Maria Cristina Silva Costa

The meanings of quality of life: interpretative analysis based on experiences of people in burns rehabilitation

Con el objetivo de interpretar los significados para la calidad de vida, este estudio parte de la atribucion dada por personas que sufrieron quemaduras graves, sus experiencias y su contexto sociocultural. El metodo etnografico fue utilizado apoyado en la teoria hermeneutica moderna. Participaron del estudio 19 pacientes con secuelas de quemadura y sus familiares, atendidos en la Unidad de Quemados del Hospital de Clinicas de la Facultad de Medicina de Ribeirao Preto. Los sujetos pertenecian al sector popular, con edades entre 18 y 50 anos, participantes del programa de rehabilitacion por lo menos un ano. Los datos recolectados a traves de entrevistas semi-estructuradas y observacion directa; siendo su analisis realizado a traves de la identificacion de unidades de significados y construccion de nucleos tematicos. Los pacientes y sus familiares mencionaron cambios en su calidad de vida debidos a sus limitaciones fisicas y psiquicas por la quemadura. La calidad de vida asociada al desempeno de los roles sociales fue estructurada en base a los nucleos: familia, trabajo, autonomia, normalidad e integracion social.This research aimed to interpret the meanings of quality of life, taking into consideration the meanings attributed by those who have undergone serious burns, their experiences and social/cultural background. We used the ethnographic method based on modern hermeneutics. Nineteen patients with burn sequelae, already discharged from the Burns Unit of the Ribeirão Preto Medical School Clinical Hospital participated in this study, along with their relatives. Participants belong to the working class, are between 18 to 50 years old and have been in rehabilitation for at least a year. Data were collected by direct observation and semi-structured interviews. The analysis was processed through the identification of units of meanings and construction of thematic nucleuses. Patients and relatives reported that quality of life had changed because of physical and psychological limitations caused by the burns. The meanings of quality of life are associated with the performance of social roles and are guided by family, work, normality, autonomy and social integration.Com o objetivo de interpretar os significados de qualidade de vida, este estudo considera os sentidos atribuidos por pessoas que sofreram queimaduras graves, suas experiencias e contexto sociocultural. Utilizou-se o metodo etnografico com apoio teorico da hermeneutica moderna. Participaram 19 pacientes com sequelas de queimadura, atendidos pela Unidade de Queimados do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, e seus familiares. Pertencentes as classes populares, os sujeitos, com idade entre 18 e 50 anos, integram programa de reabilitacao ha um ano ou mais. A analise dos dados, coletados por entrevistas semi-estruturadas e observacao direta, processou-se pela identificacao de unidades de significados e construcao de nucleos tematicos. Pacientes e familiares relataram modificacoes da qualidade de vida introduzidas por limitacoes fisicas e psiquicas provocadas pela queimadura. Qualidade de vida, associada ao desempenho de papeis sociais, estrutura-se em torno dos nucleos: familia, trabalho, autonomia, normalidade e integracao social.

Experiência da doença cardíaca entre adultos submetidos à revascularização do miocárdio

OBJECTIVE To evaluate the meanings of heart disease experience in patients undergoing rehabilitation post-coronary artery bypass grafting surgery. METHODS Ethnographic study carried out between 2003 and 2005 in the city Goiânia, Central-West Brazil. Direct observation and in-depth interviews were conducted in 11 patients undergoing rehabilitation post- coronary artery bypass grafting surgery. Using an interpretative anthropology approach, data were gathered in narrative documents and analyzed through the identification of units of meanings and thematic groups. RESULTS Disease-related meanings included heart disease realization, triggered feelings, formulated explanations, surgery acceptance and post-surgery life. Heart disease experience was understood as a biographic rupture, a situation between life and death, disability, loss of autonomy, inability to work. The meanings, analytically constructed, followed a logic that articulated common sense, religion and fragments of medical discourse for the understanding of disease and surgery. CONCLUSIONS The study results showed that heart disease and surgery experience mark a rupture in the patients lifestyle, work and their understanding of the health-disease process. The disease experience approach contributes to transcend the limits of a medical model based on disease, its symptoms and causes, and characterized by a biomedical understanding of the health-disease process focused on biological and/or psychological malfunctioning.OBJETIVO:Analisar os significados da experiencia da enfermidade cardiaca e de seu tratamento entre individuos em processo de reabilitacao da cirurgia de revascularizacao do miocardio. METODOS:Estudo etnografico realizado entre 2003 e 2005, em Goiânia, GO. Foram realizadas observacao direta e entrevistas em profundidade com 11 individuos em reabilitacao de cirurgia de revascularizacao do miocardio. Com base na antropologia interpretativa, os dados foram reunidos em dossies narrativos e analisados por meio da elaboracao de unidades de significados e nucleos tematicos. RESULTADOS:Os sentidos atribuidos a enfermidade relacionaram-se a: descoberta da doenca cardiaca, sentimentos desencadeados, explicacoes formuladas, aceitacao da cirurgia e vida pos-cirurgia. A experiencia foi interpretada como ruptura biografica, situacao entre a vida e a morte, invalidez, perda de autonomia e incapacidade de trabalhar. Os significados remeteram a uma logica que articula senso comum, religiao e fragmentos do discurso medico na compreensao da doenca e da cirurgia cardiaca. CONCLUSOES:Os resultados revelam que as experiencias da doenca e da cirurgia cardiacas marcam uma ruptura no modo de viver, trabalhar e compreender o processo saude-doenca. A abordagem da experiencia da doenca cardiaca contribui para extrapolar os limites de um modelo centrado na doenca, seus sintomas e causas, caracteristico do entendimento biomedico do processo saude-doenca, cujo foco e o mau funcionamento do processo biologico e/ou psicologico.

Heart disease experience of adults undergoing coronary artery bypass grafting surgery

OBJECTIVE To evaluate the meanings of heart disease experience in patients undergoing rehabilitation post-coronary artery bypass grafting surgery. METHODS Ethnographic study carried out between 2003 and 2005 in the city Goiânia, Central-West Brazil. Direct observation and in-depth interviews were conducted in 11 patients undergoing rehabilitation post- coronary artery bypass grafting surgery. Using an interpretative anthropology approach, data were gathered in narrative documents and analyzed through the identification of units of meanings and thematic groups. RESULTS Disease-related meanings included heart disease realization, triggered feelings, formulated explanations, surgery acceptance and post-surgery life. Heart disease experience was understood as a biographic rupture, a situation between life and death, disability, loss of autonomy, inability to work. The meanings, analytically constructed, followed a logic that articulated common sense, religion and fragments of medical discourse for the understanding of disease and surgery. CONCLUSIONS The study results showed that heart disease and surgery experience mark a rupture in the patients lifestyle, work and their understanding of the health-disease process. The disease experience approach contributes to transcend the limits of a medical model based on disease, its symptoms and causes, and characterized by a biomedical understanding of the health-disease process focused on biological and/or psychological malfunctioning.OBJETIVO:Analisar os significados da experiencia da enfermidade cardiaca e de seu tratamento entre individuos em processo de reabilitacao da cirurgia de revascularizacao do miocardio. METODOS:Estudo etnografico realizado entre 2003 e 2005, em Goiânia, GO. Foram realizadas observacao direta e entrevistas em profundidade com 11 individuos em reabilitacao de cirurgia de revascularizacao do miocardio. Com base na antropologia interpretativa, os dados foram reunidos em dossies narrativos e analisados por meio da elaboracao de unidades de significados e nucleos tematicos. RESULTADOS:Os sentidos atribuidos a enfermidade relacionaram-se a: descoberta da doenca cardiaca, sentimentos desencadeados, explicacoes formuladas, aceitacao da cirurgia e vida pos-cirurgia. A experiencia foi interpretada como ruptura biografica, situacao entre a vida e a morte, invalidez, perda de autonomia e incapacidade de trabalhar. Os significados remeteram a uma logica que articula senso comum, religiao e fragmentos do discurso medico na compreensao da doenca e da cirurgia cardiaca. CONCLUSOES:Os resultados revelam que as experiencias da doenca e da cirurgia cardiacas marcam uma ruptura no modo de viver, trabalhar e compreender o processo saude-doenca. A abordagem da experiencia da doenca cardiaca contribui para extrapolar os limites de um modelo centrado na doenca, seus sintomas e causas, caracteristico do entendimento biomedico do processo saude-doenca, cujo foco e o mau funcionamento do processo biologico e/ou psicologico.

Qualidade de vida após revascularização do miocárdio: avaliação segundo duas perspectivas metodológicas

Objective: To analyze the quality of life (QL) as proposed by Flanagan, in two groups of revascularized patients; to compare and combine results from this research with data from an ethnography study that interprets the meanings that revascularized patients gave to QL. Method: The methodological triangulation was used in two researches: one qualitative (ethnographic) and the other quantitative; the scale of Flanagan was applied in 124 individuals. Results: In the quantitative study the QL was related to “bear and raise children” and “relationships with friends”; in the qualitative study a good QL was related to wellbeing, happiness, satisfaction, opportunities in life. The identified issues were: health (physical, emotional and spiritual), work and family harmony. Conclusion: The dimensions of quality of life identified in the ethnographic study were similar to the domains of Flanagan’s QL-Scale. The spirituality/religiosity, not contemplated in the scale, is highlighted by participants as an aspect of the QL.OBJECTIVE: To analyze the quality of life (QL) as proposed by Flanagan, in two groups of revascularized patients; to compare and combine results from this research with data from an ethnography study that interprets the meanings that revascularized patients gave to QL. METHOD: The methodological triangulation was used in two researches: one qualitative (ethnographic) and the other quantitative; the scale of Flanagan was applied in 124 individuals. RESULTS: In the quantitative study the QL was related to “bear and raise [...]

MEANINGS REGARDING THE USE OF ALCOHOL IN FAMILIES OF A VENEZUELAN POOR COMMUNITY

This study is the result of an ethnographic research based on interpretative anthropology. It aims to interpret the meanings of alcohol misuse in families from a poor Venezuelan community. Twenty members from six families participated in the study. The results show differences between meanings children and parents held regarding alcohol consumption. Children held a more positive view, whereas mothers presented the lowest acceptation of alcohol consumption. Meanings were more convergent than divergent, which allowed the identification of the following units: excessive consumption, intoxication, and joy. The association of alcohol with parties and joy is the main motivation to drink and the main barrier to change drinking habits. Two units of meaning were identified: a continuum between normal and pathologic drinking; and concept of joy subordinated to alcohol consumption.Resultado de pesquisa etnografica, sob a otica da antropologia interpretativa. Este trabalho objetiva interpretar significados do consumo de alcool em familias de uma comunidade pobre venezuelana. Seis familias foram pesquisadas, totalizando 20 participantes. Os resultados mostram diferencas entre pais, maes, e filhos, na atribuicao dada aos significados do consumo de alcool, tendo uma visao mais valorativa dos filhos, e menor aceitacao entre as maes. As convergencias de sentidos foram mais frequentes que as diferencas, permitindo identificar as unidades de significado: consumo excessivo, bebedeira e alegria. Na associacao das bebidas alcoolicas com alegria e festa encontra-se a principal motivacao para beber, e a principal fonte de resistencia para a modificacao de condutas perante o alcool. Os nucleos de significados identificados foram: existencia de um continuo entre o beber normal e o patologico, sendo uma concepcao de felicidade perante o consumo de alcool.

Significados de qualidade de vida: análise interpretativa baseada na experiência de pessoas em reabilitação de queimaduras

Con el objetivo de interpretar los significados para la calidad de vida, este estudio parte de la atribucion dada por personas que sufrieron quemaduras graves, sus experiencias y su contexto sociocultural. El metodo etnografico fue utilizado apoyado en la teoria hermeneutica moderna. Participaron del estudio 19 pacientes con secuelas de quemadura y sus familiares, atendidos en la Unidad de Quemados del Hospital de Clinicas de la Facultad de Medicina de Ribeirao Preto. Los sujetos pertenecian al sector popular, con edades entre 18 y 50 anos, participantes del programa de rehabilitacion por lo menos un ano. Los datos recolectados a traves de entrevistas semi-estructuradas y observacion directa; siendo su analisis realizado a traves de la identificacion de unidades de significados y construccion de nucleos tematicos. Los pacientes y sus familiares mencionaron cambios en su calidad de vida debidos a sus limitaciones fisicas y psiquicas por la quemadura. La calidad de vida asociada al desempeno de los roles sociales fue estructurada en base a los nucleos: familia, trabajo, autonomia, normalidad e integracion social.This research aimed to interpret the meanings of quality of life, taking into consideration the meanings attributed by those who have undergone serious burns, their experiences and social/cultural background. We used the ethnographic method based on modern hermeneutics. Nineteen patients with burn sequelae, already discharged from the Burns Unit of the Ribeirão Preto Medical School Clinical Hospital participated in this study, along with their relatives. Participants belong to the working class, are between 18 to 50 years old and have been in rehabilitation for at least a year. Data were collected by direct observation and semi-structured interviews. The analysis was processed through the identification of units of meanings and construction of thematic nucleuses. Patients and relatives reported that quality of life had changed because of physical and psychological limitations caused by the burns. The meanings of quality of life are associated with the performance of social roles and are guided by family, work, normality, autonomy and social integration.Com o objetivo de interpretar os significados de qualidade de vida, este estudo considera os sentidos atribuidos por pessoas que sofreram queimaduras graves, suas experiencias e contexto sociocultural. Utilizou-se o metodo etnografico com apoio teorico da hermeneutica moderna. Participaram 19 pacientes com sequelas de queimadura, atendidos pela Unidade de Queimados do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, e seus familiares. Pertencentes as classes populares, os sujeitos, com idade entre 18 e 50 anos, integram programa de reabilitacao ha um ano ou mais. A analise dos dados, coletados por entrevistas semi-estruturadas e observacao direta, processou-se pela identificacao de unidades de significados e construcao de nucleos tematicos. Pacientes e familiares relataram modificacoes da qualidade de vida introduzidas por limitacoes fisicas e psiquicas provocadas pela queimadura. Qualidade de vida, associada ao desempenho de papeis sociais, estrutura-se em torno dos nucleos: familia, trabalho, autonomia, normalidade e integracao social.

The Experiences and Consequences of a Multiple Trauma Event from the Perspective of the Patient

This was an ethnographic investigation with the aim of comprehending the meanings of the trauma experience among multiple trauma patients. The following techniques were used for data collection: direct observation, semi-structured interview and field diary. Biographical narratives were obtained from eleven trauma victims, and ten relatives as secondary informants. The data analysis considered the set of data of each participant and all data of all subjects, searching for differences and similarities. The meanings attributed to the trauma experience are associated with interrelated feelings of fear, insecurity, anger, vulnerability and suffering and to the meanings of quality of life that converge to valorize health and work appreciation and support by social networks. This analysis shows that the concepts and experiences of the trauma are conditioning factors of the health-disease process and they are essential in planning public health actions to meet the needs of individuals.Esta e uma investigacao etnografica, realizada com o objetivo de compreender os significados da experiencia do trauma entre pacientes politraumatizados. Foram utilizadas as seguintes tecnicas de coleta de dados: observacao direta, entrevista semiestruturada e diario de campo. Obtiveram-se narrativas biograficas de 11 pessoas, vitimas de traumas, e 10 familiares, como informantes secundarios. A analise dos dados considerou o conjunto dos dados de cada participante e o todo dos dados de todos os sujeitos, buscando por diferencas e similaridades. Os sentidos atribuidos a experiencia do trauma se associam a sentimentos inter-relacionados de medo, inseguranca, revolta, vulnerabilidade e sofrimento e aos significados de qualidade de vida que convergem para a valorizacao da saude, trabalho e apoio pelas redes sociais. Esta analise mostrou que as concepcoes e vivencias do trauma sao fatores condicionantes do processo saude/doenca e fundamentais para o planejamento de acoes de saude publica voltadas ao atendimento das necessidades individuais.

Quality of life after myocardial revascularization: evaluation according to two methodological perspectives

Objective: To analyze the quality of life (QL) as proposed by Flanagan, in two groups of revascularized patients; to compare and combine results from this research with data from an ethnography study that interprets the meanings that revascularized patients gave to QL. Method: The methodological triangulation was used in two researches: one qualitative (ethnographic) and the other quantitative; the scale of Flanagan was applied in 124 individuals. Results: In the quantitative study the QL was related to “bear and raise children” and “relationships with friends”; in the qualitative study a good QL was related to wellbeing, happiness, satisfaction, opportunities in life. The identified issues were: health (physical, emotional and spiritual), work and family harmony. Conclusion: The dimensions of quality of life identified in the ethnographic study were similar to the domains of Flanagan’s QL-Scale. The spirituality/religiosity, not contemplated in the scale, is highlighted by participants as an aspect of the QL.OBJECTIVE: To analyze the quality of life (QL) as proposed by Flanagan, in two groups of revascularized patients; to compare and combine results from this research with data from an ethnography study that interprets the meanings that revascularized patients gave to QL. METHOD: The methodological triangulation was used in two researches: one qualitative (ethnographic) and the other quantitative; the scale of Flanagan was applied in 124 individuals. RESULTS: In the quantitative study the QL was related to “bear and raise [...]

Significados y contradicciones del fenómeno de las drogas: drogas lícitas e ilícitas en Chile

This is a bibliographic and documental research with the purpose to interpret the meaning of using legal and illegal drugs to the Chilean society, describing the most consumed drugs, identifying facilitating factors to the increase of drugs use, analyzing public actions and emphasizing the contradictions surrounding the question. Authors conclude that it is relevant consider the symbolic dimension in the reflections and actions regarding drugs, giving emphasis to the values and habits that stimulate drugs production, distribution and consumption.Desarrollado como una investigacion bibliografica y documental, este estudio objetiva hacer una lectura interpretativa de los significados del uso de drogas licitas e ilicitas en la sociedad chilena, describiendo las drogas mas consumidas, identificando factores favorables a la expansion del uso de drogas, examinando acciones de politicas publicas y destacando las muchas contradicciones que cercan la cuestion. Concluye que es muy relevante enfatizarse la dimension simbolica en las reflexiones y acciones respecto de las drogas, destacando los valores y habitos que estimulan su produccion, circulacion y consumo.

Significados de apoio social de acordo com pessoas submetidas à revascularização do miocárdio: estudo etnográfico

Estudio etnografico con objeto de comprender los significados de apoyo social segun un grupo de personas sometidas a la revascularizacion miocardica. Las tecnicas usadas en la recolecta de datos fueron la entrevista semi estructurada y observaciones directas, llevadas a cabo en la residencia de los participantes y durante el regreso ambulatorio. Los datos fueron recolectados entre abril/2010 y abril/2011, con once individuos, la mayoria casada, con edad entre 49 y 73 anos. La principal fuente de apoyo reportada fue de los familiares. Otro tipo de apoyo mencionado fue el religioso, considerado fundamental en el momento de toma de decision sobre la cirugia. El significado del apoyo fue relacionado al auxilio directo de los familiares, tanto instrumental (realizacion de actividades domesticas y de autocuidado) como emocional y religioso (focalizacion en el enfrentamiento de la enfermedad y cirugia y explicaciones para la enfermedad y cirugia como un momento de amenaza y ruptura).