Abstract
to analyze the practices of a home care team and their implications for caregivers' performance. qualitative study with data obtained from observation of 21 users, 30 caregivers and 6 professionals from the home health care service in a municipality in Minas Gerais, from February to June 2018. The material was analyzed from the perspective of discourse analysis according to Michel Foucault. team interference upon caregivers is exercised by disciplinary practices and prescriptive, authoritative and surveilling behaviors. The team's knowledge-power relationship determines caregivers' acceptance through convincing or through difficulty of understanding assigned orientations. Educational practices would enable caregivers to be constituted as active, participative, empowered and reflective subjects. team practices interfere with caregivers' ways of acting and being and they have implications in objectification and subjectification processes.
Highlights
The epidemiological transition experienced in the 20th century by the Brazilian population changes the pattern of health and disease in the country, with a decline of acute and infectious diseases and an increase in chronic diseases and external causes, which imposes new demands on the health system[1]
Home care services offered by the Unified Health System (SUS – Sistema Único de Saúde) are ruled by Ordinance 825 of April 2016, which regulates Best at Home Program (Programa Melhor em Casa)
In order to understand home care team practices and their interference in the performance of caregivers at home, we rely on the post-structuralist framework, according to which it is understood that “the processes of subjectification refer to the way the man understands himself as a legitimate subject of a certain type of knowledge”(9)
Summary
The epidemiological transition experienced in the 20th century by the Brazilian population changes the pattern of health and disease in the country, with a decline of acute and infectious diseases and an increase in chronic diseases and external causes, which imposes new demands on the health system[1]. Home care presents itself as a possibility in a new model that triggers different subjects and care practices beyond those traditionally instituted, fostering the team-user-caregiver participation[2]. Home care services offered by the Unified Health System (SUS – Sistema Único de Saúde) are ruled by Ordinance 825 of April 2016, which regulates Best at Home Program (Programa Melhor em Casa). In this Program, availability of a caregiver who is responsible for home care is required, be it a formal caregiver, i.e., a person who performs health assistance activities for remuneration, or an informal caregiver, who is unpaid, being, normally, a patient’s family member and not a professional[3]. Studies do not explicitly demonstrate how a home care team, through its practices that involve relationships and actions, impacts caregivers’performance
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