by professionals not as permanent, but as a stepping stone to reach recognition in the pursuit of the independent practice of physiotherapy. The intention of
this study is not to create a norm of professional conduct, but to provide an outline of possible answers to the raised questions to: recognition, anxieties and concerns. This study aims to facilitate the process of assessment that pushes professionals out of their comfort zone.
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Do encontro ao sentido: o cuidado aos sujeitos adoecidos de câncer / From the muting to the meaning: care to the subjects with cancerFernanda Azevedo de Souza 29 April 2011 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Esta pesquisa objetivou compreender como se dão as práticas de cuidado dirigidas ao sujeito adoecido de câncer no cotidiano dos serviços de saúde. Para tanto, partimos do entendimento que o processo de adoecer traz repercussões nos modos de andar a vida dos sujeitos, especialmente no que diz respeito ao câncer, patologia que traz consigo metáforas ligadas à morte, sofrimento e dor. Ao dar início à busca pelos serviços de saúde, os sujeitos se deparam com uma série de entraves que podem não proporcionar alívio, não suprindo as necessidades que essa nova condição impõe. Encontramos, em muitos momentos, práticas que negam o caráter subjetivo da experiência da doença, não valorizando a narrativa dos sujeitos. Como trajetória metodológica, escolhemos desenvolver um estudo de natureza qualitativa, utilizando como instrumento privilegiado a entrevista semi aberta. Iniciamos as entrevistas com a consigna: conte como se deu o tratamento de sua doença desde a descoberta até o momento em que se encontra. Os dados coletados a partir do encontro com os sujeitos adoecidos foram complementados por informações contidas nos prontuários médicos, bem como por observações obtidas no momento da interação. O local de realização da pesquisa foi um hospital estadual de grande porte localizado na cidade de Fortaleza, estado do Ceará. As entrevistas foram realizadas no serviço de oncologia clínica do referido hospital. Ao todo foram entrevistados doze sujeitos que estavam em tratamento ambulatorial no serviço. Dos doze sujeitos, cinco eram mulheres e sete eram homens. As idades variaram de 29 a 65 anos. A análise dos dados se deu após imersão no material empírico, posteriormente materializado nas transcrições das entrevistas. Procuramos deixar que os sentidos aflorassem, confrontando com o material que já tínhamos disponível, surgindo daí as categorias empíricas. Dividimos as categorias em duas dimensões, a do sujeito e a da rede de serviços de saúde. Ao final da análise, constatamos alguns pontos que consideramos importantes no sentido de se tornarem dispositivos de mudança. Foi possível confirmar que os sujeitos sabem de si, e realizam um processo de construção do sentido sobre sua doença e das práticas terapêuticas. A doença produz mudanças no sujeito, e os força a ressignificarem sua rotina e hábitos de vida. Foi possível observar que o encontro com os serviços de saúde tem se dado de forma truncada. A luta pelo direito a saúde é árdua: pela demora na confirmação do diagnóstico, pela demora em conseguir marcar exames e receber seus resultados, pela falta de especialistas que saibam o que estão fazendo. Os sujeitos têm descoberto a doença quando esta se encontra avançada. A importância do diálogo, da escuta, da percepção do que o outro necessita é importante, por isso, valorizar os relatos dos sujeitos adoecidos de câncer se faz urgente. / This research aimed to understand how to give care practices directed at the subject ill with cancer in everyday health services. To this end we start from the understanding on how the process of disease acts changing the subjects ways of living. Especially regarding to cancer, a pathology that brings metaphors related to death, suffering and pain. By starting the search for health services, individuals are faced with a series of obstacles that can not provide relief, not supplying the needs that this new condition requires. We found many times practices that deny the subjective experience of illness, not valuing the narrative of the subjects. As methodology chosen to develop a qualitative study, using as a privileged instrument to semi open. We began the interviews with the slogan: "Tell how was the treatment of their disease from discovery to the time that is." Data collected from the encounter with the sick subjects were supplemented by information contained in medical records and the observations obtained at the time of interaction. The venue for the research was a large state hospital in the city of Fortaleza, Ceara state. The interviews were conducted in the oncology department of the hospital clinic. In all twelve subjects were interviewed who were in outpatient treatment service. Five subjects were women and seven were men. The ages ranged from 29 to 65 years. Data analysis was carried out after immersion in the empirical material, later embodied in the interview transcript. We tried to let the senses to flourish, struggling with the material we had available, there came the empirical categories. We divide the categories into two dimensions, the subject and the network of health services. After the analysis some important points were found to consider in order to make devices change. It was confirmed that the individuals know themselves, and perform a process of constructing meaning about their illness and medical treatment. The disease produces changes in the subjects that forced them to rethink their routine and lifestyle. It seems that the encounter with the health service has been given in a truncated form. The fight for the right to health is difficult: the delay in confirming the diagnosis, the delay in getting dial and receive their exam results, lack of specialists who know what they are doing. The subjects have discovered the disease when it is advanced. The importance of dialogue, listening, perception of what the other needs is important, so to give real value at the reports of sick subjects of cancer is urgent.
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Nutrition Care Practices of Family Physicians and Nurse Practitioners in Primary Health Care Settings in Ontario – A Qualitative StudyAboueid, Stephanie January 2017 (has links)
This study aimed to provide an in-depth understanding of the way in which the macro, meso, and micro levels of the health care system affects nutrition care practices of family physicians (FPs) and nurse practitioners (NPs). It also examined how current practices compare to the clinical practice guidelines on the management and prevention of obesity. Three different types of team-based primary care settings were included: 2 Family Health Teams, 3 Community Health Centres and 1 Nurse Practitioner-Led Clinic. Within each type of setting, six to eight FPs and NPs were interviewed (for a total n= 20). Site-specific documents and government reports were also analyzed. Findings suggest that the team-based nature improves nutrition care due to the accessibility to dietitians and cost-free service. Electronic Medical Records was an important enabler for chronic disease management. Duration of medical visits and increasing prevalence of complex patients were barriers for addressing nutrition and weight. Despite the importance of addressing obesity in primary care, the topic was approached in terms of chronic disease management rather than prevention. FPs and NPs spared the dietitian on site for patients who have more severe chronic conditions. Nevertheless, the presence of a dietitian on site increased the likelihood of primary care providers bringing up the topic of nutrition. Addressing site-specific barriers could improve nutrition care practices for weight management and chronic disease prevention in the primary care setting.
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THE PRACTICE OF SELF-CARE STRATEGIES AMONG MASTER OF SOCIAL WORK STUDENTSRomero, Gracie 01 December 2019 (has links)
This study examined the different types of self-care strategies that Master of Social Work students practice. This study used the National Alliance on Mental Illness Self-Care Inventory, a survey which asks participants about commonly used methods of self-care. Engaging in self-care can bring better understanding and insights on how to prevent the signs of stress while also increasing an individual’s ability to regulate their emotional needs. All MSW students at the California university were invited to participate in the study. The surveys were administered via Qualtrics online survey software to the 68 part-time and o-time MSW students who agreed to participate in the study. However, 52 participants completed the survey. Overall, the social work students in this sample indicated high levels of self-care practice within the five domains of self-care: physical self-care, psychological self-care, emotional self-care, spiritual self-care, and workplace/professional self-care. This finding suggests that the MSW student participants in this study seemed to recognize the importance of self-care practice as MSW students. The study’s implications for social work research, practice, and education are discussed.
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Chart review of current end-of-life care needs and care practices in acute care hospitals: final report of an investigationThurston, Amy J Unknown Date
No description available.
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Chart review of current end-of-life care needs and care practices in acute care hospitals: final report of an investigationThurston, Amy J 06 1900 (has links)
A total of 1,018 charts of people who died from August 1, 2008 through July 31, 2009 were reviewed to describe and examine current end-of-life care needs and care practices provided in two acute care hospitals. The mean age of those who died was 72.5, the majority of decedents were elderly (73.8%), a slight majority were male (53.0%), a slight majority were not married (53.0%), and most were urbanites (79.5%). The most common primary diagnosis was cancer (36.2%). More than half of deaths were expected (54.6%). Only 40.3% of those who had an expected death had a palliative care referral. Of all decedents, 13.8% had CPR performed, and a total of 13.9% of people died without having a DNR order. A written will was provided in 30.8% of cases. Most had technologies in use at the time of death (97.3%). Of those who died with pain, most received analgesia (98.6%).
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Projetos de cuidado em Fisioterapia / Healthcare projects in physiotherapyLarissa de Siqueira Fernandes 29 April 2011 (has links)
Conselho Nacional de Desenvolvimento Científico e Tecnológico / As práticas de cuidado em fisioterapia, em muitas situações, resgatam a função do fisioterapeuta de executor de técnicas que lhe era atribuída nos primórdios da profissão. Ao exercer essa função meramente técnica, muitas vezes deixando-se
substituir pelo equipamento nas suas ações, o profissional compromete o estabelecimento do vínculo terapeuta-paciente, contribuindo para o esvaziamento do encontro em saúde. Nessas situações, predomina o êxito técnico (a eficiência na realização do procedimento) sobre o sucesso prático (os benefícios trazidos para vida das pessoas). Para que o sucesso prático seja atingido, é fundamental que haja o questionamento sobre o que sonham as pessoas, profissionais e pacientes, para as suas vidas e para a saúde, quais são suas perspectivas e projetos de vida, seus projetos de felicidade. Nesse sentido, é imprescindível considerar, também, os projetos de felicidade dos profissionais da saúde enquanto sujeitos desse encontro. Afinal, é a partir deles que o profissional elabora o seu projeto de cuidado para cada paciente. Assim, esse trabalho buscou compreender os elementos que configuram a construção de projetos de cuidado em fisioterapia a partir da reflexão dos próprios fisioterapeutas. Para tanto, utilizou-se a metodologia qualitativa de pesquisa por meio de entrevistas semi-estruturadas para que fossem produzidas narrativas da história de vida do trabalho. Os discursos foram analisados integralmente e a categorização foi
feita em três sub-temas: exercício profissional, relação com os pacientes e reflexões. Foi possível perceber que muitos dos arranjos de trabalho estabelecidos visam coibir o vínculo profissional-paciente, transformando-o em valor de troca e mercantilizando a relação terapêutica. Expropriada do vínculo, a prática se resume à realização de procedimentos independentes de sua finalidade, minando as possibilidades de sucesso prático. Nesse caso, não é a tecnologia que gera o afastamento e a mecanização, mas são as estratégias de mercantilização do cuidado fisioterápico. Essa situação só pode ocorrer por um processo de subordinação do profissional e seu saber, o que está
fortemente associado a condições de trabalho exploratórias. Podemos dizer que a mercantilização do cuidado facilita a restrição sobre as condições de trabalho e também é fruto dela. O problema é que essa restrição é vista pelos profissionais como não definitiva, mas como um caminho para se alcançar reconhecimento na busca pelo exercício liberal da fisioterapia. A intenção desse estudo não foi traçar um plano normativo de conduta para a profissão, mas imaginamos que o equacionamento dessas questões passa necessariamente pelo reconhecimento, pelas inquietações e indignações com o problema. O que se espera, portanto, é facilitar esse processo de
desconforto por meio da proximidade dessas questões trazidas pelas narrativas. / Despite the historical fight to prove themselves as health professionals, in many situations physiotherapy care practices bring to surface the physiotherapist‟s function of a mere executor of practical techniques, which used to be attributed to them at the very beginning of their profession. However, when the practice resumes to a set of techniques and the treatment consist of a routine of mechanical acts, the physiotherapist
compromises the relationship therapist-patient, leading to a tangent out of healthcare principles. The described situation favor the technical success, measured by the efficiency in the execution, with detriment to the overall success of the practical success, measured by the benefits the treatment brings to the health of patients. To achieve practical success, it is fundamental to question what people (both professionals and
patients) dream for their lives, health and what are their life and success projects. In that regard, it is mandatory that healthcare professionals consider their objectives and goals, since they are the starting point for therapeutic plans and each individuals care project. This works investigates deeply the elements that compose the construction of physiotherapy care plans, starting with the reflection of the physiotherapists themselves. A qualitative methodology based semi-structured interviews gathered evidence of life and work of professionals. The answers were analyzed as a whole and three categories
were identified: professional practices, relationship patient doctor and reflections. The answers pointed that the current practices aims to eliminate the relationship professional-patient, transforming the professional in a mere service provider instead of
a care provider. Deprived from the relationship, the practice resumes to a collection of independent procedures and undermining any possibility of practical success. In that
case, it is not the technique that originates the mechanization, but the economics underlying the physiotherapeutic care. This situation can only happen through a process of subordination of the professional and his domain of knowledge, which are strongly
correlated to exploratory and predatory working conditions. The monetary policy underlying the care which facilitates the restriction over the work conditions it is also a result of those working conditions, in a vicious cycle. The problem is that this restriction is viewed by professionals not as permanent, but as a stepping stone to reach recognition in the pursuit of the independent practice of physiotherapy. The intention of
this study is not to create a norm of professional conduct, but to provide an outline of possible answers to the raised questions to: recognition, anxieties and concerns. This study aims to facilitate the process of assessment that pushes professionals out of their comfort zone.
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Do encontro ao sentido: o cuidado aos sujeitos adoecidos de câncer / From the muting to the meaning: care to the subjects with cancerFernanda Azevedo de Souza 29 April 2011 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Esta pesquisa objetivou compreender como se dão as práticas de cuidado dirigidas ao sujeito adoecido de câncer no cotidiano dos serviços de saúde. Para tanto, partimos do entendimento que o processo de adoecer traz repercussões nos modos de andar a vida dos sujeitos, especialmente no que diz respeito ao câncer, patologia que traz consigo metáforas ligadas à morte, sofrimento e dor. Ao dar início à busca pelos serviços de saúde, os sujeitos se deparam com uma série de entraves que podem não proporcionar alívio, não suprindo as necessidades que essa nova condição impõe. Encontramos, em muitos momentos, práticas que negam o caráter subjetivo da experiência da doença, não valorizando a narrativa dos sujeitos. Como trajetória metodológica, escolhemos desenvolver um estudo de natureza qualitativa, utilizando como instrumento privilegiado a entrevista semi aberta. Iniciamos as entrevistas com a consigna: conte como se deu o tratamento de sua doença desde a descoberta até o momento em que se encontra. Os dados coletados a partir do encontro com os sujeitos adoecidos foram complementados por informações contidas nos prontuários médicos, bem como por observações obtidas no momento da interação. O local de realização da pesquisa foi um hospital estadual de grande porte localizado na cidade de Fortaleza, estado do Ceará. As entrevistas foram realizadas no serviço de oncologia clínica do referido hospital. Ao todo foram entrevistados doze sujeitos que estavam em tratamento ambulatorial no serviço. Dos doze sujeitos, cinco eram mulheres e sete eram homens. As idades variaram de 29 a 65 anos. A análise dos dados se deu após imersão no material empírico, posteriormente materializado nas transcrições das entrevistas. Procuramos deixar que os sentidos aflorassem, confrontando com o material que já tínhamos disponível, surgindo daí as categorias empíricas. Dividimos as categorias em duas dimensões, a do sujeito e a da rede de serviços de saúde. Ao final da análise, constatamos alguns pontos que consideramos importantes no sentido de se tornarem dispositivos de mudança. Foi possível confirmar que os sujeitos sabem de si, e realizam um processo de construção do sentido sobre sua doença e das práticas terapêuticas. A doença produz mudanças no sujeito, e os força a ressignificarem sua rotina e hábitos de vida. Foi possível observar que o encontro com os serviços de saúde tem se dado de forma truncada. A luta pelo direito a saúde é árdua: pela demora na confirmação do diagnóstico, pela demora em conseguir marcar exames e receber seus resultados, pela falta de especialistas que saibam o que estão fazendo. Os sujeitos têm descoberto a doença quando esta se encontra avançada. A importância do diálogo, da escuta, da percepção do que o outro necessita é importante, por isso, valorizar os relatos dos sujeitos adoecidos de câncer se faz urgente. / This research aimed to understand how to give care practices directed at the subject ill with cancer in everyday health services. To this end we start from the understanding on how the process of disease acts changing the subjects ways of living. Especially regarding to cancer, a pathology that brings metaphors related to death, suffering and pain. By starting the search for health services, individuals are faced with a series of obstacles that can not provide relief, not supplying the needs that this new condition requires. We found many times practices that deny the subjective experience of illness, not valuing the narrative of the subjects. As methodology chosen to develop a qualitative study, using as a privileged instrument to semi open. We began the interviews with the slogan: "Tell how was the treatment of their disease from discovery to the time that is." Data collected from the encounter with the sick subjects were supplemented by information contained in medical records and the observations obtained at the time of interaction. The venue for the research was a large state hospital in the city of Fortaleza, Ceara state. The interviews were conducted in the oncology department of the hospital clinic. In all twelve subjects were interviewed who were in outpatient treatment service. Five subjects were women and seven were men. The ages ranged from 29 to 65 years. Data analysis was carried out after immersion in the empirical material, later embodied in the interview transcript. We tried to let the senses to flourish, struggling with the material we had available, there came the empirical categories. We divide the categories into two dimensions, the subject and the network of health services. After the analysis some important points were found to consider in order to make devices change. It was confirmed that the individuals know themselves, and perform a process of constructing meaning about their illness and medical treatment. The disease produces changes in the subjects that forced them to rethink their routine and lifestyle. It seems that the encounter with the health service has been given in a truncated form. The fight for the right to health is difficult: the delay in confirming the diagnosis, the delay in getting dial and receive their exam results, lack of specialists who know what they are doing. The subjects have discovered the disease when it is advanced. The importance of dialogue, listening, perception of what the other needs is important, so to give real value at the reports of sick subjects of cancer is urgent.
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