Educação em saúde e constituição de sujeitos: desafios ao cuidado no programa de saúde da familia.

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

Health education involves different conceptions of health, education and human being according to witch two health education practices are defined: the hegemonic and the dialogical. The first one aims at the prevention of disease through the transfer of biomedical contents for reducing individual risks. The dialogical model has the individual and their reality as its starting point. This individual is recognized as the subject of education practice, whose objective is the development of autonomy in caring for their own health. This viewpoint provides socioculturally sensitive education practices. In accordance with the integrality principle, health education constitutes one of the basic attributions of all Family Health Program?s professionals. The health education practice should be developed when there are contacts with the users and the community. This study aimed at identifying and characterizing health education action in medical consultations. The literal transcriptions of 100 consultations were analysed: 50 with hypertense patients and 50 with children under six years old, conducted,respectively, by ten Family Health Program?s doctors in three towns in the State of Bahia, Brazil. The results indicated that clinical care at the Family Health Program is predominantly guided by the biomedical model. The focus given to the individual, the disease and the remission of symptoms constitutes evidence of a conception of health as the absence of disease. The patients? and families? narratives are inhibited by the medical discourse, making the consultation impermeable the psychosocial and cultural dimensions of the health-disease-care process. The medical narrative is imperative: the definition of a therapeutical process is focused on the professional, without negotiating with the patient. The health education action reveals itself as prescriptive and descontextualized of the concret life conditions of the patients. The hegemonic model of health education prevails, but actions guided by the development of patients? autonomy,even if isolated and related to the professional?s idiosyncrasies, can also be identified. In conclusion, the Family Health Program?s doctors have not assimilated in their clinical practice the full nature that constitutes the axis of the change in the care model. This highlights the need for professional training for dialoguing with cultural diversity.

ASSUNTO(S)

programa saúde da família doctor-patient relationship family health program educação em saúde relação médico-paciente health education saude coletiva

ACESSO AO ARTIGO

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