Prevenção Quaternária: envelhecendo em sociedades medicalizadas
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da PUC_SP |
Texto Completo: | https://tede2.pucsp.br/handle/handle/22226 |
Resumo: | Why is it prescribed so much for the elderly? It was based on this questioning that unfolds from my clinical practice as a nurse, in which I was confronted with its negative consequences – the drug iatrogenies – that I was motivated to carry out this research. Thus, my general objective was defined: to bring to light the problematic that involves, in the present societies, the growing use of drugs by the elderly, and in particular, to discuss the determinants of their iatrogenic effects. I proceeded from the hypothesis that there was some relation between this fact and that of living in medicalized societies, marked by the exacerbation of a prescriptive culture. In this perspective, my specific objectives were: (1) to rescue the way of constitution of the dynamics that responded, in the contemporaneity, by the medicalization of human life; (2) to identify the way in which pertinent literature has discussed the inappropriate use of drugs by the elderly, specifically addressing their iatrogenic effects; (3) to carry out field research with medical professionals to listen to them about the problem issue that this dissertation raises, opening space for a better understanding of the articulation between theory and clinical practice with the elderly. From a methodological point of view, this dissertation has a bibliographic review of the theme (chapter 1 and 2) that is pertinent to it and its articulation with the analysis / interpretation of data collected in a field research (chapter 3). The qualitative methodological approach, with an exploratory character, counted on the accomplishment of a semi-structured interview, carried out with seven physicians of different profiles that work with elderly patients. The results of the analysis indicate that there is a gap in training, not only in the teaching of Pharmacology, but also in the subjects of Geriatrics and Gerontology. Another relevant point concerns the recognition that drug iatrogeny may have as one of its determinants the removal, in modern medicine, of the doctor of the sick person's word. To this extent, the research indicated that it is necessary to recognize the importance of listening, as well as auscultation, in the prevention of drug iatrogenies in the elderly (what is called quaternary prevention). Finally, I was able to understand how in the medicalized culture, each one of us, laymen or health professionals, can become inducers of iatrogeny. If this does not happen, a cultural change is necessary. At its foundation is the recognition that human life is the fruit of a miscegenation between the biological, the psychological and the social. From this perspective, the possibility opens up for a more integral / integrative vision to be presented as a basis for avoiding excessive prescriptions at any stage of life and, especially, in old age |
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Fonseca, Suzana Carielo dahttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4325043U2Borrozzino, Nélio Fernandes2019-05-31T12:23:26Z2019-03-19Borrozzino, Nélio Fernandes. Prevenção quaternária: envelhecendo em sociedades medicalizadas. 2019. 103 f. Dissertação (Mestrado em Gerontologia) - Programa de Estudos Pós-Graduados em Gerontologia, Pontifícia Universidade Católica de São Paulo, São Paulo, 2019.https://tede2.pucsp.br/handle/handle/22226Why is it prescribed so much for the elderly? It was based on this questioning that unfolds from my clinical practice as a nurse, in which I was confronted with its negative consequences – the drug iatrogenies – that I was motivated to carry out this research. Thus, my general objective was defined: to bring to light the problematic that involves, in the present societies, the growing use of drugs by the elderly, and in particular, to discuss the determinants of their iatrogenic effects. I proceeded from the hypothesis that there was some relation between this fact and that of living in medicalized societies, marked by the exacerbation of a prescriptive culture. In this perspective, my specific objectives were: (1) to rescue the way of constitution of the dynamics that responded, in the contemporaneity, by the medicalization of human life; (2) to identify the way in which pertinent literature has discussed the inappropriate use of drugs by the elderly, specifically addressing their iatrogenic effects; (3) to carry out field research with medical professionals to listen to them about the problem issue that this dissertation raises, opening space for a better understanding of the articulation between theory and clinical practice with the elderly. From a methodological point of view, this dissertation has a bibliographic review of the theme (chapter 1 and 2) that is pertinent to it and its articulation with the analysis / interpretation of data collected in a field research (chapter 3). The qualitative methodological approach, with an exploratory character, counted on the accomplishment of a semi-structured interview, carried out with seven physicians of different profiles that work with elderly patients. The results of the analysis indicate that there is a gap in training, not only in the teaching of Pharmacology, but also in the subjects of Geriatrics and Gerontology. Another relevant point concerns the recognition that drug iatrogeny may have as one of its determinants the removal, in modern medicine, of the doctor of the sick person's word. To this extent, the research indicated that it is necessary to recognize the importance of listening, as well as auscultation, in the prevention of drug iatrogenies in the elderly (what is called quaternary prevention). Finally, I was able to understand how in the medicalized culture, each one of us, laymen or health professionals, can become inducers of iatrogeny. If this does not happen, a cultural change is necessary. At its foundation is the recognition that human life is the fruit of a miscegenation between the biological, the psychological and the social. From this perspective, the possibility opens up for a more integral / integrative vision to be presented as a basis for avoiding excessive prescriptions at any stage of life and, especially, in old agePor que se prescreve tanto para idosos? Foi baseado nesse questionamento que se desdobra minha prática clínica como enfermeiro, na qual fui confrontado com seus desdobramentos negativos – as iatrogenias medicamentosas – que me senti motivado a realizar esta pesquisa. Assim, se definiu meu objetivo geral: trazer à luz a problemática que envolve, nas sociedades atuais, o crescente uso de medicamentos por idosos e, em especial, discutir os determinantes de seus efeitos iatrogênicos. Para isso, parti da hipótese de que havia alguma relação entre esse fato e o de vivermos em sociedades medicalizadas, marcada pela exacerbação de uma cultura prescritiva. Nessa perspectiva, meus objetivos específicos foram: (1) resgatar o modo de constituição das dinâmicas que responderam, na contemporaneidade, pela medicalização da vida humana; (2) identificar o modo como na literatura pertinente ao tema se tem discutido o uso inapropriado de medicamentos por idosos, abordando especificamente seus efeitos iatrogênicos; (3) realizar uma pesquisa de campo com profissionais médicos para escutá-los relativamente à questão-problema que esta dissertação levanta, abrindo espaço para que se possa compreender melhor a articulação entre teoria e prática clínica com idosos. Do ponto de vista metodológico, esta dissertação conta com revisão bibliográfica do tema (capítulos 1 e 2) que lhe é pertinente e sua articulação com a análise/interpretação de dados coletados em uma pesquisa de campo (capítulo 3). A abordagem metodológica qualitativa, de caráter exploratório, contou com a realização de entrevista semiestruturada, realizada com sete médicos de diferentes perfis que atuam com pacientes idosos. Os resultados da análise indicam que há um gap na formação, não apenas relativamente ao ensino da Farmacologia, mas também das disciplinas de Geriatria e Gerontologia. Outro ponto relevante diz respeito ao reconhecimento de que a iatrogenia medicamentosa pode ter como um de seus determinantes o afastamento, na Medicina moderna, do médico da palavra do doente. Nessa medida, a pesquisa indicou que é preciso reconhecer a importância da escuta, tanto quanto da ausculta, na prevenção das iatrogenias medicamentosas em idosos (o que se denomina prevenção quaternária). Por fim, pude compreender como na cultura medicalizada, cada um de nós, leigos ou profissionais da saúde, podemos nos tornar indutores de iatrogenia. Para que isso não ocorra, uma mudança cultural se faz necessária. Em sua base está o reconhecimento de que a vida humana é fruto de uma mestiçagem entre o biológico, o psicológico e o social. Nessa perspectiva, abre-se a possibilidade para que uma visão mais integral/integrativa se apresente como base para evitar o excesso de prescrições em qualquer etapa da vida e, mais especialmente, na velhiceCoordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESapplication/pdfhttp://tede2.pucsp.br/tede/retrieve/49184/N%c3%a9lio%20Fernandes%20Borrozzino.pdf.jpgporPontifícia Universidade Católica de São PauloPrograma de Estudos Pós-Graduados em GerontologiaPUC-SPBrasilFaculdade de Ciências Humanas e da SaúdePrevenção quaternáriaSociedade medicalizadaGerontologiaMedicamentos - UtilizaçãoIatrogeniaQuaternary PreventionMedicalized societyGerontologyDrug utilizationCNPQ::CIENCIAS SOCIAIS APLICADAS::SERVICO SOCIAL::SERVICO SOCIAL APLICADOPrevenção Quaternária: envelhecendo em sociedades medicalizadasinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_SPinstname:Pontifícia Universidade Católica de São Paulo (PUC-SP)instacron:PUC_SPTEXTNélio Fernandes Borrozzino.pdf.txtNélio Fernandes Borrozzino.pdf.txtExtracted texttext/plain239691https://repositorio.pucsp.br/xmlui/bitstream/handle/22226/4/N%c3%a9lio%20Fernandes%20Borrozzino.pdf.txtc74f7e52bba46d6f76f5f49b0b7cdbf1MD54LICENSElicense.txtlicense.txttext/plain; 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dc.title.por.fl_str_mv |
Prevenção Quaternária: envelhecendo em sociedades medicalizadas |
title |
Prevenção Quaternária: envelhecendo em sociedades medicalizadas |
spellingShingle |
Prevenção Quaternária: envelhecendo em sociedades medicalizadas Borrozzino, Nélio Fernandes Prevenção quaternária Sociedade medicalizada Gerontologia Medicamentos - Utilização Iatrogenia Quaternary Prevention Medicalized society Gerontology Drug utilization CNPQ::CIENCIAS SOCIAIS APLICADAS::SERVICO SOCIAL::SERVICO SOCIAL APLICADO |
title_short |
Prevenção Quaternária: envelhecendo em sociedades medicalizadas |
title_full |
Prevenção Quaternária: envelhecendo em sociedades medicalizadas |
title_fullStr |
Prevenção Quaternária: envelhecendo em sociedades medicalizadas |
title_full_unstemmed |
Prevenção Quaternária: envelhecendo em sociedades medicalizadas |
title_sort |
Prevenção Quaternária: envelhecendo em sociedades medicalizadas |
author |
Borrozzino, Nélio Fernandes |
author_facet |
Borrozzino, Nélio Fernandes |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Fonseca, Suzana Carielo da |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4325043U2 |
dc.contributor.author.fl_str_mv |
Borrozzino, Nélio Fernandes |
contributor_str_mv |
Fonseca, Suzana Carielo da |
dc.subject.por.fl_str_mv |
Prevenção quaternária Sociedade medicalizada Gerontologia Medicamentos - Utilização Iatrogenia |
topic |
Prevenção quaternária Sociedade medicalizada Gerontologia Medicamentos - Utilização Iatrogenia Quaternary Prevention Medicalized society Gerontology Drug utilization CNPQ::CIENCIAS SOCIAIS APLICADAS::SERVICO SOCIAL::SERVICO SOCIAL APLICADO |
dc.subject.eng.fl_str_mv |
Quaternary Prevention Medicalized society Gerontology Drug utilization |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS SOCIAIS APLICADAS::SERVICO SOCIAL::SERVICO SOCIAL APLICADO |
description |
Why is it prescribed so much for the elderly? It was based on this questioning that unfolds from my clinical practice as a nurse, in which I was confronted with its negative consequences – the drug iatrogenies – that I was motivated to carry out this research. Thus, my general objective was defined: to bring to light the problematic that involves, in the present societies, the growing use of drugs by the elderly, and in particular, to discuss the determinants of their iatrogenic effects. I proceeded from the hypothesis that there was some relation between this fact and that of living in medicalized societies, marked by the exacerbation of a prescriptive culture. In this perspective, my specific objectives were: (1) to rescue the way of constitution of the dynamics that responded, in the contemporaneity, by the medicalization of human life; (2) to identify the way in which pertinent literature has discussed the inappropriate use of drugs by the elderly, specifically addressing their iatrogenic effects; (3) to carry out field research with medical professionals to listen to them about the problem issue that this dissertation raises, opening space for a better understanding of the articulation between theory and clinical practice with the elderly. From a methodological point of view, this dissertation has a bibliographic review of the theme (chapter 1 and 2) that is pertinent to it and its articulation with the analysis / interpretation of data collected in a field research (chapter 3). The qualitative methodological approach, with an exploratory character, counted on the accomplishment of a semi-structured interview, carried out with seven physicians of different profiles that work with elderly patients. The results of the analysis indicate that there is a gap in training, not only in the teaching of Pharmacology, but also in the subjects of Geriatrics and Gerontology. Another relevant point concerns the recognition that drug iatrogeny may have as one of its determinants the removal, in modern medicine, of the doctor of the sick person's word. To this extent, the research indicated that it is necessary to recognize the importance of listening, as well as auscultation, in the prevention of drug iatrogenies in the elderly (what is called quaternary prevention). Finally, I was able to understand how in the medicalized culture, each one of us, laymen or health professionals, can become inducers of iatrogeny. If this does not happen, a cultural change is necessary. At its foundation is the recognition that human life is the fruit of a miscegenation between the biological, the psychological and the social. From this perspective, the possibility opens up for a more integral / integrative vision to be presented as a basis for avoiding excessive prescriptions at any stage of life and, especially, in old age |
publishDate |
2019 |
dc.date.accessioned.fl_str_mv |
2019-05-31T12:23:26Z |
dc.date.issued.fl_str_mv |
2019-03-19 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
Borrozzino, Nélio Fernandes. Prevenção quaternária: envelhecendo em sociedades medicalizadas. 2019. 103 f. Dissertação (Mestrado em Gerontologia) - Programa de Estudos Pós-Graduados em Gerontologia, Pontifícia Universidade Católica de São Paulo, São Paulo, 2019. |
dc.identifier.uri.fl_str_mv |
https://tede2.pucsp.br/handle/handle/22226 |
identifier_str_mv |
Borrozzino, Nélio Fernandes. Prevenção quaternária: envelhecendo em sociedades medicalizadas. 2019. 103 f. Dissertação (Mestrado em Gerontologia) - Programa de Estudos Pós-Graduados em Gerontologia, Pontifícia Universidade Católica de São Paulo, São Paulo, 2019. |
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por |
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Pontifícia Universidade Católica de São Paulo |
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PUC-SP |
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Brasil |
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Faculdade de Ciências Humanas e da Saúde |
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Pontifícia Universidade Católica de São Paulo |
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