Abordagens inovadoras no autocuidado de pessoas com diabetes

Abstract

The innovative approaches which fortify self-care intend to overcome the biomedical paradigm on ongoing patient assistance. These are distinguished practices such as art and physical activity which do not take place on health services. This study aims to understand the way innovative approaches concern the diabetic self-care; the way they influence and change a chronic condition experience. The qualitative methodology used was the cartography, identified as intervention research to reveal the diabetic self-care process, producing simultaneously knowledge and individuals in a way there will not be a researcher- subject, like an inter subjective production. The collective research was composed by 10 diabetics, (6 women and 4 men) who had been diagnosed for at least 5 years, who participated of innovative approaches. The diagnosis time varied from 6 to 34 years. The approached themes in the interview were innovative approaches, experiences, therapeutic itinerary, connection and self-care. The Family Health Strategy (FHS) and the innovative approaches were respectively selected: Vargas (Hiperdia Group), São José (Hiperdia Group and art craft Group) Fortuna (Peer Groups) and Freitas (Walking Group). At the end of the process the recorded interviews were fully transcribed; the therapeutic itinerary map was drawn and the subjectivity development process in relation to the innovative approaches was investigated. Two maps for each participant were developed. On the descriptive map center is the patient and his or her family. Around it, five aspects are discriminated: Social support network, health network, innovative approaches connection and self-care. On the interconnected map four quoted aspects were described, except the connection which was highlighted through lines. These maps were developed with the miMind software help, aiming to describe and emphasize the existing bonds/ associations, taking into consideration that they were subsequently used to confirm the results and discuss them. Four maps were selected for the article in which appeared: technical procedures routes, subjectivation modes and autonomy development on how to manage the diabetes manifestations. The chosen maps were Rosa (FHS Vargas – Hiperdia group) and Cravo (FHS São José –Hiperdia Group) with longer diagnostic periods, respectively 20 and 34 years old, and Violeta (FHS Fortuna – peer groups) and Iris (FHS Freitas – walking groups) with 6 and 7 years shorter time. The results showed that the patients experienced a previous situation guided by the pathology unmanageability, occurrence of treble events, visit to emergency health centers, disease worsens, vulnerability feelings, misery and inability to deal with this condition. The participation of innovative approaches in workgroups enables orientations, information share, professional connection, built relationships and technology usage to measure blood glucose. Religiosity and family support joined forces to these benefits promoting together the subjectivity production, in a way the subject becomes the situation’s protagonist. This way the innovative approaches help on the self-care development so that the patients acquire the capacity of perceiving their bodies, auscultate the symptoms, regulate the medication and diet, practice physical exercises and learn how to deal with the chronicle condition, promoting their autonomies.