Itinerários terapêuticos e narrativas sobre o câncer: experiências de pessoas no percurso da rede de atenção à saúde pública na macrorregião de saúde norte de Minas

Abstract

Therapeutic itineraries have been used to understand the strategies employed by different segments and population groups to cope with health issues and the difficulties faced when using the services. It means the search for health care and treatment in individual and socio-cultural health practices in terms of paths taken by individuals, which are made up of unusual mixtures and compositions and reveal complex meanings in coping with the disease. The main objective of this study was to understand the experience of people with cancer regarding their journey through the public health care network for oncological treatment. It is a qualitative study, with data production in the field and interpretation guided by Cartography and Medical Anthropology. Data were produced from 19 interviews with people with cancer with at least six months since diagnosis. The results of the interpretation process are shown through three technical-scientific products: From the diagnosis of cancer to it's confrontation: subjects narratives and their implications on social and family relations (article 1); Production of care in the cancer care network (article 2); and (Narrando o cancer no Sertão Mineiro) Narrating cancer in the Sertão Mineiro (ebook). The results showed that the diagnosis and meaning of cancer for the subjects and their families brought awareness of finitude, awakened by the discovery of a life-threatening disease. The bodily changes resulting from illness and treatment required numerous agencies to cope with it, which was strongly supported by family members, religiosity and spirituality. Social support and the strength of the illness stricken individuals were also significant in this journey, which is permeated by numerous vicissitudes. Mapping the therapeutic itinerary has also allowed us to understand the devices employed by the users to deal with the illness, revealing the visibility and plurality of knowledge, practices and demands in the care of patients with cancer. There are still challenges to ensure access, especially with regard to timely and free diagnosis, comprehensive care, the consolidation of the care network with emphasis on Primary Health Care as a gateway and the clarification and support to cancer subjects on the guarantee of rights and how to access them. We recommend the several social players, such as managers and health professionals, to operationalize guidelines and care actions with a watchful eye to the complexity and singularity required by the subjects who experience cancer.