Occupational therapy and the expression “life production”: what do the Brazilian productions say?

Abstract

The production of national knowledge of occupational therapy took place in a contextualized way in line with the development of the profession, in its various fields of activity. In the last decades, there were propositions of expanded perspectives and concepts that point to possible interlocutions in this plurality. In this sense, this study sought to understand how the expression “life production” has been used by the national literature of occupational therapy, based on a bibliographic review of multidimensional strategy. The LILACS database and national journals in the area were consulted, identifying 29 productions with the expression “production of life” or similar, to analyze the profile of publications, authors, and references and the meanings involved in understanding the expression. The findings have become numerically more significant over the past ten years; they were related to themes of mental health, social field, arts and culture, collective health, occupational therapy foundations, and work field; and the references cited occupational therapy, psychiatry, philosophy, psychoanalysis, psychology, collective health, and anthropology authors. The analysis of their understanding indicated four categories: work as social emancipation; expanding health actions; creative experience and cultural transformation; and maintenance of existence. Emphasizing the consistent production on the expression 'life production', we concluded that the expression involves meanings in the construction of know-how more connected to the world, the different ways of existing and being the protagonist of life.

Keywords:
Occupational Therapy; Concept Formation; Review Literature as Topic

Resumo

A produção de conhecimentos nacionais da terapia ocupacional se deu de maneira contextualizada em congruência com o desenvolvimento da profissão, em seus diversos campos de atuação. Nas últimas décadas, viu-se a proposição de perspectivas e conceitos ampliados que apontam possíveis interlocuções nessa pluralidade. Nesse sentido, este estudo buscou compreender como a expressão “produção de vida” tem sido utilizada pela literatura nacional da terapia ocupacional, com base em uma revisão bibliográfica de estratégia multidimensional. Consultou-se a base de dados LILACS e periódicos nacionais da área, identificando 29 produções com a expressão “produção de vida” ou semelhante para análise do perfil das publicações, autores, referências e sentidos envolvidos na compreensão da expressão. Os achados se tornaram numericamente mais significativos nos últimos dez anos; estes se relacionavam com temáticas da saúde mental, campo social, artes e cultura, saúde coletiva, fundamentos da terapia ocupacional e campo do trabalho; e os referenciais citaram autores da terapia ocupacional, psiquiatria, filosofia, psicanálise, psicologia, saúde coletiva e antropologia. A análise de sua compreensão indicou quatro categorias: trabalho como emancipação social; ampliação de ações em saúde; experiência criativa e transformação cultural; e manutenção da própria existência. Ressaltando a produção consistente sobre “produção de vida”, concluiu-se que a expressão envolve sentidos na construção de saberes-fazeres mais conectados com o mundo, com as diferentes formas de existir e de protagonizar a vida.

Palavras-chave:
Terapia Ocupacional; Formação de Conceito; Literatura de Revisão como Assunto

Introduction

The institutionalization of occupational therapy in Brazil takes up the history of the first courses in the mid-1950s, following the International Rehabilitation Movement and the technical and positivist orientation of the models that gained strength in North American and European countries. The Brazilian professional characterization takes its contours with the transformations of the national context of the 1970s. Both the recognition of the profession as a university degree in 1969 and the scenario from the military regime between 1964 and 1985 profoundly marked university education and the social role of the profession (Cardinalli, 2017; Reis & Lopes, 2018).

The participation in the political resistance with social movements in the same period as the expansion of undergraduate courses and the reformulation of the specific minimum curriculum between 1970-80, called for a review of the ethical, political, and social dimension in professional construction. Also, it was the beginning of the entrance of occupational therapists in research and the post-graduate program, bringing human and social sciences closer to thinking about occupational therapy, supporting critical conceptions for the theoretical and methodological foundations of professional practice (Cardinalli, 2017; Galheigo et al., 2018).

In the 1990s and 2000s, with the process of consolidating the production of national knowledge, the differentiation of strands and fields of specialties in occupational therapy appeared due to the expansion of work scenarios and the theoretical deepening of research and training of professionals. postgraduate studies in different areas (Cardinalli, 2017). This movement led to the constitution of what authors such as Mângia (1998), called “multiple occupational therapies”, considering such plurality in the opposite direction to modern scientific rationality, to propose more flexible and complex conceptions for professional identity. The expressions “inter” or “transdisciplinary” also helped explain the construction of this field of knowledge that addresses a diversity of demands at the interface with other fields (Galheigo, 1999).

The acquisition of perspectives and critical references for thinking and doing occupational therapy is expressed in the resumption of historical investigations of the profession after 2010, reviewing the unique historical position and summoning themes related to fundamentals, theoretical-methodological perspectives, and epistemological understandings, in the search to encompass a greater diversity in the production of knowledge, including voices, methodologies, and productions marginalized by the hegemonic construction of science (Melo, 2015; Cardinalli, 2017; Reis & Lopes, 2018; Galheigo et al., 2018).

On the other hand, questions such as what is occupational therapy and what is its social function are highlighted by the challenge that requires investigating possible approaches and dialogues of this multiple constructions of theoretical and practical knowledge, without ignoring the contextualization of the reality in which the field has developed.

In the research by Cardinalli (2017), the five interlocutors participating in the study expressed different conceptions about the profession that, in some way, turn to the dimension of life, such as occupational therapy was born to remove people from hospitalization and take them to life; a possible common unit of the profession would be to work on the quality of occupational life; social participation, autonomy, and freedom would be values in the profession's task of making life happen in a better way; access to human activities, daily life and ways of life are the human resources for the production of life; and occupational therapy invests in human activity as an existential territory where life takes place and the production of life occurs through the power of these activities in the world.

Assuming that this motivation guiding for life is a convergent idea or, at least, indicates a certain dialogue towards a possible professional objective, this study aimed to deepen this question within the occupational therapy area. The term “production of life” was specifically chosen as a proposition already enunciated by occupational therapist Quarentei (2001) because of two reasons of interest: a) looking at a Brazilian occupational therapy perspective; and b) because it was proposed in the professional practice scenario, that is, marginal to the academic-scientific institutionality.

We agree with Cardinalli (2017) when emphasizing the production of knowledge based on clinical, social, assistance, cultural practices, among others. The knowledge produced independently lost visibility in the scientific discourses and standards. However, social mobilizations have historically contributed to changes in the national production of the profession. The dialogue between different production spaces feeds the constitution of networks of knowledge and shared meanings in occupational therapy.

For Quarentei (2001), the “production of life” is the production of ways of existing in the world, which involves its creation and enables the understanding that human life is built through a “continuum of activities” (Quarentei, 2001, p. 2). Thus, for the author, occupational therapists participate in the creation and recreation of life by stimulating activities permeated with affections, “[...] in the sense that activities can be our ground, a place to move, occupy and exist and, even or mainly, in the way that we like, we prefer. To occupy the activities, and no longer be occupied by them” (Quarentei, 2001, p. 6). Its understanding in a philosophical sense causes occupational therapists to think about occupational therapy instead of offering a ready-made definition, theories, and methodologies (Cardinalli, 2017).

The expression “production of life” can be found in other publications by occupational therapists, although they do not mention that it is a sharing of the same conception (Kinker, 1997; Buelau et al., 2009; Lima et al., 2009). In this sense, seeking to deepen the reflection on “production of life” in the social function of occupational therapy in Brazil, this study reviewed the national literature to understand how the expression has been used by Brazilian occupational therapists.

Methodological Procedures

This is a literature review with the adoption of a multidimensional investigation strategy, seeking to broaden the view of the theme, learning about the knowledge networks, and finding out how they were historically constructed, helping to understand the contextualization of the theme. All procedures followed offered a form of review that went beyond a listing. With this strategy, the techniques are not rigid but open to unforeseen events and changes along the way (Pádua, 2014).

The systematic survey of articles published in journals followed these steps: 1) bibliographic survey identifying the databases and analysis of titles, year, keywords, and authorship of publications; 2) examining the references to ascertain the sources of common research, realizing divergences or similarities between the chosen approaches; 3) elaboration of a commented synthesis based on the reading of each article, making analytical comments on each one, serving as a basis for the discussion; 4) creation of references for the general analysis of the commented syntheses, generating the discussion and conclusion of the research (Pádua, 2014).

The research was carried out between March and May 2019, with searches in the Latin American and Caribbean Literature in Health Sciences database (LILACS), with the descriptors “occupational therapy” AND “life production”. Also, we searched on the portals from Brazilian journals: Cadernos Brasileiros de Terapia Ocupacional (CBTO), Revista de Terapia Ocupacional da Universidade de São Paulo (RTO), and Revista Interinstitucional Brasileira de Terapia Ocupacional (REVISBRATO), using only the descriptor “production of life”.

As the inclusion criteria, the study covered only productions in the format of a scientific article, an experience report, and a literature review, authored by Brazilian occupational therapists and prepared in Portuguese, considering publications until May 2019. Furthermore, the expression “production of life” or similar (“life production” in six articles and “daily production of life” in one article) could be present in the body of the text, that is, in addition to the title, abstract and keywords, for further analysis in-depth use and understanding.

We found 35 productions directly in Brazilian journals, four in CBTO, 29 in RTO, and two in REVISBRATO. In the LILACS database, we found 53. As eight of them were repeated, we added 45 productions on this basis. Using the inclusion criteria, we selected 29 of the 80 findings for the literature review. Figure 1 shows the search and selection process.

Figure 1
Flowchart of the literature review paths.

We recorded and organized the general data of the 29 articles in an Excel® spreadsheet, which are: year of publication, journal, type of article, authors, title, keywords, and abstract. All articles were read to identify the expression “production of life” in the body of the text.

The steps that followed the multidimensional analysis of the productions resulted in the identification of the authorship of the productions, which present the expression, the theoretical-methodological references that feed concepts, and the theoretical-practical themes involved. The commented synthesis sought to understand the meanings of the expression “production of life” together with its references and to indicate possible approximations and dissonances. To this end, we commented on the use of the expression by each article as a basis for discussing the results.

Results

Characterization of the data

The first publication is from 1997. Between 2003 and 2005, we found five articles and, starting in 2009, we identified an increasing number of published articles, totaling 23 until 2019. There were no publications between 1998 to 2002 and from 2006 to 2008 (Figure 2).

Figure 2
Publications by period.

Regarding the types of publication, although the names vary with the journal, we found 22 original articles with results of research on the occupational therapy area, which suggests the predominance of this format for the development of theoretical and methodological proposals. The remaining seven articles were divided into three experience reports, two reflection articles, a review article, and an article classified as open space.

In the authors' analysis, we found 48 distinct names. The most recurrent authors were Eliane Dias de Castro, Elizabeth Maria Freire de Araújo Lima, and Erika Alvarez Inforsato, each subscribing to three articles. Ana Lucia Marinho Marques, Andréa do Amparo Carotta de Angeli, Denise Dias Barros, Elisabete Ferreira Mângia, Fernando Sfair Kinker, Leonardo José Costa de Lima, Mara Cristina Ribeiro, Thayne Pereira da Silva Ferreira, and Thelma Simões Matsukura are the authors of two articles each one. The other authors appeared only once in the authorship (Figure 3).

Figure 3
Word cloud with authors.

Investment themes

Regarding the fields of the specialty of Brazilian occupational therapy, we found productions related to the following groups, according to their main subject: mental health (14 articles, 48%), social field (five articles, 17%), arts and culture (four articles, 14%), collective health (three articles, 10%), occupational therapy fundamentals (two articles, 7%) and work field (one article, 3%) (Figure 4).

Figure 4
Number of articles by thematic category.

The articles of the mental health group address themes such as experiences in extra-hospital services and their therapeutic projects in a perspective of psychosocial rehabilitation (Fiorati & Saeki, 2011); the development of autism in children and adolescents from the perspective of the family (Minatel & Matsukura, 2014); the participation of mental health patients in research and the therapeutic potential of this process, with the help of occupational therapists (Dimov & Ricci, 2016); reflections on the psychiatric hospital and the logic of abandonment (Kinker, 2012); the relationship between psychiatric reform and the world of work for mental health patients (Kinker, 1997; Luiz et al., 2018); the importance of Residential Therapeutic Services in the attention and production of mental health care (Marques & Mângia, 2013; Castilho, 2012); the deinstitutionalization processes of people who lived in psychiatric hospitals, understanding the Mental Health Policy (Mângia & Marques, 2004); mental health care performed in territorial services called Psychosocial Care Center (CAPS) (Ribeiro, 2014; Castro & Maxta, 2010); the different views on people with mental disorders, recognizing them as protagonists of their own lives (Ferreira et al., 2018); artistic interventions as a resource for occupational therapy together with Mental Health patients (Silva & Raccioni, 2015; Batista & Ribeiro, 2016).

The category of the social field brought themes related to the housing of children and adolescents in shelters, emphasizing that it is a life crossed by social, political, and historical processes (Luvizaro & Galheigo, 2011); the work of occupational therapy with young offenders (Almeida, 2003); interventions by occupational therapists with the homeless population (Ghirardi et al., 2005; Andrade et al., 2014); and challenges faced in student housing (Gemelgo & Barros, 2015).

Articles related to arts and culture show the importance of creativity and aesthetic experiences (Buelau et al., 2009); reports of projects involving dialogue with artists and art that, among the different objectives, achieved the encouragement of socio-cultural processes in cultural participation (Lima et al., 2009; Castro et al., 2011); and the link between cultural production and occupational therapy, resulting in an expansion of professional performance (Castro et al., 2009).

The articles on collective health address the concept of disability and its relationship with the territory, bringing observations from the Family Health Strategy and the contributions of occupational therapy (Gelatti & Angeli, 2019); health care developed in Primary Health Care networks (Ferreira & Costa, 2017); and occupational therapy interventions and contributions in the street office (Prodocimo et al., 2018).

The group of fundamentals had articles discussing the complexity of the therapist-patient relationship in the occupational therapy area (Castro, 2005) and the exploration of the concept of everyday life in Brazilian occupational therapy (Salles & Matsukura, 2013).

The only article on the work field showed the history of human labor from slavery to the current capitalist era, considering how these work dynamics intertwine with the worker's life (Oliveira, 2003).

Theoretical-methodological references

The expression “production of life” appeared 41 times in the total of all articles found, 32 of them mentioning in the references when the expression appeared. When counting the articles, 21 publications mentioned the expression only once, six articles contained “production of life” twice in the body of the text, and in two articles the expression appeared four times.

Analyzing the references in the excerpts that mention the expression “production of life”, the authors were from the following areas: occupational therapy (24 references), psychiatry (7), philosophy (6), psychoanalysis (2), psychology (2), collective health (2) and anthropology (1). Nine articles did not mention any reference in the excerpts with the expression “production of life”.

The Brazilian occupational therapist authors were the most cited: Eliane Dias de Castro (3 citations), Elisabete Ferreira Mângia (3), Elizabeth Maria Freire de Araújo Lima (2), Fernanda Nicácio (2), Maria Inês Britto Brunello (2), Mariângela Scaglione Quarentei (2), Berenice Rosa Francisco (1), Dilma de Melo Silva (1), Erika Alvarez Inforsato (1), Fernanda Cristina Marquetti (1), Isabela Aparecida de Oliveira Lussi (1), Mara Cristina Ribeiro (1), Mariana Moraes Salles (1), Melissa Tieko Muramoto (1), Sabrina Helena Ferigato (1) and Thelma Simões Matsukura (1).

From the psychiatry area, the references were from Italians Franco Rotelli (3 citations), Benedetto Saraceno (2), and Franco Basaglia (1), in addition to the Brazilian Ricardo Luiz Narciso Moebus (1). Philosophy is represented by the French authors Félix Guattari (3), Gilles Deleuze (2), and the German Friedrich Engels (1). In psychoanalysis, the authors mentioned were the Brazilians Fernando Tenório (1) and Gilberto Safra (1). In psychology, there are two authors: the Brazilians Alex Reinecke de Alverga (1) and Magda Diniz Bezerra Dimenstein (1). Brazilians Ricardo Burg Ceccim (1) and Emerson Elias Merhy (1) were mentioned in the collective health. Finally, José Guilherme Cantor Magnani (1) was mentioned for anthropology.

When crossing the data, Marquetti, Ribeiro, Ferigato, and Matsukura are authors who refer to their publications. Castro, Mângia, Lima, Inforsato, and Salles are both in the authorship of articles and the references of other articles in our findings. Considering such investments in a network of knowledge (Cardinalli, 2017) on the topic, we can observe the interlocutors and fields of dialogue (Figure 5).

Figure 5
Word cloud with references used.

When crossing the data from the topics of the articles with the areas of the referenced authors, there are dialogues between the following knowledge: the articles on the topic of mental health used references from occupational therapy, psychiatry, psychology, public health, philosophy, and psychoanalysis when mentioning the expression “production of life”; those in the social field were based on occupational therapy, psychiatry, and anthropology in these specific excerpts; those in the arts and culture cited psychoanalysis, occupational therapy, and philosophy; in collective health, we saw occupational therapy, philosophy, and collective health; the foundations' articles refer to occupational therapy and psychiatry, and the only article on the work field used a reference to philosophy related to the expression.

Discussion

The analysis of the understandings of the excerpts that cited “production of life” pointed out four categories of discussion regarding the different uses and meanings attributed to the expression: work as social emancipation; expansion of health actions; creative experience and cultural transformation; and maintenance of existence. This categorization is not directly related to the general topics of the articles, as previously presented.

Production of life through work as a social emancipation

The issue of work has been related to occupational therapy since its origin, and its understanding has changed with the reviews of the profession, criticizing the moralizing and controlling character and recognizing its centrality in the expression of the human condition and its social organization. The comprehension review followed social movements such as deinstitutionalization and the guarantee of social spaces for the referred population. According to Lancman et al. (2016), work is a means by which individuals can engage socially and participate in the world, in addition to exercising their citizenship and creating social support networks. Thus, the subjective aspects related to work in society interfere in the construction of the world and can be a support for the social emancipation of individuals and groups.

Four articles bring the expression “production of life” related to work as a possibility of emancipation: Work as the production of life (Kinker, 1997), using Rotelli to approach the subject; Walk through the world of work (Oliveira, 2003), using Engels' reference; The place of the psychiatric hospital today: from discipline to abandonment (Kinker, 2012), without references about the expression; Challenges faced by mental health users: reflections on narratives about inside and outside work and income generation workshops (Luiz et al., 2018), in which Lussi was the reference.

Work is seen as a way of being and acting in the world and related to the quality of life, considering its centrality in the Western way of life and capitalist production. Approaching the history of human work from a Marxist perspective, Oliveira (2003) explains that its function in the production of material life consists in the conscious search for satisfying its own needs. Dialectically, work also becomes the foundation of human life since it creates and interferes with the subject of the action.

Thus, based on the Marxist reference, work as praxis or human activity in meeting human needs can raise awareness of the subject of the action, modifying himself and the reality to which he belongs. As the socio-historical reality forms the subjects, it can be transformed by their work or other subjects who share such a social reality. As work is intrinsically linked to the social and historical plot, daily life, and ways of life, changes in their relationships directly affect the conditions of existence and the ability to produce life.

Work produces the maintenance of life materially and symbolically, also reproducing processes of domination, forms of oppression and damage in the social relationships of workers, and those who are on the margins or excluded from the world of work. On the other hand, “[...] work is an important tool for social emancipation and a resource that promotes self-knowledge, self-performance, acquisition of rights, citizenship, and production of life” (Luiz et al., 2018, p. 65). As it allows subjects to transform themselves and create relationships with others and with the world in which they live, it is possible to bet on “[...] expanding technological capacity, instead of being a producer of exclusion, it could be the possibility of rescuing man work, art and leisure experiences that enrich the existence” (Kinker, 1997, p. 46).

Linked to the logic of the market, to think critically about work in the sociability patterns of modernity involves not only the methods of control but also the capitalization of affects. This enables actions in occupational therapy as the agency of new social relationships, collaborating in the creation of meanings of life and existential territories, which enable ways of existence in addition to market sociability. As a central debate on work, freedom allows promising possibilities for the existence and production of life (Kinker, 2012).

Production of life in the expansion of health actions

The concept of health in this category is approached above a health-disease process, related to changes in conceptions and social health policies in the Brazilian context after the 1980s. Broadly, health actions are those involved in life and care in an integral and multidimensional way. The production of care would be involved with the different “worlds of existence” (Ferreira & Costa, 2017, p. 270), allowing the subjects to produce life in their material and subjective territories. As occupational therapists, they understand that the individual “[...] produces and is produced in their daily activities and relationships” (Ferreira & Costa, 2017, p. 276), they contribute to this expanded health concept with teams in the territorial and community spheres.

Eight articles used the expression “production of life” based on expanded health actions. They are: Inscriptions of the therapist-patient relationship in the occupational therapy area (Castro, 2005), using Basaglia as a theoretical reference; Street life and cooperativism: moving through the production of values ​​(Ghirardi et al., 2005), which does not mention reference to the expression; Territorial mental health care practices: experiences of a psychosocial care center in the city of Rio de Janeiro (Castro & Maxta, 2010), mentioning Tenório; The insertion of psychosocial rehabilitation in extra-hospital mental health services: the conflict between instrumental rationality and practical rationality (Fiorati & Saeki, 2011), mentioning Mângia and Nicácio; Psychosocial Care Centers as spaces that promote life: reports of deinstitutionalization in Alagoas (Ribeiro, 2014), with no reference; Health and live networks of comprehensive care in primary care: articulating strategic actions in the territory (Ferreira & Costa, 2017), using Mângia and Muramoto; New looks at other modes of existence (Ferreira et al., 2018), using Alverga and Dimenstein, Rotelli, Merhy, Moebus, Deleuze and Guattari as references; A body: mapping life trajectories of subjects with stroke sequelae (Gelatti & Angeli, 2019), referring to Castro, Lima, Brunello, Ceccim, Deleuze and Guattari.

Connected to the health work, the production of life expands the understanding of the subject in its various relational dimensions, as a social being that is produced in networks, inserted in a map of existence that encompasses multiplicities and realities in the production of life. Thus, the role of occupational therapists in this network of existence involves a health perspective “[...] understood as a state of life production” (Ghirardi et al., 2005, p. 609).

There are similarities between health actions and life in the territories. In this sense, the territory is understood in two ways: as a concrete entity, “[...] dynamic, alive, full of interrelations... [with] an essential role on the life of the individual and the social body” (Lima & Yasui, 2014, p. 596), and relative to subjectivities, in their conception as the existential territory from the perspective of Deleuze and Guattari, “[...] which involves spaces built with material and emotional elements of the environment, which, appropriated and expressively managed, end up constituting places to live” (Lima & Yasui, 2014, p. 599).

The expression related to the perspective of the production of care, with a reference to the philosophy of difference, is not a general physical, psychological and emotional well-being, actions that accompany affections, flow and escape lines on maps and existential territories of each one, their worlds and subjectivities, affirming and producing life. In addition to working in occupational therapy, “[...] the visibility of the production of life and care in madness allowed health workers to propose other non-asylum, non-deterritorialized, non-institutionalized care offers” (Ferreira et al., 2018, p. 76).

Adding to the perspective of deinstitutionalization for mental health care, the horizon is a network work that promotes the valorization and protagonism of the subjects. In other words, actions that amplify the possibilities of exercising their rights, desires, creating experiences, stories, and exchanges. Finally, the transformations from non-coexistence spaces to collective living spaces as a new social place (Ribeiro, 2014). Thus, occupational therapy acts in the creation of strategies that compose and organize the care network, considering the existential territories, circulation, belonging, and life production.

Production of life in the creative experience and cultural transformation

Artistic practices in occupational therapy and precursors to their institutionalization in the country were initially associated with the expression of emotions and unconscious contents. For example, with the social struggles for the re-democratization of Brazil and the rights of people with disabilities, the promotion of bodily and artistic practices gained new meanings in the context of material and symbolic deconstruction and reconstruction of life and subjectivity. They are associated with the reorientation of concepts such as health, rehabilitation, citizenship, and activity, which started to conduct theoretical and practical experiments in the profession (Castro, 2000).

Six articles show creative experiences related to the expression “production of life”: Training in occupational therapy at the interface of arts and health: the experience of PACTO (Castro et al., 2009), with Guattari as a theoretical reference; Adolescents PACTO: art and body in the invention of devices in occupational therapy for the production of life and health in adolescence (Lima et al., 2009) not mentioning references; Exercises of dreaming together: creativity and aesthetic experiences in accompanying a child (Buelau et al., 2009), mentioning Safra; Body and art workshops: inventiveness, aesthetic production and socio-cultural participation (Castro et al., 2011), in which the reference was Inforsato; Theater workshops as an occupational therapeutic resource in a residential therapeutic service (Silva & Raccioni, 2015), who mentioned Rotelli, Castro and Silva; The use of music as a therapeutic resource in mental health (Batista & Ribeiro, 2016), in which Ribeiro was the reference.

All the articles in this category put occupational therapy at the interface with art, culture, aesthetic experience, and/or creative processes, bringing new meanings to understand human lives and promote new possibilities for existence. They are spaces for experimentation, invention, and signification of experiences such as the creation of existential territories, creating other forms of communication and life. Artistic expressions become initiatives for the production of life, sociability, creativity, and the transformation of non-coexistence spaces into shared spaces.

Occupational therapy has a lot to contribute. By creating a field of experimentation where aesthetic and symbolic forms can be invented and articulated through human activity and openness to contact with otherness, we promote care for the experience of subjects in the world, which is fundamental for the creation of new existential territories and, consequently, for the production of life (Buelau et al., 2009, p. 167).

Active involvement with aesthetic and creative experiences enhances human existence, the self-perception as a creator at the same time that learns in relationships with the world, as possible spaces for expression and cultural transformation and subjectivity, where life also takes place. It favors and strengthens the expression of traits of authorship, an agency of new possibilities and self-management. Thus, new possibilities of experience, knowledge, and creation trigger the movement to produce life and subjectivity.

A living movement was proposed based on this coexistence and, for this group, it was possible to welcome what was vital to be experienced. It can be said that this moment of work has engendered power, the power of life wanting to continue. The body is a source of knowledge, its responses and its shape can constantly guide the person (Castro et al., 2011, p. 257).

The centralization and redefinition of activities, such as human and cultural, for occupational therapy in Brazil, are permeated by the possibilities of connection and creation, facilitating the understanding of artistic and cultural production and enjoyment related to collective and everyday life, “Moving in other spaces, opening up to collective experiences that dialogued with productions, strengthened and provoked resonances for group activities” (Castro et al., 2011, p. 260). This meant aligning experimentation, creation, production of life, and subjectivity (Castro et al., 2011).

Production of life as maintenance of the own existence

This category involves articles that reference Mariângela Quarentei when mentioning the production of life in the existential condition, share investment themes with the author, such as deinstitutionalization (Quarentei, 1999), or consider human activities to refer to knowledge and actions in occupational therapy (Quarentei, 2006). Therefore, this is the category that most directly dialogues with the author and the conception of occupational therapy as the production of life.

Eleven articles used the expression “production of life” with the meaning of the condition of existence. They are: Occupational therapy group with young people after the fulfillment of socio-educational measures, a space for the production of life (Almeida, 2003), based in Quarentei; Deinstitutionalization and therapeutic residential services: new perspectives for the psychosocial rehabilitation field (Mângia & Marques, 2004), without references; Considerations about the daily life and housing of children and adolescents in institutional shelter situations (Luvizaro & Galheigo, 2011), which mentioned Francisco and Saraceno; Occupational therapy and therapeutic residential service in the city of Belo Horizonte, MG (Castilho, 2012), in which Saraceno, Mângia and Nicácio were mentioned; To be, to inhabit: therapeutic residential services in the city of Campinas, SP (Marques & Mângia, 2013), in which there was no reference; Systematic review study on the use of the concept of everyday life in the occupational therapy field in Brazil (Salles & Matsukura, 2013), referencing Castro, Lima and Brunello; The street has a magnet, I think it is freedom: power, suffering and life strategies among homeless people in the city of Santos, on the coast of the State of São Paulo (Andrade et al., 2014), in which Marquetti was referenced; Families of children and adolescents with autism: daily life and care reality at different stages of development (Minatel & Matsukura, 2014), referring to Salles and Matsukura; Feeling of deterritorialization and the challenge of self-esteem in the experience of student housing (Gemelgo & Barros, 2015), which mentioned Magnani; Academic research as a human activity: participation of mental health users and the contributions of occupational therapy (Dimov & Ricci, 2016), in which the reference was Quarentei; Performance of occupational therapy at Consultório na Rua (Prodocimo et al., 2018), citing Ferigato.

There is a concern with the activities of life expressed in daily life, with needs, desires, and interests. Daily life produces unique ways of life; however, also shared. In this sense, daily life is not limited to “instrumental activities” or the analysis of “occupational performance” as categories and technical metrics to be placed on subjects by a knowledge that is alien to them. The reflection on concepts such as human activities, daily life, and ways of life aim at not overlapping knowledge-powers over the subject, understanding him as the conductor of his reality, with occupational therapeutic know-how being just another element in this process, or that is, it triggers another professional attitude and a relationship of composition and commitment to the production of life.

Therefore, the transformation and production of life constitute the objectives of professional performance. “Occupational therapy is concerned with the production of life for the people it assists and life is composed in everyday life; it is in the small actions of daily life that we build as human beings” (Salles & Matsukura, 2013, p. 266).

The references, worldviews, and ethical-political positions of occupational therapists in the face of guided practices and involved in the production of life become facilitators of new experiences and enhance the effects of encounters, construction, ways of relating in the world, and the expression of subjectivities. For this, activities are catalysts for change, carry out experiences, expand possibilities of existing in the world, to produce more life.

The issue of emancipation in the transformation of relationships, knowledge, and practices is also reconsidered, as opposed to institutional control, in the sense of the transformations of daily life, enabling new ways of acting and expressing in the face of realities, as pointed out by Marques & Mângia (2013, p. 251):

[...] the construction of the quality of everyday life is linked to the production of life and the concrete transformation of reality and involves enhancing the expression of different subjectivities, rescuing identities and life histories, and revaluing everyday actions.

The conception of the production of life as maintenance of existence, closely related to subjective contents and realities and daily life, also resumes the understanding of territory already mentioned in the second category in a philosophical and affective reflection. With such understandings, the propositions in occupational therapy move away from the reproducible technical conception that predisposes a generalist idea about the quality of life, to recognize the diversity and uniqueness of experiences and the complexity of shared human existence.

Final Considerations

Amid its theoretical-practical diversification, the understanding of the occupational therapy area has the challenge of knowing, investing, and questioning its foundations, concepts, and dialogues highlighted in contemporary times. In its diversity, it is important to provide opportunities for contributions that may be relevant to different ways of doing and thinking about occupational therapy, considering their relationship with the whole (Guajardo et al., 2015).

The studied theme revealed other meanings of the complexity of a contemporary debate immersed in the network of knowledge produced by occupational therapy in Brazil and remains under construction, constitution, and transformation in its historical, scientific, ethical, and political paths. Furthermore, it values the production of its interlocutors in articulating, amplifying, and disseminating the profession.

It was possible to verify a certain scope of the diversity of theoretical and practical scenarios, with the mental health area as the one that most operated the expression “production of life”, followed by social, art and culture, collective health, occupational therapy fundamentals, and work field. Such fields, with some ease, dialogue with each other through the sharing of theoretical-methodological references and perspectives, which may indicate a tendency for the use of the expression.

These reflections sought to deepen approximations, marking differences, in the ways of conceiving the “production of life” in/by occupational therapy. Although the proposed analysis categories are closer to the identification of the mentioned scenarios - a) work as social emancipation; b) expansion of health actions; c) creative experience and cultural transformation, and d) maintenance of their existence - there was not always a direct link between them, such as mental health, which was present in all categories. Therefore, we found that the categories have understandings that were not constituted based on the fields of the specialty of Brazilian occupational therapy.

In general, such elaborations revealed conceptual meanings of the expression “production of life” in the construction of know-how of occupational therapy in Brazil more connected with the world, and the different realities and ways of existing and leading life. On the one hand, the expression comes close to possible professional goals, in the sense of considering work for social emancipation, conceiving health expanded in its care practices, valuing the creation and cultural transformation by/of people, and prioritizing the maintenance of existence in a singular and shared way. On the other hand, the revealed meanings distance it from pre-determined, reproducible, and uncritical methodologies.

The investigation of the identified meanings enabled a convergence with anti-hegemonic processes and critical theoretical-methodological perspectives involved in the reality and struggles of the national scenario, to promote deinstitutionalizing, territorial, networked, collective, public practices, as a right and citizenship, without underestimating singularities and subjectivities, as an exercise in creation and emancipation, related to conceptions about activity, doing, action, work and daily life developed by the profession nationally. Thus, it was derived a production of knowledge that was made in action, with openness to composition and other perceptions, ways of living and thinking, which qualified its construction. There is a presence of living relationships that mark and characterize the know-how of this profession.

With research gaps, printed articles that were not found could not be analyzed, with productions related to the theme that was not included, which still represents a hindrance in accessing and disseminating national productions. The possibility of searching only the LILACS database also presented restrictions, since not all editions of journals and magazines are indexed. Also, the expressions similar to the scope of the review were included; however, within the identified meanings, no divergence or analytical deviation from the discussion was observed.

Finally, we can conclude that the expression “production of life” does not have a single meaning for Brazilian occupational therapy, nor is it derived from a single theoretical reference, although it is possible to find shared meanings. The consistent theoretical-reflective elaboration of occupational therapists in the theme is highlighted, representing a fertile field of study for epistemological studies of national production and the development of emancipatory practices with possibilities of investigative deepening.

• How to cite: Albuquerque, G. M. P., Cardinalli, I., & Bianchi, P. C. (2021). Occupational therapy and the expression “life production”: what do the Brazilian productions say? Cadernos Brasileiros de Terapia Ocupacional, 29, e2133. https://doi.org/10.1590/2526-8910.ctoAR2133
• 1
  The references Almeida (2003), Andrade et al. (2014), Batista & Ribeiro (2016), Buelau et al. (2009), Cardinalli (2017), Castilho (2012), Castro (2000, 2005), Castro et al. (2009, 2011), Castro & Maxta (2010), Dimov & Ricci (2016), Ferreira & Costa (2017), Ferreira et al. (2018), Fiorati & Saeki (2011), Gelatti & Angeli (2019), Gemelgo & Barros (2015), Ghirardi et al. (2005), Kinker (1997, 2012), Lima et al. (2009), Luiz et al. (2018), Luvizaro & Galheigo (2011), Mângia & Marques (2004), Marques & Mângia (2013), Minatel & Matsukura (2014), Oliveira (2003), Prodocimo et al. (2018), Ribeiro (2014), Salles & Matsukura (2013) e Silva & Raccioni (2015) were raised in the second group of the review.

Referências¹

• Almeida, M. M. (2003). Grupo de Terapia Ocupacional com jovens após o cumprimento de medidas socioeducativas um espaço para produção de vida. Cadernos de Terapia Ocupacional da UFSCar, 11(2), 106-110.
• Andrade, L. P., Costa, S. L., & Marquetti, F. C. (2014). A rua tem um ímã, acho que é a liberdade: potência, sofrimento e estratégias de vida entre moradores de rua na cidade de Santos, no litoral do Estado de São Paulo. Saúde e Sociedade, 23(4), 1248-1261. http://dx.doi.org/10.1590/S0104-12902014000400011
  » http://dx.doi.org/10.1590/S0104-12902014000400011
• Batista, N. S., & Ribeiro, M. C. (2016). O uso da música como recurso terapêutico em saúde mental. Revista de Terapia Ocupacional da Universidade de São Paulo, 27(3), 336-341. http://dx.doi.org/10.11606/issn.2238-6149.v27i3p336-341
  » http://dx.doi.org/10.11606/issn.2238-6149.v27i3p336-341
• Buelau, R. M., Inforsato, E. A., & Lima, E. M. F. A. (2009). Exercícios de sonhar junto: criatividade e experiências estéticas no acompanhamento de uma criança. Revista de Terapia Ocupacional da Universidade de São Paulo, 20(3), 164-170. http://dx.doi.org/10.11606/issn.2238-6149.v20i3p164-170
  » http://dx.doi.org/10.11606/issn.2238-6149.v20i3p164-170
• Cardinalli, I. (2017). Conhecimentos da terapia ocupacional no Brasil: um estudo sobre trajetórias e produções (Dissertação de mestrado). Universidade Federal de São Carlos, São Carlos.
• Castilho, J. (2012). A terapia ocupacional e o serviço residencial terapêutico no município de Belo Horizonte, MG. Revista de Terapia Ocupacional da Universidade de São Paulo, 23(3), 230-236. http://dx.doi.org/10.11606/issn.2238-6149.v23i3p230-236
  » http://dx.doi.org/10.11606/issn.2238-6149.v23i3p230-236
• Castro, E. D. (2000). Arte, corpo e terapia ocupacional: aproximação, intersecções e desdobramentos. Revista de Terapia Ocupacional, 11(1), 7-12.
• Castro, E. D. (2005). Inscrições da relação terapeuta-paciente no campo da terapia ocupacional. Revista de Terapia Ocupacional da Universidade de São Paulo, 16(1), 14-21. http://dx.doi.org/10.11606/issn.2238-6149.v16i1p14-21
  » http://dx.doi.org/10.11606/issn.2238-6149.v16i1p14-21
• Castro, E. D., Saito, C., Drumond, F., & Lima, L. (2011). Ateliês de corpo e arte: inventividade, produção estética e participação sociocultural. Revista de Terapia Ocupacional da Universidade de São Paulo, 22(3), 254-262. http://dx.doi.org/10.11606/issn.2238-6149.v22i3p254-262
  » http://dx.doi.org/10.11606/issn.2238-6149.v22i3p254-262
• Castro, E., Inforsato, E., Angeli, A., & Lima, E. (2009). Formação em terapia ocupacional na interface das artes e da saúde: a experiência do PACTO. Revista de Terapia Ocupacional da Universidade de São Paulo, 20(3), 149-156. http://dx.doi.org/10.11606/issn.2238-6149.v20i3p149-156
  » http://dx.doi.org/10.11606/issn.2238-6149.v20i3p149-156
• Castro, L., & Maxta, B. (2010). Práticas territoriais de cuidado em saúde mental: experiências de um centro de atenção psicossocial no município do Rio de Janeiro. Revista Eletrônica Saúde Mental Álcool e Drogas, 6(1), 1-11. http://dx.doi.org/10.11606/issn.1806-6976.v6i1p1-11
  » http://dx.doi.org/10.11606/issn.1806-6976.v6i1p1-11
• Dimov, T., & Ricci, E. C. (2016). A pesquisa acadêmica como atividade humana: participação de usuários da saúde mental e as contribuições da terapia ocupacional. Cadernos de Terapia Ocupacional da UFSCar, 24(3), 651-658. http://dx.doi.org/10.4322/0104-4931.ctoEN0674
  » http://dx.doi.org/10.4322/0104-4931.ctoEN0674
• Ferreira, T. P. S., & Costa, C. T. (2017). Saúde e redes vivas de cuidado: articulando ações estratégicas no território com vista ao cuidado integral na atenção básica. Revista Interinstitucional Brasileira de Terapia Ocupacional, 1(3), 269-281.
• Ferreira, T. P. S., Sampaio, J., & Gomes, L. (2018). Novos olhares para outros modos de existência. Revista de Terapia Ocupacional da Universidade de São Paulo, 29(1), 70-79. http://dx.doi.org/10.11606/issn.2238-6149.v29i1p70-79
  » http://dx.doi.org/10.11606/issn.2238-6149.v29i1p70-79
• Fiorati, R. C., & Saeki, T. (2011). A inserção da reabilitação psicossocial nos serviços extra hospitalares de saúde mental: o conflito entre racionalidade instrumental e racionalidade prática. Revista de Terapia Ocupacional da Universidade de São Paulo, 22(1), 76-84. http://dx.doi.org/10.11606/issn.2238-6149.v22i1p76-84
  » http://dx.doi.org/10.11606/issn.2238-6149.v22i1p76-84
• Galheigo, S. M. (1999). A transdisciplinaridade enquanto princípio e realidade das ações de saúde. Revista de Terapia Ocupacional da Universidade de São Paulo, 10(2-3), 49-54.
• Galheigo, S. M., Braga, C. P., Arthur, M. A., & Matsua, C. M. (2018). Produção de conhecimento, perspectivas e referências teórico-práticas na terapia ocupacional brasileira: marcos e tendências em uma linha do tempo. Cadernos Brasileiros de Terapia Ocupacional, 26(4), 723-738. http://dx.doi.org/10.4322/2526-8910.ctoAO1773
  » http://dx.doi.org/10.4322/2526-8910.ctoAO1773
• Gelatti, M. D., & Angeli, A. A. C. (2019). Um corpo: cartografando trajetórias de vida de sujeitos com sequelas de acidente vascular cerebral. Cadernos Brasileiros de Terapia Ocupacional, 27(1), 149-167. http://dx.doi.org/10.4322/2526-8910.ctoao1697
  » http://dx.doi.org/10.4322/2526-8910.ctoao1697
• Gemelgo, F. A. K., & Barros, D. D. (2015). Reflexões em torno do sentimento de desterritorialização e do desafio da autoestima na experiência da moradia estudantil. Cadernos de Terapia Ocupacional da UFSCar, 23(4), 803-814. http://dx.doi.org/10.4322/0104-4931.ctoRE0650
  » http://dx.doi.org/10.4322/0104-4931.ctoRE0650
• Ghirardi, M. I. G., Lopes, S. R., Barros, D. D., & Galvani, D. (2005). Vida na rua e cooperativismo: transitando pela produção de valores. Interface: Comunicacao, Saude, Educacao, 9(18), 601-610. http://dx.doi.org/10.1590/S1414-32832005000300014
  » http://dx.doi.org/10.1590/S1414-32832005000300014
• Guajardo, A., Kronenberg, F., & Ramugondo, E. L. (2015). Southern occupational therapies: emerging identities, epistemologies and practices. South African Journal of Occupational Therapy, 45(1), 3-10. http://dx.doi.org/10.17159/2310-3833/2015/v45no1a2
  » http://dx.doi.org/10.17159/2310-3833/2015/v45no1a2
• Kinker, F. S. (1997). Trabalho como produção de vida. Revista de Terapia Ocupacional da Universidade de São Paulo, 8(1), 42-48.
• Kinker, F. S. (2012). O lugar do hospital psiquiátrico na atualidade: da disciplina ao abandono. Revista de Terapia Ocupacional da Universidade de São Paulo, 23(2), 178-185. http://dx.doi.org/10.11606/issn.2238-6149.v23i2p178-185
  » http://dx.doi.org/10.11606/issn.2238-6149.v23i2p178-185
• Lancman, S., Barros, J. O., Jardim, T. A., & Mângia, E. F. (2016). Saúde, Trabalho e Terapia ocupacional, uma relação indissociável. Revista de Terapia Ocupacional da Universidade de São Paulo, 27(2), 1-2. http://dx.doi.org/10.11606/issn.2238-6149.v27i2pi
  » http://dx.doi.org/10.11606/issn.2238-6149.v27i2pi
• Lima, E. M. F. A., & Yasui, S. (2014). Territórios e sentidos: espaço, cultura, subjetividade e cuidado na atenção psicossocial. Saúde em Debate, 38(102), 593-606. http://dx.doi.org/10.5935/0103-1104.20140055
  » http://dx.doi.org/10.5935/0103-1104.20140055
• Lima, E. M. F. A., Canguçu, D. F., Moraes, C., & Inforsato, E. A. (2009). PACTO adolescentes: arte e corpo na invenção de dispositivos em terapia ocupacional para produção de vida e saúde na adolescência. Revista de Terapia Ocupacional da Universidade de São Paulo, 20(3), 157-163. http://dx.doi.org/10.11606/issn.2238-6149.v20i3p157-163
  » http://dx.doi.org/10.11606/issn.2238-6149.v20i3p157-163
• Luiz, C. C. A., Leal, E. M., & Galletti, M. C. (2018). Desafios enfrentados por usuários da saúde mental. Revista de Terapia Ocupacional da Universidade de São Paulo, 29(1), 63-69. http://dx.doi.org/10.11606/issn.2238-6149.v29i1p63-69
  » http://dx.doi.org/10.11606/issn.2238-6149.v29i1p63-69
• Luvizaro, N., & Galheigo, S. (2011). Considerações sobre o cotidiano e o habitar de crianças e adolescentes em situação de acolhimento institucional em abrigo. Revista de Terapia Ocupacional da Universidade de São Paulo, 22(2), 191-199. http://dx.doi.org/10.11606/issn.2238-6149.v22i2p191-199
  » http://dx.doi.org/10.11606/issn.2238-6149.v22i2p191-199
• Mângia, E. F. (1998). Apontamentos sobre o campo da terapia ocupacional. Revista de Terapia Ocupacional da Universidade de São Paulo, 9(1), 5-13.
• Mângia, E., & Marques, A. (2004). Desinstitucionalização e serviços residenciais terapêuticos: novas perspectivas para o campo da reabilitação psicossocial. Revista de Terapia Ocupacional da Universidade de São Paulo, 15(3), 129-135. http://dx.doi.org/10.11606/issn.2238-6149.v15i3p129-135
  » http://dx.doi.org/10.11606/issn.2238-6149.v15i3p129-135
• Marques, A. L., & Mângia, E. (2013). Ser, estar, habitar: serviços residenciais terapêuticos no município de Campinas, SP. Revista de Terapia Ocupacional da Universidade de São Paulo, 23(3), 245-252. http://dx.doi.org/10.11606/issn.2238-6149.v23i3p245-252
  » http://dx.doi.org/10.11606/issn.2238-6149.v23i3p245-252
• Melo, D. O. C. V. (2015). Em busca de um ethos: narrativas da fundação da terapia ocupacional na cidade de São Paulo (1956-1969) (Dissertação de mestrado). Universidade Federal de São Paulo, Santos.
• Minatel, M., & Matsukura, T. (2014). Famílias de crianças e adolescentes com autismo: cotidiano e realidade de cuidados em diferentes etapas do desenvolvimento. Revista de Terapia Ocupacional da Universidade de São Paulo, 25(2), 126-134. http://dx.doi.org/10.11606/issn.2238-6149.v25i2p126-134
  » http://dx.doi.org/10.11606/issn.2238-6149.v25i2p126-134
• Oliveira, A. J. (2003). Passeio pelo mundo do trabalho. Revista de Terapia Ocupacional da Universidade de São Paulo, 14(1), 27-33. http://dx.doi.org/10.11606/issn.2238-6149.v14i1p27-33
  » http://dx.doi.org/10.11606/issn.2238-6149.v14i1p27-33
• Pádua, E. M. M. (2014). Pesquisa e complexidade: estratégias metodológicas multidimensionais. Curitiba: CRV.
• Prodocimo, C., Milek, G., & Ferigato, S. (2018). Atuação da terapia ocupacional no consultório na rua. Revista de Terapia Ocupacional da Universidade de São Paulo, 29(3), 270-279. http://dx.doi.org/10.11606/issn.2238-6149.v29i3p270-279
  » http://dx.doi.org/10.11606/issn.2238-6149.v29i3p270-279
• Quarentei, M. S. (1999). Criando lugar(res) para a falta de lugar. Interface, 1(5), 195-202.
• Quarentei, M. S. (2001). Terapia ocupacional e produção de vida. In Anais do 7º Congresso Brasileiro de Terapia Ocupacional (pp. 1-8). Porto Alegre: ABRATO.
• Quarentei, M. S. (2006). Ética, estética e atividade humana: experimentar, criar... afirmar, territórios, vidas... belezas. In Anais do Seminário Aberto do Coletivo de Estudos de Terapia Ocupacional e Produção de Vida. Botucatu.
• Reis, S. C. C. A. G., & Lopes, R. E. (2018). O início da trajetória de institucionalização acadêmica da terapia ocupacional no Brasil: o que contam os (as) docentes pioneiros (as) sobre a criação dos primeiros cursos. Cadernos Brasileiros de Terapia Ocupacional, 26(2), 255-270. http://dx.doi.org/10.4322/2526-8910.ctoAO1154
  » http://dx.doi.org/10.4322/2526-8910.ctoAO1154
• Ribeiro, M. C. (2014). Os Centros de Atenção Psicossocial como espaços promotores de vida: relatos da desinstitucionalização em Alagoas. Revista de Terapia Ocupacional da Universidade de São Paulo, 24(3), 174-182. http://dx.doi.org/10.11606/issn.2238-6149.v24i3p174-182
  » http://dx.doi.org/10.11606/issn.2238-6149.v24i3p174-182
• Salles, M., & Matsukura, T. S. (2013). Estudo de revisão sistemática sobre o uso do conceito de cotidiano no campo da terapia ocupacional no Brasil. Cadernos de Terapia Ocupacional da UFSCar, 21(2), 265-273. http://dx.doi.org/10.4322/cto.2013.028
  » http://dx.doi.org/10.4322/cto.2013.028
• Silva, M. L., & Raccioni, T. M. (2015). Oficinas de teatro como recurso terapêutico ocupacional em um serviço residencial terapêutico. Revista de Terapia Ocupacional da Universidade de São Paulo, 26(2), 267-273. http://dx.doi.org/10.11606/issn.2238-6149.v26i2p267-273
  » http://dx.doi.org/10.11606/issn.2238-6149.v26i2p267-273

Edited by

Section editor Profa. Dra. Beatriz Prado Pereira

Publication Dates

• Publication in this collection
  16 Apr 2021
• Date of issue
  2021

History

• Received
  05 Aug 2020
• Accepted
  08 Dec 2020