Razões e desrazões do coração: visões e significados acerca do transplante do coração a partir de narrativas orais de uma equipe interdisciplinar de saúde
Data
2015-03-18
Autores
Rossi, Antonio Carlos 
Orientadores
Gallian, Dante Marcello Claramonte
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
O presente estudo objetivou desenvolver, a partir de relatos de história oral de vida de uma equipe interdisciplinar de transplante do coração, sobre as visões e significados atribuídos ao transplante do coração, numa perspectiva não apenas funcional, mas também simbólico-cultural, psicológica e existencial. Para compreensão e análise dessa experiência, partimos de uma abordagem de cunho metodológico qualitativo. Os dados foram colhidos por meio de entrevistas realizadas de acordo com a abordagem da História Oral de Vida. Foram entrevistados nove profissionais (médico, enfermeiro, nutricionista, fisioterapeuta e psicólogo), com experiência na área. Os textos gerados a partir das entrevistas foram analisados mediante técnicas de imersão/cristalização, estilo inspirado pela Fenomenologia Hermenêutica. Os núcleos temáticos emergidos foram: 1) Coração: uma bomba-biomecânica ou sede da alma? - Detectamos na narrativa de nossos entrevistados que o coração passou a ser uma bomba biomecânica, fruto de uma compreensão absorvida pelas ciências médicas atuais e herdeira do positivismo de Descartes; porém, simultaneamente, concepções e visões de ordem ?irracionais?, simbólicas e mesmo poéticas sobre o coração, que derivam de crenças e tradições supostamente ultrapassadas, teimam em permanecer, muitas vezes, de forma surpreendente e inconsciente, não apenas no discurso do paciente leigo, mas também no do profissional especializado, tão bem formado e treinado; 2) Realidade e Fantasias no transplante do coração ? Constatamos, em alguns integrantes da equipe, a dúvida e curiosidade em saber se o coração muda a personalidade, mesmo de posse de explicações cientificas (diríamos que fica em suspenso sempre algo que transcende a uma explicação biomédica e mecânica do transplante); 3) O transplante do coração como teatro e palco para se pensar a morte - Notamos sentimentos ambivalentes na equipe de transplante, desde a chegada do órgão (doador), se este está vivo ou morto, até o procedimento em sí, acreditar ou não no transplante, passando pela questão do número de transplantes a serem realizados e terminando com a ideia do transplante como uma jogada de mestre contra a morte.
This dissertation undertakes to examine meanings, attitudes and viewpoints attributed to heart transplant via the oral histories provided by members of an interdisciplinary heart-transplant team. In addition to functional aspects, the present analytical perspective embraces psychological, existential and culturally symbolic implications of heart transplant. Efforts to comprehend and analyze the experiences recipients and practitioners/care providers extend to qualitative methodologies. Data were gathered from nine professionals having experience in the field (including doctors, nurses, a nutritionist, a physiotherapist and a psychologist), in interviews conducted in accordance with standards of the Oral Life History approach. The interview transcripts were analyzed utilizing immersion and crystallization techniques based on hermeneutic phenomenology. Core themes that emerged: 1) The Heart: Biomechanical Pump or Seat of the Soul? A narrative commonly voiced by interviewees involved transformation of their perceptions of the heart. Initially regarded, per understandings absorbed from prevailing biological science and the heritage of Cartesian positivism, solely as a biomechanical pump, over time the organ took on ?irrational,? symbolic and even poetic aspects, derived from ostensibly outdated beliefs and traditions?often unconscious, and stubbornly and surprisingly persistent. This occurs not only with the lay patient, but also with the highly educated and trained medical professional. 2) Reality and Fantasy and the Heart Transplant Some members of the team became curious, despite their grounding in scientific premises, as to whether a new heart alters the recipient?s personality. (This research suggests that there are changes and effects that transcend biomedical or mechanical explanation.) 3) Heart Transplant as Stage for the Contemplation of Mortality - The team demonstrated ambivalent feelings from the point of delivery of a heart for transplant, on the question of whether the organ is at that point dead or alive, extending to the procedure itself, and to issues concerning belief in the efficacy of heart transplant and the numbers of transplants performed. The discussion concludes with the idea of the transplant as a blow struck against death itself.
This dissertation undertakes to examine meanings, attitudes and viewpoints attributed to heart transplant via the oral histories provided by members of an interdisciplinary heart-transplant team. In addition to functional aspects, the present analytical perspective embraces psychological, existential and culturally symbolic implications of heart transplant. Efforts to comprehend and analyze the experiences recipients and practitioners/care providers extend to qualitative methodologies. Data were gathered from nine professionals having experience in the field (including doctors, nurses, a nutritionist, a physiotherapist and a psychologist), in interviews conducted in accordance with standards of the Oral Life History approach. The interview transcripts were analyzed utilizing immersion and crystallization techniques based on hermeneutic phenomenology. Core themes that emerged: 1) The Heart: Biomechanical Pump or Seat of the Soul? A narrative commonly voiced by interviewees involved transformation of their perceptions of the heart. Initially regarded, per understandings absorbed from prevailing biological science and the heritage of Cartesian positivism, solely as a biomechanical pump, over time the organ took on ?irrational,? symbolic and even poetic aspects, derived from ostensibly outdated beliefs and traditions?often unconscious, and stubbornly and surprisingly persistent. This occurs not only with the lay patient, but also with the highly educated and trained medical professional. 2) Reality and Fantasy and the Heart Transplant Some members of the team became curious, despite their grounding in scientific premises, as to whether a new heart alters the recipient?s personality. (This research suggests that there are changes and effects that transcend biomedical or mechanical explanation.) 3) Heart Transplant as Stage for the Contemplation of Mortality - The team demonstrated ambivalent feelings from the point of delivery of a heart for transplant, on the question of whether the organ is at that point dead or alive, extending to the procedure itself, and to issues concerning belief in the efficacy of heart transplant and the numbers of transplants performed. The discussion concludes with the idea of the transplant as a blow struck against death itself.
Descrição
Citação
ROSSI, Antonio Carlos. Razões e desrazões do coração: visões e significados acerca do transplante do coração a partir de narrativas orais de uma equipe interdisciplinar de saúde. 2015. 177 f. Tese (Doutorado em Saúde Coletiva) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2015.