Práticas integrativas e complementares e a promoção da saúde: avanços e desafios de um serviço municipal de saúde

Abstract

The study focused on integrative and complementary practices and their relationship to the field of health promotion. We started from the assumption that there is a limitation of the potential of complementary and integrative practices in the field of health promotion practices prevailing the seeking for eliminating or reduce symptoms, without breaking with the logic of illness. The aim of the study was to understand the meanings constructed in complementary and integrative practices by identifying the concepts of professionals and participants on integrative practices and complementary analysis of the organization of suchpractices in a municipal service of health. It is a study of qualitative approach, grounded in theoretical methodological framework of the dialectic. The study setting was a municipal health service in the metropolitan region of Belo Horizonte / MG, specialized in healthpromotion practices which includes in its offer, complementary and integrative practices, such as acupuncture, homeopathy, senior dance, workshop memory and relaxation. The study included six professionals who work in the service and fourteen participants of the practices studied. Data collection was through observation, interviews and daily practices ofthe participant. The data were subjected to thematic content analysis. The results indicate that the meanings constructed in practice, particular dimension of the phenomenon of study are determined by the service organization and the broader aspects of the integration of practices in the health system. In this sense, the practices studied reveal the expansion of supply and access to different rationalities still having, in some embodiments, the centrality in consultation and individual attention. The practices studied represent an important strategy in coping with illness and suffering from different chronicdegenerative pathologies ordisabilities that affect individuals in society. It is proven that the practices studied, inserted in different medical fields, are guided in one moment by the biomedical paradigm prays, in another moment by the vitalist. This is confirmed in the presence of elements of both paradigms that intertwine in shaping practices, with signs of maintaining the object of activityon the disease that sometimes alternate with the overrun to a model that incorporates balance and harmony as vital guiding therapy. This study highlights the sincretismoof paradigms guiding practices integrative and complementary, determined and decisive in search of meanings constructed by them. In the singular dimension, these directions wererevealed in string, in which the insertion practices favors autonomy, self-care and accountability, which in turn expands the possibilities of the subjects learn to deal and cope with health conditions or with everyday problems and ultimately, seek other health practices beyond medical therapies. Paradoxically, the results suggest that complementary andintegrative practices are not in the first search option in terms of care or as a replacement option to conventional treatment, representing therefore an extension of biomedical normativity regarding the therapeutic system of healing. The complementary nature reduces the potential of the practices studied in breaking with the prescriptive logic of biomedicalparadigm. We conclude that the complementary and integrative practices represent a movement for change in health practices, with contributions in holistic and individual empowerment. However, challenges remain for inscribing them in the field of health promotion, indicating the need to overcome the elements that make up a practice as restricted, essentially individualistic and with few elements that reveal about socialtransformation. Thus the construction of a new paradigm does not depend solely on medical rationalities, but mainly from a change in design that displaces the centrality of the diseaseto the subject and its everyday life.