A vivência do câncer em situações de vulnerabilidade social no contexto da pandemia de Covid-19: Itinerários de cuidado na Zona Leste de São Paulo
Data
2023-05-24
Autores
Santos-Moura, Greice Herédia dos 
Orientadores
Castro-Silva, Carlos Roberto de
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Esta dissertação tem como objetivo compreender os significados e sentidos da vivência do câncer de cabeça e pescoço em situações de vulnerabilidade social no contexto da pandemia de COVID-19 na Zona Leste de São Paulo. Entende-se que a compreensão multideterminada, contextual e subjetiva do sujeito e do seu processo de adoecimento permite uma atuação ampla e diversificada, favorecendo a humanização do cuidado e a diminuição das iniquidades na saúde. Como base para esta discussão, partimos da perspectiva da Psicologia Sócio-histórica, que compreende a complexidade da condição humana e da saúde abrangendo seus aspectos psicossociais, históricos e culturais. Trata-se de uma pesquisa de campo exploratória onde foram coletadas as narrativas de sete pessoas com câncer de cabeça e pescoço em situação de vulnerabilidade social e informações de caráter sociodemográficos, culturais e de saúde. Os aportes teórico-metodológicos da pesquisa qualitativa e da Hermenêutica de Profundidade - HP (Thompson, 2011) nortearam o trabalho de campo e a análise dos resultados. O trabalho apresenta uma descrição histórica e social com base em literaturas acadêmicas, populares e jornalísticas, registros oficiais de órgãos do governo e relatos dos próprios colaboradores desta pesquisa. Tudo isto pretende contextualizar o estudo, apontando elementos que envolvem o território da Zona Leste de São Paulo, onde está situado o Hospital Santa Marcelina e onde residem e transitam os colaboradores. À luz da HP e com o auxílio de um Computer Assisted Qualitative Data Analysis (CAQDAS), o trabalho de análise culminou em três zonas de sentido: 1) Câncer e Covid-19: intersecção de duas condições ameaçadoras da vida; 2) Itinerários Terapêuticos desafiadores de pessoas com câncer; e 3) Inerências da vulnerabilidade social no cuidado. Na primeira, com base em alguns aportes da afetividade de González-Rey (2010) e do constructo de sentido de Vygotsky (2003), são descritas suas trajetórias de vida, envolvendo condições ameaçadoras da vida que tecem sentidos e significados na subjetividade humana. Ficou evidente que a pandemia no cenário brasileiro agudizou as vulnerabilidades da pessoa com câncer, condicionada pelas enormes desigualdades que caracterizam nosso país. Na segunda, são descritos os itinerários percorridos pelos colaboradores na busca pelo cuidado em saúde, elencando desafios e potencialidades do SUS para o cuidado da população foco deste estudo. Nessa busca, diferentes estratégias foram construídas, influenciadas pelo conhecimento sobre o funcionamento do SUS, relações estabelecidas, contexto histórico, condições socioeconômicas, afetos, políticas públicas, e outras. Finalmente, na terceira zona de sentido, discutem-se a potência de ação e a potência de padecimento, com base nos conceitos de sofrimento ético político e necropolítica. Assim foi possível apontar como a iniquidade em saúde pode se revelar para as classes mais vulneráveis da sociedade. Além disso, a potência do cuidado e a práxis coletiva para a transformação e valorização da vida humana, como fazer ético político.
This dissertation aims to understand the meanings and senses of experiencing head and neck cancer in situations of social vulnerability in the context of the COVID-19 pandemic in the East Zone of São Paulo. Understanding that the multidetermined, contextual and subjective understanding of the subject and his/her illness process allows a broad and diversified action, favoring the humanization of care and the reduction of health inequalities. As a basis for this discussion, we start from the perspective of Socio-historical Psychology, which understands the complexity of the human condition and health, encompassing its psychosocial, historical and cultural aspects. This is an exploratory field research where the narratives of seven people with head and neck cancer in a situation of social vulnerability and sociodemographic, cultural and health information were collected. The theoretical-methodological contributions of qualitative research and Depth Hermeneutics - HP (Thompson, 2011) guided the fieldwork and analysis of results. The work presents a historical and social description based on academic, popular and journalistic literature, official records from government agencies and reports from the employees of this research. Everything is intended to contextualize the study, point out elements that involve the territory of the East Zone of São Paulo, where the Santa Marcelina Hospital is located and where the collaborators live and travel. In the light of HP and with the help of Computer Assisted Qualitative Data Analysis (CAQDAS), the analysis work culminated in three zones of meaning: 1) Cancer and Covid-19: intersection of two life-threatening conditions; 2) Therapeutic Itineraries requested by people with cancer; and 3) Inherences of social vulnerability in care. In the first, based on some contributions of affectivity by González-Rey (2010) and the construct of meaning by Vygotsky (2003), their life trajectories are described, life-threatening conditions that weave senses and meanings in human subjectivity. It was evident that the pandemic in the Brazilian scenario was exacerbated by the vulnerabilities of the person with cancer, conditioned by the enormous inequalities that characterize our country. In the second, the itineraries taken by the collaborators in the search for health care are felt, listing the challenges and potential of the SUS for the care of the population that is the focus of this study. In this search, different strategies were constructed, influenced by knowledge about the functioning of the SUS, protected relationships, historical context, socioeconomic conditions, affections, public policies, and others. Finally, in the third zone of meaning, the power of action and the power of suffering are discussed, based on the concepts of ethical, political and necropolitical suffering. Thus, it was possible to point out how inequity in health can reveal itself to the most differentiated classes of society. In addition, the power of care and collective praxis for the transformation and enhancement of human life, how to do ethical politics.
This dissertation aims to understand the meanings and senses of experiencing head and neck cancer in situations of social vulnerability in the context of the COVID-19 pandemic in the East Zone of São Paulo. Understanding that the multidetermined, contextual and subjective understanding of the subject and his/her illness process allows a broad and diversified action, favoring the humanization of care and the reduction of health inequalities. As a basis for this discussion, we start from the perspective of Socio-historical Psychology, which understands the complexity of the human condition and health, encompassing its psychosocial, historical and cultural aspects. This is an exploratory field research where the narratives of seven people with head and neck cancer in a situation of social vulnerability and sociodemographic, cultural and health information were collected. The theoretical-methodological contributions of qualitative research and Depth Hermeneutics - HP (Thompson, 2011) guided the fieldwork and analysis of results. The work presents a historical and social description based on academic, popular and journalistic literature, official records from government agencies and reports from the employees of this research. Everything is intended to contextualize the study, point out elements that involve the territory of the East Zone of São Paulo, where the Santa Marcelina Hospital is located and where the collaborators live and travel. In the light of HP and with the help of Computer Assisted Qualitative Data Analysis (CAQDAS), the analysis work culminated in three zones of meaning: 1) Cancer and Covid-19: intersection of two life-threatening conditions; 2) Therapeutic Itineraries requested by people with cancer; and 3) Inherences of social vulnerability in care. In the first, based on some contributions of affectivity by González-Rey (2010) and the construct of meaning by Vygotsky (2003), their life trajectories are described, life-threatening conditions that weave senses and meanings in human subjectivity. It was evident that the pandemic in the Brazilian scenario was exacerbated by the vulnerabilities of the person with cancer, conditioned by the enormous inequalities that characterize our country. In the second, the itineraries taken by the collaborators in the search for health care are felt, listing the challenges and potential of the SUS for the care of the population that is the focus of this study. In this search, different strategies were constructed, influenced by knowledge about the functioning of the SUS, protected relationships, historical context, socioeconomic conditions, affections, public policies, and others. Finally, in the third zone of meaning, the power of action and the power of suffering are discussed, based on the concepts of ethical, political and necropolitical suffering. Thus, it was possible to point out how inequity in health can reveal itself to the most differentiated classes of society. In addition, the power of care and collective praxis for the transformation and enhancement of human life, how to do ethical politics.
Descrição
Citação
SANTOS-MOURA, Greice Herédia dos. A vivência do câncer em situações de vulnerabilidade social no contexto da pandemia de Covid-19: Itinerários de cuidado na Zona Leste de São Paulo. 2023. 259 f. Dissertação (Mestrado Interdisciplinar em Ciências da Saúde) – Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2023.