Tesser Charles Dalcanale, Dallegrave Daniela
Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, Brasil.
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
Cad Saude Publica. 2020 Sep 4;36(9):e00231519. doi: 10.1590/0102-311X00231519.
Complementary and Alternative Medicine (CAM) need to be increasingly understood in the academic and research setting, given their growing inclusion in health institutions and scientific studies. However, vague definitions or broad generalizations are common in the Brazilian scientific literature, an example of which is the relationship between CAM and social medicalization. This study aims to discuss the medicalizing and de-medicalizing potential of the use of CAM, especially in primary healthcare (PHC). This essay summarizes the underlying lack of definition concerning the medicalizing and de-medicalizing potential of various CAM, based on the selected literature, which reports theoretical and empirical convergences. The exercise of CAM in the clinical context has a medicalizing potential, due to its positive, expanded, and holistic conception of health and its etiological multidimensionality, potentially generating so-called "holistic illness", which has been reported theoretically and empirically. CAM also have de-medicalizing potential, depending on the practitioner, due to greater interpretative flexibility, contextualization, singularization, users' participation in the care, closer clinical relationship, the values and traditions of some CAM, diversity of interventions, and the potential for enrichment of self-care. The medicalizing or de-medicalizing potential of various CAM is activated by their practitioners, and the context of PHC tends to favors the de-medicalizing potential.
鉴于补充和替代医学(CAM)越来越多地被纳入卫生机构和科学研究中,在学术和研究环境中需要对其有越来越多的了解。然而,在巴西科学文献中,模糊的定义或宽泛的概括很常见,其中一个例子就是CAM与社会医学化之间的关系。本研究旨在探讨使用CAM的医学化和去医学化潜力,特别是在初级卫生保健(PHC)中。本文基于所选文献总结了各种CAM在医学化和去医学化潜力方面存在的定义缺失问题,这些文献报道了理论和实证的趋同之处。在临床背景下运用CAM具有医学化潜力,这是由于其对健康的积极、扩展和整体观念以及病因的多维度性,可能会产生所谓的“整体疾病”,这在理论和实证方面都有报道。CAM也具有去医学化潜力,这取决于从业者,因为其具有更大的解释灵活性、情境化、个体化、用户参与护理、更紧密的临床关系、一些CAM的价值观和传统、干预措施的多样性以及自我护理丰富的潜力。各种CAM的医学化或去医学化潜力是由其从业者激发的,而初级卫生保健环境往往有利于去医学化潜力。