Práticas discursivas e produção de sentidos sobre educação em saúde no contexto pandêmico da covid-19 em uma USF/Salvador

Abstract

This dissertation aimed to understand the effects of discursive practices produced by professionals from a Family Health Unit (Unidade de Saúde da Família - USF) and Support/Extended Family Health Center (Núcleo de Apoio/Ampliado de Saúde da Família - NASF) on health educational practices in the context of coping with the covid-19 pandemic. Guided by contributions from Social Constructionist Psychology, more specifically from Discursive Practices, we read and analyzed documents in the public domain, those being understood as such: ordinances, laws and notebooks of Primary Care (Atenção Básica), scientific articles available in the Scielo database and videos produced by USF professionals in the context of the research. The analysis of documents in the public domain provided a theoretical framework for discussions of the elaborated categories. Six (06) interviews were also carried out with professionals from these teams during the period between July 9, 2021 and September 10, 2021. The interviews included, in addition to the approach to sociodemographic data and personal and professional reports, the exhibition of one of the videos produced by the teams in order to encourage discussion about how these productions were carried out and possible effects. All interviews were audio-recorded, fully transcribed and analyzed through, initially, thematic categorical analysis and, later, through the elaboration of dialogic maps. The participating professionals characterized their experiences at work, emphasizing the symbol of power of the territory and the population for the services offered by the AB (Atenção Básica), as well as the crucial link established through the community health agents, especially during a health crisis, in which the current rule is prevention. The covid-19 pandemic challenges listed by the participants make up a picture of aggravation of the SUS (Sistema Único de Saúde) scrapping and dismantling process, as well as marking the weakening of AB's power instrument: the bond with the territory and population. Based on this, we present a discussion on the expansion of the concept of health education, considering crossings such as the dimension of popular participation and the political-social-professional context in which such practices are put into effect. We conclude that the concept of Health Education touches different spheres of professional activity in AB/ESF and NASF, causing different meanings and effects that are related to the voices that produce them. This happens through experiences that are built on the dynamics of the territory and the demands, as well as familiarization or the lack thereof with health education practices (Práticas de Educação em Saúde - PES) and preconized guidelines for the operation of AB. Therefore, linguistic repertoires rescue meanings of professional practice during emergency and disaster situations, such as: reception and listening. Psychology stands out in the speeches as discourse with the greater approximation to such management, knowing that it helps professional practices and the very realization of PES in the face of the effects produced in situations such as health crises. Thus, the centrality of the organization of lives in a territory not only sets itself as a theoretical symbol to govern health services in AB, but also summons, in the midst of the covid-19 pandemic, the place of power for articulations aimed at promoting health limited to a logic of care that respects people's autonomy in the face of individual and collective health production.