Representações sociais do cuidado em saúde de pessoas em situação de rua

Abstract

Objective Identify and analyze the structure and content of the social representations of homeless people in relation to health care. Method Qualitative study, based on the structural approach of the Theory of Social Representations, conducted with homeless people, linked to two institutional shelters. To produce the data, the free-association test was used. The resulting data was processed by two software and analyzed according to the theory above. Results Seventy-two people participated in the study. The set of evocations from the four-quadrant chart refers to individual, social and cultural actions. The terms 'doctor', 'taking care of yourself' and 'eating' composed the central core of the representation, indicating image-related and functional dimensions of the object investigated. The word cloud confirmed the centrality of the terms. Conclusion The investigated group represents health care as a dynamic action, linked to the person and context, and is anchored in elements of the hygienist conception.

Homeless people's social representations about self-care

“…According to participants, prevention is based on practices such as: using condoms, doing tests, brushing teeth, bathing, vaccination, not using drugs, among others. These findings are in agreement with research carried out with HP in the city of Salvador, Bahia, on health care and STI prevention (10) . Despite the notion of prevention exposed by HP, their vulnerability condition exposes them to risks as well as to violation of rights.…”

“…On the street, people struggle to meet their needs, especially when it comes to bathing and oral care, often leading them not to practice self-care, making them dirty, smelly, exposed to prejudices and turning away. This reality was evidenced in studies with HP in the cities of São Paulo and Salvador (10)(11) . Nevertheless, the social group recognizes these practices as important and seeks to perform them.…”

“…13.714/2018, which made it compulsory to care for people in situations of vulnerability, without proof of domicile (29) . A study carried out with HP in the city of Salvador, Bahia, showed that one of the problems faced by the social group investigated was the difficult access to services, denouncing the experience of the "paper citizen" (10,30) , which enhances the processes of social exclusion, vulnerabilities and invisibilities. For self-care, it is important that each individual engages in self-care so as not to forget who one is and can take care of oneself properly (31) .…”

“…This population group, due to a lack of fixed address and civil identification documents, is not included in the Census of the Brazilian Institute of Geography and Statistics and has difficulties accessing health services and government social programs (10)(11) . These aspects hamper the planning of care actions and policies and maintain the social invisibility of the group.…”

Common mental disorders and resilience in homeless persons

“…Studies point to a number of factors that can lead a person to live on the street, such as rupture of family ties, common mental disorders, lack of a family nucleus, violence, drugs, economic situation, or even the difficulty to be in the labor market (6) . Research conducted in João Pessoa-PB, scenario of this study, revealed use of drugs and alcohol, unemployment and rupture of family ties as reasons for becoming a homeless person (7) .…”