(Sobre)Viver com condição crônica de saúde: Redes e Mapas de Cuidado
Data
2023-06-30
Autores
Silva, Franciele Finfa da [UNIFESP]
Orientadores
Andreazza, Rosemarie [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Analisar as experiências de cuidado às pessoas com condições crônicas de saúde, cartografando o caminho singular de cuidado e a construção de suas redes e mapas de cuidado a partir da internação em uma enfermaria de um Hospital de Referência na cidade de São Paulo. Métodos: Estudo qualitativo, com ethos cartográfico desenvolvido em dois movimentos. O primeiro movimento é parte de uma pesquisa-mãe destinada a análise dos arranjos tecnológicos de gestão do cuidado previstos na Política Nacional de Atenção Hospitalar, que fez uso de múltiplas técnicas para a produção de dados, como: análise documental, oficinas de trabalho com dirigentes e equipe do hospital, observação participante do arranjo tecnológico da Alta Responsável realizado na enfermaria de nefrologia do Hospital de Referência, arranjo escolhido em comum acordo com a equipe do hospital, fazendo uso do diário de campo, seminários compartilhados e grupo focal. O segundo movimento envolve o aprofundamento deste estudo com o acompanhamento de usuários-guia e a produção de narrativas de cuidado como estratégia analítica. Resultados: O acompanhamento dos usuários-guia na construção de suas redes-mapas-malhas a partir da alta hospitalar, nos evidenciam que há centralidade do cuidado na doença (especialidade) e nos serviços de saúde (hospital), com ausência do território, configurando uma fragmentação do cuidado e um distanciamento da imagem-objetivo da integralidade previsto na política das Redes de Atenção à Saúde; centralidade do trabalho na vida das pessoas que sofrem um abalo durante o diagnóstico e vivência de uma condição crônica e que repercutem nos modo de andar a vida; a autonomia das pessoas para o seu cuidado em seu agir micropolítico ativo e reativo surgiu como eixo central para o desfecho dos casos; a instituição das redes/políticas de cuidado não necessariamente garantem o cuidado, pois não são porosas às singularidades da vida como ela é. Conclusões: As narrativas nos mostram as diferentes redes-mapas-malhas compostas pelos usuários que os levam a (sobre)viver com condição crônica de saúde, mas o desejo pulsante pela vida e o acompanhamento de seus caminhos nos falam SOBRE O VIVER, um processo que não invade a vida do hospital e as redes de cuidado, configurando uma fragmentação do cuidado.
Objective: To analyze the experiences of care for people with chronic health conditions, mapping the unique path of care and the construction of their networks and care maps from admission to a ward of a Reference Hospital in the city of São Paulo. Methods: Qualitative study, with cartographic ethos, developed in two movements. The first movement is part of a parent research aimed at analyzing the technological arrangements for managing care provided for in the National Policy for Hospital Care, which made use of multiple techniques for data production, such as: document analysis, workshops with directors and hospital staff, participant observation of the Technological Arrangement of Responsible Discharge carried out in the nephrology ward of the Reference Hospital, arrangement chosen in agreement with the hospital staff, making use of the field diary. The second movement involves deepening this study with the follow-up of guide users and the production of care narratives as an analytical strategy. Results: The follow-up of the guide-users in the construction of their network-maps-knitting from hospital discharge, show us that there is a centrality of care in the disease (specialty) and in the health services (hospital), with the absence of the territory, configuring a fragmentation of care and a distancing from the objective image of integrality provided for in the policy of the Health Care Networks; centrality of work in the lives of people who suffer a shock during the diagnosis and experience of a chronic condition and which have an impact on the way they live their lives; people's autonomy for their care in their active and reactive micropolitical action emerged as the central axis for the outcome of cases; the institution of care networks/policies does not necessarily guarantee care, as they are not porous to the singularities of life as it is. Conclusions: The narratives show us the different networks-maps-knitting composed by users that lead them to (about)live with a chronic health condition, but the pulsating desire for life and the monitoring of their paths tell us ABOUT LIVING, a process that does not invade the life of the hospital and care networks, which configure a fragmentation of care.
Objective: To analyze the experiences of care for people with chronic health conditions, mapping the unique path of care and the construction of their networks and care maps from admission to a ward of a Reference Hospital in the city of São Paulo. Methods: Qualitative study, with cartographic ethos, developed in two movements. The first movement is part of a parent research aimed at analyzing the technological arrangements for managing care provided for in the National Policy for Hospital Care, which made use of multiple techniques for data production, such as: document analysis, workshops with directors and hospital staff, participant observation of the Technological Arrangement of Responsible Discharge carried out in the nephrology ward of the Reference Hospital, arrangement chosen in agreement with the hospital staff, making use of the field diary. The second movement involves deepening this study with the follow-up of guide users and the production of care narratives as an analytical strategy. Results: The follow-up of the guide-users in the construction of their network-maps-knitting from hospital discharge, show us that there is a centrality of care in the disease (specialty) and in the health services (hospital), with the absence of the territory, configuring a fragmentation of care and a distancing from the objective image of integrality provided for in the policy of the Health Care Networks; centrality of work in the lives of people who suffer a shock during the diagnosis and experience of a chronic condition and which have an impact on the way they live their lives; people's autonomy for their care in their active and reactive micropolitical action emerged as the central axis for the outcome of cases; the institution of care networks/policies does not necessarily guarantee care, as they are not porous to the singularities of life as it is. Conclusions: The narratives show us the different networks-maps-knitting composed by users that lead them to (about)live with a chronic health condition, but the pulsating desire for life and the monitoring of their paths tell us ABOUT LIVING, a process that does not invade the life of the hospital and care networks, which configure a fragmentation of care.
Descrição
Citação
SILVA, Franciele Finfa da. (Sobre)Viver com condição crônica de saúde: Redes e Mapas de Cuidado. 2023. 98 f. Dissertação (Mestrado em Saúde Coletiva) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2023.