Cuidado, "cavalo batizado" e crítica da conduta profissional pelo paciente-cidadão hospitalizado no Nordeste brasileiro

Nations, Marilyn K.; Gomes, Andréa Tayse de Lima

doi:10.1590/s0102-311x2007000900018

Cited by 22 publications

(28 citation statements)

References 12 publications

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“…For Calvasina et al 24 popular "birth weaknesses" pre-dispose the child to death before birth and mothers' nurturing. Nations & Gomes 25 reveal that patients severely criticize health professionals' dehumanizing conduct in a Fortaleza public hospital.…”

Section: Ethnoetiology Of Infant Deathmentioning

confidence: 99%

Infant death and interpretive violence in Northeast Brazil: taking bereaved Cearense mothers' narratives to heart

Nations

2008

Cad. Saúde Pública

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This study investigates bereaved mothers' ethnoetiologies of avoidable infant deaths in Northeast Brazil. It critically examines the anthropological debate concerning "selective maternal negligence" as a relevant explanation for high infant mortality, based on an analysis of preexisting data. From 2003 to 2006, 316 ethnographic interviews collected by the author from 1979 to 1989 in six communities in Ceará State were retrieved. Forty-five narratives of fatal illness and death of 56 children < 5 years of age were identified for in-depth analysis. Despite their low income and schooling, grieving mothers constructed their own explanations for early death. The most common causes were infectious-contagious diseases (37.9%) and dehumanized care by the attending health professional (24.1%). No mother reported maternal carelessness, detachment, or negligence. If there is any "disregard" in the context of poverty, it is by the unjust economic, political, and social system and inhumane public health practice which violates their rights as citizens. To characterize a bereaved mother as "negligent", or worse, as accomplices in her child's death, is an act of interpretive violence, unfairly blaming and demoraling mother-caregivers in Northeast Brazil.

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Section: Ethnoetiology Of Infant Deathmentioning

confidence: 99%

Infant death and interpretive violence in Northeast Brazil: taking bereaved Cearense mothers' narratives to heart

Nations

2008

Cad. Saúde Pública

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“…This was a qualitative, descriptive-interpretive study using a critical-constructivist approach, 11,14 aiming to uncover the relationship between children's access to health care and infant death which could be prevented by actions and health care services,using Aday & Andersen's 2 (1974) A two-stage theoretical sample was designed. 6 The following institutions were selected: Health District 1 Administrative Headquarters; Primary Health Care Services (nine ESF units and one Traditional Primary Care Unit [UBT], which provide health care according to the traditional model, with basic children's health care provided by pediatricians and without being ascribed to areas); and services of medium complexity (two outpatients clinics and an Allergology Service, which offered primary health care within the traditional model, as well as specialized health care).…”

Section: Methodsmentioning

confidence: 99%

“…Ninety-one interviewees were selected, aiming for the greatest possible variety of discourse in order to guarantee sample suffi ciency and saturation. 6,11,14 A two-part collection strategy was used to collect data: a) individual, semi-structured interviews (scripted according to the theoretical framework) with participants associated with the institutions and mother of children aged between 28 and 365 days. Ninety-one interviewees took part: 11 managers -nine district managers (M) and two unit managers (Geradm); 48 health care professionals from PACS and ESF: ten doctors (MED); 12 nurses (N); 26 Community Health Workers (ACS), 20 from ESF (PSF) and six from PACS; four outpatient clinic general managers (UB), one UBT director and seven pediatricians from outpatient clinics (PED); 20 mothers; b) a case study of a preventable, post-natal infant death.…”

Section: Methodsmentioning

confidence: 99%

Mortalidade infantil evitavel e barreiras de acesso a atencao basica no Recife, Brasil

Vanderlei

Navarrete

2013

Rev. Saúde Pública

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OBJECTIVE:Analyze the factors infl uencing avoidable infant mortality from the perspective of the protagonists involved. METHODS:Qualitative study with a critical-constructivist approach, examining children's access to health care and avoiding preventable infant mortality through health care campaigns and services in Health District I of Recife, Northeastern Brazil, between February 2007 and February 2008. The theoretical sample was designed in two stages: I) institutions providing health services to children; II) interviewees: managers (11) (20), with sample size defi ned by "saturation of the speeches". Data was collected using individual semistructured interviews and case studies of avoidable infant death. Thematic content analysis was used, generating mixed categories (emerging and scripted). RESULTS:There were perceived to be confl icting positions between different stakeholder groups refl ecting their role in the care network. All institutional participants related infant deaths to the absence/poor dissemination of child health policies and inter-sectoral actions; professionals and mothers highlighted diffi culties in accessing health care due to insuffi cient global resources, especially the lack of doctorsinFamily Health Strategy, shifting health care to nurses. Lack ofdoctors,acutediseases rejection, and dehumanized and/or poortechnical quality carewere the mainfactors which the mothers relatedto deaths. Family Health Strategy participants from the Programme of Community Health Workers and mothers identifi ed thecondition ofsocial exclusionand maternal neglectwith deaths, but the case studyof deathrevealedthe association withlowerquality of care offered. CONCLUSIONS: Numerous barriers to access indicate insuffi cient BrazilianUnifi ed Health System implementation and lack of resolution of the main access route, the Family Health Strategy. The results indicate the need for improvement of structural and organizational factors of supply, with emphasis on mechanisms to stimulate the recruitment of doctors for the Family Health Strategy professional training of all staff consistent with the model of care to comply with health care policies for children and avoiding preventable infant mortality.

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“…Finalmente, interpretamos os resultados à luz da Antropologia Médica. Desvelamos a racionalidade leiga 35 sobre sua enfermidade 13,16,17 , a violência estrutural 36 , a crítica da conduta profissional 11 , a desumanização institucional 24 e o agir popular diante da enfermidade, inclusive a resistência contra intervenções biomédicas 12,13 …”

Section: Metodologiaunclassified

“…No acompanhamento de doenças crônicas como a doença pulmonar obstrutiva crônica, a co-responsabilização dos sujeitos é imprescindível 5 ; os pacientes freqüentemente não aderem às recomendações médicas de realizar atividade física 9 , seguir a terapêutica medicamentosa ou abandonar o tabagismo 10 . Entretanto, pelo olhar crítico do paciente 11 , baseado na racionalidade leiga, a "não adesão" à intervenção terapêutica pode ser interpretada como um protesto contra um tratamento que agride seu modo de pensar e agir no mundo e não um simples não-cumprimento de ordens médicas 12,13 .…”

Section: Introductionunclassified

Sopro de vida: experiência com a doença pulmonar obstrutiva crônica na pobreza urbana de Fortaleza, Ceará, Brasil

2008

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Trata-se de estudo antropológico de pessoas com a doença pulmonar obstrutiva crônica vivenciada na pobreza urbana de Fortaleza, Ceará, Brasil. De março a novembro de 2006, conduzimos com seis pacientes o estudo de casos, a entrevista etnográfica, a narrativa da enfermidade, e a observação participante no atendimento hospitalar e visitas domiciliares. Utilizamos a análise de conteúdo temática e a interpretação semântica contextualizada para interligar a experiência individual aos sistemas de significação, ações tomadas e condicionantes estruturais. Conclui-se que a doença pulmonar obstrutiva crônica provoca sensações, sinais e significados subjetivos. O diagnóstico torna a vida "um sufoco", surgindo limitações e privações de atividades laborais, sexuais, domésticas, familiares e de lazer. Evitar o contato direto com "o catarro" do doente, deixar de fumar ou diminuir a freqüência e evitar fumaça, tratar os sintomas com remédios caseiros e terapias corporais populares, manter a calma durante as crises, rejeitar restrições categóricas e impostas e entregar-se às forças espirituais são estratégias leigas para enfrentar o cansaço, a crise e a baixa auto-estima. A subjetividade da enfermidade, portanto, jamais pode ser excluída na medição da "carga global da doença" no nordeste brasileiro.

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Cuidado, "cavalo batizado" e crítica da conduta profissional pelo paciente-cidadão hospitalizado no Nordeste brasileiro

Cited by 22 publications

References 12 publications

Infant death and interpretive violence in Northeast Brazil: taking bereaved Cearense mothers' narratives to heart

Infant death and interpretive violence in Northeast Brazil: taking bereaved Cearense mothers' narratives to heart

Mortalidade infantil evitavel e barreiras de acesso a atencao basica no Recife, Brasil

Sopro de vida: experiência com a doença pulmonar obstrutiva crônica na pobreza urbana de Fortaleza, Ceará, Brasil

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