As Representações biomédicas da saúde e da doença tidas pelos enfermeiros no contexto multicultural da prestação de cuidados da UCCI da Santa Casa da Misericórdia de Portimão

This is an anthropological research which purposes to find the answer to the following question: how nurses represent health and illness in the multicultural context of care giving of Unidade de Cuidados Continuados Integrados of Santa Casa da Misericórdia de Portimão? To reach this goal, I have described the multicultural context of nursing care in the Unidade and questioned about representations of health and illness through a methodology combining participant observation and semi-structured interviews. It was observed that, although the presence of foreign patients in the Unidade, this one does not provide any information in their idioms. The answers obtained by interview show that nurses define health and illness like WHO had defined health in 1946, as well-being and non-well-being, respectively. Based on this definition, nurses point out the physical dimension of well-being, comparing to psychological and social well-being. This fact shows that nurses share a biomedical vision supported in etiological-therapeutic constellations which reveal the objectivity of illness and the centrality of the organism as boundaries to interpret the reality of care. This means that nurses have tendency to look at the patient indistinctively, and don‘t recognize the psychological and cultural diversity in health and illness interpretation. Thus, nurses don‘t adapt care providing to patients nationalities, imposing an ethical vision supposed universal to different emic realities they found. Such attitude brings maladjusted care and communication with the patients, where, the miscomprehension of patient‘s language and the presumed consent rise up as main problems which can be counterproductive to legitimacy of beneficence principle. We argue that these maladjustments between the representations of health and illness made by nurses and the care necessities in the context of multiculturalism of Unidade result from the proximity of nursing to biomedical model, which interprets the structure of clinical reality like a scenario regulated by objectivity and reductionism of life to organic existence. In fact, data had shown that the representations of health and illness made by nurses are shaped by institutions who form them and who defines nursing practices so they are conceived as places of production of absolute truth, associating the knowledge to will of power into logic of governmentality apparently out sided to State biopolitics, transforming its neoliberal multicultural policies in authoritarian assimilating practices.