Itinerário da paternidade: a construção social da integralidade do cuidado ao recém-nascido e família na UTI- Neonatal

Abstract

This work aimed to analyze the paternity itinerary as a social construction, based on the relations among fathers and health staff, and their social networks. This construction comprised the search, by the father, of the recognition of the paternity exercise, and its repercussions on the comprehensive health care provided to the newborn at risk and his family. To define the paternity itinerary we adopted the comprehensive health care theories (developed by LAPPIS), Honneth s recognition theory, and Martins s social networks theory. The research work was conducted at the Sofia Feldman Hospital, philanthropic private institution in the outskirts of Belo Horizonte, Minas Gerais State, Brazil. The study subjects were three fathers whose babies were in the neonatal intensive care unit and their relatives, besides health staff, volunteers and managers who work at that hospital. Based on the sociological phenomenology approach, we carried out interviews, observation of institutional spaces and two focal groups with the newborns relatives, using the MARES methodology for data collection. The analysis of paternity itineraries enabled us to discuss the repercussions of these fathers trajectories along the comprehensive care dimensions (policies, services organizations and knowledge and practices of professionals). We noticed that the mother's discharge and the baby s hospitalization are a detour in the fathers path concerning their recognition as health care customer and comprehensive family care. Moreover, the relations established as the staff welcome these fathers involved knowledge negotiation among professionals, and between staff and customers, with repercussions in the construction and reconstruction of health care practices at the neonatal intensive care unit. These repercussions meant forms of including the father, a privileged observer who becomes a mediator-collaborator in the provision of comprehensive health care for his hospitalized baby. We consider the paternity itinerary a customer's comprehensive care-friendly evaluation practice tool that allows the revalorization of experience and relations among subjects, in which health action catalyzes health care transformations as a citizenship exercise.