A representação social do cuidado no Programa Saúde da Família na cidade do Natal

Abstract

The aim of this study was to learn about the social representations of the care provided by the Family Health Program (FHP) in the city of Natal, Brazil and determine how these representations guide the daily actions of doctors, dentists, nurses, nurse s assistants and oral health assistants during the work process. In this sense, we used the theoreticalmethodological approach to the Theory of Social Representations. For data collection, we used the following instruments: a two-part questionnaire, where the first part recorded sociodemographic data and the second part was adapted to the free word association technique (FWAT), which was applied to 90 professionals belonging to 18 FHP units. Interviews were also used as collection instruments. These were based on inductive stimuli and on direct observations of 30 of these professionals. After a superficial reading of the material, we constructed a corpus from which ten categories emerged. To analyze FWAT we used lexicographic analysis, combining frequency and the mean order of responses. The interviews and sociodemographic variables were analyzed using content analysis and descriptive statistical analysis, respectively. The study showed that the central nucleus of the social representation in question is composed of the elements attention, receptivity and love, revealing that the subjects have different understandings of the FHP care process and that the knowledge accumulated in this respect is supported by an approximate vision of the meaning of care. However, traditional elements with trivializing connotations about care predominate, which compromises the development of strategies to overcome traditional practices. In the set of analyses, we were able to capture the invariance of a contradiction: on one hand, professionals know and affirm the importance of providing care for FHP patients; on the other, the experience of daily practice translates into the negation of this concept. In this contradictory context, professionals build gradual and successive syntheses that allow them to act and affirm themselves by associating information from their academic formation, structured knowledge acquired in other experiences, values and symbols of their daily routine. Thus, they shape and reshape themselves, according to what is concretely and specifically required, at the same time both plural and multiple. The composition of the central nucleus indicates that any measure that intends to modify attitudes that is, the daily actions of FHP professionals with respect to care must take into account and give priority to the debate about the redefining of the semantic fields of the central nucleus (love/attention/receptivity and humanization), especially those of love and attention