Processos afetivo-semióticos da experiência de transplante para pessoas com órgãos transplantados

Abstract

Faced with the growing incidence of chronic diseases, the reality of organ transplantation is configured as a therapeutic resource for several cases, bringing a path with physical and psychosocial implications for patients. Based on this reality, this research aimed to understand the personal experience of transplantation built by people with chronic diseases. More specifically, we sought to (1) to analyze the trajectory of illness, identifying which events are configured as ruptures for individuals; (2) to identify the affective-semiotic processes involved in the experience; (3) to understand the use of institutional, interpersonal, symbolic and personal resources by participants in disruptive situations; and (4) to identify imaginative processes. The study had as theoretical contribution the Cultural Psychology. Five adults aged between 25 and 54 years old, who had undergone transplantation of one or two organs (kidney, liver, lung, heart and pancreas and kidney) participated in the study. The data were constructed with narrative interviews, semi-structured interviews and a sociodemographic questionnaire and were analyzed in the light of the Trajectories Equifinality Model and the construction of thematic axes from the objectives, theoretical constructs of Cultural Psychology and literature. In the participants' trajectories, events such as diagnosis, treatment, entry into the waiting list and transplantation were perceived as disruptive, demanding from them transitions with identity processes, learning new skills and sense making. Among the affective-semiotic processes, the participants gave meaning to the initial symptoms and other conditions of illness, in addition to the presence of uncertainties and fears. The idea of finitude is expressed in the narrative in the context of the waiting list for the transplant, in addition to more optimistic meanings such as good expectations and the possibility of life. About life and the self after the transplant, the participants point out, among other signs: the return to normality, the resumption of routine, the absence of restrictions, the increase in the quality of life and the possibility of overcoming. The Coronavirus pandemic has given rise to affective states of anxiety and panic, in addition to reports that point to the experience of a new quarantine and overload of demands. Among the resources used in the transition processes were: reflections based on cultural artifacts; hospital institutions, religion; the family, friends and personal characteristics of the participants. In the imaginative processes, the participants bring expectations about the transplant: freedom, quality of life, return to routine, being with the family and projecting the future. The shadow trajectories acted as catalyst signs, as a context for strengthening the promoting signs, which contributed to the maintenance of self-care practices. The imagination for the future points to the search for the continuity of advances made and the search for personal ideals. We emphasize the importance of spaces for the expression of the voice of people with chronic diseases, as well as the improvement in the training of health professionals.