Sociopoetic research: subjectivity of patients in substitutive renal therapy

Abstracts

Trata de abordagem e do método de pesquisar através da sociopoética. Objetiva relatar como a técnica dos sentidos sociocomunicantes do corpo é produtora de subjetividades dos pacientes portadores de cateter de diálise peritoneal sob o cuidado de profissionais de enfermagem no período de 2005 e 2008. O método é teleguiado pelos passos do grupo pesquisador com técnicas lúdicas e criativas utilizando os sentidos corporais dos sujeitos. O espaço de pesquisa durante o cuidado resulta em participação do sujeito como avaliador das experiências vivenciadas. Consideramos o método como estratégia de instituir espaços de diálogo com subsídios ao cuidado de enfermagem.

Pesquisa; Diálise renal; Enfermagem

EXPERIENCE REPORT

Sílvia Teresa Carvalho de Araújo^I; Doris de Oliveira Araújo Cruz^II

^IPhD in Nursing. Assistant Professor of the IX Inter-Department Curricular Program, Medical-Surgical Nursing Department, Anna Nery Nursing College (EEAN) of Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro (RJ), Brazil

^IINursing Master. Nurse of the Development Sector of Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro (RJ), Brazil

Corresponding Author

ABSTRACT

The purpose of this sociopoetic research was to describe subjectivity of patients undergoing peritoneal dialysis. The methodology was guided by ludic and creative techniques. Data consisted of observations of corporal expression of the patients from 2005 through 2008 during nursing care, resulting in patients participating as evaluators of their own experiences. The method is a strategy to enhance dialogue between nurses and patients and improve nursing care.

Keywords: Research/methods; Renal dialysis; Nursing

RESUMEN

El presente artículo trata el abordaje y el método de investigar a través de la sociopoética. Objetiva relatar cómo la técnica de los sentidos sociocomunicantes del cuerpo es productora de subjetividades de los pacientes portadores de catéter de diálisis peritoneal bajo el cuidado de profesionales de enfermería en el período de 2005 a 2008. El método es teleguiado por los pasos del grupo investigador con técnicas lúdicas y creativas utilizando los sentidos corporales de los sujetos. El espacio de investigación durante el cuidado da como resultado la participación del sujeto como evaluador de las experiencias vivenciadas. Consideramos el método como estrategia para instituir espacios de diálogo con subsidios para el cuidado de enfermería.

Descriptores: Investigación/métodos; Diálisis renal; Enfermería

INTRODUCTION

The present study emphasizes how the sociopoetic approach utilized in a masters dissertation developed at the Post Graduation course of Anna Nery Nursing College, Universidade Federal do Rio de Janeiro, from 2005 to 2008, uncovers the subjectivity of clients with peritoneal dialysis catheter implanted in their bodies.

The objective aimed comprises the "body social communicant"⁽¹⁾ senses experience when clients within this care context express themselves, their predominant feelings and emotions.

The theoretical references value subjectivity as of the client's body senses and imagination manifestations, whose information are greatly relevant to the nursing care. This is due to the fact the imagination uncover allows the images stored in the consciousness to be understood, whilst searches for different behavior reactions each client presents when facing the disease and the dialysis treatment.

METHODOLOGICAL ASPECTS

The methodology was guided by the researcher group principles⁽²⁾, whose six steps value the ludic, creative, and collective creation throughout the production stages, utilizing projections of illustrations that represent the sense organs and creativity and imagination liberty as of drawings, discussions and findings recording.

As of the patient's own body senses, we valued the perceptions, emotions and feelings, trying to find, through the research instruments, the individual and collective knowledge, during the monthly meetings and the production moments. Such dynamics are permeated by enunciations, discussions, and group analysis, resulting from subjectivities, becoming conscious of unconscious and/or latent structures, mainly psycho affective, that are forgotten or stored in the hidden structure, either mental or visceral.

A relaxation technique and a simple or conjugated adaptation of the social communicant senses experience technique⁽¹⁾ are utilized in the group meetings.

As of the actual experience of an outstanding situation felt by each body sense, and accessing impregnated images retained in the unconscious, the drawings are made. After the artistic creation, the subjects write down a word that synthesizes the drawing.

The data produced are individually presented and collectively discussed in meetings that take approximately one and a half hour, and a minimum of three encounters every fifteen days or monthly. After being identified through a reading and re-reading of the raw material, such perceptions concerning each of the body sociocommunicant senses, comprised the group's collective production in the research course and transcourse. We tried to promote a space where participants would be able to transmit what they felt through words and expressions during the research on the experience and nursing care.

RESULTS

Sociopoetics favors the emergence of unconscious, intuitive and emotional knowledge, as research data⁽³⁾. Encounters, union and collaboration to produce the research data develop increasingly among the participants in the sociopoetic experience. Along the research course, it is possible to observe such collaboration is intensified when one of the participants becomes conscious of something, and that represents, in the enunciations emergence during the experience itself, past, present and/or future emotion components⁽⁴⁾.

As practical results, during the activity subjects share the sentences built on each sense selected. The rotation among senses allows the enunciation stage, and the individual and group analysis related to the perception and influence each sense causes on what is outstanding in the experience during the treatment and/or provided or received care.

In general, in the interpersonal communication, the effective usage of our body social communicant senses: sight, hearing, touch, smell, taste, and the heart are responsible for ensuring the data are actual and new, based on the respect, involvement, and empathy dimensions.

Valuing the perceptions when experiencing and facing the situations presented allows us not only to become aware of the body senses, but also of what was silenced by our senses. Therefore, we hope to better understand what happens in the process and reduce the subjects' difficulties upon verbalizing their own feelings in the research dynamic.

We highlight that the bond established during the meetings allow participants to reveal their weaknesses during their testimonials and experiences, right there, cohabiting with the group itself. The imagination structures presented from time to time are sometimes opposed and contradictory, and have to be respected.

In this context, working in the nursing area does not mean pleasure and suffering are isolated as absolute entities, instead, they are tied to each professional and client experience, what they live, and how they understand the care relationship, as part of the history process comprised of the psychological, social, and organizational aspects. These interact by impacting on the subjects understanding of the process, thus establishing comprehension situations that allow adequacies to the process of providing and receiving care⁽⁵⁾. Therefore, through the research instruments, we aimed to understand the existential questions, and the pressures involving the individual in this context, through social communicant experiences⁽¹⁾. We are constantly learning, through researches, how people see the situation as of sensorial perceptions, how they react and defend themselves going through such experiences.

FINAL CONSIDERATIONS

The results repetition in the researches pointed out to an important production space regarding the clients' subjectivity, as they make time and space imposed by the renal disease, the dialysis treatment and hospital more flexible. They also demonstrated that, through this approach, it is possible to create a space where these clients are able to express their perceptions upon the reality experienced.

Using this research approach, we were able to understand how clients feel and perceive things in this context. The results refer to: creating a pre-appointment environment so as to promote the dialogue among people that have different perceptions and cohabit in the same institutional space, having a common difficulty with the catheter.

REFERENCES

• 1- Araújo STC. Os sentidos corporais dos estudantes no aprendizado da comunicação não verbal do cliente na recepção pré-operatória: uma semiologia da expressão através da sociopoética [tese]. Rio de Janeiro: Universidade Federal do Rio de Janeiro; 2000.
• 2- Freire P. Pedagogia do oprimido. 37a ed. Rio de Janeiro: Paz e Terra; 2003.
• 3- Santos I, Gauthier J. Enfermagem: análise institucional e sócio-poética. Rio de Janeiro: Escola de Enfermagem Anna Nery/UFRJ; 1999. p.190.
• 4- Cruz DOA, Araújo STC. Diálise peritoneal: a percepção tátil do cliente na convivência com o cateter. Acta Paul Enferm. 2008;21(Spe):164-8.
• 5- Koepe GBO, Araújo STC. A percepção do cliente em hemodiálise frente à fístula árterio venosa em seu corpo. Acta Paul Enferm. 2008;21(Spe):147-51.

Sociopoetic research: subjectivity of patients in substitutive renal therapy

Investigación sociopoéticas: la subjetividad de pacientes in los substitutos renais de las terapias

Publication Dates

• Publication in this collection
  09 Apr 2010
• Date of issue
  2009