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Aten??o ao usu?rio em um centro de refer?ncia HIV/Aids: perspectiva de profissionais e usu?rios

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Previous issue date: 2009-11-30 / We study the health care focused on care in an intercessor and dialogical relationship with the User, which involves the construction of therapeutic projects essential to the quality of the treatment of the user in health services, and it is necessary individual and collective actions. It is intended to acknowledge and analyze the perception of social subjects, users and professionals on the treatment given to a user of a Specialized Outpatient Service (Servi?o Ambulatorial Especializado SAE) in STD/HIV/AIDS state reference in Natal, RN. The study is structured in a transdisciplinary vision of science and knowledge, theoretical and methodological principles that give meaning to the expression of the institutional features of care and health care reconnecting them to the social context. As a research strategy we seek the expressions of 56 subjects of social research, which agreed to participate in the sample, from a symbolic map of the attention, coupled with the techniques of observation and semi-structured interview. For the analysis of the results, five categories of analysis were established: the meaning of the service, care perception, process of communication and interaction, treatment perception and organization and evaluation of the service. It is argued that the attention and care are developed in a technical health care assistance to the disease, focusing on attention based on treatment, on diagnostic and drug therapy of antiretroviral drugs, reflecting the traditional biomedical paradigm of attention to the disease. This is also the mode of organization of practical actions in daily SAE: the therapy proves to be fragmented in several specialties, vertical and feeds the same model, generating tension and overload for professionals; showing impersonal care focused on structured and informative technology, unrelated to an interactive dialogic. From the speech of the subjects, the SAE is understood as the place of confrontation with the disease, but also enables greater elaboration of the illness by meeting their peers. Living with HIV and AIDS is living with concern, apprehension and fear, but mainly with the stigma, prejudice and exclusion, which require that the disease is kept in secret. There is a movement of forces and power, expressed in the knowledge-power of those who dominate the technical and administrative capabilities, devices that concentrate the maintenance of the medicalization of care, rapid consultations and with little attention, making it difficult to interact with and listen to, combined with structural failures, organizational and inadequate management of the service. We conclude that there are dimensions that are not considered in the internal dynamics of the care service multiple forms, characterized by care conflicting models, marked by individual interventions related to the disease. The subject is not considered together with his speech as technical discourse is imposed and care production based on material technology is observed / Estuda-se a aten??o ? sa?de centrada no cuidar, em uma rela??o intercessora e dial?gica com o usu?rio, que envolve a constru??o de projetos terap?uticos essenciais para a qualidade do tratamento do usu?rio nos servi?os de sa?de, sendo fundamentais a??es individuais e coletivas. Tem-se como objetivo conhecer e analisar a percep??o dos sujeitos sociais, usu?rios e profissionais, sobre o tratamento dispensado ao usu?rio de um Servi?o Ambulatorial Especializado em DST/HIV/Aids, refer?ncia estadual em Natal, RN. Articulam-se, em uma vis?o transdisciplinar da ci?ncia e do conhecimento, referenciais te?rico-metodol?gicos que possam dar sentido ? express?o das caracter?sticas institucionais da aten??o e do cuidado em sa?de, religando-as ao contexto social. Como estrat?gia de pesquisa, buscam-se as express?es dos 56 sujeitos sociais da investiga??o, que aceitaram participar da amostra, a partir de uma cartografia simb?lica da aten??o, associada a t?cnicas de observa??o e entrevista semi-estruturada. Para an?lise dos resultados, estabeleceram-se cinco categorias de an?lise: significado do servi?o, percep??o do atendimento; processo de comunica??o e intera??o; percep??o do tratamento e organiza??o e avalia??o do servi?o. Discute-se que a aten??o e o cuidado desenvolvem-se em uma assist?ncia tecno-assistencial ? doen?a, centrados em uma aten??o focada no tratamento, na solicita??o de exames e na terap?utica medicamentosa dos anti-retrovirais, reflexo do paradigma tradicional biom?dico de aten??o ? doen?a. Este tamb?m ? o modo de organiza??o das a??es pr?ticas no cotidiano do SAE: a conduta terap?utica mostra-se fragmentada nas diversas especialidades, verticalizada e retro-alimentada no mesmo modelo, gerando tens?o e sobrecarga aos profissionais; evidenciam-se atendimentos impessoais focados em tecnologias estruturadas e informativas, desvinculadas da dial?gica interativa. A partir dos discursos dos sujeitos, o SAE ? interpretado como o lugar do confronto com a doen?a, mas tamb?m possibilita maiores elabora??es do adoecer pelo encontro com os iguais. Conviver com o HIV e Aids ? conviver com receios, apreens?o e medo, mas principalmente com o estigma, o preconceito e a exclus?o, o que requer o sigilo da doen?a. H? circula??o de for?as e de poder, expressos no saber-poder t?cnico-profissional e administrativo, dispositivos que concentram a manuten??o da medicaliza??o do atendimento, consultas r?pidas e com pouca aten??o, o que dificulta a intera??o e a escuta, aliados a falhas estruturais, organizacionais e a um gerenciamento inadequado do servi?o. Conclui-se que h? dimens?es n?o consideradas na din?mica interna das m?ltiplas formas do cuidar, caracterizado pelo modelo conflitante da aten??o, marcado por interven??es individuais relacionadas ? doen?a. Desconsidera-se o sujeito de seu discurso, imputando-lhe discursos tecnicistas, e observa-se a produ??o do cuidado baseada na tecnologia material

Identiferoai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/13572
Date30 November 2009
CreatorsCarvalho, Ana L?cia de Souza
ContributorsCPF:12852929449, GICO, V. V., Souza, Lincoln Moraes de, CPF:05944538368, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4794937H2, Barros, Denise Dias, CPF:03715916869, http://lattes.cnpq.br/6607056840278610, Gico, Vania de Vasconcelos
PublisherUniversidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Ci?ncias Sociais, UFRN, BR, Desenvolvimento Regional; Cultura e Representa??es
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN
Rightsinfo:eu-repo/semantics/openAccess

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