Carvalho Maria Bernadete de, Val Alexandre Costa, Ribeiro Maria Mônica Freitas, Santos Lúcia Grossi Dos
Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
Faculdade de Medicina, Universidade Federal de São João del-Rei. São João del-Rei MG Brasil.
Cien Saude Colet. 2016 Aug;21(8):2463-74. doi: 10.1590/1413-81232015218.16452015.
The scope of this study is to identify and contextualize aspects of the therapeutic itineraries of patients treated at a university medical clinic specialized in nervous anorexia and bulimia. For this purpose, an attempt was made to reconstitute the succession of events triggered in 20 respondents and their families with the classification of anorexia and bulimia as "health problems." The narratives were analyzed in order to link the individual experiences and the social context of their occurrence (organization of health services, characteristics of treatment and medical knowledge and characteristics of contemporary subjectivity), in light of the theoretical studies of Public Health and Psychoanalysis. Data analysis revealed that these itineraries arise from connections and disconnections between two distinct approaches: one that organizes the management of patients and the other governing the conduct of health institutions and families. If the latter presuppose a quest for health, this is not what primarily concerns the individuals in question. Their refusal to moderate their own eating disorders is notable on their itineraries, and indicates the functionality of those practices. Such practices play a part in the reconstruction of their self-images.
本研究的范围是识别在一家专门治疗神经性厌食症和贪食症的大学医疗诊所接受治疗的患者治疗过程中的各个方面，并将其置于具体情境中。为此，我们尝试通过将厌食症和贪食症归类为“健康问题”，来重构20名受访者及其家庭中引发的一系列事件。根据公共卫生和精神分析的理论研究，对这些叙述进行了分析，以便将个人经历与其发生的社会背景（卫生服务的组织、治疗特征、医学知识以及当代主体性特征）联系起来。数据分析表明，这些治疗过程源于两种不同方法之间的联系和脱节：一种方法组织患者的管理，另一种方法则指导卫生机构和家庭的行为。如果后者预设了对健康的追求，但这并非相关个体最主要关心的问题。在他们的治疗过程中，他们拒绝节制自己的饮食失调行为值得注意，这表明了这些行为的功能性。此类行为在他们自我形象的重建中发挥了作用。
