A vida após a alta

Detalhes bibliográficos
Autor(a) principal: Castro, Edna Aparecida Barbosa de
Data de Publicação: 2005
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
Texto Completo: http://www.bdtd.uerj.br/handle/1/4601
Resumo: This thesis discusses life after discharge from the hospital, using the ethnography of the experience of a group of families, as they cared for dependent family members. It was carried out between August 2001 and July 2005 in Juiz de Fora, MG. The focus of the investigation was the family s daily life with a member who required specialized health care after receiving highly complex care. The objective was to answer the question: how does the family care, at home, for a member who still needs care after being discharged from the hospital? We adopted Geertz s (1989) ethnography, which allowed us, through interpretive analysis of the webs of meanings learned through observance-contact with the subjects, an understanding of how the phenomenon (care) is evidenced, and is transformed into experience in the relationships that arise within and outside of the family. Identification of the subject families began with observation of hospital admittances at the Intensive Care Unit (ICU) of the Juiz de Fora Federal University Hospital during the second semester of 2003, followed by observation in the wards, and later, at the homes. Of 137 patients admitted to the ICU that semester, 59 died, 12 were transferred to other hospitals in the same city, as they required technology not offered by the University Hospital, and 66 were released under the category of improved . Of these, we observed only 12 cases, all residing in the city of Juiz de Fora, who fall under the same care culture and who received the same organizational standard and care flow in the local health system. Of these, one family stood out as the principal subject, due to repetition of events that were significant for the main issue of this study. We also used data from 5 of the other observed patients. The data were stored in a LOGOS® qualitative data bank. Among the results we found were the priority given to physical care, the dependence on specialized SUS health services and the alterations in the organization and functioning of the family, with redefinition of roles to adapt to the reality of living with a sick family member. Two phenomena related to the experience of caring by the families stand out: individualization in the family, which seems to influence the clinical approach (individualized) by health professionals, and a conception of the family as a collective subject , Bourdieu (1998), as a possibility for planning collective action. The suffering that was observed through continuous contact of the subjects with anguish as they sought health care in the SUS, in the health care institutions, demonstrated the uncare that this group of citizens is exposed to under the present health care system. The families experiences in dealing with a variety of types of care, including technical care, led to a network of contacts with people outside of the family, to meet the patients needs. In spite of dependence on technology, technological knowledge, and the restrictions on them, there was evidence of a kind of autonomy on the part of the subjects in terms of health care practice within the intra-family space an in the micro-sociological surroundings. In the Health Care System, the families first preference was to seek help at hospitals, then at secondary reference units, and lastly, from the Family Health Teams. They sought help from the Family Health Teams because they represented an obligatory part of the initial flow of users in the local SUS, they guarantee the supply of medicine, offer services of a bureaucratic nature, such as bills of health and doctor s opinions to present to judges, as well as requests and forwarding for laboratory exams.
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spelling Camargo Junior, Kenneth Rochel dehttp://lattes.cnpq.br/3585073727110885Loyola, Cristina Maria Douathttp://lattes.cnpq.br/5128815127967620Bonet, Octavio Andres Ramonhttp://lattes.cnpq.br/9539416788412797Sayd, Jane Dutrahttp://lattes.cnpq.br/6415761097808350Pinheiro, Rosenihttp://lattes.cnpq.br/5840346413537531http://lattes.cnpq.br/0919629615453590Castro, Edna Aparecida Barbosa de2020-08-02T16:51:39Z2012-09-132005-12-19CASTRO, Edna Aparecida Barbosa de. A vida após a alta. 2005. 255 f. Tese (Doutorado em Saúde Coletiva) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2005.http://www.bdtd.uerj.br/handle/1/4601This thesis discusses life after discharge from the hospital, using the ethnography of the experience of a group of families, as they cared for dependent family members. It was carried out between August 2001 and July 2005 in Juiz de Fora, MG. The focus of the investigation was the family s daily life with a member who required specialized health care after receiving highly complex care. The objective was to answer the question: how does the family care, at home, for a member who still needs care after being discharged from the hospital? We adopted Geertz s (1989) ethnography, which allowed us, through interpretive analysis of the webs of meanings learned through observance-contact with the subjects, an understanding of how the phenomenon (care) is evidenced, and is transformed into experience in the relationships that arise within and outside of the family. Identification of the subject families began with observation of hospital admittances at the Intensive Care Unit (ICU) of the Juiz de Fora Federal University Hospital during the second semester of 2003, followed by observation in the wards, and later, at the homes. Of 137 patients admitted to the ICU that semester, 59 died, 12 were transferred to other hospitals in the same city, as they required technology not offered by the University Hospital, and 66 were released under the category of improved . Of these, we observed only 12 cases, all residing in the city of Juiz de Fora, who fall under the same care culture and who received the same organizational standard and care flow in the local health system. Of these, one family stood out as the principal subject, due to repetition of events that were significant for the main issue of this study. We also used data from 5 of the other observed patients. The data were stored in a LOGOS® qualitative data bank. Among the results we found were the priority given to physical care, the dependence on specialized SUS health services and the alterations in the organization and functioning of the family, with redefinition of roles to adapt to the reality of living with a sick family member. Two phenomena related to the experience of caring by the families stand out: individualization in the family, which seems to influence the clinical approach (individualized) by health professionals, and a conception of the family as a collective subject , Bourdieu (1998), as a possibility for planning collective action. The suffering that was observed through continuous contact of the subjects with anguish as they sought health care in the SUS, in the health care institutions, demonstrated the uncare that this group of citizens is exposed to under the present health care system. The families experiences in dealing with a variety of types of care, including technical care, led to a network of contacts with people outside of the family, to meet the patients needs. In spite of dependence on technology, technological knowledge, and the restrictions on them, there was evidence of a kind of autonomy on the part of the subjects in terms of health care practice within the intra-family space an in the micro-sociological surroundings. In the Health Care System, the families first preference was to seek help at hospitals, then at secondary reference units, and lastly, from the Family Health Teams. They sought help from the Family Health Teams because they represented an obligatory part of the initial flow of users in the local SUS, they guarantee the supply of medicine, offer services of a bureaucratic nature, such as bills of health and doctor s opinions to present to judges, as well as requests and forwarding for laboratory exams.Esta tese discute a vida após a alta hospitalar através de uma etnografia da experiência de um grupo de famílias, ao cuidarem de um membro dependente de cuidados de saúde. Foi realizada entre agosto de 2001 e julho de 2005 em Juiz de Fora-MG. O foco da investigação foi a convivência cotidiana da família com um membro requerendo cuidados de saúde especializados após ter recebido assistência de alta complexidade. O objetivo foi compreender a questão: como a família cuida, em casa, de um familiar que necessita de cuidados de saúde após a alta hospitalar? Adotamos a etnografia orientada por Geertz (1989), que nos permitiu, através da análise interpretativa das teias de significados apreendidas pela observaçãoconvivência com os sujeitos, uma compreensão de como o fenômeno (cuidado) se evidencia e se transforma em experiência nas relações que se estabelecem dentro e fora da família. A identificação das famílias-sujeito iniciou com a observação das internações na Unidade de Terapia Intensiva (UTI) do Hospital Universitário da Universidade Federal de Juiz de Fora, no segundo semestre de 2003, seguida da observação nas enfermarias e, posteriormente, nos seus domicílios. De 137 pacientes internados nesta UTI naquele semestre, 59 foram a óbito, 12 foram transferidos para outro hospital da cidade, por demandarem tecnologias não oferecidas pela instituição e 66 tiveram alta hospitalar na condição de melhorado . Destes, observamos 12 casos, residentes na cidade de Juiz de Fora, que compartilham de uma mesma cultura assistencial e que foram submetidas a um mesmo padrão de organização e de fluxo de atendimento no sistema de saúde local. Destas, uma família se destacou como principal sujeito, pela repetição de eventos significativos à questão principal da pesquisa e utilizamos dados de outras cinco dentre as observadas. Os dados foram arquivados em um banco de dados qualitativos LOGOS®. A prioridade nos cuidados com o corpo; a dependência dos serviços de saúde especializados do SUS e as alterações na organização e no funcionamento da família, com redefinições de papéis, para se adaptar à realidade de convivência com um membro doente, estão dentre os achados. Dois fenômenos que se relacionam com o desenvolvimento da experiência de cuidar pelas famílias se destacaram: a individualização na família, que parece influenciar a forma de abordagem clínica (individualizada) pelos profissionais de saúde, e uma concepção de família como sujeito coletivo Bourdieu (1998) como possibilidade para o planejamento de ações coletivas. O sofrimento, observado pela contínua convivência dos sujeitos com sentimentos de angústia nas trajetórias de busca de cuidados no Sistema, nas instituições de saúde, evidenciou a desassistência a que esse grupo de cidadãos está exposto no modelo assistencial vigente. A lida das famílias com uma diversidade de cuidados, incluindo a prática de cuidados técnicos desencadeou uma rede extrafamiliar de aproximações, para o enfrentamento das necessidades. Apesar da dependência de tecnologias, de saberes técnicos e das restrições no acesso a esses, evidenciou-se um tipo de autonomia pelos sujeitos na prática de cuidados no espaço intrafamiliar e no entorno micro-sociológico de convivência. No Sistema de Saúde a preferência primeira das famílias para busca de ajuda é o hospital, depois, as unidades de referência secundária e, por último, as Equipes de Saúde da Família (ESF). A procura pelas ESF é por que estas representam parte obrigatória no fluxo inicial dos usuários do SUS local, garantem a aquisição de medicamentos, oferecem serviços de natureza cartorial, como atestados e pareceres para juiz e, ainda, encaminhamentos e solicitação de exames.Submitted by Boris Flegr (boris@uerj.br) on 2020-08-02T16:51:39Z No. of bitstreams: 1 Edna Aparecida B de Castro-tese.pdf: 1744132 bytes, checksum: 116b1c84c29f1453d56fb9597e036e75 (MD5)Made available in DSpace on 2020-08-02T16:51:39Z (GMT). No. of bitstreams: 1 Edna Aparecida B de Castro-tese.pdf: 1744132 bytes, checksum: 116b1c84c29f1453d56fb9597e036e75 (MD5) Previous issue date: 2005-12-19application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Saúde ColetivaUERJBRCentro Biomédico::Instituto de Medicina SocialHealth CareCareFamilyEthnographyHospital DischargeHome CareCuidadoCuidarFamíliaEtnografiaAlta hospitalarAssistência domiciliarCNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVAA vida após a altaLife after dischargeinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALEdna Aparecida B de Castro-tese.pdfapplication/pdf1744132http://www.bdtd.uerj.br/bitstream/1/4601/1/Edna+Aparecida+B+de+Castro-tese.pdf116b1c84c29f1453d56fb9597e036e75MD511/46012024-02-26 20:21:00.47oai:www.bdtd.uerj.br:1/4601Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T23:21Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false
dc.title.por.fl_str_mv A vida após a alta
dc.title.alternative.eng.fl_str_mv Life after discharge
title A vida após a alta
spellingShingle A vida após a alta
Castro, Edna Aparecida Barbosa de
Health Care
Care
Family
Ethnography
Hospital Discharge
Home Care
Cuidado
Cuidar
Família
Etnografia
Alta hospitalar
Assistência domiciliar
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA
title_short A vida após a alta
title_full A vida após a alta
title_fullStr A vida após a alta
title_full_unstemmed A vida após a alta
title_sort A vida após a alta
author Castro, Edna Aparecida Barbosa de
author_facet Castro, Edna Aparecida Barbosa de
author_role author
dc.contributor.advisor1.fl_str_mv Camargo Junior, Kenneth Rochel de
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/3585073727110885
dc.contributor.referee1.fl_str_mv Loyola, Cristina Maria Douat
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/5128815127967620
dc.contributor.referee2.fl_str_mv Bonet, Octavio Andres Ramon
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/9539416788412797
dc.contributor.referee3.fl_str_mv Sayd, Jane Dutra
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/6415761097808350
dc.contributor.referee4.fl_str_mv Pinheiro, Roseni
dc.contributor.referee4Lattes.fl_str_mv http://lattes.cnpq.br/5840346413537531
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/0919629615453590
dc.contributor.author.fl_str_mv Castro, Edna Aparecida Barbosa de
contributor_str_mv Camargo Junior, Kenneth Rochel de
Loyola, Cristina Maria Douat
Bonet, Octavio Andres Ramon
Sayd, Jane Dutra
Pinheiro, Roseni
dc.subject.eng.fl_str_mv Health Care
Care
Family
Ethnography
Hospital Discharge
Home Care
topic Health Care
Care
Family
Ethnography
Hospital Discharge
Home Care
Cuidado
Cuidar
Família
Etnografia
Alta hospitalar
Assistência domiciliar
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA
dc.subject.por.fl_str_mv Cuidado
Cuidar
Família
Etnografia
Alta hospitalar
Assistência domiciliar
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA
description This thesis discusses life after discharge from the hospital, using the ethnography of the experience of a group of families, as they cared for dependent family members. It was carried out between August 2001 and July 2005 in Juiz de Fora, MG. The focus of the investigation was the family s daily life with a member who required specialized health care after receiving highly complex care. The objective was to answer the question: how does the family care, at home, for a member who still needs care after being discharged from the hospital? We adopted Geertz s (1989) ethnography, which allowed us, through interpretive analysis of the webs of meanings learned through observance-contact with the subjects, an understanding of how the phenomenon (care) is evidenced, and is transformed into experience in the relationships that arise within and outside of the family. Identification of the subject families began with observation of hospital admittances at the Intensive Care Unit (ICU) of the Juiz de Fora Federal University Hospital during the second semester of 2003, followed by observation in the wards, and later, at the homes. Of 137 patients admitted to the ICU that semester, 59 died, 12 were transferred to other hospitals in the same city, as they required technology not offered by the University Hospital, and 66 were released under the category of improved . Of these, we observed only 12 cases, all residing in the city of Juiz de Fora, who fall under the same care culture and who received the same organizational standard and care flow in the local health system. Of these, one family stood out as the principal subject, due to repetition of events that were significant for the main issue of this study. We also used data from 5 of the other observed patients. The data were stored in a LOGOS® qualitative data bank. Among the results we found were the priority given to physical care, the dependence on specialized SUS health services and the alterations in the organization and functioning of the family, with redefinition of roles to adapt to the reality of living with a sick family member. Two phenomena related to the experience of caring by the families stand out: individualization in the family, which seems to influence the clinical approach (individualized) by health professionals, and a conception of the family as a collective subject , Bourdieu (1998), as a possibility for planning collective action. The suffering that was observed through continuous contact of the subjects with anguish as they sought health care in the SUS, in the health care institutions, demonstrated the uncare that this group of citizens is exposed to under the present health care system. The families experiences in dealing with a variety of types of care, including technical care, led to a network of contacts with people outside of the family, to meet the patients needs. In spite of dependence on technology, technological knowledge, and the restrictions on them, there was evidence of a kind of autonomy on the part of the subjects in terms of health care practice within the intra-family space an in the micro-sociological surroundings. In the Health Care System, the families first preference was to seek help at hospitals, then at secondary reference units, and lastly, from the Family Health Teams. They sought help from the Family Health Teams because they represented an obligatory part of the initial flow of users in the local SUS, they guarantee the supply of medicine, offer services of a bureaucratic nature, such as bills of health and doctor s opinions to present to judges, as well as requests and forwarding for laboratory exams.
publishDate 2005
dc.date.issued.fl_str_mv 2005-12-19
dc.date.available.fl_str_mv 2012-09-13
dc.date.accessioned.fl_str_mv 2020-08-02T16:51:39Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
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dc.identifier.citation.fl_str_mv CASTRO, Edna Aparecida Barbosa de. A vida após a alta. 2005. 255 f. Tese (Doutorado em Saúde Coletiva) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2005.
dc.identifier.uri.fl_str_mv http://www.bdtd.uerj.br/handle/1/4601
identifier_str_mv CASTRO, Edna Aparecida Barbosa de. A vida após a alta. 2005. 255 f. Tese (Doutorado em Saúde Coletiva) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2005.
url http://www.bdtd.uerj.br/handle/1/4601
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dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Saúde Coletiva
dc.publisher.initials.fl_str_mv UERJ
dc.publisher.country.fl_str_mv BR
dc.publisher.department.fl_str_mv Centro Biomédico::Instituto de Medicina Social
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