Significados de apoio social de acordo com um grupo de pessoas submetidas à revascularização do miocárdio

Abstract

O objetivo principal deste estudo foi compreender os significados culturais de apoio social e descrever a experiência da enfermidade na perspectiva de um grupo de pessoas submetidas à revascularização do miocárdio (CRVM). O método etnográfico foi utilizado na condução deste estudo bem como os modelos explanatórios, propostos por Arthur Kleinman, foram utilizados para compreender o processo de saúde e doença. Participaram do estudo 11 pacientes moradores de Ribeirão Preto que foram submetidos à CRVM em um hospital terciário e universitário da mesma cidade. Para a coleta de dados, foram utilizados questionário com registro de dados sociodemográficos, entrevista semiestruturada e observações diretas, realizadas na residência dos sujeitos e durante o retorno às consultas médicas. A maioria dos participantes era do sexo feminino (seis), casada, com idade variando entre 49 e 73 anos e ensino fundamental incompleto. A partir da análise e interpretação dos dados, dois temas principais foram identificados: 1) A experiência da revascularização do miocárdio e 2) Significado de apoio social: instrumental e emocional. A notícia da necessidade da CRVM aconteceu de forma inesperada para os pacientes que não relacionavam os sinais e sintomas que apresentavam a qualquer problema de saúde cardiovascular. A necessidade da cirurgia fez com que os pacientes elaborassem diferentes explicações para o problema, como: causas comportamentais (maus hábitos alimentares e tabagismo), físicas (casos na família e consequência de outras doenças crônicas -diabetes e hipertensão arterial), religiosas (desígnio de Deus -provação), sociais (separações, frustrações) e emocionais (muito estresse, nervoso, muitas preocupações, muita ansiedade). Para os pacientes, esse período foi muito difícil, pois não queriam operar, tinham medo de morrer. O apoio dos familiares e de DEUS foi fundamental para tomarem a decisão pela CRVM. Após a CRVM, a principal fonte de apoio para esses pacientes foram os familiares que ofereceram apoio emocional e apoio instrumental. Observamos que o apoio dos profissionais da saúde foi restrito ao ambiente hospitalar e de maneira pontual antes da cirurgia. Para os pacientes, o apoio significou ajuda nas atividades domésticas e de autocuidado, principalmente prestada pelos familiares (cônjuge e filhos). Para os pacientes é muito difícil estar dependente dos familiares, uma vez que antes da doença a situação era inversa.Descritores: apoio social; revascularização miocárdica; etnografia; cultura; saúde. The main goal of this study was to understand the cultural meanings of social support and to describe the disease experience from the perspective of a group of people submitted to coronary artery bypass graft (CABG). Ethnographic method was used to conduct this study, and the explanatory models proposed by Arthur Kleinman were used to understand the health and disease process. Study participants were 11 patients who lived in Ribeirão Preto and were submitted to CABG at a tertiary teaching hospital in the same city. For data collecti...

Rede Pessoal Significativa de Pacientes Submetidos à Cirurgia Cardíaca

“…According to the results found, it is clearly evidenced that the friendships configure relevant elements, as resources in coping with cardiac surgery, for the subjects who undergo this procedure -agreeing with the results of the study of Bin et al (2014), which, studying from the perspective of "social support", observed that the most important people in the personal network, for the patients who undergo the surgery, were the family members and friends.…”

“…These functions may be understood as analogous to those found in the study of Bin, Costa, Vila, Dantas and Rossi (2014), in the perspective of "social support" (emotional and instrumental support). In that study, the participants indicated the relationship of dependence on the family established after the cardiac event, to the extent that the members of this relational nucleus were indicated, in the study, as the main articulators of the relationships established by the patients with the other relational contexts.…”

“…It may be observed that, in these contexts, four groups were mentioned as participators of the participants' significant personal network, indicating that, in the scenario of healthcare, the participants mention that there is a team contribution on the part of health professionals who treat them, validating the joint effort of the care in relation to their condition. Contrasting these results, patients who had undergone CABG and who participated in the study of Bin et al (2014) on social support mentioned that there was no type of continuous support on the part of the health professionals subsequent to discharge from hospital, highlighting the perception that they did not feel cared for once they were out of the hospital's doors. Emphasis is placed, therefore, on the demand for continuity of care and continued treatment by the health team throughout the surgical process, which includes the period of recovery and rehabilitation.…”

“…Of the other six participants who mentioned participators of their network in the ambit of the friendships, emphasis is placed on the mentioning of neighbors by three people, a context also present for postsurgical cardiac patients studied in the perspective of "social support" (Bin et al, 2014). In the above-mentioned study, the relationship of "neighborliness" was indicated as providing emotional and instrumental support after the surgery.…”

Referral and counter-referral: repercussions of coronary artery bypass graft in the perspective of Primary Care

“…The relatives are also evidenced in the confrontation of the surgical process of these patients, receiving, along with the indication of CABGS, the guidelines. The family system is reported in a study with people submitted to the CABGS as the main source of support reported by the patients, confirming through the reports that the direct assistance of the family in the accomplishment of domestic activities and self-care, accompaniment and emotional support are fundamental throughout the treatment, and rehabilitation after hospital discharge (18) .…”