Inovação da assistência e preservação da tradição: um olhar transcultural das casas de parto de São Paulo e de Osaka

Hoga, Luiza Akiko Komura

Este estudo teve o objetivo de recuperar aspectos históricos e conjunturais relativos a Casas de parto; compreender e descrever as idéias, crenças e valores que guiam as práticas das profissionais envolvidas com a assistência em uma Casa de Parto da cidade de São Paulo, Brasil, e em outra, da cidade de Osaka, Japão; identificar e analisar as similaridades e diferenças existentes entre as duas Casas de parto. Os fundamentos teóricos foram os conceitos de enfermagem transcultural e o método de pesquisa, a etnografia. As categorias culturais e os esquemas conceituais apresentados emergiram das narrativas das enfermeiras obstétricas e auxiliares de enfermagem do contexto brasileiro e das enfermeiras obstétricas do japonês. A Casa Brasileira possui simbologias, dentre elas seu papel de modelo inovador, norteador das futuras Casas de parto e precursor de um movimento que busca transformar a cultura institucionalizada no âmbito da assistência obstétrica. A Casa Japonesa é uma instiuição familiar que procura preservar a tradição, tendo como idéias centrais a promoção da saúde da mulher, considerada essencial para o desenvolvimento sadio da gravidez e à continuidade da vida das futuras gerações. As duas Casas orientam-se por princípios semelhantes, onde se sobressai a consideração da gestante como centro do processo. Ambas enfrentam problemáticas relativas à retaguarda médico hospitalar para as patologias obstétricas e neonatais. Estes dados foram discutidos à luz do Modelo dos Componentes em Enfermagem Transcultural que inclui as perspectivas da teoria, da educação, da pesquisa e da prática.

The aim of this study is to recuperate historical and conjunctural aspects associated with the practices of professionals responsible for nursing care at two birth centers situated in different social and cultural contexts. One of them is located in the city of São Paulo, Brazil and the other in Osaka City, Japan. The ideas, beliefs and values that guide professionals conduct are described. Similarities and differences between these birth centers are identified and analyzed. The aim of this transcultural study is to describe and analize the similarities and differences between two birth centers situated in distinct social and cultural contexts. One of them is located in the city of São Paulo, Brazil and the other in Osaka City, Japan. The ideas, beliefs and values that have guided professional conduct in the past and in the present were identified and discussed. Concepts derived from transcultural nursing comprise the theoretical framework and ethnography was the basic research method employed. The cultural categories and conceptual models presented emerged from the narratives of obstetric nurses and nursing auxiliaries working at the Brazilian birth center and obstetric nurses working at the Japonese birth center. The Brazilian birth center is portrayed as a symbol of innovation, emphasis being placed on it´s role as an innovative model and as a reference for future birth centers. It is depicted as the precursor within a movement which is struggling to transform institutionalized culture within the sphere of obstetric care. The Japonese birth center is a family institution which is attempting to preserve tradition, having as it´s central ideal the promotion of women´s health care, considered essential for the healthy development of pregnancy and well being of future generations. Both birth centers are guided by similar principals, emphasis being laid on the central role occupied by the pregnant woman in the process of labour and birth. Both centers are confronting similar problems with regard to referrals to higher level of care. The data was discussed according to the Model of Components in Transcultural Nursing wich includes theoretical, educational, research and practical perspectives.