Abandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermagem

Detalhes bibliográficos
Autor(a) principal: Mandu, Juliete Bispo dos Santos
Data de Publicação: 2022
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da UFMS
Texto Completo: https://repositorio.ufms.br/handle/123456789/4493
Resumo: With the advancement of treatment of Human Immunodeficiency Virus (HIV) and the in-crease in life expectancy, HIV started to be considered a chronic condition, which reaffirms the need for comprehensive care to people living with HIV (PLHIV). However, one of the challenges to be faced is medication adherence, since treatment abandonment can occur, in-creasing the chance of complications and progression to aids, thus negatively impacting quali-ty of life. Faced with this, it is necessary to recognize the reasons for treatment abandonment and establish intervention methods to bring these patients back to the health service. The pre-sent study aims to describe the perspective of people who abandoned HIV treatment and re-turned to the service after an active search. This is a qualitative exploratory-descriptive piece of research carried out with PLHIV who had abandoned treatment. The study was carried out in the capital of Mato Grosso do Sul State, in a station specialized in PLHIV care. Data were collected from April to August 2021, by means of semi-structured, audio-recorded interviews later submitted to Bardin's content analysis. The 24 male participants were aged between 23 and 63 years (average 37.9), and reported themselves as brown (13), black (six), white (four) and yellow (one). Regarding marital status, 13 were single, eight had partners, two were wid-owed and one was divorced. The time of diagnosis ranged from two to 23 years (mean 8.5), the mean time of the abandonment period was 333 days (minimum of 114 and maximum of 1249), and six people reported weight loss, sore throat, pain in lower limbs, weight gain, weakness and tiredness. The PLHIV reported that changes in health care occurred at the be-ginning of treatment, but have not remained over time. In addition, they pointed out factors that helped them deal with the disease, such as their acceptance and involvement in the church community and health service, the perspective of being a father and the possibility of helping other people in the same condition. The reasons for dropping out treatment were the absence of signs and symptoms, the lack of a support network, the bond breaking with health profes-sionals, the difficulty in reaching the specialized service, the medication side effects and the COVID-19 pandemic. Among the motivations for their return to treatment, the following points were mentioned: the desire to live and feel good, the willing to take care of the family and the fact of having overcome the initial phase of treatment, considered the worst one. The active search, by telephone approach, was the strategy used to rescue these patients, consid-ered positive for the return to treatment. In conclusion, the flaws found in the health care network can influence the continuity of treatment and are subject to intervention to rescue the absent patient, in addition to improving treatment adherence. A special attendance is neces-sary to get to know the individuals and the context in which they are inserted, and to preco-ciously identify the risk factors and behaviors that can lead to treatment abandonment. Based on that, subsidies are generated for the development of search strategies and the elaboration of interventions to rescue PLHIV and bring them back to the service.
id UFMS_954a31fea16795ca65b06ade1e298735
oai_identifier_str oai:repositorio.ufms.br:123456789/4493
network_acronym_str UFMS
network_name_str Repositório Institucional da UFMS
repository_id_str 2124
spelling 2022-03-18T18:37:33Z2022-03-18T18:37:33Z2022https://repositorio.ufms.br/handle/123456789/4493With the advancement of treatment of Human Immunodeficiency Virus (HIV) and the in-crease in life expectancy, HIV started to be considered a chronic condition, which reaffirms the need for comprehensive care to people living with HIV (PLHIV). However, one of the challenges to be faced is medication adherence, since treatment abandonment can occur, in-creasing the chance of complications and progression to aids, thus negatively impacting quali-ty of life. Faced with this, it is necessary to recognize the reasons for treatment abandonment and establish intervention methods to bring these patients back to the health service. The pre-sent study aims to describe the perspective of people who abandoned HIV treatment and re-turned to the service after an active search. This is a qualitative exploratory-descriptive piece of research carried out with PLHIV who had abandoned treatment. The study was carried out in the capital of Mato Grosso do Sul State, in a station specialized in PLHIV care. Data were collected from April to August 2021, by means of semi-structured, audio-recorded interviews later submitted to Bardin's content analysis. The 24 male participants were aged between 23 and 63 years (average 37.9), and reported themselves as brown (13), black (six), white (four) and yellow (one). Regarding marital status, 13 were single, eight had partners, two were wid-owed and one was divorced. The time of diagnosis ranged from two to 23 years (mean 8.5), the mean time of the abandonment period was 333 days (minimum of 114 and maximum of 1249), and six people reported weight loss, sore throat, pain in lower limbs, weight gain, weakness and tiredness. The PLHIV reported that changes in health care occurred at the be-ginning of treatment, but have not remained over time. In addition, they pointed out factors that helped them deal with the disease, such as their acceptance and involvement in the church community and health service, the perspective of being a father and the possibility of helping other people in the same condition. The reasons for dropping out treatment were the absence of signs and symptoms, the lack of a support network, the bond breaking with health profes-sionals, the difficulty in reaching the specialized service, the medication side effects and the COVID-19 pandemic. Among the motivations for their return to treatment, the following points were mentioned: the desire to live and feel good, the willing to take care of the family and the fact of having overcome the initial phase of treatment, considered the worst one. The active search, by telephone approach, was the strategy used to rescue these patients, consid-ered positive for the return to treatment. In conclusion, the flaws found in the health care network can influence the continuity of treatment and are subject to intervention to rescue the absent patient, in addition to improving treatment adherence. A special attendance is neces-sary to get to know the individuals and the context in which they are inserted, and to preco-ciously identify the risk factors and behaviors that can lead to treatment abandonment. Based on that, subsidies are generated for the development of search strategies and the elaboration of interventions to rescue PLHIV and bring them back to the service.Com o avanço do tratamento do Vírus da Imunodeficiência Humana (HIV) e o aumento da expectativa de vida, o HIV passou a ser considerado uma condição crônica, o que reitera a necessidade do cuidado integral às pessoas vivendo com HIV (PVHIV). Contudo, um dos desafios a serem enfrentados é a adesão a medicação, uma vez que pode ocorrer o abandono de tratamento, o que aumenta a chance de complicações, evolução para aids e impacta negativamente na qualidade de vida. Frente a isso, é preciso reconhecer os motivos que ocasionam o abandono de tratamento e estabelecer métodos de intervenção para vincular novamente estas pessoas ao serviço de saúde. O presente estudo tem como objetivo descrever a perspectiva de pessoas que abandonaram o tratamento de HIV e retornaram ao serviço após busca ativa. Trata-se de um estudo descritivo-exploratório, de natureza qualitativa, realizado com PVHIV que estavam em abandono de tratamento. O estudo foi realizado na capital do Estado de Mato Grosso do Sul, em um serviço especializado em atendimento de PVHIV. Os dados foram coletados de abril a agosto de 2021, mediante entrevistas semiestruturadas, audiogravadas e posteriormente submetidas à análise de conteúdo de Bardin. Os 24 participantes tinham idade entre 23 e 63 anos (média de 37,9 anos), sendo 13 pardos, seis negros, quatro brancos e um amarelo. Em relação ao estado civil 13 eram solteiros, oito tinham companheiros, dois viúvos e um divorciado. O tempo de diagnóstico variou entre dois e 23 anos (média de 8,5 anos), no período de abandono o tempo médio foi 333 dias (mínimo de 114 e máximo de 1249 dias), seis PVHIV relataram perda de peso, dor de garganta, dor em membros inferiores, ganho de peso, fraqueza e cansaço. As PVHIV relataram que no início do tratamento ocorreram mudanças em relação ao cuidado com a saúde, porém estas não permaneceram ao longo do tempo. Ademais, apontaram fatores que influenciam positivamente o enfrentamento da doença como, por exemplo, o acolhimento na igreja e no serviço de saúde, a gestação e poder ajudar outras PVHIV. Foram motivos para o abandono de tratamento, a ausência de sinais e sintomas, falta de rede de apoio, quebra de vínculo com os profissionais de saúde, dificuldade de deslocamento até o serviço especializado, efeitos colaterais da medicação e a pandemia de COVID-19. Dentre as motivações que cooperaram para o retorno ao tratamento destacaram-se o desejo de viver e sentir-se bem, cuidar da família e o fato de ter superado a fase inicial, que foi considerada a fase pior do tratamento. A busca ativa, por contato telefônico, foi uma estratégia utilizada para resgatar estes pacientes e foi percebida de maneira positiva para o retorno ao tratamento. Conclui-se que, as falhas encontradas na rede de atenção à saúde podem influenciar na continuidade do tratamento e que são passíveis de intervenção para resgatar o paciente faltoso, além de melhorar a adesão ao tratamento. Torna-se necessário conhecer o indivíduo e o contexto no qual está inserido através de um atendimento singular para que seja possível identificar de forma precoce os fatores e comportamentos de risco que podem favorecer o abandono de tratamento. A partir disso, são gerados subsídios para o desenvolvimento de estratégias de busca e elaboração de intervenções para resgatar a PVHIV e vínculá-la novamente ao serviço.Fundação Universidade Federal de Mato Grosso do SulUFMSBrasilAdesão à MedicaçãoHIVQualidade de VidaMedication AdherenceQuality of LifeAbandono de TratamentoTreatment AbandonmentAbandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermageminfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisTeston, Elen FerrazMandu, Juliete Bispo dos Santosinfo:eu-repo/semantics/openAccessporreponame:Repositório Institucional da UFMSinstname:Universidade Federal de Mato Grosso do Sul (UFMS)instacron:UFMSORIGINALDissertação - JULIETE BISPO DOS SANTOS MANDU.pdfDissertação - JULIETE BISPO DOS SANTOS MANDU.pdfapplication/pdf1501572https://repositorio.ufms.br/bitstream/123456789/4493/1/Disserta%c3%a7%c3%a3o%20-%20JULIETE%20BISPO%20DOS%20SANTOS%20MANDU.pdf18768ff3fd051eeab741782107610a5cMD51123456789/44932023-03-15 09:07:20.855oai:repositorio.ufms.br:123456789/4493Repositório InstitucionalPUBhttps://repositorio.ufms.br/oai/requestri.prograd@ufms.bropendoar:21242023-03-15T13:07:20Repositório Institucional da UFMS - Universidade Federal de Mato Grosso do Sul (UFMS)false
dc.title.pt_BR.fl_str_mv Abandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermagem
title Abandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermagem
spellingShingle Abandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermagem
Mandu, Juliete Bispo dos Santos
Adesão à Medicação
HIV
Qualidade de Vida
Medication Adherence
Quality of Life
Abandono de Tratamento
Treatment Abandonment
title_short Abandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermagem
title_full Abandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermagem
title_fullStr Abandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermagem
title_full_unstemmed Abandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermagem
title_sort Abandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermagem
author Mandu, Juliete Bispo dos Santos
author_facet Mandu, Juliete Bispo dos Santos
author_role author
dc.contributor.advisor1.fl_str_mv Teston, Elen Ferraz
dc.contributor.author.fl_str_mv Mandu, Juliete Bispo dos Santos
contributor_str_mv Teston, Elen Ferraz
dc.subject.por.fl_str_mv Adesão à Medicação
HIV
Qualidade de Vida
Medication Adherence
Quality of Life
Abandono de Tratamento
Treatment Abandonment
topic Adesão à Medicação
HIV
Qualidade de Vida
Medication Adherence
Quality of Life
Abandono de Tratamento
Treatment Abandonment
description With the advancement of treatment of Human Immunodeficiency Virus (HIV) and the in-crease in life expectancy, HIV started to be considered a chronic condition, which reaffirms the need for comprehensive care to people living with HIV (PLHIV). However, one of the challenges to be faced is medication adherence, since treatment abandonment can occur, in-creasing the chance of complications and progression to aids, thus negatively impacting quali-ty of life. Faced with this, it is necessary to recognize the reasons for treatment abandonment and establish intervention methods to bring these patients back to the health service. The pre-sent study aims to describe the perspective of people who abandoned HIV treatment and re-turned to the service after an active search. This is a qualitative exploratory-descriptive piece of research carried out with PLHIV who had abandoned treatment. The study was carried out in the capital of Mato Grosso do Sul State, in a station specialized in PLHIV care. Data were collected from April to August 2021, by means of semi-structured, audio-recorded interviews later submitted to Bardin's content analysis. The 24 male participants were aged between 23 and 63 years (average 37.9), and reported themselves as brown (13), black (six), white (four) and yellow (one). Regarding marital status, 13 were single, eight had partners, two were wid-owed and one was divorced. The time of diagnosis ranged from two to 23 years (mean 8.5), the mean time of the abandonment period was 333 days (minimum of 114 and maximum of 1249), and six people reported weight loss, sore throat, pain in lower limbs, weight gain, weakness and tiredness. The PLHIV reported that changes in health care occurred at the be-ginning of treatment, but have not remained over time. In addition, they pointed out factors that helped them deal with the disease, such as their acceptance and involvement in the church community and health service, the perspective of being a father and the possibility of helping other people in the same condition. The reasons for dropping out treatment were the absence of signs and symptoms, the lack of a support network, the bond breaking with health profes-sionals, the difficulty in reaching the specialized service, the medication side effects and the COVID-19 pandemic. Among the motivations for their return to treatment, the following points were mentioned: the desire to live and feel good, the willing to take care of the family and the fact of having overcome the initial phase of treatment, considered the worst one. The active search, by telephone approach, was the strategy used to rescue these patients, consid-ered positive for the return to treatment. In conclusion, the flaws found in the health care network can influence the continuity of treatment and are subject to intervention to rescue the absent patient, in addition to improving treatment adherence. A special attendance is neces-sary to get to know the individuals and the context in which they are inserted, and to preco-ciously identify the risk factors and behaviors that can lead to treatment abandonment. Based on that, subsidies are generated for the development of search strategies and the elaboration of interventions to rescue PLHIV and bring them back to the service.
publishDate 2022
dc.date.accessioned.fl_str_mv 2022-03-18T18:37:33Z
dc.date.available.fl_str_mv 2022-03-18T18:37:33Z
dc.date.issued.fl_str_mv 2022
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://repositorio.ufms.br/handle/123456789/4493
url https://repositorio.ufms.br/handle/123456789/4493
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Fundação Universidade Federal de Mato Grosso do Sul
dc.publisher.initials.fl_str_mv UFMS
dc.publisher.country.fl_str_mv Brasil
publisher.none.fl_str_mv Fundação Universidade Federal de Mato Grosso do Sul
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFMS
instname:Universidade Federal de Mato Grosso do Sul (UFMS)
instacron:UFMS
instname_str Universidade Federal de Mato Grosso do Sul (UFMS)
instacron_str UFMS
institution UFMS
reponame_str Repositório Institucional da UFMS
collection Repositório Institucional da UFMS
bitstream.url.fl_str_mv https://repositorio.ufms.br/bitstream/123456789/4493/1/Disserta%c3%a7%c3%a3o%20-%20JULIETE%20BISPO%20DOS%20SANTOS%20MANDU.pdf
bitstream.checksum.fl_str_mv 18768ff3fd051eeab741782107610a5c
bitstream.checksumAlgorithm.fl_str_mv MD5
repository.name.fl_str_mv Repositório Institucional da UFMS - Universidade Federal de Mato Grosso do Sul (UFMS)
repository.mail.fl_str_mv ri.prograd@ufms.br
_version_ 1815448019262242816