Devir cuidadora de prematuro após a alta hospitalar e os dispositivos constituintes da continuidade da atenção

Abstract

The execution of this study based on the proposition that the assistance post-discharge of premature infants constitutes in a context of offerof service with its distinct technologies and, overall, based on the implication and intent of thesubjects involved in the care. It was possible to recognize that the interests in disputeand the desiring productions are elements imminent to the care network in the prematurity context. The objective of the study was to analyze the devices constituent of the continuity of care to the premature infant and how the service is offered to this population in the investigation municipalities. A qualitative study was opted for since it permits to capture and reveal the subjectivation processes imminent to the analyzed subject. This study was oriented by theorists Deluze and Guatarri (2007) approach, who weave a discussion capable of thinking about the contemporary based on the term rhizome. The sceneries were three municipalities from the west macro-region of the State of Minas Gerais. The field work was divided in two phases. The first pursued, with interviews with professionals and managers, to analyze how the premature infant care services after hospital discharge is offered. In the second phase of the study, interviews were performed in oral history theoretical support with ten caretakers. The analysis of the data revealed the different arrangements for the attendance of premature infants in the investigated municipalities. A formation of an assistance territory imbued of disencounters, forwarding, connective flows, lines of escape, offered services, access and non-access, desiring productions which further compose a rhizomatic network, potential for the continuance of care, or referring to a discontinuity of the care, were identified. It was identified that the rhizomatic network operates towards the continuity of care when there is opportune service offer, constitution of bond and its desiring productions, and forwarding to different services which are shown to be necessary. Care discontinuityis also present in the context of post-discharge premature infant care and is identified in situations of disencounter between offered services, in the refusal of forwarding the premature infant to specific services to its attendance and in the difficulty of access to specialist monitoring, when these are necessary. In this assistance context, it was possible to identify that the premature infant caretaker duty configures a trajectory of subjectivity productionsin which different disencounters, healthcare practices, demands, intercurrences, faith, insecurities, work abandonment, accountability, intent, reorganization of daily life and overcomingweave the experience lived. The analysis of the data permits the inference that the constitution of bond and the protagonism of the caretakers are devices constituent of care continuity and point to a life production, that is, an autonomy in the manner in which they live life in an after hospital discharge premature infant care context. There is a care discontinuity, which contributes to the production of sickness, in the absence of bond constitution between professionals and caretakers, in unfavorable socio-economic conditions, when there is passivity from the caretaker in front of premature infant post-discharge care. The production of sickness remits to an adaptation difficulty to the prematurity situation or, yet, an absence of autonomy in the manner of living life. The results of this investigation indicate that caretaker protagonism and the bond constitution in healthcare work micropolitics context, allied to distinct technologies and structures available, may favor the continuity of care with views to a production of life.