Reni Aparecida Barsaglini

Apoio social e saúde: pontos de vista das ciências sociais e humanas

This article analyses the themes and conceptual-theoretical approaches of the social support in the literature from important international journals about social sciences and medicine, and in from 1983 to 2005 are analyzed. 259 international and 57 national abstracts was reading for the identification and computing the relations of the social support with health/disease/care. A deeper conceptual analysis about social support and the theories of social science were reported in an intentional sample of 56 international and 18 national texts. The international literature is based on the social psychology, in the several trends of the sociology and of the political science and less in the anthropology. The national literature dialogues less with the psychosocial theories and more with the sociological and anthropological theories. In this latter literature the social support approaches are concerned with social network theories; reciprocity, exchanges and cultural values. It is concluded that different trends guide the conceptual-theoretical analyses of the social support, being the international literature older, wider, more diversified and empirical, but with scarce anthropological production. The national literature is more reflexive them empirical.

A alimentação e a dieta alimentar no gerenciamento da condição crônica do diabetes

OBJETIVO: analisar os aspectos materiais e simbolicos da alimentacao e das dietas envolvidos no gerenciamento do diabetes entre adoecidos usuarios de servicos publicos de atencao basica. METODOLOGIA: estudo qualitativo pautado pelas representacoes sociais e a experiencia em aspectos do gerenciamento da enfermidade, envolvendo o manejo da alimentacao e das dietas alimentares entre homens e mulheres com diabetes tipo II e seus familiares, residentes em municipio do interior paulista, atendidos por servicos de atencao basica. Os dados foram coletados mediante entrevistas com roteiro semiestruturado e a analise tematica identificou as estruturas de relevância, os valores de referencia e formas de acao relatados e subjacentes aos relatos, analisados segundo os propositos do estudo e cotejados com bibliografia especializada. RESULTADOS: no processo de gerenciamento do diabetes, o manejo das dietas e da alimentacao pelos adoecidos nao se dissocia das representacoes e da experiencia da enfermidade, sendo orientado por ideias, crencas e pelo conjunto de ajustes e microdecisoes cotidianas para controlar os efeitos/sensacoes desfavoraveis permitindo conviver com e apesar dela. As formas de manejar a alimentacao e as dietas alimentares sao componentes importantes do controle do diabetes, subtraidas do poder exclusivo dos saberes e das praticas medica e nutricional. CONCLUSAO: o manejo das dietas e da alimentacao no gerenciamento da condicao cronica e complexo, envolvendo aspectos relacionados as condicoes objetivas de vida, as dimensoes socioculturais, valorativas e ideativas, que permeiam as representacoes e as experiencias dos adoecidos, inserindo-se na totalidade de suas vidas, relacoes sociais e nas caracteristicas de seu grupo social.

Análise da percepção de gestores sobre a gestão da política de saúde penitenciária em Mato Grosso, Brasil

A saude da populacao privada de liberdade diferenciou-se em 2003 pela divulgacao do Plano Nacional de Saude no Sistema Penitenciario o qual, em 2014, foi instituido como Politica Nacional de Atencao Integral a Saude das Pessoas Privadas de Liberdade no Sistema Prisional. O estado de Mato Grosso habilitou-se ao Plano em 2004 e conta com equipes de saude em seis unidades prisionais de regime fechado, com gestao compartilhada pelas secretarias estaduais de Saude e de Justica e Direitos Humanos. Este artigo analisa a percepcao de gestores sobre a gestao da politica de saude no Sistema Prisional de Mato Grosso, enfocando suas caracteristicas, os entraves e pontos positivos. Valoriza-se a subjetividade na tomada de decisao em que o gestor se vale de referencias tecnicas, politicas, institucionais, sociais, culturais e a percepcao (perpassada pela experiencia) que tem do tema e das intervencoes. Trata-se de pesquisa qualitativa, descritiva e exploratoria que faz uso de entrevistas semiestruturadas com gestores das duas secretarias e consulta a documentos oficiais de livre acesso, tratados pela analise tematica. A gestao das acoes de saude penitenciaria encontra entraves, mas, tambem, avancos. Ressaltam-se as incongruencias nos valores que regem o setor da justica e o da saude, em que questoes juridicas, de seguranca e disciplina tensionam o direito a saude e a superlotacao nao pode ser ignorada. O contexto prisional imprime peculiaridades a assistencia que se refletem na gestao, pois ora empreendem-se adequacoes frente ao diferente mobilizando o principio da equidade, ora o compromete colocando os gestores diante de dilemas entre o cuidado necessario e o possivel.

Impactos de adoecimento de longa duração: experiência de adultos jovens com Leucemia Mieloide Aguda

This article analyzes the tangible and intangible impacts involved in the experience of young adults diagnosed with a long-term illness, namely Acute Myeloid Leukemia. It follows on from broader research, inspired by the Phenomenology of Alfred Schutz. The data were obtained through in-depth interviews with four young adults, aged between 20 and 28, who were in the maintenance phase of cancer treatment between November 2013 and January 2014 in the State of Mato Grosso. The results focus on striking aspects of the impacts of the experience during the process of becoming aware of the illness in which the diagnosis provoked feelings mobilized by ideas regarding a serious illness. This is followed by the impacts on appearance due to the treatment, especially hair loss and day-to-day coping strategies, as well as weight gain or loss. Finally, there is the marked impact of the imminence of death due to the lethality of the disease and the testimony of the occurrence in friends and family, but also for the survivors. The impacts are the effects and transformations in the lives of people and their relations and evoke (re)actions, however, they are diluted in the experience composing it, and not being homogeneous, its approach addresses the singularity encountered in contextualized biographies.

Adoecimentos e sofrimentos de longa duração: contribuições das Ciências Sociais e Humanas em Saúde

Long-term illness and suffering, referred to as chronic diseases in biomedicine, include a broad gamut of illnesses that currently occupy an important place in the morbimortality of the Brazilian population, in the process of aging and demographic and epidemiological transitions. Epidemiology has traditionally been concerned with the incidence, prevalence, mortality and morbidity related to these diseases and, for some time at least, the national social health sciences have contributed little with concepts and methodologies to investigate the diseases of those affected by them, contrary to the Anglo-Saxon tradition that has important works in research in this respect. From 2000 onwards, however, it elicited the interest of social scientists and health professionals using social science approaches and methodologies in researching a range of objects. These included the interface between epidemiology and the social sciences concerned with the social determinants of the illnesses, with the way of life of the populations, with the system of signs, meanings and actions, with the application of ethnographic studies, which complement epidemiological investigations, among other approaches. Specific investigations of the social sciences on long-term illness and suffering are in Brazilian literature addressing reflections on scholarly medical knowledge and its theories about some of these illnesses and sufferings; the contents of the media messages; common sense explanations; experience and representations; the social construction of some diseases; the history of diseases; administration of treatment and care; the educational interventions and their models, as well as specific studies on the policies, the care and management models shared with the policy and planning area. This thematic issue seeks to disseminate the contributions of Brazilian and some international researchers on certain long-term illnesses and suffering, focusing mainly on the interpretations of the patients with regard to ways of reflecting upon, acting and dealing with illnesses, their treatment, diagnosis, effect and implications on their lives and biographies. A part of the studies composed the presentations of the Working Group on Long-term Illness and Suffering of the VII Brazilian Congress of Social and Human Sciences in Health, held in Cuiabá in 2016, coordinated by the organizers of this thematic issue. It is not a question of addressing a wide range of conditions of long-term illness and suffering, but of outlining some conceptual and methodological reflections that can be incorporated into future studies; to address experiences and care with rare diseases of genetic or other origin, to focus on the types of treatments and therapies applied to certain diseases that require a long period of submission of patients suffering from them.

Compaixão, piedade e deficiência física: o valor da diferença nas relações heterogêneas

Feelings of compassion and pity for physical disability are analyzed by assessing abnormal bodies in the West and interpretations of the sufferings of the Other. The State will target this body as well as wartime and industrial mutilations. In the nineteenth century, tolerance, compassion and body equality were required, becoming imbued with hierarchizing representations and practices of bodily perfection submitting deviations to intervention. Such ambiguities mobilize sentiments at the confluence of the individual/collective and the natural/socio-cultural and can transmute into virtue or technology of power. The exegesis of suffering may result in generalizations and platitudes whereas valorizing the singular and occult sides of experience favors universalization of human dignity in heterogeneous relations.