Warmling Cristine Maria, Fajardo Ananyr Porto, Meyer Dagmar Estermann, Bedos Cristophe
Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
Grupo Hospitalar Conceição, Porto Alegre, Brasil.
Cad Saude Publica. 2018 Mar 29;34(4):e00009917. doi: 10.1590/0102-311X00009917.
The study's main objective is to analyze how discourses of medicalization and humanization reconnect in primary healthcare and shape prenatal care for pregnant women provided by family health teams. This was a single and integrated case study with multiple analytical units and a qualitative approach. A total of 17 focus groups were performed, in which 47 health professionals were heard (14 physicians, 19 nurses, and 14 dentists), members of 17 family health teams in 16 municipalities in the South of Brazil. The empirical material was analyzed from the perspective of Foucauldian discourse analysis. The family health teams, adopting general practice, reported difficulties in conducting prenatal care, evoking and bolstering the discourse of obstetric medicalization that their practice should supposedly offset. The discourse officially adopted by humanization, prioritized in the generalist model of prenatal care, continues to function as a complementary discourse to that of medicalization and specialization, which prevails in the practices reported by the teams. The emphasis on humanized care for pregnant women tests the limits of professional territories and assumes the renegotiation of competencies. Efforts at collaboration between the family health teams and obstetricians have not proved very successful in this specific case.
该研究的主要目的是分析医学化和人性化话语如何在初级卫生保健中重新联系起来，并塑造家庭健康团队为孕妇提供的产前护理。这是一个具有多个分析单元的单一综合案例研究，采用定性方法。共进行了17个焦点小组讨论，听取了47名卫生专业人员的意见（14名医生、19名护士和14名牙医），他们来自巴西南部16个市的17个家庭健康团队。实证材料从福柯话语分析的角度进行了分析。采用全科医疗模式的家庭健康团队报告称，在开展产前护理方面存在困难，引发并强化了他们的实践本应抵消的产科医学化话语。人性化正式采用的话语，在产前护理的全科模式中占据优先地位，继续作为医学化和专业化话语的补充话语发挥作用，而医学化和专业化话语在团队报告的实践中占主导地位。对孕妇人性化护理的强调考验了专业领域的界限，并假定了能力的重新谈判。在这个具体案例中，家庭健康团队与产科医生之间的合作努力并未取得很大成功。
