The illness experience is a relevant issue in current research and academic discussions. A growing number of research initiatives have undertaken to account for the subject's perspective and subjectivity in the health field. This paper discusses our research team's approach and results in studying the experience of people living with chronic illness. Our perspective is based upon the production in this relatively new field as well as health-related discussions in Latin America. The illness experience calls for an understanding of it as a subjective and existential phenomenon, entailing the phenomenological arena, immersed in the process where ill people "produce" and "reproduce" themselves. The unfolding and course of the illness as well as treatment management are some salient dimensions we evoke. Some lines of future work are presented in order to create a research agenda, highlighting its implications for existing proposals pertaining to health reform in our Latin American countries.

This article analyzes the caregiving trajectory for adults and elderly persons who suffer from diabetes. The objective is to develop a conceptual framework for understanding caregiving changes over time. An ethnographic study was conducted in a poor urban neighborhood in Guadalajara, Mexico, in which 21 caregivers were interviewed and followed from 1997 through 2001. The trajectory has a beginning and an end, and moves through three phases: semi-care, care, and dying. The phases differ by the type and timing of actions undertaken, and the degree to which the caregiver takes over the physical functions and social roles of the sick person.

En este trabajo se exploran algunos dilemas éticos enfrentados durante el trabajo de campo en la investigación cualitativa en salud. La premisa es que los códigos éticos no son suficientes para orientar las relaciones entre los investigadores y los informantes siendo necesaria una práctica reflexiva para enfrentar los mismos. La reflexión se centra en cuatro situaciones del trabajo de campo y sus dilemas. El tiempo social de la vida académica estructura la agenda de trabajo y el investigador se enfrenta a la disyuntiva de seguir los tiempos y ritmos de la academia o negociar con los informantes una agenda conjunta. El investigador también debe decidir cuál de sus múltiples identidades habrá de utilizar para ser aceptado, y al mismo tiempo decidir si oculta o no quien es realmente. En el establecimiento de una relación de intimidad con los informantes el investigador debe resolver si abre su vida personal. Y al momento de definir las formas de reciprocidad, decidir si lo hará de acuerdo a los valores de la academia o a los de los nativos. Se concluye argumentando la necesidad de crear una práctica reflexiva sobre estos y otros dilemas dirigida a colocar una agenda de temas y formas de descolonización en el debate ético en Iberoamérica.

This article focuses on home care for chronically ill adults and seniors. According to our thesis, home care should be understood as a self-care system, and its aim is to guarantee the individual's social and bodily survival. Home care consists of three areas, related to illness, the home, and to life history. Caregiving, usually under women's responsibility, is present throughout the history of the illness and the health-seeking process. The article analyzes these issues in light of the ageing process, the epidemiological changes occurring worldwide, and the urgency to incorporate this analysis into the heath care research agenda.

The mass media are recognized by many social scientists as important sources of medical information for lay people and as a positive influence on those working in the health care professions. However, there is a lack of study about print and mass media reporting on major health problems in developing countries such as Mexico. This article presents the findings of a study conducted to identify specific messages that the Mexican print media convey to the general reader about chronic diseases, especially one of the most important and pervasive, diabetes. We undertook a comprehensive review and content analysis of secondary source media reporting in the Boletin (Bulletin)--published by the Department of Education and Health, Universidad Autónoma Metropolitana, Xochimilco. The Boletin summarizes all articles related to health matters published in 12 national daily newspapers and 3 magazines. Our study covered all issues of the Boletin from 1992 through 1996. Our findings indicate that at times the press and popular print media disseminate an incomplete and often biased picture of chronic diseases prevalent in Mexico. Specifically, the press gives equal or more important coverage of acute diseases, or to AIDS, than to other major chronic conditions. The press also reproduces the biomedical model of disease and does not address topics important to certain segments of the population, including the patient. Moreover, the media may present an overly idealized impression of the capability of health services. Consequently, this failure to address the issues of certain widespread, chronic illnesses is severe enough to ask about the role of the press in medical health care reform. We conclude by suggesting areas for further research.

Ser un anciano no es sólo contar con 70 u 80 años de vida, sino convertirse en un ser dependiente. Nadie niega que el envejecimiento implica una serie de incapacidades para realizar múltiples actividades de la vida cotidiana, pero a eso se le añade el hecho de padecer por lo menos alguna enfermedad crónica. Ser viejo y enfermo es una experiencia propia de la ancianidad, cuya consecuencia es que el individuo se convierta en un ser dependiente, que para sobrevivir social v biológicamente necesita la ayuda, el apoyo y los cuidados de algún * El trabajo contó con el apoyo financiero del SiMorelos del Conacvt, convenio 980302020. La autora agradece la avuda de Alejandra Lizardi durante el proceso de investigación.

1 Financiamiento recibido del CONACYT, convenio G-34361, del proyecto Demografía de las edades avanzadas: implicaciones para el desarrollo y bienestar. 2 Doctora en Ciencias Sociales. Profesora del Departamento de Salud Pública de la Universidad de Guadalajara. Guadalajara, México. 3 Doctorante del Programa Doctorado en Ciencias de la Salud Pública de la Universidad de Guadalajara. Guadalajara, México. RESUMEN:El objetivo es identificar las valoraciones sobre el cuidado no familiar desde la perspectiva de ancianos residentes en comunidad en condiciones de pobreza. Se realizó un estudio multicéntrico con metodología cualitativa con 92 ancianos residentes en cuatro estados en México de 2002 a 2004. Se realizaron entrevistas semi-estructuradas en los hogares de los ancianos y se hizo un análisis de contenido. La expectativa de los ancianos es ser cuidados por sus hijos en sus hogares, sin embargo, este cuidado familiar no se da cuando existen rupturas en el sistema de reciprocidad entre las generaciones. En estas condiciones, el cuidado por extraños en el hogar o la institucionalización en un asilo es la opción para estos ancianos. Ambas opciones son valoradas negativamente, la primera porque no reúne los rasgos del cuidado otorgado por los hijos, y en el asilo porque no existe realmente un cuidado. ABSTRACT:The aim of this paper is to analyze the values of poor community-living elders about nonkin caregiving. A multicentric qualitative study was carried out in four states of Mexico. From 2002 to 2004, 92 old people participated. They were interviewed in their homes using a semi-structured interview. Data was content analyzed. Old people have the expectations to be cared by their children and in their homes. However, some of them do not receive care from their children because there is a lack of a reciprocity system between generations. Old people are cared by nonkin caregivers or they are institutionalized in a nursing home. Both types of care are valued negatively for two reasons, it is not a familial care and a nursing home is a place where care does not exist. RESUMO:O objetivo é identificar os valores estabelecidos sobre o cuidado não familiar a partir da perspectiva de idosos residentes em comunidades em condições de pobreza. Foi realizado um estudo multicêntrico, de 2002 a 2004, com metodologia qualitativa com 92 idosos residentes em quatro estados na República do México. Foram realizadas entrevistas semi-estruturadas nas casas dos idosos e sua posterior análise de conteúdo. Como resultado identificou-se a expectativa dos entrevistados em ser cuidado por seus filhos em suas casas, no entanto, este cuidado familiar não se dá quando há rupturas no sistema de reciprocidade entre as gerações. Nestas condições, o cuidado por estranhos em casa ou em Instituição de Longa Permanência para Idosos configura-se como a opção para estes idosos que não são cuidados por seus filhos. Ambas as possibilidades são consideradas negativamente, a primeira porque não reúne as características do cuidado outorgado pelos familiares e...

El objetivo del presente texto es analizar el discurso moral sobre la obligación filial y su sistema de recompensa para comprender el papel de la herencia en el cuidado. Los datos provienen de dos trabajos de campo, uno con ancianos y otro con jóvenes de los sectores populares de Guadalajara, México. La obligación filial continúa siendo un ciclo de reciprocidad de cuidado entre padres e hijos, mientras que su sistema de recompensa experimenta un proceso de transición cuando la herencia deja de ser una forma de recompensa y es sustituida por otras expresiones de gratitud basadas en el capital social.