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Publicação
Entre o fazer e o dever
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Orientador(es)
Resumo(s)
A compreensão da ocorrência das doenças em termos de risco e o estabelecimento de
relações com os chamados estilos de vida, colocam na experiência de doença um
acréscimo de conotações morais, um dever de autodisciplina e responsabilidade. Estes
princípios têm sido inúmeras vezes sublinhados nos discursos e políticas da Saúde
Pública, nomeadamente no que concerne às doenças cardiovasculares pela
importância epidemiológica, económica e social de que se revestem e consequente
necessidade de redução da sua grande incidência na população, como é o caso de
Portugal.
A hipertensão, como doença crónica e fator de risco cardiovascular sujeita os doentes
a controlo médico periódico, terapêutica farmacológica e impele a um
comprometimento com comportamentos alimentares e exercício físico adequado.
Através das entrevistas realizadas a doentes hipertensos utentes da consulta específica
em Cuidados de Saúde Primários, verifica-se a presença de modos diversos de agir
perante a circunstância de se ter hipertensão arterial, mostrando a presença de várias
racionalidades, apreciações e valorações práticas dos comportamentos de saúde e
doença e do próprio corpo.
Para os doentes hipertensos entrevistados, a hipertensão arterial não é encarada
como uma “verdadeira doença”, sendo vista sobretudo como resultado do
envelhecimento e dos excessos que se acumularam no corpo, consequentes da própria
vida.
Nas narrativas de experiência de doença, os conceitos de moderação e equilíbrio, “ter
cuidado”, parecem servir de mecanismo de operacionalização entre aquilo que são as
recomendações médicas e as práticas individuais.
Constatam-se as capacidades dos doentes hipertensos construírem para si formas de
gestão da doença e do medo, sendo que os seus comportamentos podem passar por
assumir o controlo dos fatores de risco ou ignorá-los. Em qualquer dos casos, as
representações e ações relativas à hipertensão e às recomendações médicas a ela
associadas integram-se nas práticas quotidianas dos doentes, ajustando-se a hábitos e
representações instaladas, constituindo-se em modos distintos de agir dos doentes
hipertensos.
Understanding the risk factors related to the onset of diseases and establishing associations with the so-called lifestyles add moral connotations, and a duty of selfdiscipline and responsibility to the illness experience. These principles have been repeatedly emphasized in Public Health discourses and policies, particularly regarding cardiovascular diseases. Those have a huge epidemiological, economic, and social impact, and is important reduce their high incidence in the population, as it is the case in Portugal. As a chronic illness and cardiovascular risk factor, hypertension forces patients to a regular medical control and pharmacological treatment, and impels them to commit to healthy eating and appropriate physical exercise. Based on interviews conducted to hypertensive patients in a specific consultation in Primary Health Care, different ways of managing hypertension were found, reflecting the existence of multiple rationalities, evaluations, and practical valuations of the health/disease behaviors and the body itself. The interviewed hypertensive patients consider that hypertension is not a “real disease”, as it is mainly seen as a consequence of the aging process and the excesses accumulated in the body as a result of life itself. In the narratives of the illness experience, the concepts of moderation and balance, “be careful”, seem to work as a mechanism to reconcile both medical recommendations and individual practices. This study shows that hypertensive patients have the ability to find their own ways of managing the illness and the fear, such as controlling the risk factors or ignoring them. In any case, the representations and practices of hypertension and associated medical recommendations are integrated into the patients’ daily practices, adjusting themselves to habits and representations already in place, and reflecting the different behaviors of hypertensive patients.
Understanding the risk factors related to the onset of diseases and establishing associations with the so-called lifestyles add moral connotations, and a duty of selfdiscipline and responsibility to the illness experience. These principles have been repeatedly emphasized in Public Health discourses and policies, particularly regarding cardiovascular diseases. Those have a huge epidemiological, economic, and social impact, and is important reduce their high incidence in the population, as it is the case in Portugal. As a chronic illness and cardiovascular risk factor, hypertension forces patients to a regular medical control and pharmacological treatment, and impels them to commit to healthy eating and appropriate physical exercise. Based on interviews conducted to hypertensive patients in a specific consultation in Primary Health Care, different ways of managing hypertension were found, reflecting the existence of multiple rationalities, evaluations, and practical valuations of the health/disease behaviors and the body itself. The interviewed hypertensive patients consider that hypertension is not a “real disease”, as it is mainly seen as a consequence of the aging process and the excesses accumulated in the body as a result of life itself. In the narratives of the illness experience, the concepts of moderation and balance, “be careful”, seem to work as a mechanism to reconcile both medical recommendations and individual practices. This study shows that hypertensive patients have the ability to find their own ways of managing the illness and the fear, such as controlling the risk factors or ignoring them. In any case, the representations and practices of hypertension and associated medical recommendations are integrated into the patients’ daily practices, adjusting themselves to habits and representations already in place, and reflecting the different behaviors of hypertensive patients.
Descrição
Palavras-chave
Hipertensão arterial Experiências de doença Comportamentos de doença Risco Conhecimento leigo Sociologia da saúde e da doença Hypertension Illness experience Disease behaviors Risk Lay knowledge Sociology of health and illness