Relações de saúde e relações de doença

Abstract

If something like "health" existed in an individualized and singular manner, it could perhaps be described in the form of a transcendent and universal object that would contrast with a noun like "disease"; except that, because this does not exist, it also cannot be considered. The historicity of health relationships and disease relationships that the population experience nonetheless rejects the possibility of reaching understandings, describing or interfering in what may come to be a state of healthiness or unhealthiness, outside of a perspective of togetherness, reciprocity and movement. In neither of these two cases can either dualist understandings or simple relativism, or even possibly obstinate culturalism, serve to explain why, in the light of the advances in production within the health sciences, the hospital and outpatient clinic structures of public nature continue to be inefficient. The efforts made by many professionals, technicians, intellectuals and managers, and by some politicians, are undeniable, but it also cannot be denied that the objectives that have attemptedly been pursued are far from being achieved. The volume and quality of attendance are not compatible with the academic knowledge that has been acquired locally, or with the proposal to take a comprehensive view of patients. The expectation of something to be done that is incomplete and the perspective of insuperable difficulties have masked the possibilities that interactions with knowledge from different disciplines might allow. Divisions between academic disciplines only exist if we insist on not regarding them as artificial constructs: at the "wholesale" stage of the production of scientific knowledge, matters that are solely biological or psychological, or matters that are solely historical or statistical, become so because we need to fill out forms and because we need to write books and papers, among other reasons that establish professional divisions in modern societies. This introduction has the purpose of presenting texts that here form a dossier united by topics within healthcare and education, bringing together different aspects of what is commonly understood to be public disclosure or dissemination of scientific knowledge. Each of the three papers described below brings out understandings regarding historical processes with the capacity to help in thinking and, with some effort, who knows, in building up healthcare practices through routes that are more inclusive. The paper by André Mota, "Cleaning up the race through the hands of ruralist education: the case of the Butantan Rural School Group in the 1930s", discusses a set of educational proposals put forward during the time of the Vargas government, within its attempts to construct a strong state and, at the same time, a civilized nation. Hence, a link was made between childhood (the central point of educational actions) and stimulation of sanitary and moral concepts that would aid in molding populations originating in rural areas. In discussing the path taken by this projec...

Comunicação de más notícias

“…Comunicação verbal são todas as palavras usadas na interação; comunicação não verbal são todas as outras formas de emissão de mensagem que não a palavra, propriamente dita, ou seja, as expressões faciais, os gestos, as posturas corporais, a maneira de tocar ou ser tocado, a distância que mantemos da outra pessoa, por exemplo 3,4 .…”

“…Essas duas dimensões da comunicação, a verbal e a não verbal, são fundamentais quando pensamos na melhor maneira de darmos uma má notícia, pois toda comunicação tem duas partes: o conteúdo -o fato ou informação que queremos ou necessitamos transmitir -e o sentimento que temos em relação à própria notícia, à pessoa para quem estamos transmitindo a mensagem e a situação/contexto em que a interação está ocorrendo 4,5 .…”

“…Essas dimensões se complementam (dizer "sinto muito" e estar com a fisionomia séria, olhando nos olhos da pessoa, por exemplo), se contradizem (dizer "sinto muito" e sair andando imediatamente, sem dar tempo para a outra pessoa se expressar) e expressam sentimentos (dizer "sinto muito" e demonstrar tristeza no tom de voz e na expressão facial) 4 .…”

“…Na dimensão não verbal, é fundamental estarmos atentos 3,4 : a) a fatores do meio ambiente -existe "adequação" para que sentimentos e angústias sejam expostos? Há algum grau de isolamento e privacidade para que a exposição de angústias e medos seja feita?…”

“…Como sabemos, não é porque não temos controle voluntário que as mensagens deixam de existir e transmitir significados. E o mais desafiador: de uma parte do nosso comportamento, do que emitimos, não temos nem consciência, nem controle 4 . O exemplo mais adequado por estarmos refletindo sobre "más notícias" é a dilatação pupilar.…”