Os sentidos dos caminhos percorridos em busca de cuidado: itinerário terapêutico da população em situação de rua do município de Palmas/TO

Abstract

Introduction: The homeless population represents a portion of the world's population that lives with vulnerabilities, justified by the violation of basic fundamental rights guaranteed by the Federal Constitution. The environment, cultural and social issues influence the health process, as well as the biological event of becoming ill. In an attempt to organize the different conceptions about the process from illness to cure, Therapeutic Itineraries emerge as a strategy in the face of established relationships of lived experiences. Objective: This study aims to understand the Therapeutic Itineraries of the homeless population in the city of Palmas, Tocantins. Methodology: This is a descriptive and exploratory study, with a qualitative and quantitative approach. The quantitative approach used information from the E- SUS information system to analyze the following variables: number of homeless people registered and monitored by the Street Clinic Team in September 2023, as well as the profile of this population in terms of age, gender, and education, which were analyzed using descriptive statistics. In the qualitative approach, semi-structured interviews were recorded and analyzed using the collective subject discourse technique. Results: Of the 178 homeless people registered in September 2023 by the Street Clinic Team, 86% are male, 67% are between 25 and 49 years old, and 58% have completed elementary school. Thirteen homeless people participated in the interview, of which three are illiterate, six have completed elementary school, and four have completed high school. The average age of the participants is 44 years, and the average length of time they have been homeless is 17 years. When analyzing the interviews using the collective subject discourse technique, two central ideas were found within the theme “what does it mean to be healthy?”, three central ideas within the theme “what does it mean to be sick?”, four central ideas in the axis “where do you seek care/what do you do?” and two central ideas in the theme “has the problem been resolved?”, totaling 11 discourses that evidenced therapeutic itineraries with care practices ranging from the use of home medication and allopathic medications to the search for health services according to the complaint. In addition, the discourses express practices of prayer for healing and support for health needs, the use of psychoactive substances to minimize their afflictions, as well as the search for care in the face of the existing support network. Final considerations: The therapeutic itineraries of the homeless population have a therapeutic plurality with the objective of achieving “health” or “cure” mediated by the experience of a complex network of political-social relations. The way in which people living on the streets exist interacts with various types of knowledge and care practices, and has meaning as the meanings are interrelated. This Master's degree work is the result of the stricto sensu Professional Master's Degree in Family Health Postgraduate Program (PROFSAÚDE)