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| Author(s): |
Tatiane Mitleton Borges Ramos
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | Ribeirão Preto. |
| Institution: | Universidade de São Paulo (USP). Escola de Enfermagem de Ribeirão Preto (PCARP/BC) |
| Defense date: | 2010-08-11 |
| Examining board members: |
Luiz Jorge Pedrão;
Rosane Pilot Pessa Ribeiro;
Manoel Antonio dos Santos
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| Advisor: | Luiz Jorge Pedrão |
| Abstract | |
The user embracement is a technical and political way aiming to guarantee the population a type of health assistance with high resolution. The attachment between the health professional and the patient is the relationship which makes possible that the autonomy and the citizenship are stimulated by an active participation of the user in the service and in the health knowledge construction. However, due to the conflicting relationship usually established between the anorexic and bulimic patients with the health professionals dealing with them, this investigation had the purpose to access how the user embracement process is in the Assistance Group of Eating Disorders of the University Hospital of the Ribeirão Preto Medical School (GRATA-HCFMRP-USP), and how the attachment between users and health professional is established. By means of the Fourth Generation Evaluation, which is based in the theoretical framework of the Constructivism and uses Guba and Lincoln\"s Hermeneutic-Dialectic Circle as methodological tool, 16 patients and 7 health professionals were interviewed. The Hermeneutic-Dialetic Circle was employed with the purpose of allowing the appearance of constructions about the meaning of the user embracement and of the attachment, which are negotiated among the research participants. The data were analyzed by the emerged constructions, the consensual and divergent aspects raised in the interviews and also by analysis of the documents and observations available in the service. The data disclosed that some elements are essential for the establishment of the user embracement and the attachment: service integrality, intersectoriality, interdisciplinary approach, degree of professional education, attachment and humanization of the health assistance process. Respectively, the GRATA showed to be a group seeking an integral patient assistance, although this integrality can be affected by the exceeding use of the biomedical model of some professionals; the sectorial articulation with the various professionals and health departments was fundamental to the service, despite some deficiencies of the HCFMRP-USP regarding its physical and structural organization; there is a consistent interdisciplinary aspect within the service, however influenced by function overload and excess use of the biomedical approach in some health professionals; the training and supervision activities were considered fundamental, which could also be extended to other professionals of the HCFMRP-USP; the attachments between the professionals and the patients were consistent and revealed some potentiality for dialogic spaces, despite being prejudiced by the lack of enough rooms, inability of some professionals for an adequate listening of the patient, and the professionals\" turnover; the relationship among the patients was considered an useful resource for facing the problem, even though it sometimes influenced the treatment negatively, considering that activities which could be offered by the service were supposed to attenuate the harm imposed by these relationships; the GRATA, in the end, was regarded as a service seeking a model of assistance centered in the patient, having a considerable degree of resolution and tending to adopt procedures that highlight the patient human dimension, despite the occurrence of some limitations and deficiencies. (AU) | |