Psychology and Public Health care: an analysis from the perspective of social representations

Este trabalho se propÃs conhecer o universo representacional dos psicÃlogos que atuam na rede PÃblica de Fortaleza e de sua clientela no que se refere a processo saÃde - doenÃa, relaÃÃo psicÃlogo-paciente, conceito de SaÃde e papel do psicÃlogo na SaÃde bem como investigar os obstÃculos para sua atuaÃÃo profissional no contexto da SaÃde PÃblica a fim de propor intervenÃÃes mais adequadas à realidade atual. A pesquisa dentro da Ãtica da Teoria das RepresentaÃÃes Sociais- TRS à uma maneira de se ter uma visÃo do mundo envolvendo o nÃvel intrapessoal, interpessoal e o grupal. Partiu-se de um roteiro de entrevista aberta adaptado do âEliciting Patients explanatory illness modelsâ procurando abarcar sete temas: 1. Processo saÃde-doenÃa 2. relaÃÃo psicÃlogo-paciente; 3. prevenÃÃo; 4. conceito de SaÃde; 5. aÃÃo do psicÃlogo na SaÃde; 6. AtuaÃÃo na Ãrea e 7. formaÃÃo na Ãrea. A amostra constou de dez psicÃlogos que atuavam na rede pÃblica de Fortaleza sorteados aleatoriamente da relaÃÃo do Conselho Regional de Psicologia â 11 regiÃo e vinte clientes, dois de cada psicÃlogo, indicados pelo prÃprio profissional. Os dados tiveram tratamento qualitativo pela tÃcnica de anÃlise de conteÃdo. O processo utilizado foi a anÃlise temÃtica na qual se destacou as categorias significantes para o objeto analÃtico visado. A RepresentaÃÃo Social do processo saÃde doenÃa da clientela à sempre inserida em dimensÃes sÃcio-familiares e espirituais enquanto que, para os psicÃlogos, ela à mais especifica da vida individual do paciente apesar destes profissionais jà relacionÃ-la com aspectos familiares. Outro fato que chama atenÃÃo à o modo como as intervenÃÃes psicolÃgicas estÃo sendo apreendidas por estes: afora as intervenÃÃes de praxe, os exercÃcios fÃsicos de relaxamento, as condutas mais diretivas como orientaÃÃo para lazer e laboterÃpica tem grande valÃncia para a clientela. O que se infere com este resultado à que a populaÃÃo absorve bem intervenÃÃes mais concretas e prÃximas de sua realidade. Houve uma equiparaÃÃo nos dois nÃveis de representaÃÃo social sobre saÃde no que tange à bem estar mas os clientes tambÃm a vÃem como ausÃncia de ocorrÃncia, ter sossego, paz e tranquilidade e viver melhor como se estivesse representando seu prÃprio momento existencial (ruptura de vida na doenÃa e, consequente, busca pela SaÃde. Percebeu-se que, enquanto a clientela tem a representaÃÃo do psicÃlogo que atua na SaÃde PÃblica idÃntica aos psicÃlogos de clÃnica, para estes profissionais a representaÃÃo social de sua atuaÃÃo ainda nÃo se firmou apresentando apenas um conteÃdo valorativo. Constatou-se que todos os psicÃlogos entrevistados nÃo vivenciaram experiÃncias na Ãrea da saÃde durante sua graduaÃÃo. Verifica-se, com relaÃÃo a atuaÃÃo e a formaÃÃo, que hà trÃs tipos de representaÃÃes que dizem respeito ao conhecimento como ter experiÃncia anterior, aprender a trabalhar em equipe, fazer disciplinas aplicativas da Ãrea, estudar psicologia institucional, atender em psicoterapia breve-focal e entender de saÃde em geral. Outras falam sobre a sua atuaÃÃo, por exemplo, falta de espaÃo fÃsico, reconhecimento da profissÃo, conquistas lentas, questÃo salarial, limitaÃÃo institucional, trabalhar com clientela de baixa renda e a Ãltima dificuldade à com relaÃÃo a si mesmo: âgostar de doenteâ, âfazer tratamento psicoterÃpicoâ e ânÃo ficar entre quatro paredes". As conclusÃes principais sÃo de que a TRS deu a condiÃÃo para apreender as formas de conhecimento empregadas pelos psicÃlogos e pela clientela. Aos psicÃlogos cabe: nÃo esquecer a dimensÃo bio-psico-socio-espiritual do indivÃduo, agir de modo mais preventivo e prospectivo, dar mais atenÃÃo ao planejamento e aÃÃes baseadas institucionalmente e socialmente, fazer uma revisÃo de sua metodologia e de suas tÃcnicas intervencionais criando novos recursos, dar vez Ãs tÃcnicas grupais e focais para lidar com problemas de sua clientela, priorizar o atendimento multidisciplinar em busca da interdisciplinaridade nas aÃÃes de saÃde.The aim of this work is to know the representation universe of the psychologists working in Fortaleza public area and their clientele regarding the health process-illness, psichologist-patient relationship, health concepts and the psychologistâs role in public health and also to investigate the hindrances toward his professional perfomance in the context of public health, in order to sugest some more suitable interventions to the present reality. The research viewed by the social representations theory â SRT is a way of having a view of the whole world encompassing the intrapersonal, interpersonal and group levels. The beginning source was an open interview adapted from âEliciting Patients explanatory illness models" and moving on from there to include seven topics: I. Health-illness process; 2. Psychologist patient relationship; 3. Prevention; 4. Health concept; 5. Psychologist action in public health; 6. Performance and 7. Graduation into the community. Ten psychologist, which worked in the public area in Fortaleza, were chosen at random from Eleven Regional Committee of Psychology, as well as twenty clients, two for each psychologist that were indicate by the professional himself. The data had qualitative treatment though the analysis of the technical contents. The process applied was the thematic analysis in which the significant categories stand out toward the analytical object in view. The social representations of the health process-illness of the clientele is always inserted in socio-familiar and spiritual dimensions while for the psychologists it is more specific from the individual life of the patient, although those professionals related it to familiar aspects. Another fact that calls oneâs attention is the way the psychological interventions are being fully understood by the psychologists: besides the common interventions, there are great values for the clientele in physical exercises for relaxation more direct procedures like orientation for recreation and labotherapeutic occupation. As a result, the population absorbs more concret and closer interventions that fit their reality. There was a balance between the two levels of the social representation about public health refering to the welfare, but the clients also see it as na absence of occurrence, calm, peace and tranquility ans a better life, as they were representing their own existential moment (rupture of life in illness and as a consequence the search for health). .1 One can notice that the clientele "doesnât differenciate the psychologist that works at the public health from the ones who works at the clinic. As for the professionals, the social representation of their perfomance is not formulated yet; it only has a worthy content. it became evident that all of the psychologists interviewed didnât undergro experiences working in health area prior to their graduation It is possible to see, regarding, the performance and graduation that there are three kinds of representation, namely: knowledge â how to have prior experience, learn how to work as a team, make applicable disciplines that can be applied to the area, study Institutional Psychology, to assist in short-term psychotherapy and to understand health in general. The second kind of representation is performance: the lack of physical space, professional recognition, stow victories, salary problems, institutional limitations, working with clientele of lower income. The last representation has to do with themselves: they have to like the patient, do a psychotherapic treatment and not staying behind four walls. The main conclusions are: SRT offered conditions to understand the forms of knowledge used by the psychologists and clientele. It is responsability of the psychologists not to forget the biological, psychological, social and spiritual dimentions of the person, act in more preventive and prospective way, pay more attention to the planning and actions that are institucionally and socially based, review their methodology and interventional technics creating new resources, use also focal groups techinics in order to cope with their clientele problems, giving priority to the multidisciplinary attending in search of the interdisciplines in health care