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Previous issue date: 2014-01-13 / Breast cancer is one the most prevalent types of cancer among women. Many causes are
known, ranging from the biological to the psychosocial. In Rio Grande do Sul, especially in
Porto Alegre, occurrence rates and fatalities due to breast cancer are some of the highest in
the country. In 2004, in an attempt to remedy this situation, a service dedicated to keeping the
breast healthy was created: the N?cleo Mama Porto Alegre (NMPOA) project. It registered
9218 women for a follow-up program that involved mammographic screening for ten years,
seeking early diagnosis as well as increasing awareness of the need for annual
mammographies. The geographic area chosen for this service was a southern region of the
city of Porto Alegre in which the greatest social vulnerability and poorest health services were
observed. As part of this project, work was undertaken to act on the risk factors for breast
cancer through interventions in the psychosocial field. The psychology department
contributes to the project by pluralizing the understanding of the disease, adding to the
already consolidated biomedical knowledgebase by viewing the disease not only as an
individual's experience, but as a collective phenomenon permeated by social agents. From this
context emerge the objectives of this study: identifying the preventative, self-care measures
taken by these women and analyzing the configurations of their support networks. This
project uses a mixed research approach, combining both qualitative and quantitative methods.
The first stage is a quantitative study utilizing techniques for the evaluation of self-care
capacity and for analyzing social support by way of the "Evaluation of Perceived Social and
Community Support" questionnaire. One hundred and nine women participating in the
NMPOA, divided into two groups, answered this questionnaire: a group of 37 who had breast
cancer and a group of 72 who underwent annual mammographies but had never been
diagnosed with the disease. After this quantitative stage, the second stage - composed of
narrative, biographical interviews - was started. The women who presented the most extreme
self-care and support network scores were invited to participate in this stage, extreme
meaning the lowest and highest levels of self-care and support networks in the quantitative
stage. The data collected in the study indicates that women who had breast cancer practiced
better self-care (t=1.791; p=0.027). Thus, reinforced by the qualitative data, it can be stated
that breast cancer diagnosis plays a key role in seeding self-care, in spite of the obvious health
risks and fragile support networks. As for social support, the groups do not differ, presenting
approximately the same thresholds in the average social support classification level for the
majority of the evaluated variables. In the qualitative study, however, the social support
received by women who had breast cancer came mainly from family and less from formal
institutions and communal efforts. / O c?ncer de mama ocupa um importante espa?o nas Pol?ticas de Sa?de devido a sua alta
preval?ncia entre as mulheres. Sabe-se de m?ltiplos fatores, indo do campo biol?gico ao
psicossocial. No Rio Grande do Sul e, especialmente em Porto Alegre, as taxas de incid?ncia
e mortalidade por c?ncer de mama est?o entre as maiores do pa?s. Diante desse cen?rio, em
2004 foi criado um servi?o de aten??o ? sa?de da mama - Projeto N?cleo Mama Porto Alegre
(NMPOA), que cadastrou 9218 mulheres para acompanhamento em formato de rastreamento
mamogr?fico por dez anos e, dessa forma, buscar um diagn?stico precoce, al?m de aumentar a
conscientiza??o sobre necessidade da mamografia anual. A ?rea geogr?fica escolhida para
constru??o deste servi?o foi a regi?o sul da cidade de Porto Alegre, na qual era observada
maior vulnerabilidade social e menor cobertura de servi?os de sa?de. Insere-se nesse projeto,
um trabalho de atua??o sobre os fatores de risco da doen?a com interven??es no campo
psicossocial. O servi?o de psicologia, no tocante ao ?ltimo item citado, contribui no sentido
de pluralizar a compreens?o acerca da doen?a agregando para al?m do j? consolidado saber
biom?dico ? o entendimento da doen?a n?o apenas como uma experi?ncia individual, mas
tamb?m como um fen?meno de inser??o coletiva. Ap?s apresenta??o deste contexto,
emergem como objetivos de pesquisa: identificar as pr?ticas preventivas de autocuidado
dessas mulheres; e analisar as configura??es da rede de apoio que as circundam. Dessa forma,
o projeto utiliza de delineamento misto de pesquisa, contemplando as abordagens qualitativa e
quantitativa. A primeira etapa corresponde a um estudo quantitativo e utiliza instrumentos
para avaliar a capacidade de autocuidado e para analisar o apoio social por meio de um
question?rio de Avalia??o do Apoio Social Percebido e Comunit?rio. Responderam a esses
instrumentos 109 mulheres participantes do NMPOA, dentre elas, um grupo de 37 mulheres
que tiveram c?ncer de mama e 72 mulheres que fazem mamografia anual e que nunca tiveram
diagn?stico de c?ncer de mama. Ap?s essa etapa quantitativa, iniciou-se a segunda parte do
estudo, composta por entrevistas biogr?ficas de car?ter narrativo. Foram convidadas a
participar dessa segunda etapa as mulheres que apresentaram escores extremos de
autocuidado e apoio social, ou seja, as entrevistadas que tiveram os maiores e os menores
n?veis de autocuidado e apoio social na etapa quantitativa. O conjunto de informa??es dos
estudos ressalta que as mulheres que tiveram c?ncer de mama apresentam melhores pr?ticas
de autocuidado do que as mulheres do rastreamento (t=1,791; p=0,027). Assim, refor?ado
pelos dados qualitativos, pode-se identificar que o diagn?stico do c?ncer de mama em suas
vidas exerceu um papel chave no despertar para pr?ticas de autocuidado apesar dos ?bvios
riscos para a sa?de e das viv?ncias de apoio fragilizado. Quanto ao apoio social, os grupos
n?o se diferem, apresentando pontos de corte aproximados com classifica??o de n?vel m?dio
de apoio social na maioria dos itens avaliados. No estudo qualitativo, no entanto, o apoio
social das mulheres que tiveram c?ncer de mama ? provindo principalmente da fam?lia e em
menor medida das institui??es formais e das estrat?gias comunit?rias.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/6531 |
| Date | 13 January 2014 |
| Creators | Hermel, J?lia Schneider |
| Contributors | Pizzinato, Adolfo |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Psicologia, PUCRS, Brasil, Faculdade de Psicologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2588426296948062698, 600, 600, 600, 2599381623216554467, 3411867255817377423 |
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