Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UEFS |
Texto Completo: | http://tede2.uefs.br:8080/handle/tede/822 |
Resumo: | The objective of this course was to analyze the associated factors to treatment abandonment in adolescents and young adults positive serology for HIV. It is set up as a quantitative and longitudinal study in which the medical records of the adolescents and young adults enrolled in the Specialized Care Service of the municipality of Feira de Santana / Bahia were analyzed from 2003 to December 2016. After the exclusion, 290 medical records of individuals between 13 and 24 years of age were reviewed, taking into account sociodemographic, clinical and follow-up variables in the service. A descriptive analysis was performed with frequencies, bivariate analysis, between categorical variables of choice, and survival analysis to estimate the median time of abandonment of treatment follow-up. Finally, for the statistically significant variables, the analysis was done by the Cox regression model. The study population is characterized by 73.4% young adults (20 to 24 years); 91.9% of black, brown or indigenous color; 64.5% heterosexual; 73.7% single, widowed or divorced; in addition, 56.2% have more than eight years of study. Of the 290 subjects analyzed, 59% presented the episode of treatment abandonment. When analyzing factors associated with dropout, age (p = 0.00), sexual orientation (p = 0.00), schooling (p = 0.00), resides in Feira de Santana (p = 0.02) and presence of opportunistic infection (p = 0.02), presented statistical significance for the event. In the log rank test, significance was found for schooling (p = 0.00) and presence of opportunistic infections (0.00). The median time to abandonment was 16 months. In the Cox model, significance was found for schooling (HR: 0.64, CI: 0.47-0.88) and for the presence of opportunistic infections (HR: 1.78, CI: 1.28-2, 48). The data found in the study, for the most part, corroborate with the literature. It identifies the juvelinization of the epidemic; feminization, although the incidence is still higher in the male population; heterosexualization; and pauperization, represented by the low level of schooling of those who left the monitoring. However, when discussed about the municipality of residence, the majority of the abandonment occurred in those living in the same city of the service, but its incidence is much higher when compared to the others. With regard to opportunistic infections, monitoring the service provides professionals with the knowledge of these events and these make the individual perceive the need to continue the service. The mean time of abandonment was 16 months, which shows us the greater vulnerability to abandonment at the beginning, due to the changes inherent in the treatment. Therefore, this study aimed to know the factors associated with abandonment so that coping strategies can be created and that prevent the occurrence of new episodes. |
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Silva, Carlos Alberto Lima da18302920568http://lattes.cnpq.br/785882234321404702554408556http://lattes.cnpq.br/0856710676251651Carvalho, Letícia Falcão de2019-08-01T23:26:12Z2018-05-30CARVALHO, Letícia Falcão de. Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS. 2018. 94 f. Dissertação (Mestrado Acadêmico em Saúde Coletiva) - Universidade Estadual de Feira de Santana, Feira de Santana, 2018.http://tede2.uefs.br:8080/handle/tede/822The objective of this course was to analyze the associated factors to treatment abandonment in adolescents and young adults positive serology for HIV. It is set up as a quantitative and longitudinal study in which the medical records of the adolescents and young adults enrolled in the Specialized Care Service of the municipality of Feira de Santana / Bahia were analyzed from 2003 to December 2016. After the exclusion, 290 medical records of individuals between 13 and 24 years of age were reviewed, taking into account sociodemographic, clinical and follow-up variables in the service. A descriptive analysis was performed with frequencies, bivariate analysis, between categorical variables of choice, and survival analysis to estimate the median time of abandonment of treatment follow-up. Finally, for the statistically significant variables, the analysis was done by the Cox regression model. The study population is characterized by 73.4% young adults (20 to 24 years); 91.9% of black, brown or indigenous color; 64.5% heterosexual; 73.7% single, widowed or divorced; in addition, 56.2% have more than eight years of study. Of the 290 subjects analyzed, 59% presented the episode of treatment abandonment. When analyzing factors associated with dropout, age (p = 0.00), sexual orientation (p = 0.00), schooling (p = 0.00), resides in Feira de Santana (p = 0.02) and presence of opportunistic infection (p = 0.02), presented statistical significance for the event. In the log rank test, significance was found for schooling (p = 0.00) and presence of opportunistic infections (0.00). The median time to abandonment was 16 months. In the Cox model, significance was found for schooling (HR: 0.64, CI: 0.47-0.88) and for the presence of opportunistic infections (HR: 1.78, CI: 1.28-2, 48). The data found in the study, for the most part, corroborate with the literature. It identifies the juvelinization of the epidemic; feminization, although the incidence is still higher in the male population; heterosexualization; and pauperization, represented by the low level of schooling of those who left the monitoring. However, when discussed about the municipality of residence, the majority of the abandonment occurred in those living in the same city of the service, but its incidence is much higher when compared to the others. With regard to opportunistic infections, monitoring the service provides professionals with the knowledge of these events and these make the individual perceive the need to continue the service. The mean time of abandonment was 16 months, which shows us the greater vulnerability to abandonment at the beginning, due to the changes inherent in the treatment. Therefore, this study aimed to know the factors associated with abandonment so that coping strategies can be created and that prevent the occurrence of new episodes.O objetivo deste estudo foi analisar os fatores associados ao abandono do tratamento em adolescentes e adultos jovens com sorologia positiva para o HIV. Configura-se como um estudo quantitativo e longitudinal no qual foram analisados os prontuários clínicos dos adolescentes e adultos jovens matriculados no Serviço de Assistência Especializada do município de Feira de Santana/Bahia, desde 2003 até dezembro de 2016. Foram revisados, após exclusões, 290 prontuários dos indivíduos entre 13 a 24 anos levando-se em consideração as variáveis sociodemográficas, clínicas e de acompanhamento no serviço. Realizou-se análise descritiva com frequências, análise bivariada, entre as variáveis categóricas de escolha, e a análise de sobrevida para estimar a mediana de tempo do abandono do acompanhamento do tratamento. Por fim, para as variáveis estatisticamente significantes foi feita a análise pelo modelo de regressão de Cox. A população do estudo se caracteriza por ser 73,4% adultos jovens (20 a 24 anos); 91,9% da cor preta, parda ou indígena; 64,5% heterossexuais; 73,7% solteiro, viúvo ou divorciado; além disto, 56,2% apresentam mais de oito anos de estudos. Dos 290 indivíduos analisados, 59% apresentaram o episódio de abandono do tratamento. Ao analisar os fatores associados ao abandono, a idade (p=0,00), orientação sexual (p=0,00), escolaridade (p=0,00), se reside em Feira de Santana (p=0,02) e presença de infecção oportunista (p=0,02), apresentaram significância estatística para o evento. No teste log rank, foi encontrada significância para a escolaridade (p=0,00) e presença de infecções oportunistas (0,00). A mediana de tempo para o abandono foi de 16 meses. No modelo de Cox, encontrou-se significância para a escolaridade (HR:0,64, IC: 0,47 – 0,88) e para a presença de infecções oportunistas (HR:1,78, IC: 1,28 – 2,48). Os dados encontrados no estudo, em sua maioria, corroboram com a literatura. Identifica-se a juvelinização da epidemia; feminização, apesar da incidência ainda ser maior na população do sexo masculino; heterossexualizaçao; e a pauperização, representada pelo baixo nível de escolaridade daqueles que abandonaram o acompanhamento. Porém, quando discutido sobre o município de residência, a maioria do abandono ocorreu naqueles residentes na mesma cidade do serviço, porém a sua incidência é bem maior quando comparado aos demais. No que diz respeito às infecções oportunistas, acompanhar o serviço proporciona aos profissionais o conhecimento destes eventos e estes fazem com o que o indivíduo perceba a necessidade de dar continuidade ao serviço. A mediada de tempo de abandono foi de 16 meses, o que nos infere perceber a maior vulnerabilidade ao abandono no início, decorrente das mudanças inerentes ao tratamento. Portanto, este estudo visou conhecer os fatores associados ao abandono para que possam ser criadas estratégias de enfrentamento e que evitem a ocorrência de novos episódios.Submitted by Joelma Souza de Oliveira (id.joelma7@gmail.com) on 2019-08-01T23:26:12Z No. of bitstreams: 1 Dissertação final - Letícia Falcão de Carvalho.pdf: 1299318 bytes, checksum: 320f1d5131254b9a73a366b8548da8ed (MD5)Made available in DSpace on 2019-08-01T23:26:12Z (GMT). No. of bitstreams: 1 Dissertação final - Letícia Falcão de Carvalho.pdf: 1299318 bytes, checksum: 320f1d5131254b9a73a366b8548da8ed (MD5) Previous issue date: 2018-05-30Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESapplication/pdfporUniversidade Estadual de Feira de SantanaMestrado Acadêmico em Saúde ColetivaUEFSBrasilDEPARTAMENTO DE SAÚDESíndrome de imunodeficiência adquiridaContinuidade da assistência ao pacienteAdolescenteAdulto jovemAcquired Immunodeficiency SyndromContinuity of patient careAdolescentYoung adultCIENCIAS DA SAUDE::SAUDE COLETIVACIENCIAS DA SAUDE::ENFERMAGEMSAUDE COLETIVA::SAUDE PUBLICAFatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDSinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis-21222253766072083266006006006006006001006395569471477890-6173167103754495199-770282653301096432731126492445846009793590462550136975366info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UEFSinstname:Universidade Estadual de Feira de Santana (UEFS)instacron:UEFSORIGINALDissertação final - Letícia Falcão de Carvalho.pdfDissertação final - Letícia Falcão de Carvalho.pdfapplication/pdf1299318http://tede2.uefs.br:8080/bitstream/tede/822/2/Disserta%C3%A7%C3%A3o+final+-+Let%C3%ADcia+Falc%C3%A3o+de+Carvalho.pdf320f1d5131254b9a73a366b8548da8edMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82089http://tede2.uefs.br:8080/bitstream/tede/822/1/license.txt7b5ba3d2445355f386edab96125d42b7MD51tede/8222019-08-01 20:26:12.584oai:tede2.uefs.br:8080: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.uefs.br:8080/PUBhttp://tede2.uefs.br:8080/oai/requestbcuefs@uefs.br|| bcref@uefs.br||bcuefs@uefs.bropendoar:2019-08-01T23:26:12Biblioteca Digital de Teses e Dissertações da UEFS - Universidade Estadual de Feira de Santana (UEFS)false |
dc.title.por.fl_str_mv |
Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS |
title |
Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS |
spellingShingle |
Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS Carvalho, Letícia Falcão de Síndrome de imunodeficiência adquirida Continuidade da assistência ao paciente Adolescente Adulto jovem Acquired Immunodeficiency Syndrom Continuity of patient care Adolescent Young adult CIENCIAS DA SAUDE::SAUDE COLETIVA CIENCIAS DA SAUDE::ENFERMAGEM SAUDE COLETIVA::SAUDE PUBLICA |
title_short |
Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS |
title_full |
Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS |
title_fullStr |
Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS |
title_full_unstemmed |
Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS |
title_sort |
Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS |
author |
Carvalho, Letícia Falcão de |
author_facet |
Carvalho, Letícia Falcão de |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Silva, Carlos Alberto Lima da |
dc.contributor.advisor1ID.fl_str_mv |
18302920568 |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/7858822343214047 |
dc.contributor.authorID.fl_str_mv |
02554408556 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0856710676251651 |
dc.contributor.author.fl_str_mv |
Carvalho, Letícia Falcão de |
contributor_str_mv |
Silva, Carlos Alberto Lima da |
dc.subject.por.fl_str_mv |
Síndrome de imunodeficiência adquirida Continuidade da assistência ao paciente Adolescente Adulto jovem |
topic |
Síndrome de imunodeficiência adquirida Continuidade da assistência ao paciente Adolescente Adulto jovem Acquired Immunodeficiency Syndrom Continuity of patient care Adolescent Young adult CIENCIAS DA SAUDE::SAUDE COLETIVA CIENCIAS DA SAUDE::ENFERMAGEM SAUDE COLETIVA::SAUDE PUBLICA |
dc.subject.eng.fl_str_mv |
Acquired Immunodeficiency Syndrom Continuity of patient care Adolescent Young adult |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::SAUDE COLETIVA CIENCIAS DA SAUDE::ENFERMAGEM SAUDE COLETIVA::SAUDE PUBLICA |
description |
The objective of this course was to analyze the associated factors to treatment abandonment in adolescents and young adults positive serology for HIV. It is set up as a quantitative and longitudinal study in which the medical records of the adolescents and young adults enrolled in the Specialized Care Service of the municipality of Feira de Santana / Bahia were analyzed from 2003 to December 2016. After the exclusion, 290 medical records of individuals between 13 and 24 years of age were reviewed, taking into account sociodemographic, clinical and follow-up variables in the service. A descriptive analysis was performed with frequencies, bivariate analysis, between categorical variables of choice, and survival analysis to estimate the median time of abandonment of treatment follow-up. Finally, for the statistically significant variables, the analysis was done by the Cox regression model. The study population is characterized by 73.4% young adults (20 to 24 years); 91.9% of black, brown or indigenous color; 64.5% heterosexual; 73.7% single, widowed or divorced; in addition, 56.2% have more than eight years of study. Of the 290 subjects analyzed, 59% presented the episode of treatment abandonment. When analyzing factors associated with dropout, age (p = 0.00), sexual orientation (p = 0.00), schooling (p = 0.00), resides in Feira de Santana (p = 0.02) and presence of opportunistic infection (p = 0.02), presented statistical significance for the event. In the log rank test, significance was found for schooling (p = 0.00) and presence of opportunistic infections (0.00). The median time to abandonment was 16 months. In the Cox model, significance was found for schooling (HR: 0.64, CI: 0.47-0.88) and for the presence of opportunistic infections (HR: 1.78, CI: 1.28-2, 48). The data found in the study, for the most part, corroborate with the literature. It identifies the juvelinization of the epidemic; feminization, although the incidence is still higher in the male population; heterosexualization; and pauperization, represented by the low level of schooling of those who left the monitoring. However, when discussed about the municipality of residence, the majority of the abandonment occurred in those living in the same city of the service, but its incidence is much higher when compared to the others. With regard to opportunistic infections, monitoring the service provides professionals with the knowledge of these events and these make the individual perceive the need to continue the service. The mean time of abandonment was 16 months, which shows us the greater vulnerability to abandonment at the beginning, due to the changes inherent in the treatment. Therefore, this study aimed to know the factors associated with abandonment so that coping strategies can be created and that prevent the occurrence of new episodes. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018-05-30 |
dc.date.accessioned.fl_str_mv |
2019-08-01T23:26:12Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
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masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
CARVALHO, Letícia Falcão de. Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS. 2018. 94 f. Dissertação (Mestrado Acadêmico em Saúde Coletiva) - Universidade Estadual de Feira de Santana, Feira de Santana, 2018. |
dc.identifier.uri.fl_str_mv |
http://tede2.uefs.br:8080/handle/tede/822 |
identifier_str_mv |
CARVALHO, Letícia Falcão de. Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS. 2018. 94 f. Dissertação (Mestrado Acadêmico em Saúde Coletiva) - Universidade Estadual de Feira de Santana, Feira de Santana, 2018. |
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http://tede2.uefs.br:8080/handle/tede/822 |
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por |
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por |
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openAccess |
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Universidade Estadual de Feira de Santana |
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Mestrado Acadêmico em Saúde Coletiva |
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UEFS |
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Brasil |
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DEPARTAMENTO DE SAÚDE |
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Universidade Estadual de Feira de Santana |
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MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da UEFS - Universidade Estadual de Feira de Santana (UEFS) |
repository.mail.fl_str_mv |
bcuefs@uefs.br|| bcref@uefs.br||bcuefs@uefs.br |
_version_ |
1809288776921382912 |