Grupo estratégico de promoção da saúde: uma pesquisa participativa sobre a autonomia de pessoas vivendo com diabetes

Abstract

Diabetes requires changes in the lives of those who become diagnosed with it, requiring healthy living habits, regular physical activity and even self-administration of medications. Sometimes, it requires a certain self-control that involves the ability to recognize options and make decisions: in this sense, the exercise of personal autonomy is necessary. Discussion on autonomy pays attention to the respect for people's choices, even in the face of restraining situations. Certainly, working with practices of autonomy in chronic diseases are still quite challenging. The purpose of this study was to compose health promotion strategies, based on a Strategic Health Promotion Group (GEPS), to help create the conditions for the exercise of people's autonomy regarding health care dealing with a disease chronic condition. The research is participatory, with a qualitative approach based on reflexivity. A previous consent was necessary to form a sixteen people group diagnosed with diabetes. Different topics were discussed, and the analysis of narratives produced in the meetings resulted in three thematic axes: a) Recognizing diabetes; b) Living with diabetes, and c) Exercising autonomy and protagonism. These axes formed three respective textual summaries, which were evaluated and validated by the participants in other three meetings. An interpretative exercise unfolded these summaries. Results demonstrate how participant´s experiences are related to the impact of diabetes diagnosis, provoking a moment of instability in the recognition of their ways of taking care of their own health, implying in the adoption of new meanings for their life habits. The recognition of this chronic condition transforms the way they come to live with diabetes, deriving in diverse personal strategies of self-control, self-care and adaptation. Sharing experiences facilitates the recognition of choices to the subject, stimulating their autonomy and protagonism. Shared care in a co-management process is critical to the longitudinality of diabetes care. In conclusion, the study emphasizes that the Strategic Group for Health Promotion extends the possibilities of self-care management and provokes reflections on health workers and health promotion practices, becoming an important tool for the health collective management. Group strategies, when directed towards the subject´s autonomy, tend to strengthen Primary Health Care and to achieve its essential attributes.