Práticas integrativas e complementares na promoção da saúde: perspectivas de trabalhadores de centro de referência (Uberlândia-MG)

Abstract

Integrative and Complementary Health Practices (PICS) present a holistic approach to health and the recognition of therapeutic pluralism. Since it supports a different approach to health care, they potentiate the construction of therapeutic bonds based on the autonomy and involvement of the subjects. Since 2006, the National Policy on Integrative and Complementary Practices (PNPIC) has incorporated the PICS into the Unified Health System and promotes the implementation of these therapies by the municipalities. In this context, the Reference Center on Integrative and Complementary Practices in Health (CRPICS) was federal created in Uberlândia, Minas Gerais. The present study aimed to understand the impacts of PICS on the promotion of workers' health that works with these practices in the CRPICS and how this worker understands the health-disease-care process. In order to guarantee the contextualized understanding of the work of these workers, a study was first carried out on the process of implantation of PICS in the municipality. This is an exploratory and descriptive study developed with a qualitative methodology. The instruments of data collection were self-administered questionnaire, focus groups and semi-structured interviews. The participants were the workers and the coordinator of the CRPICS and the professionals involved in the implantation of the institution. Thematic analysis guided the treatment of the data. The study evidenced the commitment of the workers, the involvement of the health council and the participation of civil society in the institutionalization of PICS. It was highlighted the contribution of federal funding in the process of implementation of the Center. The obstacles highlighted were: resistance from biomedical model, difficulties to institutionalize PICS in politics and municipal management, reduced number of workers to work with PICS and implementation of phytotherapy. The expansion of PICS in primary care and the training of workers were considered fundamental for the consolidation of the PNPIC in the municipal scope. Participants explained paradigmatic conflicts in the field of health and contributions of practices to the sedimentation of new forms of understanding and health care. Working with these therapies has been described as a source of continuous learning, professional development, and the development of tools for self-care. The autonomy in the organization of work, the good work environment and solidarity relations among the team members were highlighted dimensions as positive for the health of the worker. Double work journey, the precariousness of labor relations and little appreciation of PICS were understood as exhausting factors. The study revealed synergy between the defense of the expansion of PICS and the overcoming of the biomedical model and the promotion of workers' health.