Perspectiva de idosos Kaingang da terra indígena Faxinal-Paraná sobre a assistência no Sistema Único de Saúde

Abstract

Facing the growing concern about the health and well-being in aging, the growth of the indigenous elderly population stirs up the development of researches that address this issue, since there is little information about the indigenous aging. Indigenous elders make up part of a culturally differentiated population, that demands health care adequate to the multiple ethnic background that is part of it. In front of what was exposed, the objectives of the study were to describe how Kaingang elders and their main caregivers experience the access to public health services and to understand how they perceive the performance of basic care services and of the referral network of the Unified Health System. It is a study described as qualitative approach supported in ethnography, conducted with 28 elders and 19 caregivers resident in the Indigenous Land Faxinal, Paraná, Brazil. Data collection was done from December 2010 to February 2013, via three trips to Indigenous Land Faxinal, staying on the field seven days per trip. Data were collected through participant observation and ethnographic interviews aided by two instruments, observation script and interview. It was also used information recorded in field diary and in the database of the research project 'The health knowledge and practices of families of Kaingang elders in the Indigenous Land Faxinal - PR', linked to this study, in addition to the aid of key informers. It is also noteworthy that the researchers had the aid of a bilingual interpreter, since most elders speak the native language, Kaingang. The analysis of the findings was given through the theoretical framework of Madeleine Leininger. The studied elders were aged between 60 and 103 years, with 72.9 years as average. The predominant age group was from 60 to 69 years, also noting the participation of octogenarian and nonagenarians elders. Many of the elders were women, retirees and with no schooling. The access of the Kaingang elders to public health services was characterized by the ease of having medical appointments made and getting health resources, such as medicines, and also in referral to specialized services by the Basic Health Unit. On the other hand, access to the services of the reference network of the Unified Health System was marked by delays in care and referral to other specialized services when needed. Moreover, the opening hours of the health unit proved to be a hindrance to the access of older persons to public health services. With regard to the perception of the elders on the performance of health services, expressions of satisfaction with the work of the nursing team were observed, specifically, in the monitoring of drug treatment and the proximity of nurses to the daily lives of the elders. They also pointed out some negative experiences with discrimination, lack of knowledge about medical and nursing procedures, exposure and manipulation of the body and devaluation of traditional care practices. One concludes that there is a need for health professionals to know, understand and value the cultural specificities of the group, in order to provide greater opportunities for the indigenous elder of access to health services as well as comprehensive and effective care that respects the cultural differences.