O campo e o habitus nas práticas de cuidado de equipes de consultório na rua: notas etnográficas

This doctoral dissertation permeates the debate on how the field of the life of homeless persons on the street and habitus of homeless outreach workers (CnaR) come about and are constructed, in order to substantiate health care practices for homeless persons. RESEARCH AIMS: Overall objective: To analyze health care practices of two Homeless Outreach teams (eCnaR) aimed at the homeless within the municipality of Rio de Janeiro. Specific objectives: To identify essential elements in the operationalization of health care practices of two Homeless Outreach teams, based within the municipality of Rio de Janeiro; to state the way workers of two Homeless Outreach teams construct health care practices and communicate these with homeless persons; and to debate conceptions of health care of workers of Homeless Outreach teams in the municipality of Rio de Janeiro, based on Pierre Bourdieu´s concepts of field and habitus. Methodology: ethnographic research methods, carried out by means of ethnographic observation, in-depth interviews, and questionnaires. Having conducted domain analysis, the results are presented throughout three chapters and demonstrated on three levels: the first (level 1) bringing the concept of field of the life of homeless persons on the street in relation to other fields of power, particularly the field of power of health care, as present in official documents; the second (level 2), which brings about a narrative on how Homeless Outreach teams construct habitus and how the concept restructures itself on the street, constituting the field of homeless outreach; and the third (level 3) that seeks to present constituent elements of the concept of habitus of these workers and how it configures health care practices. RESULTS AND ANALYSIS: level 1, presented as an ethnography of pre-existing documents, demonstrates that, in Brazil, official publications in reference to health care for homeless persons have been produced from the outset of the struggles and experiences of health care workers and their debates on health care actions and questions raised by them on its execution. The entire construction of this field is marked by the struggles and experiences of these health care workers that construct their habitus as they continue to take on these struggles and provide health care practices aimed at the homeless. Level 2 presents itself as a narrative on the health care workers in the field of the life of homeless persons on the street, in which this particular type of care, which includes such effective elements as affection and amorosity within its practices, reveals to be of fundamental importance to those invisible lives on the street. Another issue dealt with is the promotion of health care access by Homeless Outreach teams in coordination with the health care network at the local level. Level 3 presents elements of habitus of health care workers, comprising the individual worker within the field, previous education, professional career, and personal views. CONCLUSION: The concept of habitus of workers of Homeless Outreach teams is shaped up by its very performance, by human interaction and throughout the values on which it is founded and constructs and reconstructs the field of health care that is in constant motion, renewing itself on a daily basis throughout a dynamics of construction and reconstruction. By expressing affection and amorosity that comes about through the life story of every individual worker, one´s perception of self in the world and one´s relation to others, it is this type of health care that turns out to be one of a kind