Artefatos de cuidado como expressão de poder

Abstract

Estudo de Caso, cujo objetivo principal foi de compreender a construção do cuidado no Programa de Atendimento Domiciliar ao Acamado, de uma Unidade Básica de Saúde, em Porto Alegre - RS. Dados coletados em 13 encontros de grupo com 29 cuidadores e nos domicílios, através de observação participante, de maio a dezembro/2006 e analisados através da análise do discurso. As cadeiras destinadas ao conforto do paciente no domicílio e a sonda nasoentérica foram identificadas como dispositivos de poder, nas relações dos cuidadores. A cadeira simboliza o tensionamento de poder cambiante, ora presente naquele que realiza o cuidado, ora naquele que está postado na cadeira. A sonda nasoentérica significa sofrimento e limitação imposta ao outro, mas também a preservação da vida. Referenciais pautados em Foucault, que remete à questão do homem como o que faz e exerce poder, porém sem dúvida, aponta que o poder pode produzir liberdade.

Man’s health at home: an integrative review

“…The second category called is: the political and economic, social and educational mismanagement for the caregiver and health care, in home care to man. The content of the articles [9,10,16,19,20,22,24,28,[29][30][31][33][34][35][36][37][38][39] specifies that the social, economic and educational standards of caregivers interfere in how they provide care to men. These articles also confirm that the political and economic condition affects the way health services are structured to meet the man at his home.…”

“…Predominates in recovered articles the notion that the practices directed to men in the form of home care are related to people with chronic illnesses bearers. There are a variety of chronic medical conditions that can be treated successfully in households, with some differentiation with respect to the assistance provided by formal and informal caregivers [19][20][21][22].…”

“…Chronic diseases which demand home care have been described by: cardiovascular disease, Alzheimer's, dementia, depression, schizophrenia, stroke, degenerative neuropathies, fractures, osteomyelitis, varicose ulcers, polio sequelae and cardiac arrest, as well as cancers in terminal stage users [19][20][21][22][23]. It denotes that these men assisted at home have on average more than five comorbidities and at least two clinical diagnoses [21].…”

“…It was noticed, with the analyzed studies, that men in clinical conditions of high risk of destabilization require frequent care by formal caregivers -occupational therapy, nursing, physical therapy, medical and psychology -when compared to informal -children, wives and even neighbors [8,19,20,[27][28][29][30][31]. The assistance, when provided by informal caregivers, requires training, besides the particularity of the domiciles are close to the hospital services and lack of materials, equipment and supplies to care, and it is imperative to emphasize that the residences can be their own men or support, such as nursing homes and hostels, which are constant in countries like Canada and the United States of America [8,24,31].…”

“…The minimum care and intermediaries are the most frequent at home, quote: the nasoenteric survey (SNE), care of pressure ulcers (UPP), the aid for intestinal eliminations and intermittent bladder catheterization [12,14,15,19,24].…”