“É mais ou menos muita coisa” : significações da dieta para crianças com diagnóstico de doença renal crônica em acompanhamento ambulatorial

Abstract

This study was carried out aimed at identifying and analyzing children's significances, regarding the restrictive diet for children, who were diagnosed with chronic kidney disease. It was based on the meanings shared in the groups to which the participants belong. Based on the aim of the study, it is assumed that, such significations elaborated by the children concerning to the practice of the diet, as medical prescription, may contribute for guiding actions of adherence to the treatment. Thus, having the Research Group of Infancy Psychology (GPPIN), this research had as its field of study the context the Nephrology Ambulatory in the hospital of the Federal University of Mato Grosso - UFMT, Campus Cuiabá in the state of Mato Grosso. The theoretical basis counted on the studies of Vygotsky (2006; 2009; 2010) which considers the human development constructed by the relationship of exchanges among the social partners, through processes of interaction and semiotic mediation, having emphasis on the importance conferred to the process of significance expressed on the inseparable dynamics between meanings and senses. The study also presents the dialogues with the Theory of Social Representations (MOSCOVICI, 1978; 2001; 2015, JODELET, 2001), assuming that the child development occurs in an intimate relationship with the social representations shared in the child's belonging groups and these, assume a condition of mediating element in the relation between subject and reality in the process of signification. The approximations between these two theories through the Ontogenetic approach of Social Representations (CASTORINA, 2010; 2013; DUVEEN LLOYD, 2008) are also presented in this study. This research is characterized by the qualitative approach, counted on four semi-structured interviews with the participants of this study, which were analyzed. The analysis of the data was guided by an interpretative perspective, whose option is justified on the proposal of analysis of the meanings according to Aguiar and Ozella (2006, 2013). The analysis of the data allowed the identification of six axes of meanings, titled in the following order: negative as the guiding principle of thought; information sources; making the stranger familiar; diet: contexts, limits and attitudes and the reinvention of the self after the diagnosis; medical discourse, different families, different experiences and coping strategies; the child’s protagonism and the representation of self. These cores revealed elements to consider that the child constructs a representation of itself based on its relation with the other and in this sense, the social representations about children anchored in the image of innocence and fragility, widely shared in social groups, crosses the processes of meaning of the diet, dialoguing with the experiences of the children in question. These aspects may explain the emphasis on adult obedience and dependence on detriment of the idea of self-care. However, through the results, the autonomy of the child in different levels of authorship was also observed, although this autonomous action is not widely recognized by children as a potentiality of themselves. Considering the points of individual tensions of the subjects, representations that affect certain groups were identified and these are understood as representational object that influence in the interest of adhering or not to the new representations attributed to the treatment. Thus, this study presents data to consider the protagonism of the child who reveals itself as an active interpreter in its social context, even when anchoring its situations of conflict in the knowledge of the other.