Estratégias discursivas na construção das identidades de profissionais de saúde e usuários do Programa Saúde da Família: uma perspectiva etnográfico-discursiva

Abstract

This research is part of the great area of Linguistics and is based on Critical Discourse Studies. My focus is the use of discursive strategies in the construction of identities in the discourse of health professionals and users of the Family Health Program (PSF) from the analysis of the categories evaluation and modalization, components of the identificational meaning of discourse (Fairclough, 2001; 2003). I aim to answer the following research questions: How do identity aspects in the speech of users and PSF health professionals resemble or distance themselves from identity aspects grasped in field observation?; How does the social place (user or PSF health professional) occupied by a social actor influences the use of a particular mode (epistemic or deontic) as a discursive strategy?; What is the influence of socioeconomic factors in two Basic Health Units, one of low Human Development Index (HDI) and another at high Human Development Index (HDI), in health care of PSF? We based this study on the work of van Leeuwen (2005) on Interdisciplinary Models; Halliday (1973, 1985) regarding Systemic Functional Linguistics; Resende & Ramalho (2006), Ramalho & Resende (2011), Fairclough (2001, 2003), Chouliaraki & Fairclough (1999), and Magalhães (2000; 2004) about the theoretical and methodological framework of Critical Discourse Analysis. For data analysis, we conducted a research of ethnographic character in two basic health units in the towns of Pacatuba and Fortaleza, in Ceará, using the techniques of semi-structured interviews, focus groups and field observations, aiming at the triangulation of data in the analysis. The results indicate that the identities of health professionals and users in the PSF context are constructed in practice by evaluative speech, with certain language modes for each specific social actor, showing evaluative commitment of users of Pacatuba and Fortaleza, but less evaluative commitment of Pacatuba professionals in relation to Fortaleza. In addition, the identities engendered in evaluative phrases in the speech of PSF health professionals and users show by explicit and implicit linguistic traits that effective dialogue in the health care practice is directly related to the quality of health care, in addition to pointing out problems in the investigated social practice related to socioeconomic factors.