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Previous issue date: 2010-02-22 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The practice of medicine related to the gestational processes tend to be organized
according to the context and the place of work, being thus dependent of the conditions
both social and economical, and of the physical structure and the functionality of the
services. The high mortality rate in this process has diminished, since 1986, the study
made by the World Health Organization (WHO) as to the technical aspects and the
social inequalities that influence this situation in different geographical contexts. This
culminated recommendations that proposed the reorientation of the dynamical practice
of medicine, with a focus on the safety of maternities. Brazil adopted, in the year 2000,
the suggestions of the OMS, emphasizing the humanization as the main reason for these
actions. However, this discussion tends to not consider the problems caused by the
social inequalities and the epidemiological and social conditionings that define the
actions of the Unified Health System (Sistema ?nico de Sa?de SUS). In this area, this
research seeks to analyze the practices, cares taken, and the universal symbol that
promotes and rewards the assistance to the birth of children by the SUS. Besides the
analysis of the public documents that deal with this subject, an ethnographic study was
developed in a maternity in Natal/RN, considered a model of humanization after
receiving the Galba de Ara?jo prize in 2002. In this stage, the methodological strategies
were observed, and the focus of the individual interviews with workers and users of this
service. In the analysis of the data, it became evident that the different professional
workers and women who gave birth, tend to show concern of the standards the delimit
production and reproduction of the practice of medicine, as they favor the absence of a
critical posture of the actions destined to the population. Besides this, if became evident
that the institutional difficulties associated to the economical, cultural, and political
problems also difficult the involvement and the reflection of the workers in favor of
assisting changes of the process. There is also a utilization of a perspective prescriptive
of humanization in the everyday life of the social workers, without reflection of its
meaning. Some workers present, in their statements, a preoccupation with the social and
economical aspects that affect the practice of medicine, and with the limitations of the
humanization discourse that disarticulates the necessities of those involved in the
process of formation, and soon tend to return to the discussion of humanization while a
kind practice characterized by the minimization of the interventionist actions. Now the
users of the system show themselves before the dynamic of the services, submitting
themselves to what is offered while assistance, without questioning and/or reflecting
about their usual shortages. Therefore, to think of changes in the know and do of the
practice of medicine destined to the birth of children implies reflection on the quotidian
production of these practices and of the social contexts that influence the process of
assistance in the practice of medicine. Herein it would be possible to predict the
appropriation, by different workers concerning their exasperations and necessities,
making them active in the pursuit of their rights as citizens / As pr?ticas em sa?de relacionadas ao processo gestacional tendem a se organizar de
acordo com o contexto e os espa?os assistenciais, os quais s?o dependentes das
condi??es socioecon?micas e da estrutura f?sica e funcional dos servi?os. A elevada
morbimortalidade nesse processo desencadeou, desde 1986, a reflex?o pela Organiza??o
Mundial de Sa?de (OMS) quanto aos aspectos t?cnicos e ?s iniquidades sociais que
influenciam essa situa??o em diferentes contextos, culminando nas recomenda??es que
propunham a reorienta??o da din?mica assistencial com foco na maternidade segura. O
Brasil adota, no ano 2000, as sugest?es da OMS, enfatizando a humaniza??o como eixo
orientador das a??es. Contudo, essa discuss?o tende a desconsiderar os problemas das
iniquidades locais e os condicionantes epidemiol?gicos e sociais que definem as a??es
no Sistema ?nico de Sa?de (SUS). Nesse sentido, esta pesquisa objetivou analisar as
pr?ticas discursivas nas a??es de trabalhadores e usu?rias da Maternidade de Felipe
Camar?o em face da organiza??o do cuidado na perspectiva da humaniza??o do parto e
do nascimento no contexto institucional de uma maternidade p?blica. Ent?o, al?m da
an?lise dos documentos p?blicos que lidam com essa tem?tica, foi desenvolvido um
estudo etnogr?fico em uma maternidade em Natal (RN), considerada modelo para a
humaniza??o ap?s ter recebido o pr?mio Galba de Ara?jo, em 2002. Nessa etapa, as
estrat?gias metodol?gicas foram a observa??o participante, o grupo focal e a pr?tica da
entrevista individual com trabalhadores e usu?rias do servi?o. Na an?lise dos dados,
evidenciou-se que os diferentes atores, os profissionais e as mulheres em parturi??o,
tendem a mostrarem-se alheios aos contextos que delimitam a produ??o e reprodu??o
das pr?ticas em sa?de, o que favorece a aus?ncia de uma postura cr?tica diante das a??es
destinadas ? popula??o. Al?m disso, ficou evidente que as dificuldades institucionais,
associadas ?s quest?es econ?micas, culturais, pol?ticas e de gest?o, tamb?m dificultam o
envolvimento e a reflex?o dos trabalhadores em favor de mudan?as assistenciais para o
processo. H? tamb?m a utiliza??o de uma perspectiva prescritiva da humaniza??o no
fazer cotidiano desses atores sociais, sem uma reflex?o cr?tica acerca do seu significado.
Alguns trabalhadores apresentam em seus posicionamentos uma preocupa??o com os
aspectos sociais e econ?micos que afetam as pr?ticas em sa?de e com as limita??es do
discurso humanizador, que desarticula as necessidades dos envolvidos nesse contexto.
Todavia, possivelmente por quest?es culturais e relacionadas ao processo de forma??o,
logo tendem a retornar ao discurso da humaniza??o enquanto pr?tica caridosa
caracterizada pela minimiza??o das a??es intervencionistas. J? as usu?rias mostram-se
passivas diante da din?mica dos servi?os, submetendo-se ao que lhes ? oferecido
enquanto assist?ncia, sem questionar e/ou refletir acerca das suas car?ncias usuais.
Assim, pensar em mudan?as no saber/fazer em sa?de destinadas ao parto e ao
nascimento implica refletir a produ??o cotidiana dessas pr?ticas e os contextos sociais
que influenciam o processo assistencial em sa?de. Dessa forma, seria poss?vel antever a
apropria??o, pelos diferentes atores, dos seus anseios e necessidades, fazendo-os ativos
na busca pelos seus direitos de cidadania
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/17585 |
| Date | 22 February 2010 |
| Creators | Morais, Fatima Raquel Rosado |
| Contributors | CPF:00870893432, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4703134T0, Moreira, Simone da N?brega Tom?z, CPF:00082593485, http://lattes.cnpq.br/3642294168997314, Bastos, Ana Cec?lia de Sousa Bittencourt, CPF:11867949504, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4780268A4&dataRevisao=null, Oliveira, Isabel Fernandes de, CPF:77891120444, Silva, Raimunda Magalh?es da, CPF:04693540382, http://lattes.cnpq.br/8577652222943813, Traverso-y?pez, Martha Azucena |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Psicologia Social, UFRN, BR, Psicologia Social; Processos Psicossociais; Rela??es de Poder e Sociedade |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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