RESUMO
Fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, and multiple chemical sensitivity can be considered contested illnesses. The questioning of the status of these conditions as real diseases reduces feelings of legitimacy in those affected. The purpose of this study was to analyze subjectivity construction processes in people with these diseases. A qualitative exploratory study was conducted from the perspective of hermeneutic phenomenology and ethnosociology. We used life stories for compiling data (13 informants were interviewed face-to-face), and sociological discourse analysis was developed. Three main categories were identified: (a) self and grieving; (b) images and practices relating to fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, and multiple chemical sensitivity; and (c) relationships with health professionals. This study shows that daily experiences of people living with these diseases are marked by stigmatization processes. The ultimate purpose of nursing care for people with these conditions should be to reduce their vulnerability and exclusion.
Assuntos
Síndrome de Fadiga Crônica , Fibromialgia , Sensibilidade Química Múltipla , Emoções , Humanos , Pesquisa QualitativaRESUMO
BACKGROUND: The frequent attendance is a worrying phenomenon for the health systems of Western countries, due the high work load it generates and its high costs in material and human resources. This work aims to study the meanings, categories and practices that general practitioners build around the frequent attendance. METHODS: Qualitative study, based on a socio-subjective approximation, through in-depth interviews. Eight interviews were conducted with Primary Health Care physicians in Madrid. The discourses were examined from a pragmatist perspective. RESULTS: The figure of the Primary Health Care physician is at the intersection of professional and institutional contradictory logic, which generates high levels of professional malaise. The social and psychological aspects appear in a confused way, due the consideration of the non-physical aspects as outside the realm of medicine. Frequent attendance is problematic because: it is situated in the center of the sign-symptom dichotomy. its management requires so much time. it requires a comprehensive approach. it avoids the medical performance as a professional who diagnosed and establishes an etiological treatment. These problems eventually can lead to conflict in the professional-patient relationship. CONCLUSIONS: The meanings for the frequent attendance will vary significantly depending on the socio-subjective positions, so the approach proposed here could help to understand the complexity of a problem that is built within the relationships between particular subjects crossed by different institutional dynamics, labour disputes, career paths and ideologies.
Assuntos
Mau Uso de Serviços de Saúde , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Inquéritos e QuestionáriosRESUMO
Se presentan los resultados de un proyecto de promoción de salud en relación a la prevención de la infección por VIH en personas inmigrantes residentes en la comunidad de Madrid, basada en la metodología de la educación entre iguales. Metodología: personas seleccionadas entre las comunidades de inmigrantes diana del proyecto (Marruecos, Rep. Dominicana y Africa subsahariana) realizaron dos talleres de formación consecutivos donde adquirieron conocimientos y habilidades necesarios para la transmisión de mensajes preventivos en relación con la infección por VIH, demostración del correcto uso del preservativo, y comunicación. Resultados: tras la formación realizaron intervenciones educativas tanto individuales como de grupo con personas pertenecientes a sus colectivos.795 personas pertenecientes a los 3 colectivos fueron contactadas por los educadores en las intervenciones, que se realizaron siempre en un entorno de proximidad. Las cuestiones más frecuentes que surgieron en relación con la prevención fueron desconocimiento o creencias erróneas acerca de determinados aspectos de la enfermedad, asociación de la infección a castigo divino o destino, negación del problema o asociación con "prácticas occidentales" y en general dificultad de las mujeres para la negociación del uso del preservativo con sus parejas. Conclusiones: La estrategia de educadores entre iguales resulta eficaz en programas para la prevención de VIH/SIDA sobre todo entre las comunidades inmigrantes, ya que implica un abordaje de sus aspectos diferenciales (AU)
