Representações sociais sobre promoção da saúde entre pessoas com diabetes Mellitus tipo 2

Abstract

Health promotion is one of the central components of primary health care and is classically defined as the process through which communities seek to improve their quality of life and health. Considering that diabetes is recognized as a major global public health issue, the present study aimed to analyze the care practices adopted by individuals with type 2 diabetes mellitus in their pursuit of better living conditions. The objective of this study was to understand the social representations of health promotion among people living with type 2 diabetes mellitus. This is an exploratory and descriptive qualitative study grounded in the Theory of Social Representations as its theoretical and methodological framework. Data collection was carried out at the diabetes outpatient clinic affiliated with the University Hospital of the Federal University of Maranhão, located in São Luís, Maranhão, Brazil, with 100 adult participants diagnosed with type 2 diabetes mellitus. Data were collected through the Free Word Association Technique and semi-structured interviews, in addition to a questionnaire designed to characterize the participants’ sociodemographic and clinical profiles. Evocations were analyzed using prototypical analysis based on the Central Core Theory, while interviews were examined through Content Analysis. The prototypical analysis revealed that the likely central elements of the social representation of health promotion were “medical appointment” and “care.” Content analysis uncovered three categories: conceptions of health promotion; barriers to health promotion; and experiences of living with diabetes. The findings demonstrate that users’ social

representations of health promotion are strongly anchored in practices related to self- care and disease prevention, bringing health promotion closer to individualized and

medicalized behaviors. The study concludes that there is a significant gap between the conceptual frameworks of health promotion and the users’ subjective realities. The results point to an ethical challenge for primary health care services, which are responsible for the longitudinal and comprehensive care of patients with type 2 diabetes mellitus: to use the medical consultation — symbolically valued by patients — as a supportive element within a much broader network of health promotion actions, while also strengthening collective care strategies adapted to local realities and territorially integrated, thereby expanding the focus beyond individual care.