Public Healthcare in Brazil has tended to reflect major changes in the healthcare model. New tendencies point to the importance of actions being built up from their context and focused on specific communities. The objective of this study is to describe the meanings of health / illness as produced by community groups within the context of a Family Healthcare Program. Five groups had their single-session discussions taped and recorded, under the coordination of the first author. This material was transcribed and, coupled with field notes, formed the database for this study. The analysis described the meanings of the ideas on which new healthcare proposals are being based, providing visibility for the multiplicity of meanings and denaturalizing fixed lines of discourse on healthcare / illness. The final thoughts, developed from the point of view of social constructionism, indicate that healthcare practices based on the process of constant conversation and negotiation between all the social actors involved is a fertile ground.
We are living in challenging times, surfacing many reactions, thoughts, visions and beliefs in an attempt to understand and offer ways to cope with the COVID crisis and the recovery of the world. We believe a constructionist stance can help us respond to this moment. Everyday life is uncertain, although we most often act as if it is predictable and dependably redundant. We organize our lives around certainties that lead us to feel that we are in control. The pandemic has pulled the rug from under our feet and uncertainty is now the slogan of our time. However, one “silver lining” of the pandemic might be the way it exposes the unfolding nature of our worlds. To that end, the pandemic helps us embody and thus “know from within” (Shotter, 2010) a constructionist sensibility. This embodiment of social construction takes us far beyond a simple academic understanding. The confluence of the pandemic and learning about social construction can create the opportunity to put ideas into practice and, in so doing, our understanding of constructionist ideas is deepened. From a constructionist perspective, COVID-19 is not separate from us. It is happening through us, in us, between us and because of us. Social construction helps us see the world as an interconnected and complex system in which macro and micro levels, as well as human and non-human entities are constantly creating and re-creating possible realities (Simon & Salter, 2020). Indeed, this highly contagious virus, initially framed as a public health issue, soon revealed its complexity, having also political, social, economic, environmental and relational entanglements. Our attempt to balance the shutdowns (staying at home), for health protection, with the economic need for business to operate is an illustration of how interconnected these systems are. The virus also makes it necessary to balance physical distance with social connection and collective support. Despite the fear and discomfort, the potential for change ignited by this global crisis is substantial. By coming together with a diversity of voices, experiences, and perspectives, new performances can be enacted, new ways to respond and cope can be imagined, and new forms of living can be created – and these are all changes that could possibly be sustained once the pandemic has past. The pandemic therefore is a perfect time for dialogue and innovation. Dialogue and relationality are fundamental pillars in the construction, de-construction and re-construction of knowledge and society (Gergen, 2009a). Change starts with us in our interactions, one interaction at a time. SC invites us to come together and share the challenges we face, co-creating new possibilities for health and connection. Through collective interactions, new meanings and possibilities emerge; we re-invent realities. How can we address this interconnected and complex reality? And how do we ignite change that supports a reconstruction of our world in ways that address the inequities we currently face? What are the social conditions that can ignite new forms of understanding that generate new and resourceful ways of living?
O artigo discute a criatividade e imaginação na pesquisa, questionando a visão dicotomizada: qualitativa versus quantitativa ou mesmo acadêmica versus aplicada. Oferece-se uma visão mais pragmática e orientada ao contexto, fundamentada em uma epistemologia de pesquisa como prática social. Essa aproximação epistemológica é apresentada através de projetos de pesquisa envolvendo métodos da arte para fomentar a criatividade e imaginação. Conclui-se que esta aproximação transforma a pesquisa do conceito de descoberta para o de generatividade, focando-se em questões como “para quem este conhecimento é útil?” Para além de comprovação de hipóteses o foco se dá na produção do conhecimento local. Por fim, o papel do pesquisador também se transforma de “poder sobre” para “poder com” pelo atributo da inclusão dos participantes no processo e no contexto da pesquisa. Publicação autorizada por Guilford Press, New York. Tradução: Alexandre José Guimarães Instituto Federal de Educação, Ciência e Tecnologia de Goiás(https://orcid.org/0000-0003-4256-8959)
CAMARGO-BORGES, C. Social Constructionism in the contexto of Family Health Program: articulating knowledges and practices. 2007. 207f. Tese (Doutorado) Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2007. This research brings epistemological and methodological reflections aiming to contribute to new knowledges in Healthcare, in the field of the Primary Care, problematizing the object-subject dichotomy and the monovocal discourse of knowledge and true. I propose an approach to the post-modern scientific discourse of social constructionism with the contemporary discourse of Health in the field of Primary Care, specifically in the Family Healthcare Program (ESF). Social constructionism has been described as a relational theory, in a perspective which focus the constructed, situated and relational character of knowledge. It points to the multiplicity of dialogues, concerning to what happen among people in their encounters and how do they make meaning in these interactions. The Family Healthcare Program's discourse has also in its premises the relational, contextual and constructed character in the production of the practices Thus, the objective is to construct articulations between these two discourses, pointing to the utility of this articulation. Social constructionism is proposed as a useful theoretical-practical tool contributing to the operationalization of the premises of the Program, which include: coresponsibility, sensibility to the local context, sensibility to multiplicity and sensitivity to the diversity of the social actors involved. Empirically, it is about the analysis of a hypertension group which gathers weekly in a Family Healthcare Center placed in the city of Ribeirão Preto -SP -Brazil. The concept of Relational Responsibility is used as an analytic resource, contributing with the construction of collaborative and co-responsible interventions in health. For the data collection I used the registration of the group written in the historical record; my participation in the group and the recording during the first semester of 2005; and the group diary. The analysis consisted of the transcriptions of the group conversations and extensive readings of all the conversations transcribed. From this "close reading," a narrative of the group was created and placed upon various axes for purposes of analysis. The three axes selected for the analysis focused to the visibility of the conversational aspects in this group and its differentiated relational context. The first axis presents the group as a space for the expression of the participants, providing the collective construction and negotiation of needs in Health; the second axis documents the group creating a link between the health center and the community, and finally the third axis represents the way in which the group created a privileged welcoming space to the participants, favoring conversations that open up new meanings and understandings in healthcare and thus make possible transformation. In this way, the analy...
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