The possible meanings of care: self-care and care-for-the-other

• Published in: Investigación y Educación en Enfermería 2017-05, Vol.35 (2), p.199-209
• Main Authors: Tajra, Fabio Solon, Pontes, Ricardo Jose Soares, Carvalho, Francisco Herlanio Costa
• Format: Article
• Language: English
• Subjects: Activities of daily living; atención integral de salud; avaliação em saúde; Childrens health; comprehensive health care; cuidados integrais de saúde; evaluación en salud; health evaluation; Health services; hermeneutics; hermenéutica; hermenêutica; infantil; Maternal & child health; maternal-child health services; maternalchild health services; servicios de salud materno; serviços de saúde materno
• ISSN: 0120-5307; 2216-0280; 2216-0280
• DOI: 10.17533/udea.iee.v35n2a09

Objective. To understand and to reflect about care based on the experiences of managers, professionals and users of maternal and child health services. Methods. We developed an evaluative research with a qualitative approach in a Northeastern state of Brazil with extensive experience in the regionalization and implementation process of integrated health networks. Semi-structured interviews were carried out with 68 subjects and direct observation of the maternal and child health services. We adopted the theoretical reference framework of Gadamer's hermeneutics to analyze the narratives. Results. Some units of meaning were present, such as: perception and knowledge about oneself; exercise of autonomy; weaknesses in the provision of resources for the materialization of self-care; and difficulties in accessing health services and care practices. We perceive that care is dynamic, comprises various subjective aspects with respect to the singularities of the subjects and is related to the possibility of generating both individual and collective transformation. Conclusion. Care is built based on a movement among the subjects and between them and the social and health services. Thus, when we intend to take care, we need to consider this instead of focusing care solely on the technical support of health professionals. Descriptors: comprehensive health care; maternalchild health services; health evaluation; hermeneutics. Objetivo. Comprender y reflexionar sobre el cuidado a luz de las experiencias de directivos, profesionales y usuarios de los servicios de salud materna e infantil. Metodos. Se desarrollo una investigacion de evaluacion con enfoque cualitativo en un estado en el noreste de Brasil, con una amplia experiencia en el proceso de regionalizacion e implementacion de redes. Se realizaron entrevistas semiestructuradas a 68 sujetos y la observacion directa de los servicios de salud materna e infantil. Se adopto el referencial teorico de la hermeneutica de Gadamer para el analisis de las narrativas. Resultados. Estuvieron presentes algunas unidades de significado, como la percepcion y conocimiento sobre si, el ejercicio de la autonomia, las debilidades en la oferta de recursos para la materializacion del cuidar de si mismos y dificultades en el acceso a los servicios de salud y a las practicas de cuidado. Se percibio que el cuidado es dinamico, se compone de aspectos subjetivos diversos en relacion con las singularidades de los sujetos y esta asociado a la posib