O uso cotidiano de medicamentos em pacientes com Hepatite C crônica: uma análise na perspectiva fenomenológica de Merleau-Ponty

Abstract

The subjective experience with the medication use is personal. However, it has the potential to influence health outcomes by contributing to problems related to such use. The understanding of the subjective, complex and multidimensional nature of this phenomenon can have relevant implications in health, such as the improvement of quality of care. Currently, theres a lack of studies approaching the experience with the use of medication by patients with chronical hepatitis C, specially covering the direct-acting antivirals. The objectives of this study have been to develop and use a theoretical framework, in the perspective of Merleau-Pontys phenomenology, to investigate the use of medication. Based in that strategy, the experience with everyday use of medication was evaluated, including that with specific medication for chronical hepatitis C such as second generation direct-acting antivirals. The steps are described for a research anchored in Merleau-Pontys phenomenology and structured in the form of a cascade, beginning with the definition of phenomenology as a new form of epistemology, existence as a paradigm, and the body as a theory. Furthermore, the methodology included the use of existential structures, namely, time, space, relationships with others, and sexuality, connected through the intentional arc to reach an understanding of the phenomenon of medication use. taking long-term medications at the Viral Hepatitis Outpatient Clinic of the Alfa Gastroenterology Institute of the Hospital das Clínicas, Federal University of Minas Gerais, Brazil. The content of field diaries kept during the interviews were also used. Thematic analysis was employed, enabling the identification of the ways in which individuals experienced their medication routines, which were then reorganized to encompass the essential structures of the experience. The researchers identified four ways patients experience daily medication use, all anchored in corporeality: resolution, adversity, ambiguity, and indifference. The first three were based on the perspective that daily medication use is more than a mere mechanical action, involving changes in the phenomenal body, relieving, eliminating or causing symptoms in the physical body, normalizing life and symbolizing the disease. The experience with second generation direct-acting antivirals was of resolution, and characterized by the stagnation of phenomenological time. The present study allowed the researchers to infer that the same individual can even simultaneously experience daily medication use in different ways, depending on the disease and the medication in question. It was also understood that experiences with the everyday use of medication do not follow a course through negative experiences towards positive ones; as such, the introduction of a new medication can also introduce a new experience. The results point to the complexity of this experience, which requires formal education and places health professionals as responsible for this aspect of care.