Determinantes Sociais de Saúde e o processo morte-luto-cuidado na Atenção Básica

Abstract

Primary Health Care is characterized by the comprehensive care of the patient and their family, including end-of-life care, with the Family Health Strategy (FHS) responsible for establishing care bonds and long-term support. However, service limitations, combined with social determinants of health (SDH), affect access to and the quality of healthcare services. In modern Western society, death is often denied or addressed from a biomedical perspective, though it is a complex phenomenon influenced by historical and cultural factors. Thus, the aim of this research was to analyze how nurse coordinators in Primary Health Care perceive the deathgrief-care process and its relationship with SDH. The research was based on cultural-historical psychology, using activity as the analytical category. A qualitative study was conducted, with semi-structured interviews with two Primary Health Care nurses. Data analysis was conducted through the identification of core meanings, revealing three cores of signification: the first addresses professional practices and challenges in Primary Health Care; the second examines the influence of socioeconomic, geographical, and cultural factors on health and professionals' activities; the third discusses the meanings of death and grief shared by the nurses. The research highlighted the complexity of the death-grief-care process and the challenges associated with SDH. It emphasizes the importance of non-alienating, non-biologizing training, including education in Palliative Care and attention to the social determinants that shape individuals' lives.